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El benfluorex, un hipolipemiante ampliamente conocido, ha demostrado, mediante un estudio abierto en una muestra ecuatoriana, sus propiedades al hacer descender los niveles de colesterol total, triglicéridos y LDL-C en forma significativa e incrementar los niveles del HDL-C también significativamente. Todo esto redunda en la disminución del riesgo aterosclerótico

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Echocardiographically determined left ventricular mass, diastolic septal and posterior wall thickness and end-systolic wall stress, as well as electrocardiographic indexes of left ventricular enlargement (Sokolow-Lyon index and Romhilt-Estes score) and of left atrial enlargement (P terminal index) were correlated with resting and exercise systolic and diastolic blood pressures, and with several parameters of body size (weight, height, body surface area, Quetelet index), in 130 school children (61 boys, 69 girls) 6 to 15 years of age. Parameters of body size had a positive correlation both with systolic and diastolic blood pressures and with parameters of left ventricular size. Thus, the latter were adjusted for body surface area, for correlation with blood pressure. Left ventricular mass and diastolic septal and posterior wall thickness had a very poor correlation with resting and exercise diastolic blood pressures. Left ventricular mass and diastolic posterior wall thickness had a significantly higher correlation with peak exercise systolic blood pressure than with resting systolic blood pressure. End-systolic wall stress had a positive correlation with resting diastolic and systolic blood pressures. Electrocardiographic parameters of left ventricular and left atrial enlargement had a very poor correlation with resting and exercise blood pressure. Our findings suggest that early in life left ventricular mass and wall thickness are more closely related to maximal systolic blood pressure during physical exercise than to blood pressure in basal conditions. The electrocardiogram is an insensitive method to detect early modifications of left ventricular size in relation to different levels of blood pressure. The echocardiogram is the method of choice for this purpose.

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The antihypertensive efficacy and safety of doxazosin, a selective alpha 1-inhibitor, were assessed in 33 severely hypertensive patients. The study involved three phases: a 1-day baseline period, a 32-day period in which patients received doxazosin, 1 to 16 mg, once daily, and a 4-week maintenance period. All patients were considered therapy successes (sitting diastolic blood pressure either less than or equal to 90 mm Hg or greater than or equal to 10 mm Hg reduction) at a mean daily dose of 8.1 mg. Twenty-seven patients (82%) achieved good blood pressure control (sitting diastolic blood pressure less than or equal to 90 mm Hg) at a mean dose of 6.7 mg once daily. By the final treatment visit, mean systolic/diastolic blood pressures in the sitting and supine positions were significantly reduced by 40/29 and 37/28 mm Hg from a mean baseline of 180/121 and 181/121 mm Hg to final visit values of 140/91 and 144/92 mm Hg, respectively (p less than 0.05). Eleven patients experienced one or more side effects that were mild or moderate and disappeared or were tolerated with continued therapy. During the study no abnormal laboratory test findings were identified by the investigators. The investigators' global assessment of the efficacy and toleration of once-daily doxazosin therapy was excellent or good for 31 (94%) patients and fair for the remaining two patients.

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Quit-rates for cigarette smokers in a lifestyle intervention program aimed at reducing coronary risk were 24 percent for all participants and 34 percent for non-dropouts. Recidivism remained very low during participation in the program. Half of the smokers who quit did so after being in the program more than two years. These data suggest that while engaging in an effort to make other changes in lifestyle, many smokers can be helped to quit. Sustained antismoking efforts in the clinical practice of medicine can be expected to share these same positive aspects. While mass public health programs to eliminate smoking and prevent young people from taking up the habit are being developed, health practitioners can make a significant contribution by including vigorous efforts at smoking cessation as part of routine practice.

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This study explored the association between sodium excretion and blood pressure (BP). A new method was used to minimize the measurement error introduced by the large intrinsic variability of 24-hour sodium excretion. The ratio of intra- to interindividual variation was used to estimate the number of measurements needed to characterize the individual. When seven consecutive 24-hour samples were collected from 73 children, ages 11-14 years, a significant correlation between mean individual sodium excretion and BP was demonstrated. The independent relationship persisted when controlling for height, weight, pulse, age, sex and race (p = 0.045), but was eliminated by simultaneously considering mean creatinine excretion. Although the cross-sectional association described is quantitatively weak, a linear relationship between BP and sodium over the range consumed in this society could be important for prevention.

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To ascertain current approaches of physicians to nutritional-hygienic management of hypertensive patients and their children, a survey was done among a random sample of Chicago-area generalists, internists, and cardiologists. Thirteen items related to advice for patients; two for their children. Of 713 physicians holding M.D. degrees in the sample, 573 (80%) responded. For hypertensive patients, the great majority of physicians indicated that they advise weight loss, avoidance of salt use at table, no smoking, regular exercise, limitation of alcohol intake, and avoidance of stressful situations. Although 98% advised weight loss, a minority responded positively to reduction of carbohydrate and/or fat intake. Only 25% recommended limiting the salt use of children, and only 19% recommended taking the blood pressure of children of hypertensive patients. These data indicate that the majority of Chicago-area practitioners advocate nutritional-hygienic measures for their hypertensive patients. Only a minority, however, apparently advocate primary preventive approaches for the children of hypertensive patients.

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How many 24-hour urine sodium measurements are adequate for characterizing a child's salt intake? Can overnight urine specimens accurately replace 24-hour collections for salt assessment? A sample of 73 6th-8th grade children was taken from two parochial schools in Chicago to investigate systematically these questions. Seven consecutive 24-hour-urine specimens were collected from each child. The estimated ratio of intra- to inter-individual variances was 1.94 for 24-hour-urine sodium. Based on this value, eight 24-hour specimens are necessary to limit to 10% the diminution of the estimated correlation coefficient between 24-hour-urine sodium and blood pressure. Six measurements are required to reduce to 0.01 the probability of misclassifying a child in tertile 1 versus tertile 3. The overnight specimens show a moderate consistency with the 24-hour collections in detecting children with high or low salt intake. For example 92% and 85% of children in the fifth quintile and the third tertile respectively of the true mean overnight sodium have their true mean 24-hour Na in the upper half of the distribution. These results suggest that in a large scale epidemiologic study, overnight specimens may be reasonable alternatives when 24-hour-urine sodium is practically very difficult to collect.

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It has been suggested that high fat, high cholesterol, and low fibre intakes play a role in the causation of colon cancer, but since they are highly intercorrelated, it is difficult to determine which (if any) variable is truly related to colon cancer. Food disappearance data for 1954--65 and mortality data for 1967--73 from 20 industrialised countries were used to assess which variables are independently related to colon cancer. Simple correlation analysis indicated that intake of total fat, saturated fat, monounsaturated fat, cholesterol, and fibres are each highly correlated with mortality-rate for colon cancer. The partial correlation of dietary cholesterol with colon cancer remains highly significant when fat or fibre is controlled. However, the partial correlations of fat or of fibre iwth colon cancer are no longer significant when cholesterol is controlled. Cross-classification showed a highly signficant main effect for cholesterol, but nor for fat or fibre. The findings support the possibility of a causal relationship between cholesterol intake and colon cancer.

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Despite the finding in cross-cultural comparisons that habitual sodium intake correlates with levels of blood pressure, similar studies from within population groups have yielded inconsistent results. The data presented in this report indicate that in industrialized societies the high degree of intra-individual variability of sodium intake, compared to much smaller inter-individual differences, may obscure potential biological correlations. A quantitative statistical method is presented to assess and minimize the effect of the large intra-individual variation in daily urinary sodium excretion.

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A long-term decline in death rates from cerebrovascular diseases in the United States accelerated in 1969, with a further increase in the rate of decline after 1972. This break in the pattern of the mortality curve for stroke was observed in all 4 major sex-color groups, and affected all age groups in which a significant number of stroke deaths occur. The decline for non-whites was relatively and absolutely greater than for the comparable white sex. If the 1960 rates had persisted in 1975, 87,600 more lives would have been lost to cerebrovascular diseases. Although there are no data documenting a declining prevalence of hypertension in the population, detection, treatment and control of hypertension have improved markedly over recent years. A concomitant decrease in the severity of epidemic respiratory infection may have contributed to the improvement in recorded death rates from stroke. Mortality from all major cardiovascular diseases has demonstrated a parallel downward trend. Continued emphasis on public health efforts to detect and treat hypertension and other known cardiovascular risk factors can be expected to result in further improvement in cardiovascular mortality.

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