Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Atenolol is a beta-selective (cardioselective) adrenoceptor blocking drug without partial agonist or membrane stabilising activity. Its profile of action most closely resembles that of metoprolol which differs only in that it has some membrane stabilising activity. Atenolol has been well studied and is effective in the treatment of hypertension and in the prophylactic management of angina. Its narrow dose response range obviates the need for highly individualised dose titration. In patients with angina its long duration of beta-blocking activity allows once daily dosage, whereas other beta-blockers, unless in sustained release dosage forms, need to be given in divided doses. Other beta-blockers can be given once daily in hypertension, but at presnt the evidence for effective control with a once daily regimen is more convincing with atenolol. Further studies are need to clarify any important differences in blood pressure control between the various beta-blocking drugs, both in conventional or sustained release dosage forms. As with metoprolol, atenolol is preferable to non-selective beta-blockers in patients with asthma or diabetes mellitus. Atenolol has been well tolerated in most patients, its profile of adverse reactions generally resembling that of other beta-blocking drugs, although its low lipid solubility and limited penetration into the brain results in a lower incidence of central nervous system effects than seen with propranolol. Atenolol is eliminated virtually entirely as unchanged drug in the urine and dosage needs to be reduced in patients with moderate to severely impaired renal function (glomerular filtration rate less than 30 ml/min). There is no need for modification of dosage of atenolol in liver disease.
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PMID:Atenolol: a review of its pharmacological properties and therapeutic efficacy in angina pectoris and hypertension. 3 96

In the course of 5 years, 9509 healthy adult subjects had an average annual incidence of 3.6 unrecognized infarcts per 1000 persons and 5.3 clinical ones per 1000 persons. A multivariate analysis showed that the most significant risk factors were age, left axis deviation, left ventricular hypertrophy, cigarette smoking, systolic or diastolic blood pressure, and peripheral vascular disease. Some of the known risk factors of clinical infarct, or angina pectoris or both, such as cholesterol, diabetes, anxiety, and psychosocial problems, do not play a significant role in unrecognized infarcts. Subjects whose electrocardiograms were initially interpreted by cardiologists as noninfarcts but by the computer as infarcts developed a high rate of unrecognized infarcts in the subsequent 5 years. A 7-year mortality follow-up showed a markedly higher rate among the unrecognized infarct group as compared with the noninfarct population, but significantly lower than those who developed a clinical infarct.
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PMID:Unrecognized myocardial infarction: five-year incidence, mortality, and risk factors. 13 28

The achillean reflexogram has been recorded according to Gilson's photo-electric technique among two male populations during routine cardio-vascular screening. The first population concerns 706 men aged 21 to 55 and the second one 4 437 subjects aged 46 to 52. The frequency of bilateral areflexy increases with age (from 3% before 30 to 6% after 40); it is significantly associated with the presence of angina pectoris. However, no relation is observed with diabetes or clinical suspicion of myocardial infarction. Whereas fat body mass is positively associated with the reflex duration the latter is reduced with heart rate, systolic blooc pressure and number of blood erythrocytes and leucocytes increased. These results and the interest of systematic reflexogram recording during health check up are discussed.
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PMID:[Achillean reflexogram : its measurement and its correlations with various clinical and biological factors in 2 working male populations]. 17 Jun 86

Data obtained from two multipurpose surveys of hospitalized patients were examined to determine the risk of nonfatal acute myocardial infarction in post-menopausal women 40 to 75 years of age in relation to use of estrogen-containing drugs. Eight (2.4 per cent) of 336 myocardial infarction patients and 330 (4.9 per cent) of 6730 reference patients were regular estrogen users (crude rate ratio, 0.47) at the time of hospitalization. After control for confounding variables -- among them, age, past history of myocardial in farction, angina, diabetes, and hypertension (alone or in combination) and cigarette smoking -- the summary point estimate of rate ratio was 0.97 with 95 per cent confidence limits of 0.48 and 1.95. Thus, there was no evidence of a statistically significant association between current regular use of estrogens and nonfatal acute myocardial infarction.
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PMID:Myocardial infarction and estrogen therapy in post-menopausal women. 17 69

Clinical and coronary arteriographic findings were evaluated in patients with angina pectoris who were considered not to have diabetes mellitus or to have chemical or clinical diabetes. Each of the three groups consisted of 100 consecutive referred patients. Neither the age of the patients nor duration of symptoms differed significantly among the groups. Hypertension, gout, and peripheral vascular disease were more frequent in the patients with clinical diabetes. There was no difference in serum cholesterol concentration among the groups, but plasma triglyceride levels and the frequency of type 4 hyperlipoproteinemia were significantly higher (p less than 0.01) in the chemical and clinical diabetic groups than in the nondiabetic patients. Coronary arteriographic observations indicated that the severity of the coronary arterial disease was greater in both diabetic groups than in nondiabetic patients. The difference in the coronary scores among the three groups of patients interacts to some extent with the triglyceride level, since a high score in the diabetic groups was noted only in the presence of an elevated tryglyceride concentration. The results indicate that the increased severity of coronary arterial disease in diabetic patients is not attributable to age, duration of symptoms, hypertension, type -4 hyperlipoproteinemia, or apparent severity of the glucose intolerance.
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PMID:Reappraisal of the role of the diabetic state in coronary artery disease. 18 Dec 12

Using univariate and multivariate analyses, the association between high density lipoprotein (HDL) cholesterol and coronary heart disease (CHD) incidence was investigated. Over 150 cases of myocardial infarction (MI) occurred among 6500 Israeli adult males in a five-year prospective study. At age 50 years and over, there is a significant inverse association between MI incidence and HDL cholesterol. This relationship persists when controlling for risk factors such as age, other cholesterol components, smoking, blood pressure, weight, and diabetes mellitus. Unlike hypercholesterolemia and smoking, the relative risk with HDL cholesterol increases with age above 50. Similar patterns of association occur between HDL cholesterol and angina pectoris incidence, sudden unexpected death and deaths from MI. It is suggested that HDL cholesterol is an independent risk factor for CHD, especially in males over 50, and the implication of this study is that increased HDL cholesterol might play a protective role in the pathogenesis of CHD.
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PMID:High density lipoprotein cholesterol and incidence of coronary heart disease--the Israeli Ischemic Heart Disease Study. 22 35

Although a coronary bypass operation improves the quality of life and possibly prolongs it, a small percentage of patients do not have satisfactory results and require reoperation. From July, 1970, to March 1975, 358 patients underwent coronary bypass for chronic disabling or preinfarction angina. Angina requiring operation recurred in 24 men and 2 women. Hyperlipoproteinemia was present in 19 of the 26 (73%), and 3 patients had early-onset diabetes mellitus. Only 2 of 14 patients with progression of arteriosclerosis were helped by a second operation. Of 7 patients with occluded grafts, local disease, and no progression, 5 were helped by reoperation. Patients with occluded coronary bypass grafts without progression of arteriosclerosis benefit substantially from a second revascularization procedure. Aguarded prognosis must be held, however, for those with progression of arteriosclerosis with hyperlipoproteinemia or juvenile-onset diabetes who undergo reoperation. Patients with initially diffuse disease and graft occlusion also seem to benefit less from a second operation.
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PMID:Results of reoperation for recurrent angina pectoris. 29 7

Twenty-eight patients with subendocardial infarction (Group A) were compared with 28 patients with unstable angina (Group B) and 28 with stable angina (Group C) matched for age and sex. The three groups did not differ in prevalence of diabetes, hypertension, old infarction or duration of disease. There were no significant differences in number of diseased vessels, coronary score, abnormal left ventricular wall motion or left ventricular end-diastolic pressure. Angiograms performed 2 weeks postoperatively revealed closure of 3 of 31 grafts (16 patients) in Group A, closure of 3 of 34 grafts (17 patients) in Group B and closure of 6 of 50 grafts (22 patients) in Group C (differences not significant). Postoperative angiograms showed improved wall motion in 37 percent of Group A, 53 percent of Group B and 36 percent of Group C (differences not significant). Postoperative new Q waves appeared in one hospital in Group A and in two patients in Groups B and C. There were no hospital or late deaths. In a mean follow-up period of 29 months, 68 percent of patients in Group A, 61 percent in Group B and 54 percent in Group C were asymptomatic. Thus, bypass grafting was performed with similarly low mortality and morbidity in patients with subendocardial infarction and in those with angina; more than one third of postoperative angiograms in the three groups showed improved wall motion; and late follow-up studies demonstrated functional improvement in the majority of patients in all three groups.
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PMID:Results of aortocoronary bypass grafting in patients with subendocardial infarction: late follow-up. 30 5

To evaluate the efficacy of coronary bypass surgery in reduction of sudden death, the prognosis of 286 similar patients with multivessel coronary stenosis was studied prospectively and the results of medical therapy (Group I, 114 patients) were compared with those of surgical therapy (Group II, 172 patients) after cardiac catheterization and coronary arteriography. During 39 months' evaluation of both groups, mortality from congestive heart failure and noncardiac causes did not differ (Group I, 14 percent; Group II, 8 percent) (P greater than 0.05). Sudden was evaluated in the remaining 217 patients (Group I, 96; Group II, 121 patients) who were matched for age (Group I, 52 years; Group II, 51 years); duration of overt coronary disease (Group I, 3.8 years; Group II, 4.0 years); angina pectoris (Group I, 83 percent; Group II, 95 percent); prior myocardial infarction (Group I, 77 percent; Group II, 74 percent); and congestive heart failure (Group I, 30 percent; Group II, 23 percent) (all P greater than 0.05). In addition, the prevalence of coronary risk factors was the same (P greater than 0.05) in both groups (hypertension, cigarette smoking, diabetes mellitus, lipid abnormalities and family history of coronary disease). Importantly, arteriography and catheterization established a similar extent and location of major coronary arterial stenoses and of ventricular dysfunction; two vessel disease (Group I, 32 percent; Group II, 33 percent) and three vessel disease (Group I, 68 percent; Group II, 67 percent); left ventricular end-diastolic pressure (Group I, 13; Group II, 14 mm Hg);cardiac index (Group I, 2.85; Group II, 2.91 liters/min per m2); and coronary collateral vessels (Group I, 58 percent; Group II, 61 percent) (all P greater than 0.05). Fifty-six percent of patients in Group II had multiple bypass grafts and a late patency rate (average 21 months) of 87 percent of one or more grafts. During subsequent prospective evaluation of over 3 years, bypass surgery provided greater symptomatic benefit of improved functional capacity (Group I, 12 percent; Group II, 69 percent) (P less than 0.05) and complete anginal relief (Group I, 30 percent; Group II, 60 percent) (P less than 0.05). Moreover, bypass surgery was associated with marked reduction in sudden death (Group I, 24 percent; Group II, 6 percent) (P less than 0.05). Thus, in patients with multivessel coronary disease carefully matched for clinical factors, hemodynamics, atherogenic precursors and coronary pathoanatomy, effective aortocoronary bypass surgery appeared to prolong survival by decreasing the incidence of sudden death, possibly by a decrease of unexpected fatal arrhythmias.
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PMID:Improved longevity due to reduction of sudden death by aortocoronary bypass in coronary atherosclerosis. 32 59

160 consecutive CCU-treated AMI patients below 66 yr were investigated for ventricular ectopic beats (VEB) by 6-h telemetry prior to discharge and after 1 yr. During the follow-up year 11 patients died suddenly and 20 suffered reinfarction. By stepwise discriminant analysis three independent prognostic parameters were found: (1) radiologic cardiomegaly; (2) severe VEBs prior to discharge; (3) diabetes mellitus. Previous infarct, angina, functional class II to IV, smoking, higher age and radiologic cardiomegaly were significantly more frequent in patients with VEBs prior to discharge. History of heart failure, functional class deterioration, higher age, male sex, large first infarct, VT or VF in CCU, transmural infarction, radiologic cardiomegaly were more frequent in patients with severe VEBs prior to discharge. VEB severity increased significantly during the follow-up year in survivors without reinfarction. This increase occurred in patients with previous infarction, angina pectoris, higher age and heart failure.
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PMID:Ventricular arrhythmias after an acute myocardial infarction. Prognostic weight and natural history. 35 1


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