The Microvascular and Macrovascular Benefits of Fibrates in Diabetes and the Metabolic Syndrome: A review.

BACKGROUND: The purpose of this article is to discuss the evidence regarding potential macrovascular and microvascular benefits of fibrate therapy in general and fenofibrate specifically. METHODS: We performed a literature review summarizing the results of studies testing fibrates on relevant. RESULTS: Although statins are the first line therapy with an unparalleled amount of evidence for reducing the risk of cardiovascular disease (CVD) in patients with dyslipidemia and the metabolic syndrome (MetS), there are several landmark studies that have focused on the potential benefits of fibrate therapy for reducing CVD risk. Fibrates confer benefits mostly for patients with diabetes mellitus (DM), MetS, and atherogenic dyslipidemia. Recently, many studies have shown that fibrates confer benefits on the vascular system as well as the liver and kidneys. Fibrates also have demonstrable benefits in cohorts of patients with DM and renal disease. CONCLUSIONS: Fibrates appear to provide significant microvascular and macrovascular benefits particularly in patients with DM, MetS, or renal disease.

Meditation and coronary heart disease: a review of the current clinical evidence.

BACKGROUND: Chest pain from coronary heart disease (CHD) accounts for more than 8 million emergency department visits every year in the United States, emphasizing the need for cardiovascular (CV) interventions to help reduce this high number. Meditation--a state of contemplation, concentration, and reflection--has the potential to help decrease CV disease. METHODS: This article reviews the available data regarding the effects of meditation on various aspects of CV health. RESULTS: During the past few decades, multiple studies have demonstrated the beneficial effects of meditation on various CV risk factors. In addition to decreasing CV mortality, meditation has also been shown to improve conditions such as hypertension, type 2 diabetes mellitus, dyslipidemia, and high cortisol levels. Still unclear is how current medical therapies impact overall CHD in comparison to meditation techniques. CONCLUSION: Prospective trials are needed to study the effects of meditation on CV risk factors, to provide guidelines for daily meditation practice, and to determine the efficacy of meditation compared to current pharmacologic therapies.