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Update in Cardiology
2004–2005 Series: Update Sessions from ACP's 2004 Annual Session
This year's Update in Cardiology incorporates the most interesting, innovative, and important articles in the field from 2003, including papers on risk factors for heart disease, new treatment approaches, and issues in chronic heart failure. Despite strides in public education and treatment, cardiovascular disease is still the leading cause of death in the United States. Since 1997, the relative mortality rates from coronary artery disease and stroke have decreased by 4.5% and 1.6%, respectively, and the prevalence of hypercholesterolemia and of smoking has decreased by 14% and 3.8%, respectively. However, in that same period, the national prevalence of hypertension, physical inactivity, diabetes, and obesity has increased by 18%, 5%, 4%, and 8%, respectively. All of these factors fuel the increasing prevalence of the metabolic syndrome and contribute to current and future cardiovascular disease.
Risk Factors for Heart Disease
Exercise Capacity Is an Independent Predictor of Cardiovascular Death in Asymptomatic Women
Reduced physical fitness increases the risk for death in men, but long-term cardiovascular studies have not measured the effect in women. This 10-year study launched in 1992 examined the effects of physical activity on cardiovascular disease among 5721 women (mean age at baseline [±SD], 52 ± 11 years). The investigators measured physical fitness with an exercise stress test at the start of the study to determine whether reduced exercise capacity was associated with increased mortality. At baseline, they collected medical and family history, demographic characteristics, and a nonfasting blood sample. They also conducted a physical examination and symptom-limited stress electrocardiography, using the Bruce protocol and measuring exercise capacity in metabolic equivalents. Using the National Death Index, the investigators performed a search to identify death from any cause and date of death through December 2000.
When the investigators separated the women into tertiles of exercise capacity, those with the lowest exercise capacity (inactive) had a 2-fold increased risk for …
This 100-word excerpt has been provided in the absence of an abstract.
