As compared with lidocaine, amiodarone leads to substantially higher rates of survival to hospital admission in patients with shock-resistant out-of-hospital ventricular fibrillation.

Despite the finding in cross-cultural comparisons that habitual sodium intake correlates with levels of blood pressure, similar studies from within population groups have yielded inconsistent results. The data presented in this report indicate that in industrialized societies the high degree of intra-individual variability of sodium intake, compared to much smaller inter-individual differences, may obscure potential biological correlations. A quantitative statistical method is presented to assess and minimize the effect of the large intra-individual variation in daily urinary sodium excretion.

Background The reasons for racial/ethnic disparities in hypertension prevalence in the U.S are poorly understood. Methods Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we investigated whether individual and neighborhood-level chronic stressors contribute to these disparities in cross-sectional analyses. The sample consisted of 2679 MESA participants (45–84yrs) residing in Baltimore, New York, and North Carolina. Hypertension was defined as systolic or diastolic blood pressure ≥140 or 90mmHg, or taking anti-hypertensive medications. Individual-level chronic stress was measured by self-reported chronic burden and perceived major and everyday discrimination. A measure of neighborhood (census tract) chronic stressors (i.e. physical disorder, violence) was developed using data from a telephone survey conducted with other residents of MESA neighborhoods. Binomial regression was used to estimate associations between hypertension and race/ethnicity before and after adjustment for individual and neighborhood stressors. Results The prevalence of hypertension was 59.5% in African Americans (AA), 43.9% in Hispanics, and 42.0% in whites. Age and sex adjusted relative prevalences of hypertension (compared to whites) were 1.30 [95% Confidence Interval (CI): 1.22–1.38] for AA and 1.16 [95% CI: 1.04–1.31] for Hispanics. Adjustment for neighborhood stressors reduced these to 1.17 [95% CI: 1.11–1.22] and 1.09 [95% CI: 1.00–1.18] respectively. Additional adjustment for individual-level stressors, acculturation, income, education, and other neighborhood features only slightly reduced these associations. Conclusion Neighborhood chronic stressors may contribute to race/ethnic differences in hypertension prevalence in the U.S.

Abstract-We examined the association between urine albumin excretion (UAE) and common and internal carotid artery intima-media thickness (IMT), end-diastolic left ventricular (LV) mass, and coronary artery calcification (CAC) scores using data from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study of 6814 adults aged 45 to 85 years without clinical cardiovascular disease (CVD). The mean age of the MESA participants was 62.7 years, 47% were male, and 15% had diabetes mellitus (DM). Sex-specific spot urine albumin/creatinine ratios were used to define 4 UAE categories: normal, high normal, microalbuminuria, and macroalbuminuria. CAC scores were log-transformed after adding 1 to all scores. Key Words: cardiovascular diseases Ⅲ urine M icroalbuminuria, increased urine albumin excretion (UAE) below the detection of urinary dipstick measurement, strongly predicts cardiovascular disease (CVD) mortality in nondiabetic patients with established CVD. 1 Moreover, the association between UAE and increased CVD mortality in high-risk groups begins at levels of UAE below clinically defined thresholds for microalbuminuria. 1 Subclinical CVD, such as left ventricular (LV) hypertrophy 2-6 and increased carotid artery intima-media thickness (IMT), [7][8][9][10][11][12] has been associated with microalbuminuria among individuals at high risk for CVD. Whether the presence of increased UAE provides any additional predictive value for the presence of subclinical CVD in groups not at high risk aside from established, independent CVD risk factors remains unestablished. Coronary artery calcification (CAC) is highly correlated with the presence of coronary atherosclerotic plaque. [13][14][15] However, information on the association between CAC scores and UAE is currently limited.This study examined the association between UAE and several measures of subclinical CVD, including CAC scores, in a large multi-ethnic population without clinical CVD. We hypothesized that increased UAE is associated with subclinical CVD reflecting kidney damage caused by exposure to CVD risk factors, particularly diabetes mellitus (DM) and hypertension, and that these associations exist at UAE cutpoints below thresholds currently used to define microalbuminuria. An association between increased UAE and subclinical CVD in adults without clinical CVD may give further credence to using UAE to identify individuals who may benefit from aggressive risk factor intervention for the primary prevention of CV events.