- It has long been recognized that the problems with alcohol relate not to the use of a bad thing, but to the abuse of a good thing. Abraham Lincoln
- In the current issue of Mayo Clinic Proceedings, Alexander et al report on meta-analyses of data addressing the effects of eicosapentaenoic and docosahexaenoic (EPA+DHA) omega-3 fatty acids on the risk of coronary heart disease (CHD) events.1 Their research employed data from 2 types of studies: (1) randomized controlled trials (RCTs) (approximately 93,000 patients) and (2) prospective cohort studies (approximately 732,000 patients). Their research is, to date, the most comprehensive analysis of its kind within the indexed biomedical literature.
- Everything in excess is opposed to nature.Hippocrates1
- For every problem, there is one solution which is simple, neat, and wrong.— H. L. Mencken
- In this issue of Mayo Clinic Proceedings, Shepherd et al1 report that high-dose statin therapy improved cardiovascular (CV) outcomes particularly well for diabetic patients with mild to moderate chronic kidney disease (CKD). These authors focused, in a post hoc analysis of the Treating to New Targets (TNT) study, on the effects of high-dose atorvastatin (80 mg/d) vs low-dose atorvastatin (10 mg/d) in diabetic patients with coronary artery disease (CAD) with and without CKD. Interestingly, high-dose atorvastatin reduced the relative risk of major CV events by 35% in diabetic patients with CKD but by only 10% in those with diabetes and normal kidney function.
- Considerable evidence during the past 3 decades from epidemiologic, serial angiographic, and major randomized clinical trials has established the importance of low-density lipoprotein cholesterol (LDL-C) in modulating atherosclerosis, particularly coronary artery disease (CAD).1 More recently, the constellation of evidence has shown the clinical value of reducing LDL-C levels, even lower than that recommended by prominent guidelines.1–4