Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007222 (cardiovascular disease)
 65,817 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The high incidence, great import, and long duration of cardiovascular diseases are reflected in high demands placed on the health services. Experience shows that utilization of the results of research in general practice is lagging behind. The application of any improvement in the diagnosis, therapy, and prevention in health care waits several years for its accomplishment. In order to improve this situation, the Ministry of Health of the CSR constituted, in line with WHO recommendations, a Department for Cardiovascular Diseases Control. The Department has worked out a programme of prevention and control of the major cardiovascular diseases, in particular, ischaemic heart disease, systemic hypertension and its complications, rheumatic heart disease, congenital cardiac and vascular defects, and cor pulmonale. New diagnostic, therapeutic, and preventive procedures are first tried out in so-called model areas and are only after this introduced into the national health care of people suffering from or endangered by cardiovascular diseases. In parallel, organizational measures necessary for comprehensive care are implemented. The authors report on the experience gained so far with the realization of the programme of care of people suffering from IHD and acute myocardial infarction. They emphasize the importance of continual schooling of medical personnel and of health education of the entire population. They describe the implementation on a national scale of postgraduate cardiological courses intended especially for first-line doctors.
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PMID:Present state of cardiovascular community control programme in the Czech Socialist Republic. 94 76

In a group of 34 men aged 30-59 years with essential hypertension of a mild or moderate degree the authors evaluated the behavior of the left ventricular ejection fraction and the rate of shortening of the circumferential fibre, using radionuclide ventriculography during exercise. The results were compared with a control group of 19 subjects lacking signs of cardiovascular disease. Asymptomatic hypertonic patients without signs complicating IHD have on average a small statistically insignificant reduction of values of the ejection fraction at rest and of the shortening of the circumferential fibre. However, they respond to a load by a significantly lower rise of the resting values than the control group. In 12% of the patients the authors found an abnormal reaction of the ejection fraction, i.e. a decline as compared with original values. The above differences can be ascribed to a reduction of left ventricular systolic function during chronic overload as a result of arterial hypertension. This functional reduction is not related to the values of the systolic or diastolic pressure at rest nor to the duration of hypertension.
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PMID:[Left ventricular systolic function during exertion in persons with mild and medium levels of hypertension]. 262 36

Gentamicin concentrations, pharmacokinetic parameters, and calculated doses from enzyme multiplied immunoassay (EMI) and fluorescence polarization immunoassay (FPIA) were compared in 79 samples from 39 patients. Associations between patient factors and the differences between assay results were also assessed. Concentrations were lower when measured by EMI than by FPIA in 71 of the 79 samples (p less than 0.001). Mean EMI values for elimination rate constant, volume of distribution, clearance, dose, and daily dose were 10-20% higher than mean FPIA values (p less than or equal to 0.01). Dosing intervals calculated from EMI and FPIA data were different in 20 pairs of intervals and varied depending on the length of calculated interval. Univariate and multivariate analyses revealed that renal function and the presence or absence of cardiovascular disease, cimetidine, or ranitidine, and heparin were related to differences between the assay results. EMI and FPIA yielded different results for gentamicin concentrations, pharmacokinetic parameters, and calculated daily doses in the clinical setting. Such differences could result in toxic or subtherapeutic doses being administered and may be related, in part, to various patient factors.
Ther Drug Monit 1989
PMID:Comparison of gentamicin immunoassays using univariate and multivariate analyses. 264 7

Should one catheterize the pulmonary artery (PA) for cardiac surgery before or after induction of anesthesia? Issues of central importance to this question include (1) the patient's preexisting hemodynamic abnormalities, (2) cardiovascular effects of anesthetic induction drugs, and (3) hemodynamic stress caused by laryngoscopy, endotracheal intubation, and PA catheter insertion. Some clinicians use the PA catheter immediately before anesthetic induction to detect and correct acute abnormalities in preload and ventricular function. This approach has been described as being partially responsible for decreased morbidity and mortality in patients with cardiovascular disease. Hemodynamic instability during induction has been reported with many of the common anesthetic induction agents, especially in patients with poor ventricular function. Since blood pressure is the product of cardiac output and systemic vascular resistance, accurate interpretation and treatment of hypotension are possible only when these variables are provided by vigorous use of the PA catheter. Early detection of myocardial ischemia is possible with examination of acute changes in the pulmonary capillary wedge pressure tracing. However, the lack of such information can restrict even the best anesthetist. Insertion of the PA catheter in the awake patient can be accomplished effectively and with minimal risk, so long as good patient rapport, adequate premedication, and continuation of antianginal medication until the time of surgery are assured. Preinduction placement of the PA catheter provides valuable, objective information for the cardiac anesthesiologist without incurring significant risk to the patient.
J Clin Monit 1985 Jul
PMID:Pulmonary arterial catheterization before anesthesia in patients undergoing cardiac surgery. Placement of the pulmonary arterial catheter before anesthesia for cardiac surgery: safe, intelligent, and appropriate use of invasive hemodynamic monitoring. 383 Dec 59

The association between psychological characteristics and ventricular arrhythmias was investigated in 150 men (50 with manifest IHD, 50 with risk indicators of IHD and 50 healthy men). Arrhythmias were recorded with 24-hour Holter monitoring. Psychological characteristics were assessed by the Emotions Profile Index and the Structured Interview for pattern A behaviour. A depressive emotional state was associated with prognostically severe ventricular arrhythmia in healthy men, but not in men with overt IHD or risk indicators of IHD. When clinical characteristics and age were taken into account, depressiveness was-among healthy men-the second most important factor after high age. The results suggest that-in absence of IHD or other cardiovascular disease-a depressive emotional state may participate in the formation of ventricular arrhythmia.
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PMID:Relation between ventricular arrhythmias and psychological profile. 644 56

Hypertension is a disease more common to advanced societies, possibly due to diet and life style. It is a disease that can be readily controlled, and active efforts to decrease blood pressure correlate with decreased incidence of cardiovascular disease. Important in the armamentarium of the physician dealing with hypertension are a variety of drugs. The common drugs include diuretics (thiazides, loop of Henle diuretics, potassium-sparing diuretics), beta-blockers, alpha-agonists, neuron-blocking drugs, and vasodilators. The role of monitoring the blood concentration of each of these drugs in the interest of enhancing clinical usefulness is reviewed in light of the pharmacology of each drug group. We conclude that clonidine, guanethidine, hydralazine, and prazosin have properties that lend themselves to monitoring. Propranolol, metoprolol, nadolol, and alpha-methyldopa are drugs that have pharmacological properties that complicate monitoring. The drugs reserpine and minoxidil have properties that preclude monitoring, and the diuretics should only be monitored under unusual circumstances.
Ther Drug Monit 1981
PMID:Antihypertensive agents: role of therapeutic drug monitoring. 703 3

Available are the results of WHO programs (Acute Myocardial Infarction Register, Monitoring of Trends in Cardiovascular Diseases and Underlying Factors) investigations in three districts of Novosibirsk. The trends in mortality, case incidence, lethality for 15 years in 25-64-year-old myocardial infarction patients have been established as well as these trend relationships with main IHD risk factors, treatment efficacy, environmental factors, social stress.
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PMID:[Myocardial infarct (the epidemiological problems)]. 803 67

By late 70's, Portugal had one of the lowest IHD mortality rates amongst developed countries, with a declining trend. As for CVD, Portugal's figures were one of the highest, and showing a trend to increase. In what concerns to our country, by early 80's there were some data showing important regional variations concerning IHD and CVD mortality. So, the aims of this study were to analyse the evolution of IHD and CVD mortality rates in Portugal during the 80's and its possible relations with known risk factors evolution and distribution. The study also observed regional variations and regional mortality excesses, and international comparisons were established. During the studied decade, CVD and IHD were the leading causes of death in Portugal, with a ratio of 2.7/l respectively. There was a 24% decrease in CVD death rates, and 11% for IHD, equal for male and female. We found important differences amongst age groups: CVD predominates in extreme ages (the youngest and the oldest), whereas IHD predominates only in men 25-54 years old. We also found striking differences between provinces: in the northern coast CVD predominates, whereas in the South and Azores islands IHD leads. At the end of the decade, CVD mortality rates in Portugal where the highest in Europe; on the contrary, IHD mortality was the second lowest, just after France. This pattern is similar to the southern countries of Europe and Japan. Trends in the main cardiovascular risk factors in Portugal during the 80s are an incomplete explanation for this evolution pattern, although the authors value the suggested decrease in arterial hypertension prevalence as the main factor responsible for the observed reduction in IHD and CVD mortality in the country.
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PMID:[The evolution of mortality from ischemic heart disease and cerebrovascular diseases in Portugal in the decade of the 80s]. 817 94

Gene therapy techniques are under development for many areas of medicine, including cardiovascular disease. Identifying appropriate gene targets will require more detailed knowledge of the molecular pathophysiology of these disorders, and choosing appropriate vectors and delivery systems will contribute significantly to the challenge of developing this approach for clinical use. The concepts of toxicology and therapeutic drug monitoring will need to be broadened to account for the unique chemical, biological, and genetic characteristics of gene therapeutic agents. This review will provide an overview of strategy development, currently available vectors, and examples of their application to cardiovascular gene transfer. Considerations of the potential toxicities associated with particular vectors and delivery systems, as well as the types of genetic modifications possible, will provide some guidelines regarding appropriate monitoring of their clinical application.
Ther Drug Monit 1996 Aug
PMID:Cardiovascular gene therapy: current concepts. 885 61

There has been at least forty empirical investigations concerning cardiovascular disease (CVD) among professional drivers (PDs). Standard cardiac risk factor status does not consistently distinguish PDs from other lower risk groups. PDs showed more than twice the overall exposure to stressful work factors compared to referents. They also showed lower maximum bicycle exercise level with a higher double product and higher diastolic blood pressure at the end of exercise compared to controls. Catecholamine excretion has been reported to be elevated during driving. Ambulatory measurements showed higher systolic and diastolic blood pressure in drivers before, during and after driving shifts. Using spectral analysis, the low to high frequency ratio was more than doubled towards the end of a 4-hour drive compared to the early one and a linear increase in 0.1 heart rate variability as a function of distance driven. Reactivity to headlight glare has been shown to roughly parallel the degree of CVD severity in PDs with IHD, essential and borderline hypertension. It was postulated that PDs with IHD form a powerful association between the exposure to glare and the stressfulness of driving and this association was resistant to extinction. The occupational medicine specialist "should have the authority to check the patient regularly in the workplace itself (to ascertain whether or not) the decision to return to work is still valid". An integrated diagnostic approach for PDs might entail using exercise stress testing, with evaluation of silent myocardial ischaemia and heart rate variability during work as well as laboratory tests which simulate aspects of their work environment, with catecholamines measured in relation to these procedures. Assessment of left ventricular mass and further evaluation of atherogenic biochemical abnormalities would be of value for further untangling the mechanisms of cardiac risk among PDs.
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PMID:Occupational profile and cardiac risk: possible mechanisms and implications for professional drivers. 963 94


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