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

This review provides a scientific assessment of current knowledge of health effects of soybean oil (SBO) and sunflower oil (SFO). SBO and SFO both contain high levels of polyunsaturated fatty acids (PUFA) (60.8 and 69%, respectively), with a PUFA:saturated fat ratio of 4.0 for SBO and 6.4 for SFO. SFO contains 69% C18:2n-6 and less than 0.1% C18:3n-3, while SBO contains 54% C18:2n-6 and 7.2% C18:3n-3. Thus, SFO and SBO each provide adequate amounts of C18:2n-6, but of the two, SBO provides C18:3n-3 with a C18:2n-6:C18:3n-3 ratio of 7.1. Epidemiological evidence has suggested an inverse relationship between the consumption of diets high in vegetable fat and blood pressure, although clinical findings have been inconclusive. Recent dietary guidelines suggest the desirability of decreasing consumption of total and saturated fat and cholesterol, an objective that can be achieved by substituting such oils as SFO and SBO for animal fats. Such changes have consistently resulted in decreased total and low-density-lipoprotein cholesterol, which is thought to be favorable with respect to decreasing risk of cardiovascular disease. Also, decreases in high-density-lipoprotein cholesterol have raised some concern. Use of vegetable oils such as SFO and SBO increases C18:2n-6, decreases C20:4n-6, and slightly elevated C20:5n-3 and C22:6n-3 in platelets, changes that slightly inhibit platelet generation of thromboxane and ex vivo aggregation. Whether chronic use of these oils will effectively block thrombosis at sites of vascular injury, inhibit pathologic platelet vascular interactions associated with atherosclerosis, or reduce the incidence of acute vascular occlusion in the coronary or cerebral circulation is uncertain. Linoleic acid is needed for normal immune response, and essential fatty acid (EFA) deficiency impairs B and T cell-mediated responses. SBO and SFO can provide adequate linoleic acid for maintenance of the immune response. Excess linoleic acid has supported tumor growth in animals, an effect not verified by data from diverse human studies of risk, incidence, or progression of cancers of the breast and colon. Areas yet to be investigated include the differential effects of n-6- and n-3-containing oil on tumor development in humans and whether shorter-chain n-3 PUFA of plant origin such as found in SBO will modulate these actions of linoleic acid, as has been shown for the longer-chain n-3 PUFA of marine oils.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Food use and health effects of soybean and sunflower oils. 195 19

Low-dose aspirin has been postulated to decrease risks of cardiovascular disease by affecting atherosclerotic progression as well as acute thrombosis. In the Physicians' Health Study, a randomized double-blind placebo-controlled trial of alternate day aspirin (325 mg), 22,071 apparently healthy male physicians were treated and followed over a period of 5 years for the occurrence of myocardial infarction and of new angina pectoris. In an analysis of the cumulative incidence and cumulative relative risks of these end points, it was found that the full protective effect of aspirin in reducing the risk of myocardial infarction is apparent soon after initiation of therapy and does not change over time. In contrast, long-term aspirin therapy has no apparent role in decreasing the risk of developing future angina pectoris. Taken together, these clinical observations support the hypothesis that the primary effect of prophylactic low-dose aspirin therapy is to inhibit acute thrombosis, but do not support the hypothesis that long-term platelet inhibition for a duration of up to 5 years slows the initiation and progression of atherosclerosis.
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PMID:The effect of chronic platelet inhibition with low-dose aspirin on atherosclerotic progression and acute thrombosis: clinical evidence from the Physicians' Health Study. 195 53

Elevated plasma levels of low density cholesterol and their major apolipoprotein (apo B) are associated with an increased risk of coronary artery disease (CAD). We have examined allele frequencies of restriction fragment length polymorphisms (RFLP) of the apo B gene in 111 male Caucasians with premature CAD (mean age 49 +/- 7 years) and in 122 elderly Caucasian males (mean age, 73 +/- 5 years), free of clinical cardiovascular disease. The rare allele (R1) of the EcoR1 RFLP in exon 29, resulting in an amino acid change (Glu----Lys4154) was seen more frequently in CAD than in controls (0.270 vs 0.207, P less than 0.05). The R1 RFLP and the MspI insertion polymorphisms (MI) within the 3' hypervariable region (HVR) were observed together in 87% and are likely in linkage disequilibrium. The MI RFLP were slightly more frequent in CAD than control (0.239 vs. 0.211, P = 0.08). A second MspI RFLP in exon 26 results in an amino acid change (Arg----Glu3611); the rare allele M2 was seen more frequently in patients than in controls (0.150 vs. 0.057, P less than 0.005). No significant differences in allele frequencies were observed for the Xba1 RFLP in exon 26 (0.500 vs. 0.529, P = ns) or for the PvuII RFLP near the 5' end (P2) (0.105 vs. 0.088, P = ns). No statistically significant differences in lipid, lipoprotein cholesterol or apolipoproteins A-I and B were observed in patients or in controls. Two of the RFLPs examined (R1 and M2) result in changes in amino acid sequence and their allele frequencies are increased in CAD cases when compared with controls. Genetic variability within the apo B gene may thus contribute to cardiovascular risk. The physiological effects of individual mutations within apo B remain to be determined. It is unlikely, however that the single site polymorphisms examined in this study, will impart further information about CAD risk than conventional lipid parameters.
Atherosclerosis 1990 May
PMID:DNA polymorphisms of the apolipoprotein B gene in patients with premature coronary artery disease. 197 79

A "male" distribution of adipose tissue in women (excess of fat in the abdomen compared with that in the hips; i.e., elevated waist/hip ratio) has been related to symptomatic cardiovascular disease. An elevated waist/hip ratio has also been related to symptomatic cardiovascular and cerebrovascular diseases in men, as well as to risk factors for these diseases and various metabolic conditions. To determine whether adipose distribution was related to coronary atherosclerosis, we performed a case-control study in patients with angiographically documented coronary atherosclerosis (cases) and in angiographically normal hospital and neighborhood controls. The data show that distribution of adiposity as assessed by waist/hip ratio is significantly related to coronary atherosclerosis in both females and males. Waist/hip ratio is significantly greater in female cases compared with either control group; in males, waist/hip ratio is significantly greater in cases compared with asymptomatic neighborhood controls but not compared with patients with normal coronary arteries. These results persist after control for age, plasma concentrations of lipids and lipoproteins, body mass index, history of hypertension, history of diabetes, and smoking status. The connection between the male adipose distribution in females and coronary atherosclerosis partly explains the greater likelihood of symptomatic cardiovascular disease in them. Males with excess deposition of fat in the abdominal region are also likely to experience increased risk.
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PMID:Central adipose distribution is related to coronary atherosclerosis. 199 50

The clinical manifestations of atherosclerosis, such as stroke and coronary heart disease, are the major cause of death and disability in the western world. Recent technological progress in cell and molecular biology have provided new opportunities of studying the basic biological mechanisms involved in atherogenesis. Several lines of evidence suggest that the macrophage accumulation of cholesterol in atherosclerotic plaques occur as a result of lipid peroxidation. Macrophages lack a receptor for normal low density lipoprotein (LDL), but express a high affinity receptor for oxidized LDL - the scavenger receptor. Oxidized LDL has also been found to be cytotoxic to endothelial cells and to promote the adhesion of monocytes to the endothelium. Growth in plaque size is chiefly due to a proliferation of smooth muscle cells. Studies using a variety of hybridization techniques have demonstrated expression of different growth factor genes in atherosclerotic plaques. It has also been shown that cultured smooth muscle cells have the capacity to produce growth factors, and that this production is subject to factors associated with known risk factors for cardiovascular disease.
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PMID:[Atherosclerosis--the molecular background]. 199 71

Hypertension and atherosclerosis make independent contributions to the pathogenesis of cardiovascular disease. Diuretics and beta adrenergic blockers, effective antihypertensive medications, exhibit some untoward effects on lipid metabolism, while most other antihypertensive medications tend not to exhibit such effects. In animal models, beta adrenergic blockers, angiotensin converting enzyme (ACE) inhibitors, and calcium antagonists have anti-atherogenic effects. A vascular biological approach to therapy for the patient with both hypertension and atherosclerosis is recommended. This includes effective reduction of blood pressure--preferably with agents that do not adversely affect lipid metabolism--and treatment of lipid metabolism disorders.
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PMID:Antihypertensive therapy and atherosclerosis. 203 28

We present the clinical and laboratory findings of 8 patients with cerebrotendinous xanthomatosis. The clinical features consisted of a combination of bilateral Achilles tendon xanthomas, cataracts, low intelligence, pyramidal signs, cerebellar signs, convulsions, peripheral neuropathy, foot deformity, cardiovascular disease or atherosclerosis, EEG abnormality, and increased CSF protein. Increased cholesterol was present in the serum, CSF and red cell membrane of all 8 patients. The bile of one patient with late age onset of the disease showed an attenuated production of bile acids and bile alcohols. Three of the 7 had obstruction and/or marked narrowing of the coronary arteries. Data on 136 patients reported throughout the world are reviewed.
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PMID:Cerebrotendinous xanthomatosis: clinical and biochemical evaluation of eight patients and review of the literature. 207 21

In 1972, the Brisighella Study was initiated to monitor the spontaneous trend of risk factors for atherosclerosis and the incidence of coronary heart disease (CHD) in a rural population. This study, which is one of the largest Italian studies on the epidemiology of atherosclerosis and cardiovascular disease, established a strong correlation between increased cholesterol levels and the incidence of CHD. The apparent unwillingness of the population to alter dietary and exercise habits independently led the researchers to establish the Brisighella Heart Study in 1984. This study attempted to reduce the risk of CHD by modifying the population's dietary habits through a nutritional education program. While the nutritional education program succeeded in lowering total cholesterol, a segment of the population still remained at risk. At this point, the high-risk strategy arm of the study was initiated. In 1988, those participants whose total cholesterol level was greater than 239 mg dl-1 were started on a twice-daily regimen of 600 mg of gemfibrozil. The Brisighella Heart Study High-Risk Project will continue for at least 5 years, during which all participants will be followed-up every 6 months and all fatal and non-fatal events will be recorded.
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PMID:The Brisighella Heart Study: an interim report. 207 12

We investigated the association of elevated serum low density lipoprotein (LDL) cholesterol levels, smoking and hypertension with different manifestations of carotid atherosclerosis in a population-based sample of 720 Eastern Finnish men aged 42, 48, 54 or 60 years, examined in the Kuopio Ischaemic Heart Disease Risk Factor Study. Carotid atherosclerosis was assessed with high-resolution B-mode ultrasonography. Men who had neither a history nor symptoms of cardiovascular disease with serum LDL cholesterol concentration in the highest tertile (4.17 mM or more) had 3.40-fold (95% confidence interval (CI) 1.98-5.84) age-, smoking- and hypertension-adjusted probability of intimal-medial thickening as compared to men in the lowest serum LDL cholesterol tertile. The odds ratio for carotid plaque versus intimal-medial thickening was only 1.03 (95% CI 0.47-2.28). The respective odds ratios for smoking (28 pack-years or more) were 1.62 (95% CI 0.79-3.32) and 3.02 (95% CI 1.41-6.47) and those for hypertension were 1.10 (95% CI 0.70-1.73) and 0.99 (95% CI 0.53-1.84). Our findings suggest that elevated serum LDL cholesterol concentration associates with an increased risk of common carotid arterial wall thickening, whereas smoking is associated more strongly with carotid plaques than intimal-medial thickening. Our cross-sectional data do not support association between hypertension and either manifestation of carotid atherosclerosis.
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PMID:Association of serum low density lipoprotein cholesterol, smoking and hypertension with different manifestations of atherosclerosis. 208 21

Current findings and controversies between oral contraceptives (OCs) and cardiovascular disease and cancers. Specifically, venous thromboembolism, stroke, myocardial infarction, (MI), atherosclerosis, breast cancer, cervical cancer, endometrial cancer, and ovarian cancer are reviewed. The concentration in the literature is on higher dose estrogen (at least 50 mg) studies which suggest that there is with current users, particularly older women who smoke, a risk of myocardial infarction, venous thrombosis, and subarachnoid hemorrhage. Of the 11 case control studies and 4 cohort studies it appears that venous thrombosis increases in risk with an increase in estrogen content and remains constant for duration of use. However, definitive studies have not been completed on 50 mg doses of ethinyl estradiol (EE) and mestranol (ME). The actual individual risk may be small, 1/1000 current users/year. Thrombotic and hemorrhagic stroke in the 1970s had a risk of 37/100,000 users per year, mostly among smokers 35 years and older with predisposing medical conditions. It is suggested that although there were mixed findings between current and past users in the 1970s low dose current or past users are not substantially at risk. The pre-mid 1970 risk of MI was 7 and 67 cases/100,000 current users ged 30-39 respectively per year. The risk group is similar to stroke. Thrombosis seems to be responsible for the increased risk, rather than atherosclerosis. More data are needed on low preparations; however limited findings suggest little if any risk. There is no available data on the risk for coronary artery atherosclerosis due to OC use, even though 50% of all women die from atherosclerosis-related processes regardless of OC use. Non human primate studies, however, suggest that there may be a reduced risk, perhaps due to the presence of estrogen receptors in arterial endothelium and smooth muscles. Data clearly indicate that the overall risk of breast cancer pre and post 1950 is the same, but age may be a factor with younger OC users at risk; parity protects. The association for lifetime risk, however, cannot be determined since most use occurred in the 1960s. For cervical cancer, 8 found no increased risk and 9 did, and the suggestion is the 5 years use is related to increased risk. Biases related to sexual behavior confound control and analysis of data. The most common cancer in developing countries is cervical, which warrants greater Pap smear screening to reduce this preventable cancer. Protection from cancer of the endometrium occurs for 15 years following 12 months of OC use at a 40% reduced risk. A protected effect is also found for epithelial ovarian cancer, with a 40% risk reduction. It is concluded that health benefits of OCs far exceed the health risks.
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PMID:Long-term health risks and benefits of oral contraceptive use. 209 41


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