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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to assess the ischemic burden and the hemodynamic changes during daily activities in patients with coronary heart disease. Three exercise tests were performed during the day (10:00 a.m., 2:00 p.m., 6:00 p.m.), recording ST-segment depression, pulmonary artery pressure, pulmonary wedge pressure, and cardiac output as well as heart rate and systemic blood pressure during placebo and nitrate therapy. With placebo as well as nitrate therapy there was a gradual increase of ischemia and preload and a decrease of cardiac output during the day. High nitrate concentrations led to a significant reduction of both preload and ST depression with a marked circadian phase dependency of cardiovascular effects.
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PMID:Chronotherapy in coronary heart disease: comparison of two nitrate treatments. 181 88

Epidemiologic studies have shown that insulin is a risk factor for coronary heart disease (CHD). Clinical studies have also demonstrated positive correlations between insulin and blood pressure, triglycerides, total cholesterol, fibrinogen, and plasminogen activator inhibitor. Moreover, there is an inverse correlation between insulin and high-density lipoprotein (HDL). These studies have provided evidence in support of the biologic plausibility of epidemiologic observations, but they have not clearly established insulin's role in the pathogenesis of human cardiovascular diseases (CVD) such as hypertension. In fact, there is considerable evidence that insulin resistance (abnormal nonoxidative glucose disposal), not hyperinsulinemia, is the primary insulin-related abnormality in human hypertension, and that hyperinsulinemia occurs as a response to insulin resistance. Skeletal muscle appears to be the primary site of insulin resistance in essential hypertension, although other organs, such as the kidneys and liver--key sites for cell and water homeostasis and lipoprotein regulation, respectively--may respond normally to insulin. Adipocytes also appear to be a site of insulin resistance. Thus, the putative interrelationship between hyperinsulinemia and insulin resistance, on the one hand, and with blood pressure and lipoproteins, on the other, is a complex one and may involve organ-specific insulin resistance. Altered cation transport is one of several mechanisms by which insulin resistance might raise blood pressure. The Na+, K(+)-ATPase and Ca(2+)-ATPase pumps are insulin sensitive. Thus, when insulin resistance is present, the activity of these pumps in the smooth muscle of the arterial wall might be reduced. This would lead to an intracellular accumulation of sodium and calcium, thereby sensitizing the vascular wall to pressor substances. Moreover, secondary hyperinsulinemia will occur, and insulin has been shown to stimulate sympathetic nervous system activity and to increase renal tubular absorption of sodium. Insulin is also a growth factor and therefore might have a trophic effect on the vessel wall, one that could initiate and/or sustain hypertension as well as atherosclerosis. Abnormal lipoprotein metabolism is yet another possible explanation for the accelerated atherosclerosis that has been observed in persons with abnormal carbohydrate tolerance and insulin resistance. Hyperinsulinemia and insulin resistance both play a role in the expression of elevated very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) levels as well as in the depression of HDL levels. Coronary risk reduction has been disappointing when blood pressure has been lowered with treatment regimens based on thiazide diuretics and/or beta blockers. Thiazides and some beta blockers may further impair tissue insulin sensitivity and often cause blood lipoprotein abnormalities.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Epidemiologic and clinical aspects of insulin resistance and hyperinsulinemia. 186 24

Regular physical activity increases a person's ability to perform daily activities with greater vigor and may reduce the risk for specific health problems, including coronary heart disease (1), hypertension (2), noninsulin-dependent diabetes mellitus (3), colon cancer (4), and depression (5), as well as lower all-cause death rates (6). In addition to extracurricular activities (e.g., sports and recreational organizations), high school physical education (PE) classes provide an opportunity to ensure a minimal, regular amount of desirable physical activity and help establish physical activity patterns that may extend into adulthood. This report examines the prevalence of self-reported enrollment, attendance, and participation in PE classes by students in grades 9-12.
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PMID:Participation of high school students in school physical education--United States, 1990. 188 83

Diagnostic indices based on various sets of signs were developed to define functional classes of angina pectoris. At the same simultaneous application of clinical parameters (age, conditions for onset of anginal episodes and their arrest, the number of weekly anginal episodes, the level of daily exercise, over 1-mm ST segment depression, resting ECG signs of left ventricular hypertrophy, etc.) and bicycle ergometer testing data (cardiac output, peak exercise heart rate, etc.) augmented the accuracy and reliability of identification of a functional class in patients with stable angina. The diagnostic indices are highly reproducible and may be useful in the assessment of the course of the disease and its prognosis in patients with coronary heart disease.
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PMID:[Reproducibility of functional classification in patients with stable angina pectoris]. 189 36

The anti-ischaemic and haemodynamic effects of two transdermal nitroglycerin systems, each offering 15 mg of nitroglycerine, the first giving continuous release (group 1) and the other discontinuous release (group 2), were compared in 30 men (mean age 56.5 [33-70] years) with coronary heart disease confirmed by angiography. Resting and exercise haemodynamics together with the degree of exercise-induced ST segment depression were measured on the first day, before and two hours after application of the plaster. After one week's therapy these measurements were repeated 24 hours after the application of the plaster on the previous day and two hours after the last application. Two hours after the first application both groups showed significant reduction (P less than 0.01) in exercise-induced ST segment depression (group 1: -60%, group 2: -50%) and in mean pulmonary artery pressure during exercise (group 1: -10%; group 2: -7%). After one week's therapy the reduction in exercise-induced ST segment depression was still significant in group 1 (-60%; P less than 0.01), but in group 2 (-30%) it was no longer significant. After one week had passed there was no longer any significant reduction in mean pulmonary artery pressure in either group (group 1: -6%; group 2: 0%). The acute anti-ischaemic and haemodynamic efficacy of both transdermal nitroglycerin systems was hence comparable; however, the emergence of nitrate tolerance during long-term use was not prevented even by phased release of the drug.
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PMID:[Transdermal nitroglycerin systems with continuous and discontinuous drug release. A comparison of the anti-ischemic and hemodynamic acute and long-term effects]. 189 44

The prognosis of coronary patients in terms of the mortality of coronary heart disease shows a positive relation to the severity of clinical and functional diagnostic parameters. Thus exercise therapy should be monitored by criteria that take ischemia, the myocardial situation and rhythm disorders into account. These criteria should be reliable and should be easy to determine as well as to apply. For pragmatic reasons the non-invasive evaluation of findings and the diagnostic symptom-limited ergometer test are especially significant for dosage and monitoring of exercise therapy. Monitored exercise therapy is here understood to mean individually adjusted exercising by patients, and training thus has to be based on diagnostic findings. First existing complaints have to be analyzed and such findings as size of infarction in the ECG, heart volume in the X-ray, size and function of the left ventricle by echography, etc. checked. Afterwards maximum physical work capacity on a multistage bicycle ergometer test is measured with respect to the following termination criteria: a) subjective reports by the patient during exercise (e.g. onset and severity of angina pectoris, dyspnea and/or fatigue of the leg muscles) and b) objective criteria such as significant ischemic ST-depression, exercise-hypertension, age-related submaximal heart rate and significant rhythm disorders. An inverse correlation is found between measured maximum symptom-limited physical performance and the frequency of cardiac termination criteria; a comparable inverse correlation exists with heart volume: max. O2 pulse.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Can the training of coronary patients be monitored by readily measurable parameters?]. 191 21

This article reviews the current body of literature linking anabolic steroids to atherogenic alterations in serum lipid levels. Anabolic steroids cause marked high-density lipoprotein2 levels [corrected] depression (weighted average, 52%) and severe depression of high-density lipoprotein b levels (weighted average, 78%) while raising low-density lipoprotein levels an average of 36%. The mechanism of these lipid changes, their time course in relation to anabolic steroid use, and their dependency on route of anabolic steroid administration are discussed. Interpretation of the observed lipid level changes in light of the epidemiologic data linking lipids to coronary heart disease risk is used to estimate the lipid-based increase in coronary heart disease risk due to anabolic steroid use.
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PMID:Atherogenic effects of anabolic steroids on serum lipid levels. A literature review. 192 79

Excessive secretion of macrophage monokines is proposed as the cause of depression. Monokines when given to volunteers can produce the symptoms necessary for the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised (DSM-III-R) diagnosis of major depressive episode. Interleukin-1 (IL-1) can provoke the hormone abnormalities linked with depression. This theory provides an explanation for the significant association of depression with coronary heart disease, rheumatoid arthritis, stroke and other diseases where macrophage activation occurs. The 3:1 female/male incidence of depression ratio is accounted for by estrogen's ability to activate macrophages. The extraordinary low rate of depression in Japan is consistent with the suppressive effect of eicosapentanoic acid on macrophages. Fish oil is proposed as a prophylaxis against depression and omega-6 fat as a promoter. Infection, tissue damage, respiratory allergies and antigens found in food are some of the possible causes of macrophage activation triggering depression.
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PMID:The macrophage theory of depression. 194 79

Patients with obstructive sleep apnea show a fall in arterial oxygen saturation during apneas. Whether this is causing myocardial ischemia and consecutively ST segment depressions in the electrocardiogram is not known. Therefore 15 consecutive patients (53 +/- 8 years, apnea index 45 +/- 28, minimal oxygen saturation 71 +/- 14%) with OSA were studied by Holter electrocardiogram and polysomnography. History and exercise testing gave no evidence of coronary heart disease. Three patients had ventricular arrhythmias Lown IVA and 10 had Lown I or III. Three patients showed unspecific negative T waves or ST segment elevations. In no patient significant ST segment depression was found. It is concluded that OSA does not lead to ischemic ST segment depression in the absence of coronary heart disease. The cause of ventricular arrhythmias in OSA seems not be related to myocardial ischemia.
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PMID:[ST segmental changes and arrhythmias in obstructive sleep apnea]. 194 65

The prevalence of mental distress in a general population north of the Arctic Circle at 69 degrees N was studied over 4 midwinter months. Within the framework of a health survey for coronary heart disease, 3 questions about depression, coping problems and insomnia were posed. They were answered by 7759 people randomly assigned to a survey date from November to February. The extreme lack of daylight in December and January taken into consideration, the prevalence of mental distress found, 14% in men and 19% in women, is remarkably low compared with previous epidemiologic research. Except for insomnia in women, which was most prevalent in December, no significant relationship between month of survey and any of the 3 symptoms were found. Thus, the findings cast some doubt upon the importance of daylight for mental distress in the general population.
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PMID:Mental distress during winter. An epidemiologic study of 7759 adults north of Arctic Circle. 195 Jun 7


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