This is Journal Watch, a medical-literature
survey produced by the Massachusetts Medical
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  Contents copyright 1994, Mass. Medical Society.

Journal Watch Summaries for November 22, 1994.

CAROTENOIDS FOUND TO LOWER RISK FOR MACULAR
DEGENERATION ....
  JAMA 1994 Nov 9; 272:1413-20.

 ... AND CORONARY HEART DISEASE.
  JAMA 1994 Nov 9; 272:1439-41.

ANXIETY IS A RISK FACTOR FOR SUDDEN DEATH.
  Circulation 1994 Nov; 90:2225-9.

RESCUE ANGIOPLASTY AFTER FAILED THROMBOLYSIS.
  Circulation 1994 Nov; 90:2280-4.

WEANING HAS POSITIVE EFFECTS ON MOTHERS.
  Obstet Gynecol 1994 Nov; 84:872-6.

NEW MOLECULAR INSIGHTS INTO ALZHEIMER'S DISEASE.
  Nature 1994 Nov 3; 372:92-4.

APO-E AND CREUTZFELDT-JAKOB DISEASE.
  Lancet 1994 Nov 12; 344:1315-8.

CAROTENOIDS FOUND TO LOWER RISK FOR MACULAR
DEGENERATION ....
   Basic and clinical investigations have suggested that
nutritional factors may be associated with age-related
macular degeneration, the leading cause of irreversible
blindness in the elderly. To test this hypothesis, a
multicenter study compared dietary intake of carotenoids (a
group of antioxidants that includes beta carotene) and of
vitamins A, C, and E in 356 white patients with advanced
age-related macular degeneration and 520 controls from the
same geographic area. All subjects completed questionnaires
about cooking.net">food frequency during the past year.
   People in the highest quintile of carotenoid intake had a
43 percent lower risk for age-related macular degeneration
than those in the lowest quintile. The carotenoids found in
dark green, leafy vegetables were most strongly associated
with decreased risk. Preformed vitamins A (retinol), C, and
E were not statistically associated with decreased risk.
   Comment: This study supports the theory that eating foods
that contain antioxidants lowers the risk for developing
acute macular degeneration. A large trial to test this
theory is planned. --TH Lee.
   Citation: Seddon JM; et al. Dietary carotenoids, vitamins A,
C, and E, and advanced age-related macular degeneration. JAMA
1994 Nov 9; 272:1413-20.

... AND CORONARY HEART DISEASE.
   An article in the same issue of JAMA reports new data
from an older epidemiologic study linking increased serum
carotenoids with a reduced risk for coronary heart disease.
The 1899 subjects were men with hypercholesterolemia, aged
40 to 59, who were drawn from the placebo group of the Lipid
Research Clinics Coronary Primary Prevention Trial and
Follow-up Study. (This study compared cholestyramine with
placebo for prevention of coronary disease over a 13-year
period.)
   Serum carotenoids were measured at baseline. After
adjustment for CHD risk factors, men in the highest quartile
of serum carotenoids had a relative risk for coronary events
of 0.64 as compared with men in the lowest quartile. The
decrease in risk was strongest among those who never smoked
(relative risk, 0.28), but trends among past and current
smokers suggest that carotenoids have a protective effect
for these groups also.
   Comment: This study was not an experiment. It does not
prove that dietary carotenoids reduce the risk for coronary
disease, but it provides new support for the theory that
antioxidants may be useful for this purpose. Readers should
bear in mind that the study population included only men at
high risk for coronary disease; the associations observed
may not be found in other groups. --TH Lee.
   Citation: Morris DL; et al. Serum carotenoids and coronary
heart disease: the Lipid Research Clinics Coronary Primary
Prevention Trial and Follow-up Study. JAMA 1994 Nov 9; 272:1439-
41.