Circulation. 2007;116:2095
doi: 10.1161/CIRCULATIONAHA.107.187615
(Circulation. 2007;116:2095.)
© 2007 American Heart Association, Inc.
Issue Highlights
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PHYSICAL ACTIVITY AND REDUCED RISK OF CARDIOVASCULAR EVENTS: POTENTIAL MEDIATING MECHANISMS, by Mora et al.
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A large body of epidemiological data demonstrates that higher
levels of physical fitness as well as physically active lifestyles
are associated with a lower risk of subsequent cardiovascular
events. Many putative mechanisms to explain this association
have been proposed, including the effect of exercise on cardiovascular
risk factors, inflammation, autonomic tone, and endothelial
function. In the largest and most comprehensive study to date,
researchers from the Women’s Health Study provide a detailed
evaluation of more than 27 000 women to assess the contribution
of conventional risk factors and inflammatory/hemostatic biomarkers
to lower cardiovascular risk at various graded levels of physical
activity. The findings of this study provide important biological
insights to the observation that physical activity confers health.
See p
2110.
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IMPACT OF THE METABOLIC SYNDROME ON MACROVASCULAR AND MICROVASCULAR OUTCOMES IN TYPE 2 DIABETES MELLITUS: UNITED KINGDOM PROSPECTIVE DIABETES STUDY 78, by Cull et al.
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The metabolic syndrome is associated with an undisputed increased
risk of cardiovascular disease events. However, there are several
areas of controversy associated with the syndrome, including
which of the 4 diagnostic schemes is most predictive of cardiovascular
disease and whether metabolic syndrome adds to risk prediction
in individuals with diagnosed type 2 diabetes mellitus. Cull
and colleagues followed newly diagnosed patients with type 2
diabetes mellitus from the United Kingdom Prospective Diabetes
Study for about 10 years. Regardless of the classification system
(Adult Treatment Program III, World Health Organization, International
Diabetes Federation, or European Group for the Study of Insulin
Resistance), the prevalence of metabolic syndrome was fairly
high (ranging for 24% to 61%) and was associated with an increased
risk of cardiovascular disease (relative risk 1.19 to 1.45).
However, the metabolic syndrome by any diagnostic scheme did
a poor job of discriminating those individuals with diabetes
who developed incident cardiovascular disease. Hence, metabolic
syndrome does not effectively risk stratify individual patients
with diabetes. See p
2119.
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DIFFERENCES IN STROKE SUBTYPES BETWEEN BLACK AND WHITE PATIENTS WITH STROKE: THE SOUTH LONDON ETHNICITY AND STROKE STUDY, by Markus et al.
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Mortality attributable to stroke is higher in blacks than in
whites, in part because of a higher incidence of stroke in blacks.
A greater burden of stroke risk factors, such as hypertension
and socioeconomic factors, may explain in part the greater incidence
of stroke in blacks. There are some data to suggest that the
distribution of stroke subtypes may also vary between blacks
versus whites. In this issue of
Circulation, Markus and colleagues
carefully compare the stroke subtypes (assessed via imaging
studies) in 600 black and 600 white patients with stroke in
South London. The authors observed a higher prevalence of stroke
risk factors such as hypertension, obesity, and diabetes in
black patients with stroke, whereas the prevalence of smoking
and atrial fibrillation was higher among white stroke patients.
Black stroke patients more often had cerebral small vessel disease,
whereas white patients with stroke had a higher prevalence of
extracranial atherosclerosis and a cardioembolic etiology. The
data emphasize the need for additional studies to further investigate
the mechanisms underlying these differences in stroke subtypes.
See p
2157.
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Images in Cardiovascular Medicine
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Massive Air Embolism After Central Venous Catheter Removal.
See p
e516.
ST-Segment Elevations Secondary to Electrical Cardioversion. See p e519.
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Correspondence
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See p
e521.
Related Articles:
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Massive Air Embolism After Central Venous Catheter Removal
- Olivier Deceuninck, Luc De Roy, Simona Moruzi, and Dominique Blommaert
Circulation 2007 116: e516-e518.
[Extract]
[Full Text]
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ST-Segment Elevations Secondary to Electrical Cardioversion
- Qaiser Shafiq and Riyaz Bashir
Circulation 2007 116: e519-e520.
[Extract]
[Full Text]
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Letter by Fisher and Johns Regarding Article, "Variable Platelet Response to Aspirin and Clopidogrel in Atherothrombotic Disease"
- Matt Fisher and Tony Johns
Circulation 2007 116: e521.
[Extract]
[Full Text]
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Differences in Stroke Subtypes Between Black and White Patients With Stroke: The South London Ethnicity and Stroke Study
- Hugh S. Markus, Usman Khan, Jonathan Birns, Andrew Evans, Lalit Kalra, Anthony G. Rudd, Charles D.A. Wolfe, and Paula Jerrard-Dunne
Circulation 2007 116: 2157-2164.
[Abstract]
[Full Text]
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Physical Activity and Reduced Risk of Cardiovascular Events: Potential Mediating Mechanisms
- Samia Mora, Nancy Cook, Julie E. Buring, Paul M Ridker, and I-Min Lee
Circulation 2007 116: 2110-2118.
[Abstract]
[Full Text]
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Impact of the Metabolic Syndrome on Macrovascular and Microvascular Outcomes in Type 2 Diabetes Mellitus: United Kingdom Prospective Diabetes Study 78
- Carole A. Cull, Christine C. Jensen, Ravi Retnakaran, and Rury R. Holman
Circulation 2007 116: 2119-2126.
[Abstract]
[Full Text]
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