This study showed that when rimonabant was available, medium term prescription resulted in a non-significant weight loss in morbidly obese patients but was associated with metabolic benefits including improved insulin resistance and lipid profiles consistent with an improvement in hepatic steatosis. A. S. Wierzbicki, 1 S. Pendleton, 2 Z. McMahon, 1 A. Dar, 3 J. Oben, 3 M. A. Crook, 1 A. J. Botha 4 1 Departments of Metabolic Medicine / Chemical Pathology, Guy’s & St Thomas’ NHS Trust, St Thomas Hospital, London, UK 2 Departments of Nutrition & Dietetics, Guy’s & St Thomas’ NHS Trust, St Thomas Hospital, London, UK 3 Departments of Gastroenterology, Guy’s & St Thomas’ NHS Trust, St Thomas Hospital, London, UK 4 Departments of Bariatric & upper gastrointestinal surgery, Guy’s & St Thomas’ NHS Trust, St Thomas Hospital, London, UK Email: anthony.wierzbicki@kcl.ac.uk References 1 Wierzbicki AS. Rimonabant: endocannabinoid inhibi- tion for the metabolic syndrome. Int J Clin Pract 2006; 60: 1697–706. 2 National Institute for Health and Clinical Excellence. Rimonabant for the treatment of overweight and obese adults. 2008 Report No.: TA144. 3 Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assess- ment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–9. 4 Topol EJ, Bousser MG, Fox KA et al. Rimonabant for prevention of cardiovascular events (CRESCENDO): a randomised, multicentre, placebo-controlled trial. Lancet 2010; 376: 517–23. 5 de Toledo Triffoni-Melo A, Dick-de-Paula I, Portari GV, Jordao AA, Garcia CP, Diez-Garcia RW. Short- term carbohydrate-restricted diet for weight loss in severely obese women. Obes Surg 2010, in press (PMID 20195788). 6 Higgins M, D’Agostino R, Kannel W, Cobb J, Pinsky J. Benefits and adverse effects of weight loss. Observa- tions from the Framingham Study. Ann Intern Med 1993; 119(7 Pt 2): 758–63. 7 Barros F. Biopsy-proven NASH treatment with rimo- nabant: a case series. J Hepatol 2009; 50(Suppl. 1): S355. 8 Torres DM, Harrison SA. Diagnosis and therapy of nonalcoholic steatohepatitis. Gastroenterology 2008; 134: 1682–98. 9 Tam J, Vemuri VK, Liu J et al. Peripheral CB1 can- nabinoid receptor blockade improves cardiometabolic risk in mouse models of obesity. J Clin Invest 2010; 120: 2953–66. Disclosures Dr Wierzbicki was a member of National and International Advisory boards for Sanofi- Aventis on rimonabant in 2005–2008, was UK lead investigator on the ETERNAL trial (2007–2009) and an investigator on the CRESCENDO trial (2007–2009). He also received travel support and lecture honoraria from this source. Supporting Information Additional Supporting Information may be found in the online version of this article: Figure S1. Database characteristics of the retrospective cohort analysis of rimonabant therapy. Table S1. Baseline characteristics of patients adherent to treatment pathway and prescribed rimonabant therapy. Comparisons were performed between the continued and discontinued therapy groups. Table S2. Discontinuations associated with rimonabant therapy. Patients could have more than one reason for discontinuing treatment. Please note: Wiley-Blackwell are not responsible for the content or functionality of any supporting materials supplied by the authors. Any queries (other than missing material) should be directed to the corre- sponding author for the article. doi: 10.1111/j.1742-1241.2011.02683.x LETTER Gender-based cardiometabolic risk evaluation in minority and non-minority men grading the evidence of non-traditional determinants of cardiovascular risk To the Editor: We read with interest the review entitled ‘Gender-based cardiometabolic risk evaluation in minority and non-minority men grading the evidence of non-traditional determinants of cardiovascular risk’ (1). This review high- lights the relevance of surrogate markers for the evaluation of vascular risk. South Asians formed 4% of the UK popu- lation in 2001 and they are at a high risk of vascular events (2,3). We screened 1027 Gujrati Indians (both genders) in faith based settings. Our preliminary analysis (n = 434) shows that at least one modifiable risk factor was present in 92% of those screened, 15% of the participants screened had a 10 year CV risk score >20% using QRISK2. Central adi- posity (according to the 2009 consensus defi- nition of metabolic syndrome) (4) was present in 75% of subjects. Therefore, this population has a high prevalence of metabolic syndrome and central obesity which are dis- cussed in the Billups et al. review (1). In line with the review of Billups et al. (1), we will include some of the surrogate markers of vascular risk in our screening programme. For example, we will measure arterial stiffness, ankle-brachial index and carotid intima media thickness. We will also be using Point of Care Testing (5) to mea- sure glycated haemoglobin and microalbu- minuria. Hopefully, increasing the number of markers of vascular risk will help to estimate risk better in primary prevention as well as to potentially monitor the success of treat- ment in both primary and secondary preven- tion. A. Jain, D. Harvey, L. Robertson, D. P. Mikhailidis, D. R. Nair Department of Clinical Biochemistry, Royal Free Hospital, London Email: anjly.jain@nhs.net References 1 Billupus KK, Miner MM, Wierzbicki AS, Jackson G. Gender-based cardiometabolic risk evaluation in minority and non minority men grading the evidence of non-traditional determinants of cardiovascular risk. Int J Clin Pract 2011; 65: 134–47. 2 Office National Statistics. Population of United King- dom: by ethnic group (2001) http://www.statistics. gov.uk/cci/nugget_print.asp?ID=455 (accessed 24 Feb- ruary 2011). Letters 715 ª 2011 Blackwell Publishing Ltd Int J Clin Pract, June 2011, 65, 6, 713–716