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)

Two patients with severe hyperlipidemia receiving long-term hemodialysis were classified as type III hyperlipoproteinemic subjects. They are homozygous for apolipoprotein E2 and have an elevated VLDL-cholesterol/plasma-triglyceride ratio. The dyslipoproteinemia was severely aggravated by the renal failure, but careful treatment with bezafibrate was able to effectively lower elevated serum lipids. Accurate diagnosis of lipid abnormalities in patients with chronic renal failure seems to be necessary to plan appropriate therapeutic interventions and to lower the risk for accelerated atherosclerosis.
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PMID:Severe type III hyperlipoproteinemia in two patients maintained on chronic hemodialysis. 231 34

The treatment of hypertension is clearly beneficial. Blood pressure reduction with antihypertensive drugs reduces mortality and the incidence of complications such as stroke, renal failure, and congestive failure. However, analysis of long-term studies using different antihypertensive drugs indicates that the outcome of patients treated in those studies may be determined by effects of the antihypertensive drugs other than the lowering of blood pressure. Evidence is increasing that certain antihypertensive drugs have adverse effects on plasma lipid profiles that are of sufficient magnitude to offset the benefit of antihypertensive treatment in mild hypertensives. Furthermore, the effects of antihypertensive drugs on arterial flow disturbances, although they have received scant attention until now, may be important in the progression of atherosclerosis or even in the primary prevention of atherosclerosis. This article highlights differences in the effects of antihypertensive drugs on plasma lipids and on arterial flow disturbances as they may pertain to prevention of atherosclerosis.
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PMID:Effects of antihypertensive drugs on atherogenic factors: possible importance of drug selection in prevention of atherosclerosis. 240 60

Plasma thromboxane B2 (TXB2) concentration was measured in 7 cases of terminal renal failure before and after haemodialysis. The TXB2 levels were higher in the investigated group than in the control group (p less than 0.05). Haemodialysis induced a further increase in the TXB2 concentration. Increased thromboxane production may play a part in the pathogenesis of accelerated atherosclerosis in uraemic patients treated with chronic haemodialysis.
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PMID:Plasma thromboxane B2 in haemodialysed patients. 241 74

Since intravascular and endoparietal fibrin deposition is thought to be involved in the development of atherosclerosis, we measured factor XIII activity and its subunit 'a' and 'b' concentrations against a background of other haemostasis parameters in diabetics with angiopathy and in 2 control groups (healthy subjects and diabetics without vascular complications). Diabetics with angiopathy revealed a significant increase of factor XIII activity as well as its subunit concentrations. They also had significantly elevated anti-thrombin III, alpha 2 macroglobulin, alpha 1 antitrypsin, C1 inhibitor, fibrinogen, FDP concentrations and prolongation of euglobulin lysis time. The highest factor XIII levels were found in diabetics with renal failure. We suppose that increased factor XIII level and other observed changes of haemostasis in patients with diabetic angiopathy might promote intravascular and endoparietal fibrin deposition and contribute to the development of atherosclerotic complications of diabetes.
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PMID:Plasma factor XIII and some other haemostasis parameters in patients with diabetic angiopathy. 243 83

High blood pressure (BP) is associated with increased risk of vascular disease, including myocardial infarction and stroke. Since drugs that lower BP will reduce the risk of those complications of hypertension that are due to high pressure (strokes due to small-vessel disease, including lacunar infarction and intracerebral hemorrhage due to rupture of microaneurysms, heart failure, and renal failure), it has been assumed that such drugs would also reduce the risk of myocardial infarction due to atherosclerosis. However, in addition to hypertension, many other factors are involved in the atherosclerotic process including blood lipids such as cholesterol, blood platelets, and arterial flow disturbances such as turbulence and vortex formation. Some drugs that lower BP have unwanted effects on blood lipids and arterial flow patterns, which are thought to offset the benefit of BP reduction, whereas other drugs have beneficial effects on such factors. Ames has calculated that the adverse effects of antihypertensive drugs on lipids are enough to completely offset the benefit of treating mild hypertension. We have shown that antihypertensive drugs have different effects on blood velocity, and that these effects are associated with differences in the effects of drugs on arterial flow disturbances at the site of carotid stenosis in man, such that propranolol reduced, and hydralazine increased, the occurrence of abnormal high-velocity flow patterns associated with turbulence and vortex formation. In cholesterol-fed hypertensive rabbits (one-kidney Goldblatt), propranolol was more effective than hydralazine in preventing the occurrence of aortic atherosclerosis, even though hydralazine lowered blood pressure more effectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hypertension and atherosclerosis: effects of antihypertensive drugs on arterial flow patterns. 248 Nov 60

Hyperlipidemia is usually present in patients with the nephrotic syndrome. The most common lipid abnormality is hypercholesterolemia, although as the disorder progresses, hypertriglyceridemia may develop. Elevated plasma lipids have two potential vascular consequences, namely, atherosclerosis and progression of renal failure. Neither of these complications has been proven with certainty, but there is growing evidence to indicate that both may be long-term consequences of the nephrotic syndrome. Therefore, effective therapy of hyperlipidemia, particularly elevated cholesterol levels, is needed as a protection against these complications. Since nephrotic hypercholesterolemia frequently is severe, dietary therapy, although a valuable adjunct, will not normalize cholesterol levels in most nephrotic patients. Thus, if effective serum cholesterol lowering is to be achieved, drug therapy will be required. Bile acid-binding resins have been shown to lower cholesterol levels in nephrotic patients, but the decline in cholesterol concentrations is usually insufficient to produce a marked reduction in coronary risk. Nicotinic acid theoretically should be useful for treatment of nephrotic hyperlipidemia, but it has not been adequately tested. The new drugs that inhibit cholesterol synthesis, e.g., lovastatin, appear to be highly promising for treating elevations of both serum cholesterol and triglycerides in the nephrotic syndrome. However, testing of these drugs in this condition has been limited, and the possibility of significant side effects in an appreciable portion of patients has not been ruled out. Of particular concern is the development of severe myopathy that can produce myoglobinuria and acute renal failure. This side effect is relatively rare in patients without the nephrotic syndrome, but its prevalence in the latter condition has not been determined. The fibric acids will lower triglyceride levels in nephrotic patients, but they are not effective in lowering cholesterol levels; consequently, they probably have little role in the treatment of nephrotic hypercholesterolemia. Finally, the drug probucol will lower cholesterol levels in nephrotic patients, although not to desirable levels; still, probucol could prove useful in combination with other cholesterol-lowering drugs.
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PMID:Rationale and management of hyperlipidemia of the nephrotic syndrome. 248 42

In elderly patients with generalized atherosclerosis and longstanding hypertension, progressive renal insufficiency should suggest renal artery occlusive disease and/or renal cholesterol embolization. Renal cholesterol embolization is not an absolute contraindication to successful surgical revascularization. Renal cholesterol emboli were identified in biopsy specimens obtained in 24 cases at the Cleveland Clinic from 1978 to 1986, and renal artery stenosis was an associated finding in 19. Clinical manifestations of generalized atherosclerosis were common, including ileofemoral atherosclerosis (18), coronary artery disease (16), carotid occlusive disease (15), and carotid occlusive disease with a history of stroke (8). Evidence of embolic events in other organs was common. Hypertension worsened before biopsy in 21 patients with and without renal artery stenosis. Surgery or angiography definitely or probably contributed to renal failure in 16. Of 12 who underwent surgical revascularization of a renal artery, renal function improved in five, remained stable in five, and worsened in one. Renal function improved in the three patients undergoing dialysis before revascularization, and two were able to discontinue dialysis.
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PMID:Atheroembolic renal disease: association with renal arterial stenosis. 252 69

Since 1980, we have applied lasers experimentally in the following three categories in the fields of cardiovascular surgery. That is, Group 1: New myocardial revascularization in the patients whose coronary arteries are too small or diffuse due to atherosclerosis, Group 2: Laser vascular anastomosis especially for small-caliber vessels, such as coronary artery bypass grafting, Group 3: Laser angioplasty for obstructive arterial disease. Subsequently, efficacy of laser application could be obviously recognized in these fields. On the basis of excellent results of our experimental studies, laser was clinically employed for 112 patients with anginal pain, intermittent claudication and renal failure. They consisted of new myocardial revascularization in one case and vascular anastomosis in 89 cases including 7 cases (LIMA-LAD2, SVG-LAD5) of the coronary artery bypass grafting and laser angioplasty in 22 cases including 5 cases (LAD3, RCA2) of intraoperative laser coronary angioplasty. Optimal conditions of vascular anastomosis were 20-40mW in output and 6-12sec/mm in irradiation time. On the other hand, optimal conditions for laser angioplasty were 6 watts in output and 3sec in irradiation time for each shot. Laser irradiation was carefully repeated according to the grade of atherosclerotic changes. These patients are doing well without any complications throughout laser. Our experimental and clinical experiences of laser application in the fields of the cardiovascular surgery were presented in detail.
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PMID:[Experimental and clinical studies on the laser application in the cardiovascular surgery; analysis of clinical experience of 112 patients]. 258 72

Hypertension related to renal parenchymal disease is the most common cause of secondary hypertension. Poor control of renal hypertension is associated with an increased risk for progressive atherosclerosis and progressive renal failure. This review discusses the prevalence, significance, and pathophysiology of renal hypertension. Treatment options, both dietary and pharmacologic are reviewed. Special emphasis is given to important pharmacokinetic changes in chronic renal failure. Treatment of hypertensive urgencies and emergencies in this population is also reviewed.
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PMID:Control of hypertension in patients with chronic renal failure. 265 99

Endoaortic calcified proliferation, also known as coral reef atherosclerosis represents a rare form of atherosclerosis characterized by a gross appearance and location in the thoracic and celiac aorta. We report two new cases of calcified obstruction of the aorta. In the first case, clinical examination revealed hypertension, abdominal angina associated with abdominal bruit, and diminished femoral pulses. The second case was diagnosed postoperatively when intractable hypertension and renal failure ensued following reconstruction of an abdominal aortic aneurysm. Accurate evaluation of lesions was possible through Doppler sonography, CT scan, and aortography. Because of hypertension and visceral ischemia, surgical treatment was required. Hypertension and intestinal angina were completely relieved in the first case, while hypertension and renal failure improved greatly in the second.
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PMID:Endoaortic calcific proliferation of the upper abdominal aorta. 266 16


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