ISCHAEMIC HEART DISEASE

The polypill for all >55 years old ▸ The polypill strategy, based on a single daily pill containing six components for all of the population over 55 years old, would prevent 88% of heart attacks and 80% of strokes. About one in three people would directly benefit, each on average gaining 11–12 years of life without a heart attack or stroke (20 years in those aged 55–64). This is based on estimates of the beneficial effects of aspirin, statin, triple antihypertensive therapy, and folic acid. The authors suggest that the data is robust, but before the whole population is treated, a trial versus the known best treatment (taking a statin a day whatever your cholesterol!) would be warranted.

HAART may not be as bad for the heart as once thought ▸ Before treatment, HIV infection results in substantial decreases in serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) concentrations. Subsequent highly active anti-retroviral therapy (HAART) initiation is associated with increases in TC and LDL-C but little change in HDL-C. Increases in TC and LDL-C observed after about three years of HAART possibly represent a return to preinfection serum lipid values after accounting for expected age related changes.

Treatment of AMI is improving (slowly) ▸ US patients with acute myocardial infarction (AMI) between 1994–95 (n = 234 754 discharges) and 1998–99 (n = …