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In This Issue of Archives of Internal Medicine
May 13, 2002

In This Issue of Archives of Internal Medicine

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Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

Arch Intern Med. 2002;162(9):971. doi:10.1001/archinte.162.9.971
Low- High-Density Lipoprotein Cholesterol and Ischemic Cerebrovascular Disease

Koren-Morag et al studied the occurrence of cerebrovascular disease (CVD) in 11 177 patients with documented coronary heart disease. During a 6- to 8-year follow-up period, 941 patients were identified with nonhemorrhagic CVD, 487 of whom had verified ischemic stroke or transient ischemic attack. Adjusting for clinical covariates, lipid values in the upper vs lower tertile were associated with the following odds ratios (95% confidence intervals) for the end point of nonhemorrhagic CVD: total cholesterol, 1.43 (1.20-1.70); low-density lipoprotein cholesterol, 1.52 (1.27-1.81); high-density lipoprotein cholesterol, 0.84 (0.70-1.00); and percentage of total serum cholesterol contained in the high-density lipoprotein moiety, 0.69 (0.58-0.83). These findings clearly support the role of total cholesterol and its fractions in prediction of ischemic CVD among patients with established coronary heart disease.

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Serum Potassium and Risk of Cardiovascular Disease: The Framingham Heart Study

To determine the association between serum potassium and risk of cardiovascular disease, Walsh and coworkers studied 3151 participants in the Framingham Heart Study free of cardiovascular disease and not taking medications that alter serum potassium level. Over 16 years of follow-up, there was no association between serum potassium level and risk of cardiovascular disease (hazard ratio per 1-mg/dL increment, 1.00; 95% confidence interval, 0.98-1.03) or death due to cardiovascular disease (hazard ratio per 1-mg/dL increment, 1.04; 95% confidence interval, 0.97-1.11).

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Epidemiological Evidence of Increased Bone Mineral Density in Habitual Tea Drinkers

Tea is the most popular beverage worldwide. Tea extracts contain high concentrations of caffeine, fluoride, flavonoids, and phytoestrogen. These compounds have all been thought to influence bone mineral density (BMD) and fracture risk, but information about the effects of tea consumption on bone mass is limited and equivocal. In this study, 497 men and 540 women 30 years and older were enrolled. A dose-response effect between the duration of habitual tea consumption and BMDs of 4 measured regions was found. In other words, subjects who consumed tea habitually for more than 10 years had significantly higher BMDs compared with the nonhabitual tea drinkers. After being analyzed with all the covariates, tea consumption was still a significantly positive variable on BMDs of all measured regions. These findings suggest that habitual tea consumption might have a beneficial effect on BMD in both men and women.

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Dose-response effect between the duration of habitual tea consumption (year) and bone mineral density (BMD) in 4 regions.

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Use of Cholesterol-Lowering Therapy by Elderly Adults After Myocardial Infarction

To assess the use of cholesterol-lowering therapy and related beliefs during 1999 and 2000, Ayanian et al surveyed 815 elderly Medicare beneficiaries who had been hospitalized for acute myocardial infarction in California, Florida, Massachusetts, New York, or Pennsylvania during 1994 and 1995. In this cohort, 59% reported they were taking a cholesterol-lowering drug, and in adjusted analyses this treatment was significantly more common among women, younger patients, and those who reported that a cardiologist was responsible for their cholesterol management. Lowering cholesterol level was viewed as "very important" by 77% of respondents, but only 33% of respondents knew their cholesterol level. Use of cholesterol-lowering drugs was substantially greater than in prior studies of elderly patients after myocardial infarction, but most patients were unaware of their cholesterol level or the potential adverse effects of cholesterol-lowering drugs, suggesting opportunities to enhance patient education.

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