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

A study was carried out using 616 participants in a randomized clinical trial at the Harvard MRFIT (Multiple Risk Factor Intervention Trial) Clinical Center, to test if there were differences in the psychological dimensions of anxiety, depression, and functional heart symptoms in groups given different levels of treatment in a CHD (Coronary Heart Disease) Intervention Program. A theoretical framework was given to justify a number of hypotheses as to the induction of adverse psychological effects. At the end of two years in the MRFIT Program there were no significant differences between the special intervention group (SI) and the usual care group (UC) in the selected psychological variables.
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PMID:The psychological effects of differential treatment of a high risk sample in a randomized clinical trial. 48 65

Menopause is a reproductive milestone in a woman's life around which many different myths have developed. We reviewed three sets of myths that middle-aged premenopausal women hold and evaluated those myths according to scientific data from our own work and that of others. First, middle-aged women expect to experience depression, irritability, and vasomotor symptoms during the menopause. It appears that the vast majority of postmenopausal women do not experience depression, but do experience vasomotor symptoms that are uncomfortable and may have secondary effects on psychological well being, especially during the perimenopause. Second, middle-aged women believe that holding negative expectations about the menopause affects the quality of the menopausal experience. Indeed, that appears to be the case, perhaps because myths can function as self-fulfilling prophecy. The third myth is that there are no important changes that occur during the menopause. That is incorrect. Estrogen deficiency during the menopause sets the stage for substantial changes in risk for CHD, which becomes clinically apparent later in life. We discussed how estrogen deficiency may influence both lipids and lipoprotein levels and the magnitude of neuroendocrine and cardiovascular respond to mental stress. That latter pathway is of particular interest because middle-aged women may be exposed more often to interpersonal stress and may respond more emotionally to it, relative to men, suggesting a potential interactive effect of the decline in reproductive hormones and co-occurring social and psychological changes during the menopausal period. This discussion of the myths and realities of the menopause has deliberately not been exhaustive.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Myths and realities of the menopause. 155 95

Thirty-four patients with coronary heart disease who had silent myocardiac ischemic episodes as evidenced by long-term ECG monitoring were examined. Silent ST-segment elevations and depressions were encountered 2.7- and 4.9-fold as compared to manifest ones. The fact that the CHD patients had silent ST-segment depressions and/or prolonged high-amplitude silent ST-segment elevations suggests a grave severity of abnormal myocardial processes. There was a reduction in the number, duration of silent ST-segment elevations and depression episodes and in the amplitude of silent ST-segment depressions. This may indirectly indicate that the agent affects predominantly coronary blood flow and coronary vascular tone.
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PMID:[Effect of diltiazem on silent myocardial ischemia]. 175 70

Syndrome "X" comprises a heterogeneous group of patients with normal coronarographic findings whose repeatedly occurring chest pain is of ischaemic origin, similarly as angina pectoris in patients with CHD. One of the signs of ischaemic etiology of pain in these patients is significant depression of the ST interval on the ECG during ergometry. We were interested to know whether the depression of the ST interval and angina pectoris which develop during a load are associated also with a transient disorder of left ventricular local kinetics. We examined therefore five patients, using the dipyridamol test combined with an isometric load evaluated by two-dimensional (2D) echocardiography. All examinations revealed a normal coronarographic finding and significant electrocardiographic manifestations of ischaemia during ECG stress test. The investigation showed that none of the patients with "X" syndrome suffered from transient changes in the local kinetics of the heart muscle and we assume therefore that myocardial ischaemia in syndrome "X" does not affect a sufficiently large portion of the cardiac wall in the transmural section to be manifested by impaired kinetics detectable by 2D-echocardiography.
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PMID:[The dipyridamole echocardiography test combined with isometric loading in the diagnosis of syndrome "X"]. 179 45

The authors evaluated after 4-year interval the results of coronarographic and spiroergometric examination after a work load on a bicycle ergometer up to the limiting work syndrome in 51 all patients with the aim to reveal "risk factors" of sudden death in CHD patients. The following parameters were recorded: age, duration of treatment number of cigarettes smoked, systolic blood pressure at rest and the daily dose of the most frequently used drugs. After the work load the limiting values of pulse rate, systolic blood pressure, oxygen consumption, blood lactate level and the work ECG were evaluated. In the group of 7 sudden deaths of CHD patients the authors found statistically significant (p less than 0.001) a lower mean limiting value of oxygen consumption/kg and a deeper (p less than 0.0001) mean depression of the S-T segment in the work ECG when compared with 35 CHD patients surviving for 4 years. Both indicators are considered the main "risk factors" for sudden death.
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PMID:[The role of the exercise test in patients with ischemic heart disease in estimating the risk of sudden death]. 184 42

In 2208 boys aged 15 to 22 years the incidence of risk factors of atherosclerosis were determined. The risk factors were found in 33.7% of boys. The level of risk factors in youth has increased with age (p = 0.001), especially hypertension (p = 0.001) and smoking (p = 0.001). The authors concluded that the most important methods of prevention of atherosclerosis in youth should be: identification of high-risk individuals (overweight, hypertension, hyperlipidemia, family history of CHD and PAD, ischemic postexercise ST segment depression), health education and motivation for change, modification nutritional habits in cases of hyperlipidemia and overweight (prevention of early atherosclerotic lesions in childhood), early diagnosis and control of hypertension, practice of low salt intake, avoidance of smoking, sufficient physical activity (prevention of atherosclerotic disease mainly in adulthood).
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PMID:Epidemiology of risk factors of atherosclerosis and preventive program for youth. 221 95

Type A behavior and a Vital Exhaustion/Depression cluster seem to be the most crucial elements of the psychological 'coronary risk profile'. The question is, what physiological mechanisms intervene between these characteristics and CHD risk. In the present study the relationship was investigated between type A behavior and Vital Exhaustion on the one hand and the reaction of blood pressure, catecholamines and cholesterol to a real life stressor (Ph.D. thesis defence) on the other. Type A was shown to be related to a stronger response of adrenaline and diastolic blood pressure to the stressor. Vital Exhaustion was also positively correlated with the adrenaline reaction, and moreover, with cholesterol base level, stress induced cholesterol change, and noradrenaline and cholesterol stress levels. It was suggested that the relation between Vital Exhaustion and cholesterol parameters may originate in noradrenaline induced lipolysis. Type A and Vital Exhaustion may exert their influence on coronary risk by way of different physiological mechanisms. Type A via exaggerated hemodynamic reactivity, and Vital Exhaustion via lipid metabolism.
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PMID:The relation of type A behavior and vital exhaustion with physiological reactions to real life stress. 262 75

Although the study of coronary heart disease has provided a fruitful area of research for the psychosocial risk factors for disease, the amount of information among women is limited. Many of the psychological concepts tested in women have been developed from studies of men. The assumption that these psychological constructs (such as type A behavior) are pertinent to the psychology of women must be questioned. When women are included in studies of any disease, the questions asked of them must be applicable to their environment, behaviors, and psychological milieu. Because of the limited amount of data on women, it is difficult to draw conclusions regarding the relationships of psychosocial variables and the development of CHD. Several studies have indicated, however, that the change from a positive to an inverse relationship of SES to CHD in men has not been observed in women. Across various time periods and in different populations low SES is related to the occurrence of CHD in women. The reason for this is not known, and this is clearly an area for future investigations. Several measures of low social support have been found to be related to increase risk of CHD mortality and morbidity in women. A problem with this research is that each study demonstrated a different measure of social support to be the detrimental factor. This may be due to true differences between populations or may be a result of bias introduced from studying different age groups and different populations. It seems to be fairly clear that type A behavior, as measured in Framingham, is not related to definite CHD in women. The fact, however, that type A is related to anginal pain should not be minimized. These men and women are suffering from chest pain and are at increased risk to develop subsequent acute coronary events. For the most part, other personality variables, such as emotional lability, anxiety, depression, and neuroticism, have not been shown to be related to coronary disease in women. This may also be due to a true lack of effect or may be the result of not being able to separate the various manifestations of CHD and perhaps to limited sample sizes of women, which leads to a lack of power to detect at true effect. In the field of coronary heart disease epidemiology, as more studies include women and ask questions that are meaningful to them, a clearer understanding of the possible psychosocial etiology of disease will be possible.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Psychosocial factors in the epidemiology of coronary heart disease in women. 265 6

In 11 patients (2 female, 9 male) suffering from angiographically proven CHD (age 45-60 years; 54.3 years on an average) the efficacy of a once-daily oral medication with 120 mg ISDN/50 mg ISMN and diltiazem (D) each in a long-acting preparation was examined in a placebo-controlled study. Each period lasted for 3 days; 2 capsules were given at 0700 a.m. one capsule at 5 p.m. Long-term ECG-recordings for 24 hrs (Tracker recorder, Pathfinder III) were performed twice under placebo and once during the third day of ISDN or ISMN, ISDN/ISMN + D in the morning and JSDN or ISMN in the morning and D in the afternoon. The rate of ischemic events declined from 10.4 to 4.7, 3.3 and 2.2; the duration of ischemia in 24 hours declined from 128 min to 43 min, 44 min and 34 min. The product of ST-depression (mV) and time of duration (min) showed an equivalent course. A more than 80% reduction of ischemia (duration and frequency) was achieved by a combination therapy in 72% of the patients. Minimal increase of heart rate at the beginning of ST-depression increased significantly during all periods of therapy, maximal increase of heart rate at that time showed a decrease only during combination therapy with D, the mean value did not change significantly. The once-daily application of ISDN/ISMN (50 mg) in a long-acting preparation (120 mg) led to a significant reduction of silent myocardial ischemia. The efficacy of ISDN/ISMN can be improved by D (120 mg, long acting preparation) up to a greater than 80% reduction in frequency and duration of ischemic events.
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PMID:[Combination therapy with slow release isosorbide nitrate and diltiazem in silent myocardial ischemia]. 268 57

For effective treatment of coronary heart disease with calcium antagonists, knowledge of both the dose-response relationship of a remedy and equipotent dosage for comparison of different drugs is necessary. We performed controlled studies to evaluate the influence of single oral doses of calcium antagonists on ischemic ST-depression (calculated as the mean of all exercise and recovery minutes = mean ST-depression) in exercise ECGs of patients with proven CHD and stable angina pectoris. Ergometries were carried out under constant conditions, particularly with individually constant work load and duration. All calcium antagonists reduced ischemic ST-depression during ergometry dose-dependent when compared to placebo. Diltiazem: 90 mg: 6% (n.s.), 120 mg: 19% (n.s.) und 180 mg: 26% (p less than 0.025); gallopamil: 25 mg: 19% (n.s.), 50 mg: 34% (p less than 0.01) und 100 mg: 57% (p less than 0.0025); nifedipine-Cps.: 5 mg: 17%, 10 mg: 33% und 20 mg: 42%; nifedipine-Tbl.: 20 mg: 8% (p less than 0.05), 40 mg: 23% (p less than 0.057 und 60 mg: 31% (p less than 0.05); tiapamil: 300 mg: 30% (p less than 0.05) und 600 mg: 60% (p less than 0.01). As the result of our findings, comparable antiischemic effects can be expected with 120 mg diltiazem, 50 mg gallopamil, 20 mg nifedipin as capsule or 60 mg nifedipin as tablet and 600 mg tiapamil.
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PMID:[Dose-response relation of gallopamil in comparison with nifedipine, diltiazem and tiapamil in patients with coronary heart disease]. 269 66


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