Cardiovascular Topic Center Selected Articles

Predicting the Risk of Type 2 Diabetes: When Does the Clock Start Ticking?

American medicine is undergoing the greatest financial scrutiny in its history. The hue and cry for reform stems primarily from the soaring costs of health care. However, placing the blame for these costs solely on increased utilization of technology, cutting-edge pharmaceuticals, cost-shifting hospitals, and physicians misses a bigger mark.

Diabetes and Cardiovascular Disease: Does Lowering Hemoglobin A1c Help or Harm?

Conflicting data about the safety and effectiveness of intensive glycemic control have caused confusion over the best approach to cardiovascular risk reduction in patients with diabetes. A recent meta-analysis has helped reconcile these seemingly contradictory data. The optimal mechanism, speed, and extent of glycated hemoglobin reduction are different for differing populations. For patients with recently diagnosed diabetes, aggressive treatment will lower cardiovascular risk. In patients who have diabetes of more than 15 years’ duration and are older and have other comorbidities, less aggressive treatment is indicated. For all patients, treatment of the dyslipidemia and hypertension that are associated with diabetes further reduces cardiovascular risk.

Coronary calcium scoring can be trusted to guide cardiac test selection

Coronary artery calcium scanning predicts the risk of myocardial infarction and sudden death accurately enough to guide the selection of diagnostic tests for symptomatic patients, according to a multicenter prospective study. 

Falling Through the Cracks: Middle-Aged Stroke Survivors Not Receiving Care

Recurrent stroke is an important health concern not only from a patient perspective but also from clinical and public health standpoints. Many studies have shown that the risk of a second cerebral infarction is greatest immediately following the primary event. Consequently, clinical management of stroke survivors is focused on preventive therapy to minimize risk.Recurrent stroke is an important health concern not only from a patient perspective but also from clinical and public health standpoints. Many studies have shown that the risk of a second cerebral infarction is greatest immediately following the primary event. Consequently, clinical management of stroke survivors is focused on preventive therapy to minimize risk.