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(Circulation. 2006;113:2165.)
© 2006 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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CHARACTERISTICS AND BASELINE CLINICAL PREDICTORS OF FUTURE FATAL VERSUS NONFATAL CORONARY HEART DISEASE EVENTS IN OLDER ADULTS: THE CARDIOVASCULAR HEALTH STUDY, by Pearte et al. |
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The aging of the population has brought increased focus onto the high morbidity and mortality of coronary heart disease (CHD) in the elderly. Pearte and colleagues examined the predictors and the temporal trends in CHD mortality in community-dwelling elderly adults participating in the Cardiovascular Heath Study. They observed that traditional risk factors and indicators of subclinical disease assessed before CHD event predicted an increased risk of CHD fatality. For instance, antecedent heart failure regardless of left ventricular systolic function conferred a 3-fold increased risk of death. The authors noted that although case-fatality decreased slightly over time, CHD remains lethal for almost one third of elderly individuals suffering a CHD event. In the era of personalized medicine, the authors argue that further efforts should be directed toward identifying effective strategies to prevent poor outcomes in high-risk elderly patients with CHD events. See p 2177.
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ROLE OF DIURETICS IN THE PREVENTION OF HEART FAILURE: THE ANTIHYPERTENSIVE AND LIPID-LOWERING TREATMENT TO PREVENT HEART ATTACK TRIAL, by Davis et al. |
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High blood pressure is a key risk factor for congestive heart failure (CHF). The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was a randomized controlled comparison of chlorthalidone, amlodipine, and lisinopril (representing diuretics, calcium channel blockers, and angiotensin-converting enzyme inhibitors) for prevention of cardiovascular disease events in hypertensive patients. In this issue of Circulation, Davis and colleagues report on the relative effects of these 3 antihypertensive agents on rates of hospitalized/fatal CHF in ALLHAT. The authors observed that comparative risks for CHF in the 3 arms varied over time. In the first year of the trial, patients in the amlodipine and lisinopril
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