The enigma of the endothelium.

The endothelium was earlier regarded as a relatively inert layer performing rather simple physiological functions. However extensive research has recently revealed that the endothelial layer performs a vast array of functions such as maintenance of vascular tone, control over coagulation and fibrinolysis besides a lot of chemical interactions. More recently, endothelial dysfunction has been implicated as important in the pathogenesis of atherosclerosis, coronary artery disease, myocardial ischemia and post-intervention restenosis. The demonstration that endothelial dysfunction may be reversible by employing various strategies raises the possibility of retarding the progress or even preventing the process of atherosclerosis thereby reducing the risk of acute cardiovascular events.

Madurai Area Physicians Cardiovascular Health Evaluation Survey (MAPCHES)--an alarming status.

BACKGROUND: Studies have shown that South Asians are highly susceptible to cardiovascular diseases (CVDs). There is very little information available about the prevalence of risk factors for CVD in the physician population, a group that might be expected to be more aware of cardiovascular risk and health status. AIM: To evaluate the prevalence of cardiovascular risk factors - including metabolic, dietary and behavioural - among the physician population in southern India. METHODS: Approximately 4000 physicians of differing specialties from eight southern districts in Tamilnadu, India, in and around the city of Madurai were listed. Of these, 1600 were randomly selected to participate in a cross-sectional survey, of which 1514 physicians agreed to participate. The survey included demographic questionnaires, objective measurements of blood pressure, fasting blood sugar, fasting lipids and waist circumference, and questionnaires about their dietary and behavioural habits. RESULTS: Complete data were available for 1433 physicians. Using a blood pressure cut-off value of 130/85 mmHg or higher, the study recorded a prevalence of 41% among men and 23% among women. On applying the International Diabetes Federation criteria for the metabolic syndrome for the South Asian population, the present study identified 49% of female physicians and 41% of male physicians as having the metabolic syndrome. Only 17% were physically active. Less than one-half of them consumed vegetables. Nearly 31% of male physicians were smokers. CONCLUSION: Analysis of these data suggests that the risk for CVD and stroke is at epidemic proportions in a cohort of well-educated physicians who are in the highest quintile of income.