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

Today there can be little doubt about the fact that fibrinogen is a major, independent cardiovascular risk factor. Therefore one should consider circumstances that might lead to an increment of plasma fibrinogen levels. Oral contraceptives (OCs) have been reported to be associated with high fibrinogen. The present review details the information on this potentially important side effect. Cross sectional studies report both increased fibrinogen in OC users as well as no such change. Longitudinal studies yield a much clearer picture. They demonstrate that OCs lead to a significant rise in fibrinogen within 1-3 months of medication. The effect seems to be strongest in OCs with a high oestrogen concentration. Upon discontinuation, fibrinogen returns to normal, usually within about 3 months. These findings suggest that OC use might contribute to the cardiovascular risk partly by elevating fibrinogen levels.
Atherosclerosis 1992 Mar
PMID:Oral contraceptives, fibrinogen and cardiovascular risk. 159 92

Therapy for hypercholesterolemia has been shown to reduce the risk for coronary heart disease in middle-aged men. Current guidelines for detecting and treating hypercholesterolemia in adults render large numbers of elderly patients eligible for medical intervention. The elderly are a heterogeneous group of individuals who differ widely in their ability to function physically, behaviorally, cognitively and emotionally. Not all elderly patients qualify for cholesterol-lowering therapy. Decisions regarding diagnostic and therapeutic interventions should be based on the physiological age of the patient rather than the chronological age, and on the presence and severity of concomitant disease, mental status and cognitive ability, as well as on the patient's expectations from medical care. Suggestions for dietary therapy and drug therapy in the elderly are provided. The objectives and potential benefits of therapy are described. Based on the information currently available, it is concluded that the elderly are likely to benefit from cardiovascular risk factor modification and should not be denied cholesterol-lowering therapy simply on the basis of their chronological age.
Atherosclerosis 1991 Dec
PMID:Clinical considerations regarding treatment of hypercholesterolemia in the elderly. 178 16

The relationship between cigarette smoking and blood pressure and serum lipids was studied in 1775 men aged 20-59 years, in non-drinkers and drinkers separately, controlling for body mass index and physical fitness (VO2max). While systolic blood pressure was not associated with cigarette smoking, diastolic blood pressure decreased with increasing levels of cigarette smoking in non-drinkers but not in drinkers. Total cholesterol was inversely associated with smoking cigarettes in drinkers and was not associated in non-drinkers. High density lipoprotein (HDL)-cholesterol decreased with an increasing degree of cigarette consumption in non-drinkers but not in drinkers. An increase in total cholesterol/HDL-cholesterol ratio and triglyceride levels was positively associated with smoking cigarettes regardless of drinking habit. The present study suggests that cigarette smoking is a cardiovascular risk factor, partly due to its effect of increasing the atherogenic index, but it remains to be consolidated whether chronic smoking has an effect of lowering diastolic blood pressure.
Atherosclerosis 1990 Oct
PMID:Relationship of cigarette smoking to blood pressure and serum lipids. 228 98

Children initially aged 21/2 to 14 years living in Bogalusa, Louisiana (n = 2530) were examined twice, 3 years apart, for fasting serum pre-beta- and beta-lipoprotein cholesterol (beta-LPC) levels. Based on averages of these levels, the children were ranked for pre-beta- and beta-LPC in combinations of extreme quintiles (low-low, high-high) or quartiles (low-high, high-low), n = 388, and were reexamined for serum lipids, lipoprotein cholesterol, glucose tolerance, and anthropometry. Skinfolds were thicker in whites than in blacks except for subscapular skinfold. Children in the high-high stratum were heavier and more obese. The postglucose insulin level was positively correlated with fasting serum triglycerides and pre-beta-LPC. Compared with other strata, high-high strata showed more clustering among half-hour and 1-hour plasma insulin, serum triglycerides and pre-beta-LPC, and trunk skinfolds. We conclude that racial differences in lipid and carbohydrate metabolism occur in all four strata, and that a strong clustering occurs more in the high-high stratum, which may, in part, explain the coincidence of several high cardiovascular risk factor levels observed in the same children. These observations document in free-living children changes of obesity, plasma glucose, and insulin metabolism related to serum lipoproteins that are involved in the early natural history of atherosclerosis.
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PMID:Clustering of anthropometric parameters, glucose tolerance, and serum lipids in children with high and low beta- and pre-beta-lipoproteins. Bogalusa Heart Study. 705 36

Resting heart rates were ascertained during the 1978-1979 school year in 3590 children aged 5-17 years in the biracial geographic population of Bogalusa, Louisiana. These rates were found to be relatively independent of the method of measurement, whether supine by physician's stethoscope or dressed sitting radial pulse taken by a nurse, and in either case adhering to a strict measurement protocol. Apart from the known influences of age and sex, the authors found a small but consistent racial influence, with whites having 3-4 beats/min higher rates than blacks. Controlling for age, the authors found heart rate to be positively correlated with blood pressure in whites and with subcapsular skinfold thickness in boys. No consistent relation between heart rate and amount of cigarettes smoked was observed. Boys in the upper five percentiles of blood pressure-heart rate ("double") product values were found to have about twice the subscapular skinfold thickness compared to the lower five percentiles. Likewise, boys in the upper five percentiles of subscapular skinfold thickness had significantly increased double products. Since the double product is an index of cardiac oxygen consumption, this finding could point to a possible etiologic link between obesity and chronic cardiac stress in males beyond the mediation of lipoproteins, cholesterol, and diabetes mellitus in contributing to atherosclerotic heart disease, but this issue needs further study. Ascertainment of resting heart rate provides an additional parameter in the study of cardiovascular risk factor variables, in youth as in adulthood, to supplement the natural history of the atherosclerosis-hypertension syndrome with its sequelae.
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PMID:Resting heart rate and pressure-rate product of children in a total biracial community: the Bogalusa Heart Study. 711 38

In view of the postulated association between plasma lipids and the development of atherosclerosis, there is growing interest in the effects of beta blockers on plasma lipids. This study was undertaken to investigate whether a nonselective beta blocker, such as mepindolol, which possesses intrinsic sympathomimetic activity, causes significant changes in serum lipids, particularly in their ditribution among the different lipoproteins. Eighteen healthy subjects, twelve males and six females, were given mepindolol orally, daily doses of 0.2 mg/kg averaging 10-15 mg. Pre- and post-treatment fasting total serum cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were evaulated; the ratio LDL cholesterol/HDL cholesterol was also calculated. Total cholesterol did not change significantly after treatment with mepindolol (- 1.9 mg%), whereas a small and nonsignificant decrease was observed in LDL cholesterol (- 6 mg%); no change was found in HDL cholesterol (- 0. mg%). Serum triglycerides showed a significant increase (+ 20.9 mg%, p less than 0.01). Thus, the most prominent effect of even a short period of treatment with mepindolol is a net increase in serum triglyceride levels. It must be remembered that high triglyceride levels do not constitute a cardiovascular risk factor. On the other hand, no significant changes in total cholesterol, HDL and LDL cholesterol, and in LDL cholesterol/HDL cholesterol ratio were observed. The results of this study show that mepindolol, unlike other beta-blocking agents, does not affect cholesterol concentration and distribution among the lipoproteins. In particular it does not reduce HDL cholesterol, which is currently assumed to be inversely related to the development of atherosclerosis.
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PMID:Effect of mepindolol on serum lipids. 717 57

Several studies have shown that obesity is associated with atherosclerosis. The reason may be that there is often a gathering together of risk factors for cardiovascular disease in obesity. Recently plasma fibrinogen level has been identified as an important cardiovascular risk factor. The aim of the study was to investigate fibrinogen levels in obesity before and after weight reduction. Obese but otherwise healthy patients with overweight problems were studied. 448 female patients (39.1 +/- 13.2 years, body mass index 38.7 kg/m2) and 136 male patients (39.4 +/- 12.8 years, body mass index 40.7 kg/m2) were examined after overnight fasting. Sixty patients (44 female, 16 male) were studied after 9.5 +/- 6.2 month of dieting (1200 kcal/day: 20% protein, 30% fat and 50% carbohydrates). The weight loss was 16.7 +/- 11.0 kg in the female and 16.2 +/- 6.7 kg in the male patients, and blood pressure, triglycerides, blood glucose and uric acid had declined. The fibrinogen level correlated with the body mass index, the waist circumference, the hip circumference and the waist to hip ratio. The fibrinogen level also correlated with insulin. A partial correlation of fibrinogen and insulin continued to exist after removing the linear effects of the other variables measured. After weight reduction, the level of fibrinogen was lower. In patients with extreme overweight and high fibrinogen levels, who reduced their BMI by 7.4 +/- 1.24 kg/m2, the weight loss correlated with the decrease in fibrinogen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fibrinogen in obesity before and after weight reduction. 771 58

Epidemiological evidence suggests that fibrinogen represents a major cardiovascular risk factor. Clinical data is in full agreement with this hypothesis. As fibrinogen also represents an acute phase protein, its association with atherosclerosis could be linked to infection or inflammation of other organs. Moreover, it could be connected to the inflammatory phenomena of atherosclerosis itself. These two possible explanations for the link between fibrinogen and atherosclerosis are discussed in detail. On balance, the evidence for either is not fully convincing. Therefore the most likely explanation for the striking association between fibrinogen and cardiovascular events is that hyperfibrinogenaemia is causally related to atherothrombosis, independent of its role as an acute phase protein. Several plausible pathophysiological pathways exist which would explain how fibrinogen leads to major cardiovascular disease. It is concluded that fibrinogen is a cardiovascular risk factor in its own right; its measurement should be included in future cardiovascular risk profiles.
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PMID:Fibrinogen as a cardiovascular risk factor--interrelationship with infections and inflammation. 813 95

Untreated acromegaly is associated with an increased cardiovascular morbidity and mortality. The contribution of altered lipid metabolism remains unclear. We investigated the relationship between serum apolipoprotein(a) (apo(a)) and growth hormone (GH) levels in 15 patients with acromegaly before and during treatment with octreotide, a long-acting somatostatin analogue, 288-600 micrograms/day s.c., for 6 months. Before treatment serum apo(a) was significantly elevated in acromegalic patients (geometric mean being 323 U/l vs. 142 U/l in controls (n = 92; P < 0.01)). Octreotide treatment resulted in significant reductions in serum apo(a) concentration (F = 7.22; P < 0.01; geometric mean being 232 U/l and 248 U/l at 3 months and 6 months respectively) and apo(a) concentrations on treatment were not significantly different from control values. There were significant reductions in serum GH (F = 7.30; P < 0.01), insulin growth factor 1 (IGF1) (F = 31.4, P < 0.001) and insulin (F = 4.57; P < 0.05) concentrations. Plasma glycosylated haemoglobin levels were unchanged. Apo(a) levels correlated with serum GH (r = 0.450; P < 0.01) but showed no correlation with basal insulin concentrations. Serum HDL cholesterol increased on treatment (F = 4.29; P < 0.05). Triglycerides were reduced only in the 12 patients without diabetes mellitus (F = 4.75; P < 0.05). No significant change in LDL cholesterol occurred. Our findings suggest that apo(a) may constitute another cardiovascular risk factor in untreated acromegaly and that GH may be involved in the regulation of circulating apo(a) concentration.
Atherosclerosis 1993 Dec
PMID:Serum apolipoprotein(a) correlates with growth hormone levels in Chinese patients with acromegaly. 814 41

Single cardiovascular risk factor intervention is probably not sufficient to prevent atherosclerosis progression. There is a lack of data on concomitant use of hypocholesterolemic agents and antihypertensive drugs with respect to possible interactions and adverse experiences. We studied 293 patients (below 65 years of age) under treatment with either lisinopril (n = 144) or nifedipine (n = 149) for mild to moderate hypertension for 10 weeks, and with serum cholesterol above 6.5 mmol/L, who were randomized to either lovastatin 20 mg every day or placebo in a double-blind, double-dummy design for 6 weeks. Lovastatin effectively lowered cholesterol by 16% and 15% in the lisinopril and nifedipine group respectively (P < .01 compared to placebo for both groups) without any negative impact on the antihypertensive efficacy of either lisinopril or nifedipine. The drugs in combination were well tolerated and did not affect the well-being of the patients, and did not cause any more adverse effects than the antihypertensive agents alone. Liver enzymes increased slightly during lovastatin therapy, while no case of myopathy was reported. Combined therapy with lovastatin and antihypertensive therapy can be safely undertaken.
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PMID:Effect and tolerability of combining lovastatin with nifedipine or lisinopril. 821 32


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