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 aim of this study is to describe the clinical characteristics and the pathological mechanisms of carotid transient ischemic attacks (TIA) in 117 patients which were hospitalised for such symptoms. Our results show a male predominance, except for age group under 40 and over 79 years. The principal cardiovascular index and risk factors are: arterial hypertension, smoking, hyperlipidemia, vascular intermittent claudication and hematocrit greater than 46%. Amongst our patients, 17% with hemispherical and mixed TIAs had a cerebral infarction proved by CT-Scan, the recent aspect and localisation of which were compatible with symptoms. The atherosclerotic causes are more frequently associated with mixed and retinal TIAs than hemispheric TIAs. This fact may be attributed to a larger proportion of stenotic atherosclerotic lesions by mixed TIAs than hemispheric ones. The cardiac embolic pathogenic mechanism is responsible for 11% of TIAs if considered individually; of 5% if associated with carotid atherosclerosis.
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PMID:[Transitory carotid ischemic attacks: clinical and pathogenic aspects]. 172 4

The treatment of hypertension in arteritic patients must take account of several parameters: respective severity of hypertension and of arteriopathy, possibility of other sites of atherosclerosis and supposed cause of hypertension. The association of essential hypertension and of an arteriopathy does not sum up all possibilities. Hypertension may be purely systolic, due to decreased compliance. A stenosis of the renal arteries is also worth evoking in the context of an already symptomatic atherosclerotic disease. For the confirmation of the latter hypothesis, Doppler associated to echography may be an alternative to the intravenous or intra-arterial opacification of the renal arteries. In case of moderate hypertension (diastolic pressure ranging from 90 to 104 mmHg), non-medicamentous treatments should be preferred: low-sodium diet, suppression of tobacco and other risk factors, weight loss. Beta-blockers, whatever their class, reduce the walking distance in case of intermittent claudication. Though not formally contraindicated, especially when their use is justified by an associated coronary insufficiency, they are not advised in hypertensive arteritic patients. On the other hand, captopril allows both reducing blood pressure and preserving the walking distance. However, a prerequisite to the possible use of agents inhibiting the conversion enzyme is the preliminary search for a stenosis of the renal arteries. In fact, when these medications are carelessly used in case of bilateral stenosis or of stenosis on a functionally single kidney, they entail a risk of renal failure or of thrombosis of the stenosed renal artery. Calcium inhibiting agents are also anti-hypertensive substances of choice in hypertensive arteritic subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of hypertension in arteritic patients]. 179 78

Chronic ischemia of the lower extremities with atherosclerosis background is being manifested by intermittent claudication. For treating the intermittent claudication many drugs are used, which may give rise to therapeutical side effects. In 50 patients with diagnosed arteriosclerosis affecting the lower extremities in II stage according to Fontain, a vegetable preparation PADMA-28 was applied for 16 weeks. A marked, statistically significant elongation of the claudication distance was achieved. That was measured, under standardized condition, on an ergometer-treadmill. Moreover, there was also a decrease in the index of blood platelets aggregation, a drop in the level of cholesterol, triglycerides, total lipids, beta lipoproteins, and an increase in ++alpha lipoproteins. Also 50 patients were receiving placebo for 16 weeks, but no positive results were observed in comparison with preparation PADMA-28. The studies were carried out by the method of double blind test, the latter was accomplished by randomized method. Observation, the performed biochemical examinations did not reveal any undesirable effect. Drug tolerance was excellent. The positive influence of the drug may result from summed action of components contained in the preparation namely: bioflavonoides, salicylates, valepotriates, tannins, phenol acids, ethereal oils and esters of acids. PADMA-28 may be a useful adjuvant to therapeutic methods with regard to chronic ischemia of the lower extremities in II stage, according to Fontain.
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PMID:[Treatment of chronic ischemia of the lower extremities with complex herbal preparation]. 181 52

The ratio of ankle-to-arm systolic blood pressure (ankle/arm index or AAI) appears to be a non-invasive indicator of flow-significant atherosclerosis and may be a useful measure of burden of disease in a high risk population. The prevalence of lower extremity arterial disease (LEAD) was assessed by this method in the Systolic Hypertension in the Elderly Program (SHEP). Subjects were aged 60 and older with systolic blood pressure greater than 160 mmHg upon entry to the study. An AAI of 0.90 or less was considered indicative of flow-significant LEAD. The prevalence of LEAD by this method was 26.7% (50/187), while the prevalence of intermittent claudication (IC) was only 6.4% (12/187). Of those with IC, 66.7% (8/12) had confirmed LEAD. The prevalence of LEAD as measured by AAI increased with age in women and was associated with a history of current smoking and lower levels of high density lipoproteins. In this study population with systolic hypertension, LEAD, as measured by the AAI, is more prevalent than previously described in elderly populations and is associated with other risk factors for atherosclerosis.
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PMID:Lower extremity arterial disease in elderly subjects with systolic hypertension. 198 53

To assess the clinical effectiveness of pentoxifylline (Trental) in the treatment of intermittent claudication and ischemic rest pain, 129 patients were retrospectively interviewed with respect to compliance and improvement of symptoms. Risk factors for the development of atherosclerosis were tabulated, as was the severity of symptomatic lower extremity peripheral vascular insufficiency. The duration of pentoxifylline treatment was 35.8 +/- 45.0 weeks (mean +/- 1 S.D.). Forty-eight percent of the patients discontinued pentoxifylline on their own, most commonly because of side effects (13%) or perceived lack of improvement (23%). Of those patients taking pentoxifylline for eight weeks or more (n = 110), 64% noted some improvement, with 31% reporting increased claudication distance and 52% reduced claudication pain. Pentoxifylline provided pain relief in 52% of patients with ischemic rest pain (n = 27). Neither diabetes, hypertension, concomitant antiplatelet therapy, the severity of claudication, nor pretreatment ankle-brachial Doppler pressures were related to treatment outcome. Increased daily walking exercise during treatment was associated with successful outcome (p = 0.04). Clinical response to pentoxifylline was inversely related to the number of cigarettes smoked daily in those with 1 block claudication (n = 71, p = 0.05). Pentoxifylline was not very effective in increasing reported claudication distance. This review suggests that pentoxifylline may be of value for patients with ischemic rest pain when arterial reconstruction is not possible. Whether pentoxifylline is useful adjunctive therapy for intermittent claudication requires further scrutiny.
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PMID:Pentoxifylline in the nonoperative management of intermittent claudication. 199 79

The aim of the investigations was to show the influence of increased blood and plasma viscosity on the claudication distance in patients with obliterative atherosclerosis of lower limbs. The investigations were carried out in 53 patients: 41 men and 12 women (group I, age 45-67 years). The control group consisted of 100 healthy persons (group II) with similar range of age. The rheological studies of blood were carried out by low-shear 100 Contraves viscometer, the plasma viscosity--by means of capillary viscometer. Moreover, the total lipids, alpha, pre-beta, beta-lipoproteins, triglycerides, total cholesterol, free fatty acids, fibrinogen and hematocrit of the blood were determined. The blood for above mentioned estimations was collected before testing of the claudication distance. A significant increase of blood and plasma has been shown as well as an increase of total lipids, fibrinogen, triglycerides, total cholesterol, free fatty acids. The alpha lipoproteins were significant decreased in patients with intermittent claudication compared to the controls. The claudication distance ranged 10-500 m (the mean: 143 +/- 119 m). The correlation between claudication distance and blood and plasma viscosity was significantly negative (r = -0.42, p less than 0.001 and r = -0.32, p less than 0.05 respectively). The obtained results indicated that an increase of blood and plasma viscosity in patients with obliterative atherosclerosis of lower limbs was correlated to the decrease of claudication distance.
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PMID:[Blood and plasma viscosity versus claudication distance in patients with obliterative atherosclerosis of the lower limbs]. 203 75

Ketanserin is the archetype of a new class of cardiovascular drugs, the 5HT2 (S2) serotonergic receptor antagonists. In humans, ketanserin inhibits serotonin-induced vasoconstriction and platelet activation. In addition, it reduces platelet hyperactivity, blood viscosity and total serum cholesterol. The antihypertensive effect of ketanserin is more pronounced in older people, in whom it decreases blood pressure gradually to normal levels. It lowers systemic vascular resistance resulting in a reduction of pre- and afterload. It improves vascular compliance and reduces left ventricular hypertrophy. Ketanserin improves the microcirculation of the skin, in particular capillary blood flow. Placebo-controlled studies have established that ketanserin prevents amputations in patients with atherosclerosis, enhances ulcer healing in patients with scleroderma and reduces the frequency and duration of attacks in patients with Raynaud's disease. In a placebo-controlled trial the on-treatment analysis of 3071 patients with intermittent claudication (the PACK-trial) showed a 23% reduction of severe cardiovascular events with ketanserin, suggesting that ketanserin may prevent complications of atherosclerosis. The accumulated clinical evidence indicates that serotonergic antagonism opens new perspectives in the treatment of cardiovascular disease. Current clinical research with ketanserin further explores its potential as a vascular protective agent.
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PMID:Ketanserin: a novel cardiovascular drug. 213 Sep 34

Intermittent claudication may represent a severe limitation in daily life-style for young, active patients and may result in loss of professional career for members of the armed forces. Our recent experience with young patients with atherosclerotic claudication was reviewed to determine whether more liberal use of angioplasty and surgery is warranted in these patients to salvage their military careers and improve their life-styles. A systemic review was made of patients aged 40 years and younger with atherosclerosis who have undergone arteriography at our institution during the past 67 months. From this study, 22 patients were found with the initial complaint of intermittent claudication. Fifteen of these patients (68%) had occlusive disease confined to the iliac arteries, and six (27%) had single-level occlusive disease in a femoropopliteal distribution. Only one patient had multilevel disease. Symptoms of coronary occlusive disease developed in five patients (23%) within 38 months of the onset of claudication, and two of these patients died of myocardial infarctions. Of 19 patients who underwent interventions to correct symptoms of claudication, 16 (85%) had complete relief of symptoms at the end of follow-up, ranging from 6 months to 7 years. Ten of these patients remained symptom free after a single intervention, but six patients had rapid progression of disease and required secondary procedures. These results indicate that a majority of young patients with claudication caused by atherosclerosis can be returned to full active-duty status in the military after angioplasty or surgery. However, some patients may require secondary procedures to relieve recurrent symptoms caused by rapid progression of disease. We believe that an aggressive interventional approach is warranted in the evaluation and treatment of young patients with work-limiting claudication caused by atherosclerosis. These patients are at significant risk of developing premature coronary occlusive disease and should be monitored closely.
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PMID:Intermittent claudication caused by atherosclerosis in patients aged forty years and younger. 213 46

The relation between the presence of calcified plaques in the thoracic aorta, as detected on chest x-rays, and the development of cardiovascular disease is examined during 12 years of follow-up of the Framingham cohort (n = 5,209). The prevalence of aortic calcified plaques approximately doubled with each decade of age, with only a trivial male predominance. Its presence was associated with a twofold increase in risk of cardiovascular death in men and women younger than age 65, even after other risk factors were taken into account. Similar increases in risk were found for coronary artery disease, stroke and intermittent claudication among middle-aged women. In middle-aged men these risks were less marked. The predictive value of aortic calcified plaques generally diminished with age. Risk of sudden coronary death in men with calcified plaques in the thoracic aorta ranged from a sevenfold increase at age 35 to no excess risk at age 70 years. These results support the view that atherosclerosis is a generalized process. The finding of aortic calcified plaques in a relatively young subject on a routine chest x-ray should be regarded as a sign for potential development of clinically manifest atherosclerotic disease in the cardiac, cerebral and peripheral arterial circulation.
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PMID:Aortic calcified plaques and cardiovascular disease (the Framingham Study). 222 Jun 32

The purpose of the present study was to assess among a representative group of middle-aged newly diagnosed type 2 diabetics and control subjects the baseline prevalence and 5-year incidence of arterial calcifications of aorta and lower limb and their relationship to cardiovascular morbidity. The relationship of baseline risk factors to the development of arterial calcifications was also studied. At the time of diagnosis the age-adjusted prevalence of aortic and lower limb intimal calcifications was higher in diabetics than in control subjects (aortic calcifications: 29 vs. 17% for men, P = 0.05; 26 vs. 19% for women, P = 0.06; lower limb intimal calcifications: 24 vs. 12% for men, P = 0.02; 10 vs. 7% for women; P = NS), whereas no significant difference in baseline prevalence of lower limb medial calcifications was observed (15 vs. 21% for men, 9 vs. 10% for women). The 5-yr incidence of aortic calcifications in both sexes and of lower limb calcifications in men was similar in diabetic and control subjects, but the incidence of lower limb calcifications was higher in diabetic women than in control women (intimal: 33 vs. 11%, P = 0.009: medial: 29 vs. 14%, P = 0.05). The baseline prevalence of abdominal aortic (37 vs. 22%, P = NS for diabetics; 42 vs. 16%, P = 0.02 for control subjects), lower limb intimal (24 vs. 16% for diabetics, P = NS; 15 vs. 7% for control subjects, P = NS) and medial calcifications (23 vs. 7% for diabetics, P = 0.03) were higher in subjects who developed intermittent claudication during the follow-up than in those free of it at the 5-yr examination. Abnormalities in VLDL-metabolism and high systolic blood pressure were associated with the development of aortic calcification in diabetic subjects. In conclusion, already at the time of diagnosis atherosclerotic calcifications are more prevalent in type 2 diabetics than in nondiabetic subjects. During the follow-up diabetic women, but not men, had higher incidence of lower limb intimal and medial calcifications than non-diabetic subjects. Arterial calcifications tended to be associated with the development of intermittent claudication during the follow-up in diabetic and control subjects.
Atherosclerosis 1990 Sep
PMID:Aortic and lower limb artery calcification in type 2 (non-insulin-dependent) diabetic patients and non-diabetic control subjects. A five year follow-up study. 224 22


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