PARIS, September 24 /PRNewswire/ --

- Survey Highlights Need to Follow-up and Manage Both Classical and 
Emerging Cardiometabolic Risk Factors to Change Risk

Results from a survey conducted in 28 countries to coincide with World
Heart Day, 30th September 2007, reveal an increase in physician awareness
about the link between too much fat around the waist (abdominal obesity) and
the development of diabetes and heart disease.(1) However the study
indicates that physicians are still more likely to screen and manage
classical cardiovascular and metabolic risk factors such as type 2 diabetes,
high levels of bad cholesterol and high blood pressure than emerging risk
factors such as abdominal obesity, low levels of good cholesterol
(HDL-Cholesterol) and high levels of fat in the blood (also known as
triglycerides). Additionally over 80 percent of physicians feel their
patients are not adequately educated about how they can reduce risk factors
for cardiovascular and metabolic diseases (cardiometabolic risk) in order to
lower their risk.

(Logo: http://www.newscom.com/cgi-bin/prnh/20070924/274348-a )

(Logo: http://www.newscom.com/cgi-bin/prnh/20070924/274348-b )

Global cardiometabolic risk represents the overall risk of developing
type 2 diabetes and heart disease, which is due to a cluster of modifiable
risk factors such as: high blood sugar, unhealthy cholesterol (high levels of
LDL- or low levels of HDL-cholesterol in the blood), high levels of
triglycerides in the blood, high blood pressure or too much fat around the
waist (as measured by waist circumference).(2,3) Recent evidence has
shown that this cluster of modifiable factors can increase the risk of people
developing type 2 diabetes and heart disease.(2,3) Therefore it is important
that these cardiometabolic risk factors are measured regularly in order to
assess the risk of type 2 diabetes and heart disease and to provide the basis
for intervention with preventive therapies.

Results released today from the Shape of the Nations 2007 survey show
that about three-quarters of physicians rate classical risk factors such as
type 2 diabetes, high blood pressure, smoking and high of LDL-cholesterol
(bad cholesterol) as the highest risk for heart disease. However they are
considerably less likely to state a high level of concern for emerging
cardiometabolic risk factors that put their patients at risk, such as
abdominal obesity, high levels of triglycerides in the blood and low levels
of HDL-cholesterol (good cholesterol).

The survey also demonstrates that only six percent of the general
population and 11 percent of at-risk patients recognise that type 2 diabetes
is a cardiometabolic risk factor. Furthermore, only about one in three
at-risk patients reported that their doctor or nurse had ever measured
emerging cardiometabolic risk factors.

"Heart disease and stroke are largely preventable if the main risk
factors, including high blood pressure, high levels of cholesterol and blood
glucose, tobacco use, inadequate intake of fruit and vegetables, overweight
and obesity, and physical inactivity are reduced," said Professor Sidney
Smith, Chairman of the World Heart Federation's Scientific Advisory Board.

"The results of the Shape of the Nations 2007 Survey demonstrate the need
for continuing education, assessment and follow up of risk factors. On World
Heart Day we're calling for physicians worldwide to team up with their
patients and support them in living longer, healthier lives," said Professor
Smith.

Shape of the Nations 2007

Shape of the Nations 2007 is a joint initiative between sanofi-aventis,
the World Heart Federation, the International Association for the Study of
Obesity and the International Diabetes Federation and coincides with World
Heart Day each year. This year's World Heart Day under the theme "Team Up for
Healthy Hearts", encourages people to join together and create heart-healthy
communities. Communities - from families to schools, social groups,
workplaces and religious circles - can encourage smoke-free environments,
regular physical activity and healthy food choices. World Heart Day falls on
30th September this year and is run by the World Heart Federation and its
member organisations in over 100 countries. For more information visit
http://www.worldheartday.com

Over 11,000 people across 28 countries took part in the Shape of the
Nations 2007 Survey.(1) The survey assessed awareness, understanding and
behaviours with respect to cardiometabolic risk factors, across three groups:
primary care physicians, a population at-risk for heart disease and the
general population.

A high percentage of primary care physicians are able to identity
classical risk factors for heart disease - such as high blood sugar, high
levels of bad cholesterol, high blood pressure and smoking. The survey showed
that recognition of high blood pressure as a cardiometabolic risk factor has
increased to 71 percent from 57 percent in 2006, 68 percent of physicians
recognise general obesity as a risk factor versus 61 percent in 2006 and 64
percent recognise smoking versus 43 percent in 2006.

However, only 24 percent of physicians recognize abdominal obesity as a
cardiometabolic risk factor, 24 percent recognise high levels of
triglycerides in the blood and 12 percent recognize low levels of good
cholesterol as cardiometabolic risk factors

Results from the Shape of the Nations 2007 Survey show that while
physicians recognize and treat classic cardiovascular risk factors, fewer
than two-thirds regularly assess and follow-up emerging cardiometabolic risk
factors. Physicians still routinely measure more of the classical risk
factors such as high blood pressure (96 percent), high blood sugar (87
percent) and high levels of bad cholesterol (79 percent) than emerging risk
factors: such as abdominal obesity (66 percent), low levels of good
cholesterol (72 percent) and high levels triglycerides in the blood (76
percent). In addition to a need for further education, these results
highlight the need for patients to team up with their doctors to measure and
regularly follow-up the emerging cardiometabolic risk factors as well as
classical cardiovascular risk factors. This is easily achieved through a five
point healthy heart check which includes waist circumference, blood sugar,
good and bad cholesterol, blood fat and blood pressure.

Abdominal obesity and cardiometabolic risk factors

Current clinical strategies for the management of heart disease still
focus on treating individual risk factors. Despite major advances in reducing
the prevalence of certain well recognized risk factors, such as smoking, high
cholesterol, high blood pressure and diabetes and other emerging risk
factors, it is estimated that nearly a third of all deaths every year are
still caused by heart disease.(4) In addition, 246 million people worldwide
currently have type 2 diabetes and the number of people affected is expected
to reach 380 million by 2025.(5) Every year, nearly four million deaths are
attributable to diabetes.(6)

Cardiometabolic risk factors tend to
cluster with the dominant feature being abdominal obesity (easily measured by
waist circumference).(2,3) Studies show that people with a cluster of
cardiometabolic risk factors known as the metabolic syndrome have an elevated
global cardiometabolic risk, i.e. more than double the risk of developing
atherosclerotic cardiovascular disease events and nearly a five-fold risk of
developing type 2 diabetes, compared to those without any cardiometabolic
risk factors..(7,8). Emerging cardiometabolic risk factors, such as low
levels of good cholesterol (HDL - Cholesterol) and high levels of
triglycerides in the blood, are frequently found among people with abdominal
obesity, especially those with excessive intra-abdominal adiposity.(9)

Emerging risk factors, such as low HDL-cholesterol and
elevated triglycerides, are frequently found among people with abdominal
obesity, especially those with excessive intra-abdominal adiposity.(10)
Recently, research has identified the endocannabinoid system (ECS), a network
of receptors throughout the body that tends to be overactive in individuals
who struggle with weight and weight-related health risks. This over-activity
contributes to high blood glucose, an unhealthy lipid profile and the storage
of fat as excess weight and midsection weight. (11,12,13,14)

Change My Risk for a Healthy Heart

The Shape of the Nations 2007 Survey findings demonstrate a clear need
for education among both patients and physicians to better understand
cardiometabolic risk factors. It is particularly important that people with
abdominal obesity who are at risk of type 2 diabetes or heart disease have
regular 5-point healthy heart check for waist circumference, blood sugar,
good and bad cholesterol, blood fat and blood pressure so that their doctor
can follow-up all their cardiometabolic risk factors and take action to
reduce global cardiometabolic risk and change their risk.

Notes to the Editor

Survey Methodology

The Shape of the Nations 2007 survey, funded by sanofi-aventis and
endorsed by the World Heart Federation, was carried out with the main aim of
assessing awareness, understanding and behaviours with respect to
cardiometabolic risk factors. The survey involved 11,183 participants in 28
countries and was conducted via telephone or in-person interviews among three
target audiences:

- General population (approximately 200 participants per country except
US = 400, Malaysia =150), total of 5,796 interviews

- At-risk population identified as being at-risk for heart disease due to
being overweight or obese (approximately 80 per country except US = 400,
Malaysia = 60), total of 2,556 interviews

- Primary care physicians (approximately 100 participants per country
except Canada = 130, Malaysia = 70), total of 2,831 interviews

The countries surveyed were:

    1. Australia            11. Greece             21. South Korea
    2. Austria              12. Hungary            22. Spain
    3. Belgium              13. Ireland            23. Sweden
    4. Brazil               14. Italy              24. Switzerland
    5. Canada               15. Malaysia           25. Taiwan
    6. Czech Republic       16. Mexico             26. Turkey
    7. Denmark              17. Norway             27. United Kingdom
    8. Finland              18. Portugal           28. United States
    9. France               19. Russia	
    10. Germany             20. South Africa



About sanofi-aventis

Sanofi-aventis is one of the world leaders in the pharmaceutical
industry, ranking number one in Europe. Backed by a world-class R&D
organisation, sanofi-aventis is developing leading positions in seven major
therapeutic areas: cardiovascular, thrombosis, oncology, metabolic diseases,
central nervous system, internal medicine and vaccines. Sanofi-aventis is
listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY).

About the World Heart Federation

The World Heart Federation, a non-governmental organization based in
Geneva, Switzerland, is committed to helping the global population achieve a
longer and better life through prevention and control of heart disease and
stroke, with a particular focus on low and middle-income countries. It is
comprised of 195 member societies of cardiology and heart foundations from
100 countries covering the regions of Asia-Pacific, Europe, the Americas and
Africa. For further information visit: http://www.worldheart.org

References

(1) Shape of the Nations Survey, 2007. Conducted by IFOP North America.
Data on file sanofi-aventis

(2) Vasudevan AR, Ballantyne CM. Cardiometabolic risk assessment; an
approach to the prevention of cardiovascular disease and diabetes mellitus.
Clin Cornerstone 2005; 7:7-16.

(3) Université Laval. Establishment of a Chair on Cardiometabolic Risk.
(press release on the Internet) Ontario, C2006. (last accessed 6th July 2006)
Available from:
http://www.scom.ulaval.ca/communiqués.de.presse/2006/mars/Chair_Cardiometabol
ic_Risk.htm.

(4) World Health Organization. Cardiovascular Disease - Prevention and
Control. (fact sheet on the Internet) Geneva: 2007. (last accessed 21st April
2007). Available from:
http://www.who.int/dietphysicalactivity/publications/facts/cvd/en/

(5) International Diabetes Federation. Diabetes e-atlas 3rd Edition.
(Publication on the Internet). Brussels; 2006 (cited 29th March 2007)
Available at: http://www.eatlas.idf.org/webdata/docs/At%20a%20glance_lg.jpg

(6) International Diabetes Federation. Diabetes e-atlas 3rd Edition.
(Publication on the Internet). Brussels; 2006 (cited 21st April March 2007)
Available at:
http://www.idf.org/home/index.cfm?unode=3B96906B-C026-2FD3-87B73F80BC22682A

(7) Malik S, Wong ND, Franklin SS, Kamath TV, L'Italien GJ; Pio JR et al.
Impact of the metabolic syndrome on mortality from coronary heart disease,
cardiovascular disease, and all causes in United States adults. Circulation
2004; 110:1245-50.

(8) Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic
Syndrome as a Precursor of Cardiovascular Disease and Type 2 Diabetes
Mellitus. Circulation 2005; 112:3030-2.

(9) Wajchenberg, BL. Subcutaneous and visceral adipose tissue: Their
relation to the metabolic syndrome. Endocr Rev 2000; 21:697-738.

(10) Sharma, A. M. Adipose tissue: a mediator of cardiovascular risk.
International Journal of Obesity, 2002, 26, S5 - S7

(11) Di Marzo V, Matias I. Endocannabinoid control of food intake and
energy balance. Nat Neurosci. 2005 8:585-9

(12) Osei-Hyiaman D, DePetrillo M, Pacher P, Liu J, Radaeva S, Batkai S,
et al. Endocannabinoid action at hepatic CB1 receptors regulates fatty acid
synthesis: role in diet-induced obesity. J Clin Invest. 2005;115:1298-1305.

(13) Catalano KJ, Bergman RN, Ader M. Increased susceptibility to insulin
resistance associated with abdominal obesity in aging rats. Obesity Research.
2005; 13:11-20

(14) Pouliot MC, Després JP, Lemieux S, et al. Waist circumference and
abdominal sagittal diameter: best simple anthropometric indexes of abdominal
visceral adipose tissue accumulation and related cardiovascular risk in men
and women. Am J Cardiol 1994;73:460-8