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Objective: To evaluate the effects of the angiotensin converting enzyme inhibitor perindopril on six minute walking distance and quality of life in very old patients with left ventricular systolic dysfunction. [...]

Coronary heart disease is a condition in which the arteries supplying blood to the heart (coronary arteries) become narrowed, resulting in a decreased supply of blood and oxygen to the cardiac muscle (myocardial ischemia). This can compromise the ability of the heart to pump blood to the body which, in an extreme case, can be fatal. The prevalence of coronary heart disease varies by geographical region, and there is much interest in identifying the variables that cause these variations. A large study (10,359 men and women), carried out in 22 districts of Scotland, attempted to correlate the prevalence of coronary heart disease with various factors relating to lifestyle, medical status, and sex. Cigarette smoking was highly correlated with the incidence of coronary heart disease in both men and women, as was low vitamin C consumption. Blood pressure in men, and high density lipoprotein cholesterol (HDL) levels in women were weakly correlated with coronary heart disease. Clustering, or the tendency of multiple risk factors to be present in single individuals, was associated with coronary heart disease in both sexes: smoking, alcohol consumption, and diets of high saturated fat, and low fiber in men; and smoking, similar diets, and obesity in women. The relation of obesity and coronary heart disease in women has not been previously reported. This study suggests that either obesity in women is a more serious risk factor than has been thought, or that risk factors among Scottish women differ from those among women elsewhere. (Consumer Summary produced by Reliance Medical Information, Inc.)

An introduction to randomized controlled clinical trials. J N S Matthews. (Pp 189; price not stated). London: Arnold. This book sets as its aim to provide an introduction to the [...]

BackgroundChildren with parents who smoke are often exposed to high levels of environmental tobacco smoke, and children with asthma are particularly susceptible to the detrimental effects of passive smoking. Data were collected from parents who smoke and from their asthmatic children. The families are currently taking part in a randomised controlled trial to test an intervention designed to reduce passive smoking in children with asthma. This paper reports on the baseline data. Questionnaire data and cotinine levels were compared in an attempt to assess exposure and to identify factors which influence exposure of the children. The aim of the study was to identify the scope for a reduction in passive smoking by these children.MethodsA sample of 501 families with an asthmatic child aged 2-12 years was obtained. Factors influencing passive smoking were assessed by interviewing parents. Cotinine levels were measured from saliva samples using gas liquid chromatography with nitrogen phosphorous detection.ResultsCotinine levels in children were strongly associated with the age of the child, the number of parents who smoked, contact with other smokers, the frequency of smoking in the same room as the child, and crowding within the home. Parental cotinine levels, the amount smoked in the home, and whether the home had a garden also exerted an independent effect on cotinine levels in the children.ConclusionsMany children are exposed to high levels of environmental tobacco smoke and their cotinine levels are heavily dependent upon proximity to the parent who smokes. Parents who smoke have a unique opportunity to benefit their child's health by modifying their smoking habits within the home.