This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content

(Circulation. 2005;112:297.)
© 2005 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	CORTISOL, TESTOSTERONE, AND CORONARY HEART DISEASE: PROSPECTIVE EVIDENCE FROM THE CAERPHILLY STUDY, by Smith et al.

 
There are abundant animal and human data as well as lay support for the concept that chronic stress predisposes to heart disease. However, the pathophysiological basis of the stress-heart disease connection remains poorly understood. In a prospective observational study of middle-aged men in Caerphilly, South Wales, Dr Davey Smith and colleagues examined whether elevated cortisol-to-testosterone ratio, a reputed biological marker of stress, increased the risk of ischemic heart disease. The investigators observed that there was a dose-response relation between increasing levels of cortisol to testosterone and the longitudinal development of ischemic heart disease, but no other causes of death. When the authors further adjusted for components of the insulin resistance syndrome, the relation with ischemic heart disease was significantly attenuated. The researchers acknowledged that their findings will need to be replicated in other study cohorts and with other designs. However, given that it is unlikely that chronic stress will be eliminated from modern life, understanding the biology of the stress-coronary artery disease connection will be important to facilitate the development of effective stress prevention and treatment strategies. See p 332.

	STATIN THERAPY MAY BE ASSOCIATED WITH LOWER MORTALITY IN PATIENTS WITH DIASTOLIC HEART FAILURE: A PRELIMINARY REPORT, by Fukuta et al.

 
The pathophysiology and therapy of heart failure with a normal ejection fraction remain poorly understood. Fukuta et al examined the relationship between survival and the type of therapy in 137 patients with clinical heart failure and an ejection fraction 0.50. Although the number of deaths was small, there was a strong relationship between the use of a statin and survival, whereas no apparent relationship was found for angiotensin-converting enzyme inhibitors, . . . [Full Text of this Article]