Background and Purpose-Glycohemoglobin (hemoglobin A 1c [HbA 1c ]) and high-sensitivity C-reactive protein (hsCRP) are risk indicators for atherosclerosis. Limited information exists regarding the combined effects of inflammation and hyperglycemia. We investigated the joint effects of both parameters on early carotid atherosclerosis progression and major vascular events in diabetic and nondiabetic subjects. Methods-We analyzed the data of INVADE (Intervention Project on Cerebrovascular Diseases and Dementia in the Community of Ebersberg, Bavaria), a prospective, population-based study conducted in 3534 subjects (mean age, 69 years). In addition to common risk factors, measurements of carotid intima-media thickness (IMT), hsCRP, and HbA 1c were performed at baseline and after 2 years of follow-up. Results-For the entire population, IMT progression was significantly related to HbA 1c (Pϭ0.003) but not to hsCRP (Pϭ0.06) after risk factor adjustment. The interaction hsCRPϫHbA 1c was highly significant (Pϭ0.001), and the most pronounced IMT progression was seen in subjects with both parameters in the fourth quartiles compared with subjects with both parameters in the first quartiles (0.

An intensive medical care programme in the office setting managed by trained nurses can improve BP control effectively. Nurses could take more responsibility for managing hypertensive patients.

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Background--Stroke and dementia are the major causes for long-term care (LTC) dependence in old age. This intervention trial compared a multidomain prevention program for stroke and dementia with usual medical care in reducing the need for LTC.

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