Primary Care Blog
A rose is a rose is a rose is a rose.
-Gertrude Stein
If Ms. Stein were a physician, she might proclaim that "a blood vessel is a blood vessel is a blood vessel is a blood vessel" regardless of what organ it supplies. The implication is that blockage of one leads to blockage of others. Thus peripheral artery disease is considered a coronary heart disease equivalent by the Adult Treatment Panel III. For that matter, so is symptomatic carotid artery disease. Most recently, twice in January, studies were published in Circulation: CQ&O and PLoS Medicine linking erectile dysfunction to future heart disease.
Along those lines, we're now familiar with the use of coronary artery calcification scoring to provide additional information for risk stratification beyond the Framingham risk score. While we're struggling to come to grips with primary prevention of heart disease, it's interesting to note that a population-based study published early online last week in Stroke concluded that CAC was useful in predicting future stroke. 4,180 low-intermediate risk participants avg 59yo were followed for ~8 years in order to arrive at this conclusion. Interestingly, 3 other well known studies failed to demonstrate this association, possibly due to a smaller number of participants.
Should we be surprised at this finding? Probably not. In fact, I would go so far as to say that aside from statistics, I was more surprised by the other 3 studies' inability to demonstrate this link. Bottom line, we need to aggressively heart disease risk factors which are remarkably similar to those for stroke.
Alvin B. Lin, MD, FAAFP
Dr. Lin is an associate professor of family and community medicine at University of Nevada School of Medicine and an adjunct professor of family medicine and geriatrics at Touro University Nevada College of Medicine. He also serves as an advisory medical director for Infinity Hospice Care and as medical director of Lions HealthFirst Foundation. Dr. Lin maintains a small private practice in Las Vegas, NV. The posts represent the views of Dr. Lin, and in no way are to be construed as representative of the above listed organizations. Dr. Lin blogs about current medical literature and news at http://alvinblin.blogspot.com/.
