Several doctors say they are worried about possibility of heart attacks because many of arthritis patients taking drugs are elderly and have a higher risk of cardiovascular problems to begin with. The current debate centers on whether higher heart attack rate found in patients taking Vioxx is a result of drug’s actually causing damage in some patients or to an absence of heart-protecting benefits that Naproxen may have.

“Naproxen had a similar anti-platelet effect to aspirin,” said Dr. Eve E. Slater, senior vice president of external policy for Merck’s research labs, “and those people had fewer heart attacks.”

Neither Vioxx nor Celebrex has been shown to have same heart-protecting benefit.

Slater also said that Stover’s report was flawed and biased in favor of Pharmacia. But regulators and some doctors say they still worry that there may be more of a problem with Vioxx. And even if Vioxx and Celebrex do not damage heart, fact that they do not have heart-protecting benefits of aspirin reduces ability of companies to market them as being significantly safer than other pain relievers. Merck recommended last year that doctors involved in clinical trials of Vioxx consider prescribing low doses of aspirin to patients taking Vioxx if they are at high risk of heart attacks - although low doses of aspirin could increase risk of ulcers. Ulcers are main side effect that Vioxx and Celebrex were developed to avoid.

There have been no studies done to determine whether patients have fewer ulcers if they take low doses of aspirin with either Vioxx or Celebrex. In February Dr Maria Lourdes Villalba, at an FDA advisory meeting, stated that Merck had proved Vioxx [Rofecoxib] caused fewer serious ulcers than Naproxen. However, she also state that potential safety advantage was offset by a higher risk of heart problems,in her opinion. She reported that “Overall, there was no safety superiority of Rofecoxib over Naproxen, mainly due to an excess of serious cardiovascular events”.

Dr Villalba also stated that there had been no studies to prove Merck’s claim that Naproxen worked like aspirin in decreasing heart attacks. The FDA expressed some concern over higher rate of heart attacks with Vioxx, stating that this could be caused by drug’s ability to produce blood clots.

“There is still a tremendous benefit with these drugs” reported Dr Eve Slater of Merck.

Margot B, Writer, Web Developer Margot B has written a book and hundreds of articles, specializing in health and the environment.

Treatment for described metabolic syndrome therefore aims at treating all of: features of syndrome that exist in a given woman.

The first step, then, is to identify risk for insulin resistance syndrome—women who are overweight, those who have a parent or sibling with Type II diabetes, women who had diabetes which occurred during pregnancy are more succeptable .

General recommendations :

Because these conditions occur in a cluster, steps you take to bring one of conditions into a healthy range will likely improve others. 1.If you're overweight,try to lose some extra kilos.Losing up to 10 or 15 percent of your current body weight can bring blood pressure down and increase your cells' sensitivity to insulin. 2.If you are sedantry, engage in some vigorous physical activity for 30 minutes or more a day,3-5 times a week . Exercise is an important component of weight loss. It also raises HDL blood levels, even without weight loss. A sedantry lifestyle is responsible for about 25 percent of effect of syndrome X.

3.Aim for a diet moderately low in fat and concentrated sweets or one that has 20% calories as fat, if not more. The Dietary Guidelines recommend to eat 55 percent of total calories from carbohydrates, primarily complex carbohydrates. The key words here are "complex carbohydrates," such as grains, beans and vegetables, rather than sweets and desserts, and total number of calories being consumed--just enough to maintain or achieve desirable weight.

4. In case if pharmacological intervention is required your doctor might prescribe blood pressure medications which will improve insulin sensitivity and have no adverse effects on blood lipids, blood sugar medicines which improve insulin sensitivity and blood lipid levels, blood pressure treatments may be particularly beneficial for kidneys of women with diabetes 5. Other factors include cessation of smoking, and moderation of alcohol intake .

This approach to caring for women with insulin resistance syndrome, that of comprehensive evaluation and risk factor management, is essential if we are to meet and overcome real health danger which accompanies this constellation of metabolic abnormalities—cardiovascular disease.