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 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Today hyperuricaemia and gout are likewise seen in every population of the western industrial world and have been increasing since the fifties. As known from number of studies hyperuricaemia often occurs in connection with hyperlipoproteinaemia, obesity, diabetes mellitus, arterial hypertension and atherosclerosis. Up to now it was not clear whether one disease caused the other. In 1988 Abbot could prove that among men, those afflicted by gout as compared to those without gout experienced a 60% excess of coronary heart disease. Therefore, patients with gout should receive a regular thorough cardiovascular evaluation. Furthermore risk factor levels which predispose to coronary heart disease, arterial hypertension and gout should be reduced. There is a significant positive correlation between the plasma uric acid levels and the prevalence of attacks of gouty arthritis and nephrolithiasis. It is possible to avoid gouty arthritis, tophi and nephrolithiasis with a consequent diet and medical treatment. Unfortunately, many patients interrupt therapy during intervals free of pain. The consequence is that even today the complications of hyperuricaemia cause days of inability to work and to earn one's living, despite of modern therapy. Hyperuricaemia not sufficiently treated reduces the quality of life through attacks of gout, chronic gout and nephrolithiasis as well as life expectancy caused by nephropathy, arterial hypertension and atherosclerosis. This is of special importance because of the frequency of gout and hyperuricaemia in our population. An early diagnosis, a consistent therapy and a thorough monitoring could stop an increase of this disease and prolong life expectancy for those who have gout and the other attendant diseases.
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PMID:[Hyperuricemia--does modern therapy improve life expectancy?]. 227 73

Coronary arteriography was performed in 1,029 consecutive patients with ischemic heart disease and the relationship between the arteriographic features of coronary atherosclerosis and coronary risk factors was analyzed by case control studies. Patients were divided into four groups according to coronary arteriographic findings. Patients with normal or near normal coronary arteriograms (Group I) showed a high prevalence of smoking habit and a higher value of serum uric acid compared with the control group, so smoking and hyperuricemia were considered to be the risk factors for coronary atherosclerosis in patients of group. Four selected variables: smoking, hyperuricemia, hypertension and hyperlipidemia, were identified to be risk factors for the patients with minor plaques in the coronary arteries (Group II). As in Group I, smoking and hyperuricemia had a close relationship to solitary tight plaque in a branch of the coronary artery (Group III). Multiple tight stenoses in the coronary arteries (Group IV) correlated closely with smoking, hyperuricemia, hypertension, hyperlipidemia and diabetes mellitus. Thus, there were many strong risk factors for patients with diffuse, extended coronary atherosclerosis (Group II and Group IV), while only two factors, smoking and hyperuricemia, were considered to be risk factors for the patients with near normal coronary arteries ies or a solitary plaque in a branch of the coronary artery. These findings suggest that the role of the coronary risk factors on the pathogenesis of coronary atherosclerosis is not uniform but variable depending on the morphologic variability of the coronary atherosclerosis and on the pathophysiology of the ischemic heart disease.
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PMID:Relationship between coronary risk factor and arteriographic feature of coronary atherosclerosis. 239 25

Muscle and fat development are regulated by opposite and also cooperating factors. Adipo-muscular ratio is the result of those forces. The need of a determined fat mass and of its corollary a determined muscle mass is an important physiologic parameter. Sexual differentiation is the main factor adipo-muscular ratio. Feminine fat is twice as big as masculine fat: it predominates in the lower body, masculine fat in the upper body. Brachio-femoral adipo-muscular ratio is, among others, a good index of fat sexual differentiation. Android obesity, predominating in both sexes in the upper body, is, with genetic predispositions, the main factor of non insulin dependent diabetes carbohydrate sensitive hyperlipoproteinemia, hyperuricemia, atherosclerosis. Easy determination on fat topography before the age of 30 is, particularly in women, the best tool for an efficacious prophylaxis of obesity's metabolic complications.
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PMID:[Sexual differentiation of the adipose tissue-muscle ratio. Its metabolic impact]. 276 1

Major risk factors have been identified that enhance the chances of cardiovascular morbidity and mortality. These include such modifiable factors as hypertension, hyperlipidemia, obesity, diabetes mellitus, smoking and hyperuricemia. Other factors that also increase risk are not modifiable and include advancing age, male gender and black race. The development of left ventricular (LV) hypertrophy imposes another significant risk for increased morbidity and mortality. Development of LV hypertrophy may be produced by hemodynamic as well as nonhemodynamic mechanisms. Included in the latter group are some of the same factors that in and of themselves participate in the production of increased LV mass (i.e., aging, gender and race, obesity, coronary disease, diabetes and the underlying mechanisms that subserve the hypertensive disease). This article discusses the concept, drawn from clinical and experimental studies, that demonstrate that the additional increased risk of LV hypertrophy may be ascribed to loss of reserve cardiac function, accelerated atherosclerosis, development of abnormal cardiac rhythm secondary to ischemia, fibrosis or drug-induced hypokalemia, inherent predisposition to ventricular dysrhythmias and sudden death, risks directly or coincidentally related to associated diseases or perhaps even the paradoxical risk of beneficial antihypertensive therapy.
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PMID:Potential mechanisms explaining the risk of left ventricular hypertrophy. 294 82

Asymptomatic hyperuricemia was recognized in 344 patients with obesity. The use of low-calorie diets led to a reduction in the body weight and made purine metabolism more normal. The correcting effect was most remarkable with the use of low-caloric diets with a low purine content. Inasmuch hyperuricemia of long standing plays an important role in the development of podarga, atherosclerosis, it is recommended that obese patients should be treated with the diets with a low content of food purines.
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PMID:[Differentiated dietotherapy of patients with obesity and hyperuricemia]. 408 17

To evaluate the optimal discriminators for peripheral atherosclerosis, we studied retrospectively 49 male patients and 39 male controls between 40 and 60 years of age. In addition to hypertension, cigarette smoking, diabetes mellitus, and hyperuricemia, we determined the most common lipids, lipoproteins, and apolipoproteins. Highly significant differences of median values between patients and controls in decreasing order of magnitude were recorded for apo A-II/apo B, apo A-I/apo B, apo B, total cholesterol, and LDL-cholesterol. A retrospective classification of patients and controls under optimal conditions with one variable (apo A-I/apo B) yielded an error rate of 25%. We found that apolipoproteins were better discriminators for peripheral atherosclerosis than than were lipids or lipoprotein lipids. The application of a linear regression discriminant analysis including 29 variables greatly decreased the rate of error and increased the sensitivity and specificity of the classification. From 229 possible models, we used an economic selection strategy to sort out those which either gave the best segregation or were considered the most practicable. The optimal model with 14 variables gave an error rate of less than 5% for the group studied. Suboptimal models yielded error rates between 13% and 18%. We conclude that a mathematical treatment of laboratory data which includes lipid parameters in addition to apolipoprotein values can improve the classification of peripheral vascular atherosclerosis.
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PMID:Risk factors for peripheral atherosclerosis. Retrospective evaluation by stepwise discriminant analysis. 640 92

During an 8-months treatment period the effect of Duolip on serum uric acid in 112 patients with hyperlipidemia was studied. In this open clinical trial a long-lasting hypouricemic effect could be shown for Duolip. This response was more pronounced with higher initial serum uric acid concentrations and could only be observed in patients with serum uric acid levels above 6.4 mg%. Thus, in one patient both risk factors of atherosclerosis--hyperlipidemia and hyperuricemia--can be treated by a single drug.
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PMID:[Modification of serum uric acid concentration under long-term therapy with the lipid-regulating drug Duolip]. 662 96

Examination of all patients who had been admitted with myocardial infarction or with acute cerebral attacks to a medical department within one year reveals differentiation by age and by sex of these events. Age and sex differentiate the patients also with regard to course and mortality of the disease. Retrospective evaluation reveals specific patterns of risk factors for specific atherosclerotic complications. There is a prevalence of smoking in myocardial infarction of men while metabolic parameters predominate atherosclerotic complications in women. Diabetes and low HDL-cholesterol correlate with the incidence of mortality of myocardial infarction in men and women. Mortality in cerebral hemorrhage of men is associated with hypertension and hyperuricemia and the same atherosclerotic complication in women correlates with hypertension and diabetes. The pattern of risk factors in cerebral malacia with a lethal course differs from that in lethal cerebral hemorrhage. In men it is dominated by smoking and by hyperuricemia and in women by hypertension and by hyperuricemia. Finally, it is not the single risk factor that predisposes for atherosclerotic complications and for the mortality incidence of these diseases but it rather seems that the total of several risk factors results in severe atherosclerosis. In this pattern of risk factors single parameters seem to be exchangeable by others.
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PMID:[Risk factors and atherosclerotic complications in Vienna: myocardial infarct and stroke]. 686 41

We utilized a standardized in vitro method which employs transmission electron microscopy to monitor the degree of surface activation (cytoplasmic spreading) and amount of aggregation displayed by platelet populations from 314 patients with one of five distinct rheumatic diseases and from 72 normal subjects. The percentage of patients in each group whose platelet populations were hyperactive was as follows: polymyalgia rheumatica, 75 percent; scleroderma, 65 percent; primary gout, 61 percent; rheumatoid arthritis, 57 percent; and degenerative joint disease, 40 percent. Pair-wise contrasts performed after an analysis of variance suggest the following differences and similarities: (1) the mean differential platelet count of the normal subjects differed from that in each disease state; (2) the platelet responsivity in patients with degenerative joint disease most closely resembled that in normal subjects; (3) the platelet response in polymyalgia rheumatica plus temporal arteritis was the most abnormal; and (4) platelet response in scleroderma, rheumatoid arthritis, and gout closely resembled each other. The increased platelet response in vitro may reflect the in vivo presence of disease-related "risk factors" (hyperuricemia, immune complexes, and atherosclerosis). Those patients with "triggered" platelet populations may be appropriate candidates for antiplatelet therapy.
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PMID:A comparative study of platelet reactivity in arthritis. 694 59

The value of hyperuricemia as a risk factor for cardiovascular mortality was investigated in 3195 men and 3160 women aged 40-69 years in Finland. Hyperuricemia was associated with obesity, impaired glucose tolerance, hypertension and history of heart disease. The total mortality of hyperuricemic men and women in 5 years was significantly higher than the mortality of normouricemics. Cardiovascular mortality was not higher in hyperuricemics than in normouricemics. However, in hyperuricemic women without known heart disease cardiovascular mortality was significantly increased in the follow-up period between 5 and 12 years. Total and cardiovascular mortality rates were significantly higher in hyperuricemic men with known heart disease than in corresponding normouricemic men. A rise of serum uric acid may be secondary to more advanced atherosclerosis. Thus, hyperuricemia may be associated with more advanced heart disease and it is not an independent cause of cardiovascular diseases.
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PMID:Hyperuricemia as a risk factor for cardiovascular mortality. 696 92


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