Minerva

Minerva

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7091.1426 (Published 10 May 1997) Cite this as: BMJ 1997;314:1426

Myocardial infarction may sometimes be beneficial–when it has been deliberately induced in patients with hypertrophic obstructive cardiomyopathy. A septal infarction induced by catheterisation may improve the left ventricular outflow gradient. A report in Circulation (1997;95:2075-81) describes 18 patients treated in this way in Germany and in Britain; 16 of the 18 showed substantial improvement in their symptoms.

The benefits of physical activity, such as prevention of heart disease and osteoporosis, are well known, so it is not too surprising that a link can also be shown with total mortality. Follow up for seven years of 40 000 women aged 55-69 (JAMA 1997;277:1287-92) showed that women who claimed to “do something to keep you fit” had a relative risk of dying of 0.77 compared with women who said they did “nothing.”

Also in JAMA (1997;277:1293-8) were some data extracted from the multiple risk factor intervention trial in heart disease in the early 1970s. Follow up showed that the numbers who developed end stage renal disease were 14/100 000 in the white men but 44/100 000 in the African Americans, and further analysis showed that the main reasons were the excess of hypertension in the black men and their lower incomes.

Headache and other symptoms attributable to lumbar puncture may be prevented to some …

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