The latest report from Finland: a lesson in expectations

Article Abstract:

Coronary heart disease has many different causes, and its progress varies from person to person. In addition, risk factors such as cigarette smoking, cholesterol levels and diabetes mellitus vary in their effects upon individuals. These and other confounding factors have made the study and prevention of heart disease a very complicated process. Timo E. Strandberg and his colleagues, in an article in the September 4, 1991 issue of the Journal of the American Medical Association, reported the surprising findings of a study of intervention to lower the risk factors for coronary heart disease. The intervention group suffered significantly more deaths from cardiovascular and other causes than the control group, both during the study and during the 11 year follow-up. However, the study was relatively small, and the role of chance cannot be ruled out. The publication of unusual results in this type of study serves a very useful purpose by provoking discussion and pointing out areas of persisting ignorance. This study cannot be dismissed, and must be replicated so that, if there are excess deaths caused by preventive measures, individuals at risk can be identified or treatment methods can be changed. At this time, most of the evidence suggests that decreasing the risk factors for heart disease does in fact decrease the likelihood of death from cardiovascular disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

editorial

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Triglyceride, high-density lipoprotein, and coronary heart disease

Article Abstract:

There is considerable evidence that high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) are related to the development of coronary heart disease (CHD). High blood levels of HDL-C appear to protect against CAD and elevated TG levels may increase the risk of CHD. A National Institutes of Health (NIH) panel recommends measuring HDL-C in addition to total cholesterol in all individuals and including a TG measurement in those who have elevated total cholesterol, CHD or risk factors for CHD. Several measurements should be taken several weeks apart to account for the natural variability in levels. Individuals who have elevated TG or low HDL-C should be encouraged to change their diet, lose weight, exercise regularly and stop smoking. Drugs should only be used in those who do not respond to such treatment or those who have CHD or risk factors for CHD.

Health aspects, Care and treatment, Cholesterol, HDL, HDL cholesterol lipoproteins, Hyperlipidemia, Triglycerides

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Severe mental illness and risk of cardiovascular disease

Article Abstract:

The article discusses about the disparities in cardiovascular disease mortality and prevention efforts by comparing the general population and individuals with severe mental illness and emphasizing the urgent need for new paradigms.

Cardiovascular diseases, Risk factors, Mental illness, Mental disorders

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