Objectives: To determine prevalence of themetabolic syndrome using United Stat es Adult Treatment Panel-3 (ATP-3) guidelines in an urban Indian population. M ethods: Randomly selected adults >20 years were studied ...Objectives: To determine prevalence of themetabolic syndrome using United Stat es Adult Treatment Panel-3 (ATP-3) guidelines in an urban Indian population. M ethods: Randomly selected adults >20 years were studied using stratified samplin g. Target study sample was 1800 with population proportionate distribution (men 960, women 840). Evaluati on of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Subjects(1123; response 62.4%) were examined, fasting blood sam ples were available in 1091(532 men, 559 women) and analysed for prevalence of m etabolic syndrome. Atherosclerosis risk factors were determined using the curren t guidelines. Metabolic syndrome was diagnosed when any three of the following w ere present: central obesity, raised triglycerides ≥150 mg/dl (≥1.7 mmol/l), l ow high density lipoprotein (HDL) cholesterol, blood pressure ≥130/≥85mm Hg, and diabetes or fasting glucose >110 mg/dl (>6.1 mmol/l). Intergroup comparisons were performed using t test or chi square test. Results: Metabolic syndrome w as present in 345 (31.6%) subjects; prevalencewas 122 (22.9%) in men and 223 ( 39.9%) in women(p< 0.001); the age adjusted prevalence was 24.9%, 18.4%in me n and 30.9%in women. There was a significant age related increase in its preva lence(Mantel Haenzel χ2 for trend p< 0.05). Prevalence of components of metabo lic syndrome in men and women was: central obesity (waist, men>102 cm, women>88 cm) in 116 (25.6%) and 246 (44.0%); low HDL cholesterol(men<40 mg/dl,<1.0 mmol /l), women< 50 mg/dl,<1.3 mmol/l) in 292 (54.9%) and 504(90.2%); high triglyce rides ≥150 mg/dl(≥1.7 mmol/l) in 172 (32.3%) and 160 (28.6%); and impaired f asting glucose or diabetes in 90(16.9%) and 90 (16.1%). The prevalence of phys ical inactivity, hypertension, hypercholesterolemia(≥200 mg/dl, ≥5.2 mmol/l) a nd high LDL cholesterol (≥130 mg/dl, ≥3.4 mmol/l) was greater in the metabolic syndrome group in both men and women (p< 0.05). Conclusions: There is a high pr evalence of metabolic syndrome in an urban Indian population. Focus of cardiovas cular prevention should be at this high risk group.展开更多
Aim To study the efficacy and tolerability of β-blockade in elderly p atients with heart failure in the MERIT-HF study. Methods and results Cox proportional hazards model was used to calculate hazard ratios (HR) with...Aim To study the efficacy and tolerability of β-blockade in elderly p atients with heart failure in the MERIT-HF study. Methods and results Cox proportional hazards model was used to calculate hazard ratios (HR) with 95%confidence inte rvals (CI). Risk reduction was defined as (1-HR). In patients ≥65 years total mortality was reduced by 37%(95%CI 17%to 52%; p=0.0008), sudden death by 43 %(95%CI 17%to 61%; p=0.0032), and death from worsening heart failure by 61% (95%CI 32%to 77%; p=0.0005). Hospitalisations for worsening heart failure was reduced by 36%(p=0.0006). Elderly patients with severe heart failure (NYHA cla ss III/IV with ejection fraction < 0.25; n=425), and patients above 75 years (n= 490) showed similar risk reductions. Metoprolol CR/XL was safe and well tolerate d both during initiating therapy and during long-term follow-up. Conclusions M etoprolol CR/XL was easily instituted, safe and well tolerated in elderly patien ts with systolic heart failure. The data suggest that these are the patients in whom treatment will have the great est impact as shown by number of lives saved and number of hospitalisations avoi ded. The time has come to overcome the barriers that physicians perceive to β- blocker treatment, and to provide it to the large number of elderly patients wit h heart failure in need of this therapy.展开更多
文摘Objectives: To determine prevalence of themetabolic syndrome using United Stat es Adult Treatment Panel-3 (ATP-3) guidelines in an urban Indian population. M ethods: Randomly selected adults >20 years were studied using stratified samplin g. Target study sample was 1800 with population proportionate distribution (men 960, women 840). Evaluati on of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Subjects(1123; response 62.4%) were examined, fasting blood sam ples were available in 1091(532 men, 559 women) and analysed for prevalence of m etabolic syndrome. Atherosclerosis risk factors were determined using the curren t guidelines. Metabolic syndrome was diagnosed when any three of the following w ere present: central obesity, raised triglycerides ≥150 mg/dl (≥1.7 mmol/l), l ow high density lipoprotein (HDL) cholesterol, blood pressure ≥130/≥85mm Hg, and diabetes or fasting glucose >110 mg/dl (>6.1 mmol/l). Intergroup comparisons were performed using t test or chi square test. Results: Metabolic syndrome w as present in 345 (31.6%) subjects; prevalencewas 122 (22.9%) in men and 223 ( 39.9%) in women(p< 0.001); the age adjusted prevalence was 24.9%, 18.4%in me n and 30.9%in women. There was a significant age related increase in its preva lence(Mantel Haenzel χ2 for trend p< 0.05). Prevalence of components of metabo lic syndrome in men and women was: central obesity (waist, men>102 cm, women>88 cm) in 116 (25.6%) and 246 (44.0%); low HDL cholesterol(men<40 mg/dl,<1.0 mmol /l), women< 50 mg/dl,<1.3 mmol/l) in 292 (54.9%) and 504(90.2%); high triglyce rides ≥150 mg/dl(≥1.7 mmol/l) in 172 (32.3%) and 160 (28.6%); and impaired f asting glucose or diabetes in 90(16.9%) and 90 (16.1%). The prevalence of phys ical inactivity, hypertension, hypercholesterolemia(≥200 mg/dl, ≥5.2 mmol/l) a nd high LDL cholesterol (≥130 mg/dl, ≥3.4 mmol/l) was greater in the metabolic syndrome group in both men and women (p< 0.05). Conclusions: There is a high pr evalence of metabolic syndrome in an urban Indian population. Focus of cardiovas cular prevention should be at this high risk group.
文摘Aim To study the efficacy and tolerability of β-blockade in elderly p atients with heart failure in the MERIT-HF study. Methods and results Cox proportional hazards model was used to calculate hazard ratios (HR) with 95%confidence inte rvals (CI). Risk reduction was defined as (1-HR). In patients ≥65 years total mortality was reduced by 37%(95%CI 17%to 52%; p=0.0008), sudden death by 43 %(95%CI 17%to 61%; p=0.0032), and death from worsening heart failure by 61% (95%CI 32%to 77%; p=0.0005). Hospitalisations for worsening heart failure was reduced by 36%(p=0.0006). Elderly patients with severe heart failure (NYHA cla ss III/IV with ejection fraction < 0.25; n=425), and patients above 75 years (n= 490) showed similar risk reductions. Metoprolol CR/XL was safe and well tolerate d both during initiating therapy and during long-term follow-up. Conclusions M etoprolol CR/XL was easily instituted, safe and well tolerated in elderly patien ts with systolic heart failure. The data suggest that these are the patients in whom treatment will have the great est impact as shown by number of lives saved and number of hospitalisations avoi ded. The time has come to overcome the barriers that physicians perceive to β- blocker treatment, and to provide it to the large number of elderly patients wit h heart failure in need of this therapy.
