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

A large segment of the population gradually develops insulin resistance, and the related metabolic syndrome is one of the most frequent causes of atherosclerosis. Searching for a practical indicator of insulin resistance, we studied the correlations between fasting serum insulin level, the general manifestations of insulin resistance syndrome, and various aspects of coronary artery disease in 797 men and 322 women. After we classified patients according to the quartiles of serum insulin level, we noted in the top quartile the presence of practically all manifestations of insulin resistance syndrome in persons of both sexes (e.g., increased waist/hip ratio, body mass index, glucose, uric acid, triglycerides, apolipoprotein B and decreased high-density lipoprotein cholesterol levels as well as apolipoprotein A-I/B ratios, and so forth). We also noted a higher prevalence of hypertension, diabetes mellitus, and type IV hyperlipidemia. Significantly more women in the fourth than in the first quartile had angiographically documented significant stenosis of the coronary arteries (p = 0.0016, odds ratio 2.9, 95% confidence interval 1.5 to 5.6) and previous myocardial infarction (p = 0.0297, odds ratio 2.1, 95% confidence interval 1.1 to 4.1). Men in both the first and the fourth quartile had a more disturbed lipid profile and a higher prevalence of significant stenoses of coronary arteries and/or previous myocardial infarction than women; there was a tendency toward a lower prevalence of alcohol consumption (p = 0.0503), a higher prevalence of gout (p = 0.0634), and previous myocardial infarction (p = 0.0791) in men in the fourth than in the first quartile.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fasting hyperinsulinism, insulin resistance syndrome, and coronary artery disease in men and women. 748 1

Lower extremity atherosclerosis results in significant morbidity in women, particularly in women following the menopause. Up to 25% of women aged 55 to 74 years are affected by this disease. When noninvasive testing is used to determine the prevalence of lower extremity atherosclerosis, and men in this age group are equally represented. Cigarette smoking, diabetes mellitus, and menopause are risk factors for atherosclerosis of particular interest in women. The prevalence of cigarette smoking is rising rapidly among women, and diabetes appears to be a greater risk factor for atherosclerosis in women than in men. Risk factor reduction, in addition to an exercise program, are important parts of the treatment program for stable claudication. In both men and women with more severe symptoms, an ankle/branchial index (ABI) of less than 0.3 is associated with more severe symptoms, an ankle/brachial index (ABI) of less than 0.3 is associated with a poor prognosis. Men and women fare equally well following revascularization for severe peripheral atherosclerosis. However, there are some data to suggest that women may be offered peripheral revascularization at a lower rate.
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PMID:Peripheral arterial-vascular disease in women: prevalence, prognosis, and treatment. 755 10

Young survivors of myocardial infarction represent a poignant challenge to clinical research on atherogenic mechanisms and factors predisposing to and precipitating coronary thrombosis. Young male postinfarction patients are characterized by heavy smoking, dyslipoproteinaemias involving very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL), a family history of premature coronary artery disease, hyperinsulinaemic responses to oral and intravenous glucose challenges, an elevated plasma fibrinogen concentration and defective fibrinolytic function. Based on the multiplicity of metabolic and haemostatic disturbances present in these patients, a double-blind, randomized, placebo-controlled angiographic trial was initiated to determine whether bezafibrate, a clofibrate analogue, retards the progression or facilitates regression of premature coronary atherosclerosis. Men under the age of 45 years who survived a first myocardial infarction were screened for participation in the study. A fasting serum cholesterol value > or = 5.2 mmol/l and/or serum triglycerides > or = 1.6 mmol/l after three months of dietary treatment and angiographically demonstrable lesions in at least one coronary segment were required for inclusion. Treatment with diet and bezafibrate (200 mg t.i.d.) or matching placebo is continued for five years during which time re-angiography is performed after two years and at the end of the study. The primary aim of the trial is a comparison between the bezafibrate and placebo groups for change in mean minimum luminal diameter between the baseline and five-year coronary angiograms. This report presents the design features of the Bezafibrate Coronary Atherosclerosis Intervention Trial (BECAIT) and a review of current knowledge of mechanisms underlying premature coronary atherosclerosis and myocardial infarction at a young age.
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PMID:Design features of a five-year Bezafibrate Coronary Atherosclerosis Intervention Trial (BECAIT). 755 14

The influence of cigarette smoking and use of smokeless tobacco on plasma fibrinogen level, fibrinolytic variables, glucose tolerance and serum insulin was studied in a randomly selected population sample consisting of 604 men and 662 females between 25 and 64 years. Subjects were grouped according to tobacco habits as follows: regular smokers (> 1 cig/day), ex-smokers, snuff dippers, and non-tobacco users. An oral glucose tolerance test was performed on 54% of the participants. Tissue plasminogen activator (tPA) activity and plasminogen activator inhibitor type 1 (PAI-1) activity were used to study fibrinolysis. Men who smoked had 0.34 g/l (95% CI 0.17 to 0.49) higher fibrinogen level than non-tobacco users and numbers of cigarettes smoked correlated with plasma fibrinogen levels (r = 0.21, P = 0.006). Female smokers had significantly higher fibrinogen levels than ex-smokers but the difference compared with non-smokers was not significant. Snuff dipping did not affect fibrinogen levels. We found no relationship between tPA activity, PAI-1 activity and tobacco use. Post-load plasma glucose was lower in women who smoked, otherwise no influence of tobacco use on glucose levels was seen. Lower post-load insulin levels (-8.8 mU/ml, 95% CI -2.4 to -16.3) than in non-smokers were also found in women who smoked. This was only partially explained by a lower body mass index in smokers. We conclude that cigarette smoking is associated with increased fibrinogen levels, unaltered fibrinolysis, normal glucose tolerance and insulin levels. The use of smokeless tobacco, as moist oral snuff, does not appear to affect these potential cardiovascular risk factors.
Atherosclerosis 1995 Feb
PMID:Relationship of cigarette smoking and snuff dipping to plasma fibrinogen, fibrinolytic variables and serum insulin. The Northern Sweden MONICA Study. 775 54

The association between cardiorespiratory fitness (VO2max) and carotid atherosclerosis was analyzed in 163 men, aged 50 to 60 years. VO2max was assessed using breath-by-breath respiratory gas analyses during maximal exercise stress test. Atherosclerosis was evaluated quantitatively as intima-media thickness (IMT) of the right and left carotid arteries by high-resolution B-mode ultrasonography. Mean VO2max was 29.6 ml/kg per min (95%CI 28.7;30.5), common carotid IMT 1.04 mm (95%CI 1.01;1.07) and carotid bifurcation IMT 1.73 mm (95%CI 1.66;1.81). VO2max correlated inversely with carotid bifurcation IMT (r = -0.31, P < 0.001), but not with common carotid IMT (r = -0.13, P = 0.102). Men in the highest quartile of VO2max had lower (P < 0.001) bifurcation IMT 1.51 mm (95%CI 1.41;1.61) than men in the lowest (1.95 mm (95%CI 1.75;2.16)) and in the second lowest VO2max quartile (1.79 mm (1.63; 1.95)). The difference persisted (P = 0.014) after controlling for age, LDL-cholesterol, systolic blood pressure, saturated fat intake, current health status and exercise-induced ST-segment depression. These data suggest that cardiorespiratory fitness is an important independent predictor of carotid atherosclerosis in middle-aged men.
Atherosclerosis 1995 Jan 20
PMID:Inverse relationship between cardiorespiratory fitness and carotid atherosclerosis. 777 80

Twelve men and thirteen women with hypercholesterolaemia participated in a 20-week controlled cross-over trial to assess the interaction between dietary fat intake, gender and an HMGCoA reductase inhibitor, simvastatin. Subjects were matched for total cholesterol, age, body mass index (BMI) and plasma triglyceride. Gender-drug interactions were noted with men demonstrating only a 27% fall in LDL cholesterol with simvastatin when consuming a high fat (40% energy) diet compared to women with a 35% fall. In men, the lowest LDL/HDL ratio was achieved with simvastatin on a low fat diet (22% energy). Gender differences in the effect of simvastatin on HDL were confined to HDL3 cholesterol, although the drug raised HDL2 in both sexes on the low fat diet. Simvastatin was responsible for an 11% increase in HDL3 cholesterol in men particularly when on a low fat diet but did not affect HDL3 in women. An important diet-drug interaction was seen in triglyceride response, with a lowering of 17%-20% only when subjects were on a low fat diet. There was a gender difference in response to dietary fat change with men demonstrating a 19% decrease in triglycerides with dietary fat reduction while on simvastatin, whereas women showed a 9% increase which did not reach significance. Men also responded more favourably to dietary fat reduction with at least two-fold greater falls in plasma cholesterol than was seen in women.(ABSTRACT TRUNCATED AT 250 WORDS)
Atherosclerosis 1994 Sep 30
PMID:Gender and diet interactions with simvastatin treatment. 785 67

The association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% CI 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% CI 1.73; 2.09)] apo(a) quartile. The difference remained (p = 0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.
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PMID:Apolipoprotein(a), fibrinopeptide A and carotid atherosclerosis in middle-aged men. 858 28

Men have significantly more atherosclerotic disease than women. Platelet-mediated thrombosis plays a role in the initiation of myocardial infarction and stroke. Citrated whole blood from male and female donors was perfused through an annular system over everted human umbilical artery segments. Comparisons were made between platelet adherence and thrombus formation on subendothelium, platelet aggregation in citrated whole blood, hematologic variables, and the bleeding time. Platelet spreading and adherence were approximately 22% greater with male blood (P < 0.001), whereas thrombus formation on subendothelium and collagen- and arachidonic acid-induced platelet aggregation did not show sex-related differences. Platelet aggregation with adenosine diphosphate was greater in women, related to their lower hematocrit values. By contrast, in women hematocrit values showed a slight but significant positive correlation with platelet adherence on subendothelium. Fibrinogen was significantly correlated with collagen- and adenosine-diphosphate-induced platelet aggregation and with platelet adherence, spreading, and thrombus formation on subendothelium. The mean bleeding time was slightly longer in women than in men (P = 0.118). Platelet aggregation was not associated with the bleeding time except for collagen-induced platelet aggregation in males; the latter was significantly correlated with platelet adherence and spreading in both sexes, while arachidonic acid-induced platelet aggregation predicted platelet adherence and spreading in males. Male blood shows enhanced primary hemostatic activity; this may predispose men to atherosclerosis.
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PMID:Sex differences in platelet adherence to subendothelium: relationship to platelet function tests and hematologic variables. 790 Jul 41

We investigated the prevalence and associations with cardiovascular symptoms, signs, and risk factors of common carotid atherosclerosis using B-mode ultrasonography in a population sample of 182 eastern Finnish men aged 70 to 89 years. Men were examined in 1989 as a part of the 30-year follow-up examination of the eastern Finnish cohort of the Seven Countries Study. The mean maximal intima-media thickness (IMT) of the right and left common carotid arteries was 1.5 mm (range, 0.7 to 5.3 mm; standard deviation, 0.7 mm). Fifty-one percent of the subjects had nonmineralized atheroma and 91% had single or multiple mineralizations in any of the arterial segments imaged. Both mean maximal IMT and nonmineralized atheromas were associated significantly (P < .05) with the presence of cerebral atherosclerosis, carotid murmur, at least one nonpalpable peripheral arterial pulse, ischemic resting electrocardiographic abnormalities, and history of coronary heart disease but not with intermittent claudication at the 30-year follow-up. No significant associations were found between carotid mineralizations and clinical cardiovascular disease. Long-term elevations of serum cholesterol and long-term smoking, measured as the number of risk factor elevations in the six examinations, were associated with the presence of nonmineralized atheroma in the elderly (in 1989). Smoking and repeatedly detected hypertension, on the other hand, had an association with the presence of mineralizations in 1989.
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PMID:Ultrasonographic manifestations of common carotid atherosclerosis in elderly eastern Finnish men. Prevalence and associations with cardiovascular diseases and risk factors. 791 14

The prevalence of coronary heart disease (CHD), cardiovascular disease (CVD) and associated risk factors was studied in 413 men aged 70-89, the survivors of the Finnish cohorts of the Seven Countries Study. Men were divided into five categories according to manifestations of prevalent CVD: I, history or ECG evidence of previous myocardial infarction (MI; 48 men, 12%); II, typical angina pectoris (AP; 56 men, 14%); III, other ischaemic electrocardiographic (ECG) changes (82 men, 20%); IV, stroke, transient ischaemic attack, intermittent claudication or minor ECG changes (other CVD; 78 men, 19%); V, free of CVD (149 men, 36%). Both systolic and diastolic blood pressures were lowest in men with previous MI and in men free of CVD, and highest in men with other ischaemic ECG changes (P = 0.017). Low HDL-cholesterol (< 0.9 mmol/l) was more prevalent and the total/HDL-cholesterol ratio and triglyceride levels were higher in men with prevalent CHD (P < 0.05). Total and LDL-cholesterol, smoking, body mass index, fibrinogen, coagulation factor VIIc, apolipoprotein A-I, apolipoprotein B and lipoprotein(a) were not associated with prevalent CVD. The results show that manifestations of CHD and CVD are common among elderly Finnish men. Low HDL-cholesterol, total/HDL ratio, triglycerides and hypertension were associated with manifest CVD cross-sectionally.
Atherosclerosis 1993 Dec
PMID:Prevalence of coronary heart disease and associated risk factors among elderly Finnish men in the Seven Countries Study. 814 50


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