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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Corpulent male rats of the atherosclerosis prone JCR:LA-corpulent strain were fed diets supplemented with 10% by weight of olive oil or red fish oil. These rats are obese, with VLDL hyperlipidemia and marked insulin resistance. The diets were maintained to 9 months of age. Olive oil-fed rats had a 45% reduction in triglyceride concentrations with no significant changes in cholesterol or phospholipids. Red fish oil caused significant reduction in all lipid classes, with a 65% reduction in triglycerides and 35% reduction in cholesterol concentrations. Olive oil caused increases in the relative concentrations of oleic acid-containing triglycerides, while red fish oil preferentially enriched the longer chain fatty acids. There were no significant changes in insulin or glucose metabolism. The incidence of myocardial lesions, characteristic of the JCR:LA-cp strain, was unaltered by either oil-supplemented diet. These results, in a spontaneous animal model for cardiovascular disease, are consistent with other studies showing that diets rich in n-3 fatty acids do not, in themselves, confer protection against cardiovascular disease in animal models with genetically or experimentally induced lipid disorders.
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PMID:Effect of dietary n-3 fatty acids on atherosclerosis prone JCR:LA-corpulent rats. 174 17

The relationships between emotional status, neurohormonal control and the cardiovascular function are reviewed. In the first part of this paper, we reviewed (1) the pathways between brain and heart, physiology of the defense reaction and the role of the autonomic nervous system in the mediation of the effects of stress; (2) the cardiac manifestations of emotional stress, and (3) the role of stress and the influence of circadian variations in the occurrence and development of myocardial ischemia, myocardial infarction and sudden death. In the second part, we discussed the relationship between behavior, coronary heart disease and particularly the role of the so-called type A behavior and hostility. Finally, we emphasize the importance of life-style changes to improve the prognosis of coronary disease and to limit the progression and ultimately to cause a regression of atherosclerosis. Thus, it appears that a transdisciplinary approach associating cardiologists, neuroscientists and behavior scientists will help to devise more effective strategies for the prevention and early therapy of cardiovascular disease.
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PMID:The effects of stress, emotion, and behavior on the heart. 176 51

Medical writings on cardiovascular disease focus on intravascular pressures. Tissue pressure is assumed to be essentially atmospheric. Yet, under dynamic conditions of sitting, standing, walking, breathing, and the beating of the heart, significant pressures, both above and below atmospheric, do develop outside of important arteries. These dynamic extra-arterial pressures either decrease or increase the pressure gradients across arterial walls, i.e. the transmural pressures are changed. Physical fitness may either prevent the development of negative extra-arterial pressure or increase positive extra-arterial pressure, thereby protecting important arteries from high effective pressures. Deconditioning, old age, abdominal obesity, and other cardiovascular disease risk factors may do just the opposite, in effect, causing 'localized hypertension' in clinically important arteries. This, in turn, may lead to localized acceleration of atherosclerosis. The correlation of predictions made from this hypothesis with clinical findings is so remarkable that it suggests there is a direct cause and effect relationship between transmural arterial pressure and atherosclerosis. The concept of dynamic extra-arterial pressure seems to solve a number of puzzles and paradoxes in cardiovascular disease, it suggests key measurements that may be predictive of disease, and it offers new ideas for treatment and prevention.
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PMID:Physical fitness, dynamic extra-arterial pressures, and the pathogenesis and distribution of atherosclerosis. 178 17

Recent prospective investigations have reported that higher plasma fibrinogen concentrations and higher factor VII coagulant activity are associated with greater risk of cardiovascular disease. To discover what characteristics may influence fibrinogen and factor VII, we analyzed data from the Atherosclerosis Risk in Communities Study obtained from over 12,000 men and women, aged 45-64 years, from four communities in December 1986 to June 1989. Fibrinogen was higher in blacks than whites and in women than men; in general, it increased with age, smoking, body size, diabetes, fasting serum insulin, LDL cholesterol, lipoprotein(a), leukocyte count, and menopause, and it decreased with ethanol intake, physical activity, HDL cholesterol, and female hormone use. Factor VII was higher in women than men and, in women, increased with age; in both sexes, it increased with body size, triglycerides, LDL cholesterol, and HDL cholesterol, and it decreased with ethanol intake. These findings indicate that elevations in fibrinogen and factor VII may be modifiable through appropriate lifestyle changes.
Atherosclerosis 1991 Dec
PMID:Population correlates of plasma fibrinogen and factor VII, putative cardiovascular risk factors. 178 4

Numerous intervention trials have demonstrated clear benefits when patients with hypertension have been treated with antihypertensive drugs. During the last five years, however, community-based studies from Dalby, Gothenburg and Glasgow have reported a high remaining risk of cardiovascular (especially cardiac) disease, even though the hypertensive patients have been well cared for and their blood pressure controlled. There may be several possible explanations for the high remaining risk. First, long-standing hypertension may have caused irreversible cardiovascular change and atherosclerosis, which contribute to the increased risk even when the elevated arterial blood pressure has been reduced to normotensive levels. Another possible explanation is that the antihypertensive drugs themselves, in addition to their desired and beneficial antihypertensive effect, have some adverse effects. Thus, by elevating serum lipoproteins or by lowering serum potassium, some agents could increase the risk of cardiovascular complications and, to a certain extent, offset the beneficial effects of lowering blood pressure. Different drugs may, of course, also differ in their ability to prevent cardiovascular disease. In the studies mentioned above, blood pressure had not been reduced to strictly normotensive levels. This may be a third reason for the high remaining risks. A fourth possibility is that other metabolic factors may be implicated, and it may be necessary to tackle other, non-biological factors, such as smoking, stress and unemployment, in order to reduce the excess risk in hypertensive patients. It is clearly necessary to focus on the overall risk profile of the patient, including smoking and alcohol habits, cholesterol level, diet, weight, etc., rather than the blood pressure level alone.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cardiovascular risk factors and their interactions in hypertensives. 179 97

Health workers took blood samples from 41 black women living in the greater Harare area of Zimbabwe before they began taking a combines oral contraceptive (OC) with 30 mcg ethinyl estradiol and 150 mg desogestrel (Marvelon formulation) and 3, 6, 9, and 12 months after taking it to conduct metabolic tests. They also recruited 190 other black women from Harare and rural Chiweshe, Mazowe, and Domboshawa populations taking the same new generation progestogen-containing OC to determine the efficacy, acceptability, and safety of the OC. Only high density lipid (HDL) cholesterol levels rose considerably between pretreatment and 12 months (0.94-1.3 mmol/ml; p.05). Low density lipid (LDL) cholesterol levels remained basically the same. This accounted for the significant rise of the HDL cholesterol/LDL cholesterol ratio over 12 months from 0.41 to 0.61. Triglyceride levels did not rise significantly and always stayed within the normal range. No woman became pregnant during the clinical trial. 2% experienced minor side effects including backache, spotting, headache, and nausea. Body weight and blood pressure did not change significantly. Sociodemographic reasons accounted for the high dropout rate (60%). The leading reason was change of address since many women were migrant farm workers. Since HDL levels rose and LDL levels were the same, this OC appears to have a reduced risk of atherosclerosis and cardiovascular disease. The findings indicated that the Marvelon formulation OC did not adversely affect lipid metabolism and therefore did not increase the risk of atherosclerosis or cardiovascular disease among these women. It also effectively protected them from pregnancy and induced minimal side effects.
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PMID:Evaluation of a combined oral contraceptive pill in black Zimbabwean women. 180 54

Estrogen replacement therapy may offer significant benefits to nearly all postmenopausal women, especially those for whom the menopause occurred at an early age. Women at high risk for atherosclerosis, or who already have cardiovascular disease, may particularly benefit from estrogen use. The increased risk for endometrial and breast cancer seen with estrogen replacement therapy is low in comparison with its protective effect against cardiovascular disease. For women who cannot or choose not to take estrogens, etidronate may be of value in preventing osteoporotic fractures. For women many years beyond menopause who consume low-calcium diets, calcium supplementation should be recommended.
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PMID:Menopause: advanced management strategies. 181 2

The major risk factors for cardiovascular disease include hypertension, hyperlipidemia, hyperinsulinemia and smoking. They promote the development of atherosclerosis and thromboembolic complications, i.e. strokes and heart attacks. There are diverse interactions between these factors, the outstanding common denominator being alterations in serum lipoproteins, mainly elevated low-density lipoprotein (LDL)-cholesterol and reduced high-density lipoprotein (HDL)-cholesterol concentrations, which results in disturbed cholesterol homeostasis (transport and metabolism) and eventually in perturbations of cellular integrity/function. In addition to their roles as cholesterol-transporting molecules, LDL and HDL directly influence inter- and intracellular communication via stimulation of pivotal signal transduction processes. The 'hormonal' effects of LDL on platelets, endothelial cells and vascular smooth muscle cells are potentially harmful, whereas the effects of HDL may be protective in as much as HDL can antagonize LDL-mediated stimulation of cells. Therapy aimed at reducing serum LDL-cholesterol levels and increasing HDL-cholesterol levels will have multifactorial beneficial effects on cardiovascular disease.
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PMID:Low- and high-density lipoproteins as hormonal regulators of platelet, vascular endothelial and smooth muscle cell interactions: relevance to hypertension. 181 68

A comparison of the effects of two low-dose oral contraceptives on lipid metabolism was undertaken in an open-group comparative design study at the Family Planning Clinic, Groote Schuur Hospital, Cape Town. Sixty healthy women aged 18-35 years requesting oral contraception were allocated alternately to use a monophasic oral contraceptive containing 30 micrograms ethinyloestradiol and 150 micrograms desogestrel (Marvelon, group A), or a triphasic oral contraceptive containing 30-40 micrograms ethinyloestradiol and 50-125 micrograms levonorgestrel (Triphasil, group B). The changes in the lipoprotein profile elicited by the two preparations differed significantly. Group A subjects had a much greater triglyceridaemic response (42.4%) than group B (14.6%) and had a significant increase in high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-1 (Apo-A1). In group B, HDL-C decreased and Apo-A1 showed little change. Non-HDL-C (NHDL-C) and Apo-B levels hardly changed in either group. The atherogenic ratios, NHDL-C/HDL-C and Apo-B/Apo-A1 were higher in group B. This study confirmed a significant difference in the response of plasma lipoproteins to the two oral contraceptive preparations. The evidence suggests that the desogestrel-containing oral contraceptive elicits a less atherogenic lipoprotein profile than does the levonorgestrel-containing preparation. Although unsupported by direct clinical evidence that changes in the lipoprotein pattern induced by oral contraceptives cause atherosclerosis, these effects should be considered when prescribing oral contraceptives for women who have risk factors for cardiovascular disease.
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PMID:The clinical and biochemical effects of two combination oral contraceptive agents. 182 69

The aim of this study was to investigate the long-term results of percutaneous transluminal angioplasty of atherosclerotic renal artery stenosis (PTRA) in patients with renovascular hypertension with or without impending renal insufficiency who were followed up intensively with aggressive reintervention. Diagnostic work-up was based on angiography, pressure gradient and renal venous renin measurement. Patients were scheduled for regular follow-up after the PTRA and a deterioration in blood pressure or renal function was an indication for re-evaluation, and reintervention if necessary. Sixty-five patients had 71 renal artery stenoses where PTRA was attempted. It was technically successful in 59 stenoses and two occlusions and failed in ten (14%). At the end of follow-up (median 56 months [2-99]), the primary patency rate was 55%, 27 had restenosed and four were occluded, all but two within 12 months. Seventeen were treated by a further PTRA and eight by surgical reconstruction. At the end of follow-up the secondary patency after all interventions was 90%. One patient died 1 month after PTRA, and at the end of follow-up 21 patients (32%) had died, most of them (80%) from cardiovascular disease. Multivariate analyses showed a significantly reduced survival rate in patients with multiocular atherosclerosis, renal insufficiency, contralateral renal artery stenosis and ischaemic heart disease. At the end of follow-up 90% of the patients were cured or improved with regard to blood pressure. In patients with impending renal insufficiency renal function was improved in 50% and unchanged in 39%. With this strategy 55% of the patients needed only one treatment with PTRA, 25% needed a re-PTRA and 20% had to be operated on. PTRA can be recommended as initial treatment of atherosclerotic renal artery stenosis provided intensive follow-up and aggressive reintervention are performed when indicated.
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PMID:Long-term results after percutaneous transluminal angioplasty of atherosclerotic renal artery stenosis--the importance of intensive follow-up. 183 Aug 55


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