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  1. Iqbal Malik, Editor

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    ISCHAEMIC HEART DISEASE

    The Mediterranean diet may save lives ▸

    A total of 74 607 men and women, aged 60 years or more, without coronary heart disease, stroke, or cancer at enrolment and with complete information about dietary intake and potentially confounding variables, were assessed in the EPIC-elderly study. An increase in the modified Mediterranean diet score (a composite score which includes nine components of a Mediterranean diet such as legumes, fruit, cereal, alcohol intake, etc) was associated with lower overall mortality, a two unit increment corresponding to a significant reduction of 8% (95% confidence interval (CI) 3% to 12%). No significant evidence of heterogeneity was found among countries in the association of the score with overall mortality even though the association was stronger in Greece and Spain.

    ▴ Trichopoulou A, Orfanos P, Norat T, et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ2005;330:991.
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    No end in site for CHD just yet ▸

    The incidence of ST elevation myocardial infarction (MI) is decreasing as is coronary heart disease (CHD) mortality over the course of time. This population based study looked at trends in less severe brands of CHD, namely angina. The age adjusted annual relative changes were −3.6% (95% CI −4.8% to −2.4%; p < 0.001) for all major coronary events, +2.6% (95% CI 1.1% to 4.0%; p < 0.001) for first diagnosed angina, and −0.8% (95% CI −1.8% to 0.3%; p  =  0.18) for first diagnosed coronary heart disease. The fall in major coronary events occurred across all categories of event (fatal and non-fatal, first and recurrent). The increase in angina may well reflect earlier and better diagnosis rather than a genuine increase over time.

    ▴ Lampe FC, Morris RW, Walker M, et al. Trends in rates of different forms of diagnosed coronary heart disease, 1978 to 2000: prospective, population based study of British men. BMJ2005;330:1046.
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    Antibiotics do not reduce the risk of CHD events ▸

    Both the ACES (azithromycin and coronary events study) trial by Grayson et al and the PROVE IT–TIMI (pravastatin or atorvastatin evaluation and infection therapy–thrombolysis in myocardial infarction) study by Cannon et al confirm the same thing: in large scale randomised controlled trials in stable angina and in acute coronary syndromes, antibiotic treatment against Chlamydia pneumoniae does not reduce CHD …

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