doi: 10.1161/CIRCULATIONAHA.107.182501
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(Circulation. 2007;115:2087.)
© 2007 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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DEFINING OBESITY CUT POINTS IN A MULTIETHNIC POPULATION, by Razak et al. |
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Current clinical thresholds for defining obesity were derived from samples that were predominantly white and of European descent. The generalizability of these thresholds to other ethnicities and races has been disputed. Razak and colleagues used principal components factor analysis to derive thresholds for obesity based on 3 cardiovascular disease factors: glucose metabolism, lipid metabolism, and blood pressure. They applied these factors to >1000 individuals from 4 ethnic groups in Canada, including South Asians, Chinese, Aboriginals, and Europeans, and observed that the threshold to define obesity is
6 kg/m2 lower among non-European than European individuals. Definitive obesity thresholds will require further examination in larger samples from other countries and other ethnicities/races and will require cardiovascular disease end points. However, the investigation by Razak et al has 2 major implications: 1) The threshold for obesity of 30 gm/m2 is inappropriately high in many nonwhite individuals, and 2) the global burden of obesity is much larger than currently appreciated. See p 2111 (editorial p 2089).
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ADHERENCE TO STATIN THERAPY UNDER DRUG COST SHARING IN PATIENTS WITH AND WITHOUT ACUTE MYOCARDIAL INFARCTION: A POPULATION-BASED NATURAL EXPERIMENT, by Schneeweiss et al. |
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Financial barriers to medication use are associated with worse outcomes for patients with acute myocardial infarction. These barriers can affect medication use even for patients with health insurance, raising questions about how coverage for medications affects patient behavior. Investigators were able to take advantage of a natural experiment in British Columbia, where an evolution of coverage occurred over a 4-year period. In 2001, full drug coverage existed, whereas in 2002, a $10 or $25 copay was instituted, and in 2003–2004, 25% coinsurance was implemented. The study examines
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