The entire distribution of diastolic and systolic blood pressure values was shifted upwards in the north-eastern as compared to the south-western German population samples and the prevalences of hypertension differed accordingly. Despite such substantial epidemiologic differences, the community management of hypertension was of almost identical quality.

Complicated atherosclerotic plaques in the aortic arch represent an independent risk factor for systemic embolism similar to atrial fibrillation and severe atherosclerosis of the carotid arteries.

SummaryThe purpose of the study was to evaluate alterations of the hemostatic system and the effect of anticoagulant therapy in nonvalvular atrial fibrillation. A set of molecular hematologic markers was measured prospectively in 69 patients with atrial fibrillation and 28 age-matched patients in sinus rhythm. Significantly elevated levels of thrombin-antithrombin III complex (8.5 ± 1.6 vs. 2.5 ± 0.3 αg/1; p <0.001), fibrin monomers (27.1 ± 3.2 vs. 13.4 ± 3.7 nM; p <0.001), D-dimers (788 ± 76 vs. 405 ± 46 αg/l; p <0.005), and tissue-type plasminogen activator (9.6 ± 0.5 vs. 7.2 ± 0.5 αg/l; p <0.05) were observed in patients with atrial fibrillation compared to those in sinus rhythm. In a subgroup of patients in whom anticoagulant therapy with oral coumadin or standard intravenous heparin was established after the initial study, hemostatic activation decreased significantly. In conclusion, molecular hematologic markers indicate a hypercoagulable state in atrial fibrillation which may characterize a group of patients at elevated risk for thromboembolic disease.

Patients with the finding of protruding plaques or plaques with mobile components have a high risk of subsequent vascular events.

Background and Purpose-Epidemiologic studies have shown a J-shaped association between alcohol consumption and vascular diseases. However, only few studies have reported on the association between alcohol intake and subclinical atherosclerosis. The aim of the study was to investigate the relation between alcohol intake and carotid intima-media thickness (IMT) in participants of the population-based Study of Health in Pomerania. Methods-In 1230 men and 1190 women, the mean IMT of the right and left common carotid arteries was measured by B-mode ultrasonography. Alcohol consumption was assessed with a computer-assisted face-to-face interview. Results-In men, carotid IMT as a function of alcohol intake was depicted as a J-shaped curve with a nadir for the alcohol intake category of 61 to 80g/d. Linear regression models controlled for age, diabetes, systolic blood pressure, leisure time physical activity, food frequency patterns, smoking status, and education revealed a significant inverse association between IMT and alcohol intake Յ80g/d in men (␤ϭϪ0.009, PϽ0.02), which became insignificant after further controlling for HDL cholesterol and fibrinogen (␤ϭϪ0.007, PϭNS). In women, neither a J-shaped relation nor significant differences in IMT between the drinking and nondrinking groups were found. Conclusions-Alcohol consumption is inversely correlated with carotid IMT in men but not in women. However, the total daily level of alcohol intake that shows a maximum protective effect against atherosclerosis is above the threshold where severe alcohol related comorbidity and organ damage have been reported. Key Words: alcohol drinking Ⅲ atherosclerosis Ⅲ carotid arteries Ⅲ epidemiology Ⅲ intima-media thickness E pidemiologic studies have shown a J-shaped or a U-shaped relation between alcohol consumption and vascular diseases. [1][2][3][4] The majority of these studies focused on clinical end points, such as mortality and morbidity from coronary heart disease (CHD) or stroke. The common pathophysiologic basis for the subsequent occurrence of clinical vascular end points is atherosclerotic changes of the vessel wall. Carotid intima-media thickness (IMT) is widely considered to be a surrogate marker for the severity of atherosclerosis, and it is highly predictive for prevalent and incident CHD and stroke. [5][6][7][8] In contrast to the large number of studies for clinical end points, only few studies have reported on the association between alcohol intake and subclinical atherosclerosis. 9 -16 Their results are incongruent. Cross-sectional studies found either no association between alcohol intake and carotid atherosclerosis 11 or a J-shaped relation between alcohol consumption and carotid plaques 12 or between alcohol consumption and carotid IMT in an elderly population. 16 A study from Finland demonstrated that binge-drinking men had the highest progression rates of IMT during a 4-year follow-up period. 15 The objective of our study was to investigate the relation between alcohol intake and carotid IMT as an indicator of...