Measures of adiposity do not greatly improve cardiovascular risk prediction beyond that provided by blood pressure, diabetes history, and lipid profile, according to a study in the Lancet.
Researchers assessed data on 220,000 patients free of cardiovascular disease in 58 prospective cohorts. Over a mean 5.7 years' follow-up, some 14,000 cardiovascular events occurred.
After adjustment for age, sex, smoking status, systolic blood pressure, diabetes history, and total and HDL cholesterol, increasing increments of BMI, waist-to-hip ratio, and waist circumference were individually associated with roughly similar increases in cardiovascular risk (with hazard ratios ranging from 1.07 to 1.12). In addition, adding these adiposity measures to a cardiovascular risk prediction model that included traditional risk factors did not improve the model's risk discrimination.
Commentators note: "The study dispelled previous hope that assessment of body size could replace the cost, time, and inconvenience of blood lipids assay."
Sunday, March 13, 2011
Thursday, March 3, 2011
Long-Term Use of Proton-Pump Inhibitors May Lower Magnesium Levels
Using a proton-pump inhibitor for extended periods may cause low serum magnesium levels, the FDA cautioned yesterday. The agency issued the alert after reviewing more than 50 cases of hypomagnesemia in patients taking PPIs over long periods, usually a year or more.
Possible adverse effects of hypomagnesemia include tetany, arrhythmias, and seizures. The alert primarily applies to prescription PPIs, which are indicated for long-term use. The FDA says there is little risk from over-the-counter PPIs when taken as directed for 14 days.
Before prescribing a PPI for a long period, clinicians should consider baseline magnesium testing as well as occasional testing throughout treatment. Periodic magnesium testing is also advised in patients concurrently taking digoxin, because low magnesium in these patients carries a greater risk for serious side effects.
The FDA said that long-term PPI use may affect intestinal absorption of magnesium, although the mechanism is unknown.
Possible adverse effects of hypomagnesemia include tetany, arrhythmias, and seizures. The alert primarily applies to prescription PPIs, which are indicated for long-term use. The FDA says there is little risk from over-the-counter PPIs when taken as directed for 14 days.
Before prescribing a PPI for a long period, clinicians should consider baseline magnesium testing as well as occasional testing throughout treatment. Periodic magnesium testing is also advised in patients concurrently taking digoxin, because low magnesium in these patients carries a greater risk for serious side effects.
The FDA said that long-term PPI use may affect intestinal absorption of magnesium, although the mechanism is unknown.
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