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4 December 2001 Annals of Internal Medicine Tip Sheet

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.

Hormones and Women's Risk for Heart Disease

Two studies and an editorial in the December 4 issue of Annals of Internal Medicine examine the role of sex hormones in causing heart disease in women. The first article reported findings in 10 premenopausal women with a form of heart disease in which a short segment of a coronary artery spontaneously becomes very narrow, which prevents blood from reaching the heart muscle. The authors found that these episodes of coronary artery spasm were much more likely to occur at a time in the menstrual cycle when estrogen was low (Brief Communication, p. 977). The writer of the editorial says that better understanding of how the menstrual cycle affects blood vessels will ultimately lead to improved medical care of menstruating women with coronary artery disease. (Editorial, p. 1002). The second study was about postmenopausal women who did not have coronary artery disease but were at high risk of developing it because they had high levels of LDL ("bad") cholesterol. In women who took estrogen, arteriosclerosis progressed more slowly than it did in women who took a placebo -- a dummy pill that looked like the estrogen pill (Article, p. 939).

New Automated External Defibrillators Appear Safe and Easy to Use

A review of automated external defibrillators finds that the latest models are relatively easy for trained laypersons to use, compared to earlier non-automated models (Review, p. 990). Defibrillators restore normal heart rhythm by giving a shock to a heart that has stopped beating or is beating irregularly. Automatic defibrillators deliver the shock at precisely the right time by analyzing the heart rhythm and "advising" the operator to push the shock button if needed. The article examines the technical aspects of the new machines and legal obstacles affecting their use by laypersons. The author sees a bright future for automated external defibrillators, which he envisions may eventually be sold for home use.

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