Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

THe records of 78 young adults, who had suffered cerebral infarction, were reviewed with regard to possible pathogenetic mechanisms. Atherosclerosis risk factors appeared to play a major role between the age of 40 and 50, especially in males. Non atherosclerotic factors of cerebral ischemia were found predominant among females under 40, owing to contribution of migraine, oral contraceptive use and pregnancy/puerperium. In 18% of the patients no etiology could be identified.
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PMID:[Juvenile cerebral infarct. Retrospective analysis of risk factors in 78 cases]. 730 Nov 82

Atherosclerosis is the leading cause of death and serious morbidity in economically developed societies through its sequelae of coronary artery and cerebrovascular disease. The causes and mechanisms of atherosclerosis are still largely unknown. Serum levels of a lipoprotein, Lp(a), have been shown, in retrospective and some prospective clinical studies, to be associated with increased risk of myocardial and cerebral infarction. The active part of Lp(a), apo(a), has > 80% homology with plasminogen; thus it may competitively inhibit the thrombolytic action of plasminogen and enhance thrombogenesis. Lp(a) has been shown to be deposited in the vascular wall of the aorta and coronary vessels, but its presence in the cerebral vessels has not yet been shown. Autopsy specimens of vessels of the circle of Willis from 23 patients were examined for degree of atherosclerosis and deposition of apo(a) by immunohistochemistry with apo(a)-specific monoclonal antibodies. The amount of apo(a) deposition in cerebral vessels correlated well with the degree of cerebral atherosclerosis. Arterial deposition of apo(a) was found entirely within the endothelial cell and subendothelial cell layers. There was no staining within the media and adventitia, with the exception of staining within the endothelial cells of the vasa vasorum. Correlation between the morphology of apo(a) deposition and plaque stage was found suggesting that detection of apo(a) in endothelial cells is an early event in the development of the atherosclerotic plaque of cerebral vessels.
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PMID:Apolipoprotein(a) deposition in atherosclerotic plaques of cerebral vessels. A potential role for endothelial cells in lesion formation. 749 81

Calcium antagonists block calcium entry into cells, resulting in relaxation of smooth muscle and limitation of the cytotoxic effects of ischaemia in various organ systems. They are most frequently used for clinical conditions requiring vasodilatation, i.e. hypertension and Raynaud's phenomenon, and this also suggests that the most common adverse effect of these drugs for noncardiovascular indications is an unwanted decline in blood pressure. Other uses include treatment of supraventricular arrhythmias and angina. There is some evidence that these drugs retard the development of atherosclerosis. Calcium channel blockers also improve renal reperfusion and may reduce renal insufficiency due to various nephrotoxins, and are particularly useful in renal transplantation for protection against cyclosporin toxicity and post-transplant acute tubular necrosis. These drugs are also useful in pregnancy-induced hypertension and unwanted uterine contraction. Affective disorders and malignancies may be other conditions which benefit from calcium antagonist therapy. Calcium antagonists, in particular nimodipine which is most selective for the cerebral vasculature, have been approved for treating vasospasm after subarachnoid haemorrhage. They are probably also effective for treatment of migraine. Calcium channel blockers may be effective for treating acute cerebral infarction, but results of clinical trials to date have been equivocal, largely because it has been difficult to recruit patients within the short interval after the onset of stroke when these drugs would be most effective, and because of the unwanted hypotensive effect of high doses.
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PMID:New uses for calcium channel blockers. Therapeutic implications. 751 Jun 13

Among 172 cases of coronary artery bypass grafting, 9 cases (5%) revealed severely atherosclerotic ascending aorta. In 3 of the 9 cases, total aortic cross-clamping in the distal anastomoses of saphenous vein graft (SVG) and partial aortic clamp in the proximal anastomoses of SVG were performed. In 1 case with this technique, cerebral infarction was occurred. In 4 cases, total aortic cross-clamping in the distal and proximal anastomoses of SVG was performed. In 2 of these cases with this technique, cerebral infarctions were occurred. Hypothermic circulatory arrest was performed in 2 of the rest. In one case that was predicted to have atherosclerosis of ascending aorta prior to operation, the left internal thoracic artery was anastomosed to the left anterior descending, and SVG to the right coronary artery with hypothermia and ventricular fibrillation. And during the proximal anastomoses of SVG, hypothermic circulatory arrest without aortic clamping was initiated. In another case, atherosclerosis of ascending aorta was noted after aortic cross-clamping. Then the aorta was declamped, hypothermic circulatory arrest was established, the aorta was opened, the diseased segment was resected, and proximal anastomoses of SVG was performed to Dacron patch which was implanted for aortic wall. There were no cerebral infarction in last two patients.
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PMID:[Coronary artery bypass grafting in cases with the atherosclerotic ascending aorta]. 756 18

Persistent inappropriate blood pressure elevation leads to the development of left ventricular hypertrophy, progressive atherosclerosis, and structural changes in the arterial tree. These changes result in clinical manifestations such as ischemic cardiac and cerebral events, congestive heart failure, renal failure, and peripheral vascular insufficiency. This article reviews the 5-year course of 439 patients with primary hypertension who were seen at a time (1946-1953) when potent antihypertensive therapy was not widely used. At the end of 5 years, 55% of the men (78 of 143) and 28% of the women (83 of 296) were dead. The principal causes of death were coronary insufficiency, congestive heart failure, cerebral infarction and hemorrhage, accelerated hypertension, renal failure, and dissecting aneurysm of the aorta. Coronary insufficiency and accelerated hypertension predominated in men, whereas women died principally of cerebral events and congestive heart failure. The 439 patients were stratified according to the level of their office blood pressure on the first visit, the severity of the changes in the optic fundi, the degree of left ventricular hypertrophy determined by electrocardiogram, cardiac enlargement determined by roentgenogram and their renal function, as measures of end-organ damage. Patients who had higher initial blood pressures showed more evidence of end-organ damage than patients with lower initial pressures. The higher the initial blood pressure or the more advanced the evidence of end-organ damage, the greater was the 5-year mortality. The mortality was particularly high in patients who had already sustained a clinical cardiovascular event before entry into the study and in those with malignant hypertension or gross cardiomegaly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Retrospective and prospective research on hypertension-related end-organ damage. 760 71

To evaluate the effect of obesity on atherosclerosis, health, and longevity in the elderly, we studied the relationship between body mass index, atherosclerosis, and the duration of disability by multivariate analyses. We analyzed data from 521 residents of the Yokufu-kai home for the aged. They underwent a 50 g oral glucose tolerance test, and autopsies were done after they died. All functional evaluations were done retrospectively from the hospital records. The mean age of the time of death was significantly higher in the overweight group than in the lean group. The incidence of marked cerebral atherosclerosis was significantly higher in the overweight and the obese groups than in the lean and the medium-weight groups. The incidence of cerebral infarction with neurological deficits was significantly higher in the overweight group than in the lean group, but there were no differences in other types of infarction. The incidence of severe coronary artery stenosis was significantly higher in the obese group than in the lean and medium-weight groups, but there was no difference in the incidence of myocardial infarction between groups. There were no differences in the incidence of severe atherosclerosis of the aorta, femoral artery, or renal artery between groups. Patients in the overweight group were bedridden for a significantly longer time than those in the lean group. We conclude that body weight in the elderly is positively associated with survival. However, overweight subjects suffered from non-fatal cerebral infarction, and prolonged survival was associated with greater disability.
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PMID:[Relationships among obesity, atherosclerotic disorders, and longevity in the elderly. An autopsy study]. 761 95

The average incidence, prevalence and mortality rates of cerebrovascular disease (CVD) in China were markedly increased with increase of age and were much higher in senile stage and males than those in presenile stage and females. The constituent ratio of CVD consisted cerebral infarction for 67.5% and cerebral hemorrhage about 24.8%. There was no difference between the characters of lesions confirmed by CT scan in senile and presenile groups. The majority of CT lesions in the two groups was lacunar infarction, being 76.3% and 85.9% respectively. There were more cases of lobar hemorrhage in the senile group. The most important risk factor for CVD was hypertension (65.8%). Heart disease and diabetes mellitus take second place, accounting 19.0% and 10.7% respectively. The incidence of mixed type of hypertension was high in CVD especially the isolated systolic hypertension. The incidence of cerebral stroke was obviously higher than myocardial infarction in China. The percentage of positive findings of atherosclerosis in extracranial portion of carotid artery system in elderly patients with thrombosis and transient ischemic attacks was 60-100% and 55-100%.
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PMID:Study on cerebrovascular disease of the elderly in China. 761 18

Nicardipine is a second generation dihydropyridine-type Ca2+ antagonist with high vascular selectivity and strong cerebral and coronary vasodilatory activity. The compound is used in the treatment of hypertension, primarily in the elderly. In this review the main evidence of the cerebrovascular activity of nicardipine in preclinical studies using in vitro and in vivo models is detailed. A particular physico-chemical property of nicardipine is the almost complete protonation in acid environment. This allows its accumulation in ischemic brain regions and makes it a candidate for the treatment of cerebrovascular disorders characterised by impaired brain perfusion. The main clinical data on the use of nicardipine in cerebral ischemia and related disorders, subarachnoid haemorrhage and stroke, are also reviewed. These studies included 5940 patients affected by chronic cerebrovascular insufficiency (cerebral ischemia, cerebral atherosclerosis mainly associated with hypertension, transient ischemic attacks, sequelae of cerebral infarction, thrombosis or embolia, hypertensive encephalopathy), 1540 patients affected by sequelae of subarachnoid haemorrhage and 206 patients affected by stroke. Both preclinical studies and clinical trials have shown that nicardipine is a safe Ca2+ antagonist with powerful cerebrovascular activity. This suggests its possible use in cerebrovascular disorders in which blockade of Ca2+ channels of the L-type and/or selective cerebral vasodilatation is desirable. Further studies are necessary to establish if modulation of neuronal Ca2+ channels of the L-type by nicardipine may have a neuroprotective effect independent by the cerebrovascular activity of the compound.
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PMID:Nicardipine and treatment of cerebrovascular diseases with particular reference to hypertension-related disorders. 765 45

To clarify the mechanism of ulcer formation of atherosclerotic plaques in human carotid arteries, autopsy investigations were performed on eight patients who had died of cerebral infarction due to recent carotid thrombosis. Eleven control patients who had carotid atherosclerosis without thrombosis were also investigated. Histological changes of the arteries in serial sections were reconstructed three-dimensionally. Each artery with occlusive thrombosis was found to have an intimal ulcer at the head of the thrombus on the proximal slope near the base of the thickened atheromatous plaque at the carotid sinus. Most ulcers formed obliquely or longitudinally, were parallel to the vessel axis, had a fusiform shape, and measured 7 +/- 2 x 3 +/- 1 mm (mean +/- s.d.). The ulcers arose by marginal separation of the innermost layer from the underlying layer of the stratified intima. An underlying atheroma developed along the borders of these intimal layers reaching the subendothelium, with thinning of the intimal cap to less than 150 microns. The process of ulceration may be generated by vessel injury induced by hemodynamic forces, such as tensile forces and shear stress. The ulcer may extend along the fragile region where the wall may exhibit uneven compliance due to differences in the tissue structures of each intimal layer. Furthermore, macrophages may play a key role in ulcer formation.
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PMID:Three-dimensional analysis of human carotid atherosclerotic ulcer associated with recent thrombotic occlusion. 783 75

A comparative community-based study of serum lipids and other blood chemistry data in the elderly was carried out in two Japanese rural towns, Kahoku and Yaku. We studied the following blood chemistry factors; total proteins (TP), albumin (Alb), blood glucose (glucose), urea nitrogen (BUN), uric acid (UA), total cholesterol (T-Cho), high density lipoprotein (HDL-C) and lipoprotein (a) (Lp(a)). Subjects were the 312 eligible elderly aged over 75 years in Kahoku, and 172 similar elderly in Yaku. There were no significant differences in TP, Alb, glucose, BUN and UA of the elderly in the two areas. Mean HDL-C level was significantly lower and mean Lp(a) concentration was significantly higher in the elderly in Kahoku than in Yaku, Mean value of T-Cho did not differ significantly between the elderly in the two areas, however, the ratio of subjects whose T-Cho concentrations were over 220 mg/dl was significantly higher in Kahoku than in Yaku. These data suggested that the risk of atherosclerosis from the standpoint of view of serum lipids was higher in the elderly in Kahoku than in those in Yaku. Epidemiological data of Kochi and Kagoshima prefecture indicated that the mortality ratio from ischemic heart disease was higher in Kahoku than in Yaku, although that from cerebral infarction was lower in Kahoku than in Yaku. Comparative study of laboratory data in various districts is useful to investigate the relationship between lifestyle and diseases.
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PMID:[Comparative study of serum lipids and other blood chemistry factors in the elderly in Kahoku and Yaku]. 785 42


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