Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.
C-reactive protein (CRP) is an indicator of inflammation. Blood levels of CRP increase in heart disease but not cancer, according to a study of 643 women (Brief Communication, p. 529). The authors found that higher levels of CRP were present in women who developed coronary heart disease than in women who developed cancer or didn't develop either during nearly five years of close observation. An accompanying editorial agrees that levels of CRP are an indicator of increased cardiovascular risk in people with no signs of heart disease (Editorial, p. 550). However, the authors caution that CRP is present in the blood during many infectious and inflammatory diseases, such as arthritis. Elevated levels of CRP indicate that a person may have a disease that deserves medical attention.
The small blood vessels in the heart normally increase in size in response to exercise and certain medications. This response enables the heart to function more effectively during stress. The authors of this study found that a high-fat meal, which increased the blood levels of triglycerides (a form of fat), reduced the ability of the small vessels to increase in size in 15 healthy men. Five of the men ate a low-fat meal and did not experience a reduction in the ability of the vessels to increase in size. The study did not prove that the high-fat meals and increased triglyceride levels caused the decrease in the capacity of the heart blood vessels. But the authors say that high-fat meals may be detrimental to heart circulation.
An analysis of data on 2419 adults from 54 studies of exercise found that regular exercise decreased blood pressure in all groups of people, including those who had high or normal blood press, those who were overweight or not overweight and those who were black, white or Asian (Article, p. 493). Exercise decreased systolic blood pressure by 3.84 mm Hg and diastolic blood pressure by 2.58 mm Hg in the participants, who were previously inactive. The types of aerobic exercise included walking, swimming, jogging and cycling.
The authors say that aerobic exercise is a simple and inexpensive strategy for prevention and treatment of high blood pressure. They point out that about 20 to 30 percent of adult Americans are not physically active, that about 25 percent have high blood pressure, and that high blood pressure is an important risk factor for heart disease (the number-one cause of death in the United States) as well as for other conditions such as diabetes, kidney disease and stroke.
Experts say that even a small reduction in blood pressure can help make a hypertensive person less dependent on drug treatment. And small decreases in the overall rates of hypertension in the United States can substantially cut the number of people who die from heart disease and the costs to treat diseases linked to high blood pressure.
(This study is highlighted in a video news release produced by the American College of Physicians-American Society of Internal Medicine to be released on Monday, April 1 at 5 p.m., EST.)