Predicted coronary heart disease risk reduction and dual blood pressure/cholesterol goal attainment in patients with hypertension treated in real-world clinical practice.

Hypertension and dyslipidemia are highly co-prevalent, but often poorly controlled, coronary heart disease (CHD) risk factors. A retrospective cohort study was conducted between January 2004 and April 2008 to compare estimated 10-year CHD risk reduction and dual blood pressure and low-density lipoprotein cholesterol goal attainment (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel III]) in patients with a first prescription for amlodipine monotherapy, co-prescribed amlodipine + statin, or single-pill amlodipine/atorvastatin. In total, 2739 patients were prescribed amlodipine monotherapy, 653 were co-prescribed amlodipine + statin, and 227 were prescribed single-pill amlodipine/atorvastatin. Baseline CHD risk was similar in all 3 cohorts (11.0%-12.5%). Relative CHD risk reduction was greater in those prescribed single-pill amlodipine/atorvastatin (24.5%) compared with amlodipine monotherapy (14.4%, P<.01), and co-prescribed amlodipine + statin (18.4%, P=.01). The findings were driven by greater dual goal attainment for patients prescribed single-pill amlodipine/atorvastatin (50.2%) compared with amlodipine monotherapy (31.7%, P<.05) and co-prescribed amlodipine + statin (37.5%, P<.05).

Preservation of ventricular function in amateur athletes after completion of a marathon.

BACKGROUND: Previous studies have demonstrated the development of impaired systolic function and new segmental wall motion abnormalities following completion of ultraendurance events. Limited information is available on the effect of an endurance event such as a marathon on the left ventricular indices and hemodynamics. METHODS: We examined 45 patients (26 men, 19 women with the average age of 35+/- 8 years) who successfully trained and completed the 2001 Chicago Marathon (26.2 miles). Transthoracic 2-dimensional and Doppler echocardiography (TTE) was preformed prior to the marathon (17+/-10.7 days), immediately following the marathon (71+/-42 minutes), and at follow-up (29+/-12.9 days). RESULTS: Left ventricular end diastolic volumes declined immediately post marathon and returned to baseline at the one-month follow-up. Ejection fraction was maintained and no regional wall motion abnormalities were identified at any time point. Diastolic parameters decreased immediately post marathon but returned to baseline during follow-up principally reflecting a change in volume status. CONCLUSION: Marathon running by a group of well-trained recreational athletes does not result in impairment of left ventricular systolic or diastolic function.