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Query: UMLS:C0018099 (
gout
)
5,192
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Cardiovascular diseases are the leading cause of death in Western countries, with an enormous increase in death rate and involvement of younger age groups during the last decades. This applies especially to
coronary heart disease
and is mainly caused by first-degree risk factors: hypertension, hyperlipoproteinemia, cigarette smoking,
gout
, obesity, polycythemia, lack of physical activity, and stress. These risk factors are discussed with special reference to overnutrition and increased cholesterol levels. Recent resuults of research concerning lipids and their relation to atherosclerosis are reviewed.
...
PMID:[Etiology and pathogenesis of arteriosclerosis]. 20 5
A study about
gout
associated with hypertension, diabetes, ischemic cardiopathy and different alterations in the sanguineous levels of lipids was conducted on 80 patients of the Rheumatology Service at the National Institute of Cardiology in Mexico City. We found abnormal levels of tryglicerids in the blood of 55% of the patients and a high level of cholesterol in only 5%. In 27% of the patients, some alteration showed in the carbo-hydrates methabolism, and in 22,5% of them we found systemic arterial hipertension. Slight ischemic cardiopathy was showing in a 37% of the patients, but uric acid level in blood seemed to be of little importance for the frequency, type or severity of the
coronary heart disease
. We made a comparison between the results we obtained through these studies and those found among the Mexican population and with information found in international medical publications.
...
PMID:[Incidence of coronary disease and other metabolic diseases in 80 gout patients]. 43 57
Gouty arthritis in females is relatively infrequent, although the sex ratio may be somewhat altered in different races. A positive family history is relatively prevalent among females whose onset of
gout
is premenopausal. In those patients with a postmenopausal onset, the incidence of diuretic-associated
gout
is high. The bimodal distribution of serum urate might be related to some variance of genetic transmission in female
gout
. Hypertension and
coronary heart disease
are common coexisting conditions, as is true of gouty arthritis in males. Chronic urinary tract infection dating from previous pregnancies is a frequent complication. The relative prevalence of proteinuria and diminished renal function leads to increased hyperuricemia, with a tendency to a low urinary uric acid output. This explains in part the higher incidence of extensive tophaceous deposition but lower incidence of renal calculi. Diuretics are associated with a higher urine pH, likewise, they reduce the urinary uric acid excretion. This also may contribute to the lower incidence of renal calculi. There may be some statistical support for the low fertility rate among the gouty females. Only two females became pregnant after the onset of gouty arthritis. All other pregnancies occurred before the onset of arthritis. Even then, abnormal pregnancies were relatively frequent. Some hormonal malfunction among the gouty females cannot be discounted. Both renal calculi and tophi are frequent in female
gout
associated with blood dyscrasias. They may manifest early, preceding the first attack of acute gouty arthritis. In both the male and female secondary
gout
, the primary underlying disease governs the uric acid metabolism and the clinical symptomatology of
gout
. The predominant role in pathogenesis is the excessive rate of uric acid production, and its disposal is governed by the different stages of the underlying disease and the treatment. Thus, secondary
gout
in females appears to be somewhat different from primary
gout
in females, but not different from secondary
gout
in males.
...
PMID:Some unusual features of gouty arthritis in females. 83 22
Diseases of urban and rural Blacks in South Africa are reviewed. In rural Blacks the major problems are infection and malnutrition. Other important disorders include cancer of the oesophagus, liver and cervix, and rheumatic heart disease and cardiomyopathy. The diseases in urban Blacks are those of a population in transition. Characterised by all gradations of socioeconomic development, from the relatively primitive to the completely westernised, these people exhibit a correspondingly wide and varied range of disease embracing the afflictions of rural dwellers and the new diseases of the city. Whereas the prevalence of some of the former, such as infection and malnutrition, is declining, they still constitute a considerable problem in urban Blacks. More important is the increasingly serious impact of the new disorders, which may be divided into two groups: (a) a large range and variety of alcohol-related disorders with serious effects at the social, economic, psychological and physical levels; and (b) most, if not all, of the diseases encountered in western populations. Some of these, such as obesity and hypertension, have not only attained epidemic proportions among urban Blacks, but their prevalence may actually have exceeded that among Whites. Other conditions, such as
coronary heart disease
,
gout
, gallstones and colonic cancer, which emerged later, are relatively uncommon or rare. A plea is made for much greater epidemiological research. This is necessary in order to obtain reliable knowledge of the prevalence of disease, to determine the best ways of applying present knowledge with existing and future resources, and to obtain knowledge regarding both old and new diseases of which the pathogenesis is still obscure.
...
PMID:Diseases in urban and rural Black populations. 85 Aug 43
As part of a cardiovascular survey study on the relationships between physical fitness and
coronary heart disease
, 5249 Copenhagen males aged between 40 and 59 were interviewed to identify a history of
gout
. Subjects who had experienced attacks of painful swelling, with abrupt onset and remission in one to two weeks, diagnosed and treated as
gout
by their own physician, were regarded as having experienced
gout
. In an initial cross-sectional examination, 86 men fulfilled the criteria. At a one year follow-up examination it was discovered that 56 men had had
gout
during the year of observation. Among these 18 were new cases. At the end of the study a total of 104 men had experienced
gout
and these were compared, with respect to the continuously distributed variables, those 104
gout
subjects were compared to 208 computer selected age-matched controls drawn at random from the entire sample. The
gout
cases were found to have higher relative weights, higher diastolic blood pressure and lower levels of physical fitness estimated by use of a bicycle ergometer test. Angina pectoris occurred more frequently among the
gout
cases than among controls. No significant differences in the occurrence of myocardial infarction, intermittent claudication or renal stones were found. The habits of smoking and coffee consumption were equal in
gout
cases and controls. Alcohol consumption and consumption of drugs were higher in
gout
cases than controls.
Gout
was the most frequent in the lowest social classes.
...
PMID:Occurrence of gout in Copenhagen males aged 40-59. 95 64
Careful consideration of all relevant scientific evidence and a critical assessment of data quality show that thiazide diuretics are not cardiotoxic. Of 12 reported trials only two recorded more
coronary heart disease
events in thiazide-treated patients than in controls. One of these two was a subgroup of a larger study (Heart Attack Prevention in Primary Hypertension, HAPPHY) which found no difference between thiazide-treated and beta-blocker-treated patients. The other, the Oslo study, was too small to allow valid conclusions. Results from a subgroup in the Multiple Risk Factor Intervention Trial (MRFIT) that appeared to supply evidence for thiazide-related cardiotoxicity are suspect when examined critically. Further evidence from 24- to 28-h ECG monitoring does not support the hypothesis that thiazide diuretics, either in the presence or absence of hypokalemia, increase the frequency or severity of ventricular arrhythmias. Reports of a thiazide-induced intracellular magnesium deficiency as a cause of ventricular arrhythmias have also not been confirmed; the development of arrhythmias in acute myocardial infarction appears to be due to an increase in catecholamine levels rather than hypokalemia. There appears to be little evidence to support the assumption that long-term use of thiazide diuretics aggravates or accelerates atherosclerosis of the coronary arteries; any fall in serum cholesterol appears to be transient. For the great majority of patients with uncomplicated hypertension, without a previous myocardial infarction, congestive heart failure, diabetes mellitus or
gout
, thiazide diuretics appear to be both safe and effective antihypertensive agents.
...
PMID:The cardiotoxicity of thiazide diuretics: review of the evidence. 221 84
Today hyperuricaemia and
gout
are likewise seen in every population of the western industrial world and have been increasing since the fifties. As known from number of studies hyperuricaemia often occurs in connection with hyperlipoproteinaemia, obesity, diabetes mellitus, arterial hypertension and atherosclerosis. Up to now it was not clear whether one disease caused the other. In 1988 Abbot could prove that among men, those afflicted by
gout
as compared to those without
gout
experienced a 60% excess of
coronary heart disease
. Therefore, patients with
gout
should receive a regular thorough cardiovascular evaluation. Furthermore risk factor levels which predispose to
coronary heart disease
, arterial hypertension and
gout
should be reduced. There is a significant positive correlation between the plasma uric acid levels and the prevalence of attacks of gouty arthritis and nephrolithiasis. It is possible to avoid gouty arthritis, tophi and nephrolithiasis with a consequent diet and medical treatment. Unfortunately, many patients interrupt therapy during intervals free of pain. The consequence is that even today the complications of hyperuricaemia cause days of inability to work and to earn one's living, despite of modern therapy. Hyperuricaemia not sufficiently treated reduces the quality of life through attacks of
gout
, chronic
gout
and nephrolithiasis as well as life expectancy caused by nephropathy, arterial hypertension and atherosclerosis. This is of special importance because of the frequency of
gout
and hyperuricaemia in our population. An early diagnosis, a consistent therapy and a thorough monitoring could stop an increase of this disease and prolong life expectancy for those who have
gout
and the other attendant diseases.
...
PMID:[Hyperuricemia--does modern therapy improve life expectancy?]. 227 73
The Japanese population in Hawaii has one of the longest life expectancies of any large population subgroup in the U.S. and the world. Cross-sectional data on 1,379 elderly, noninstitutionalized, male Japanese American survivors of a population-based cohort study indicated the most common health problems were hypertension (43%), arthritis (33%), diabetes (13%), and
gout
(9%). For cancer and hypertension there is a trend toward higher prevalence in older age groups. For
coronary heart disease
, stroke, and angina the oldest age group (75-81 years) has a higher prevalence than that seen in younger age groups. Other relatively common diseases such as diabetes,
gout
, peptic ulcer, and arthritis do not have higher prevalence in older age groups. Drugs reported to be used frequently by study participants were for hypertension,
gout
, CHD, and diabetes. The prevalence rates of major limitations of mobility and of living alone appear to be relatively low in this population. Less than one percent of the current population rate their health status as poor. The prevalence of normal serum cholesterol and smoking are similar to those seen in U.S. White males, while the rates of hypertension appear lower. Prevalence rates for stroke and heart attack also appear to be somewhat lower in these long-lived individuals than those seen in U.S. Whites.
...
PMID:Health status and life style in elderly Japanese men with a long life expectancy. 239 21
Serum total cholesterol, HDL cholesterol, LDL cholesterol, and triglyceride were measured in three groups of male patients with primary
gout
. The groups were defined by the presence of 0, 1, or more than 1 coexisting medical conditions or cardiac risk factors (
coronary heart disease
, hypertension, diabetes, proteinuria, overweight). Mean values of total, LDL, and HDL cholesterol were lower in patients with one or more associated conditions than in those with none. By contrast, triglyceride levels were significantly higher and exceeded the desirable range. Distributions of individual values of all lipid parameters except triglycerides were similar along the three groups. Triglyceride values, however, were significantly higher in patients with multiple complications. Observed differences in lipid values could not be correlated with patient age or type of nature of medication received. High triglycerides and LDL cholesterol are not a feature of uncomplicated
gout
in men. HDL cholesterol tends to be normal and triglyceride mildly elevated. Only in patients with two or three associated medical conditions are high triglycerides or low HDL cholesterol common. Our results suggest that these findings are independently related to concurrent disease and that
gout
is not necessarily in itself a risk factor for cardiovascular or diabetic disease.
...
PMID:Lipid studies in primary gout. 278 77
Numerous trials have shown the efficacy of ACE-inhibitors in moderate and severe essential hypertension. Their use must be regarded as very promising. They lower peripheral vascular resistance without influencing cardiac index and heart rate. Additionally, they maintain serum potassium and do not effect plasma lipids or provoke diabetes mellitus or
gout
. In 20-30% of hypertensive patients ACE-inhibitors have to be combined with diuretics and/or calcium antagonists. The addition of beta-blockers is useful in patients with resting tachycardia. In mild hypertension the use of ACE-inhibitors as first-line drugs is indicated in patients with adverse reactions to beta-blockers or diuretics. In bilateral renovascular hypertension, ACE-inhibitors may induce a strong blood pressure fall; in bilateral stenosis they contribute to a deterioration of renal function with reversible renal insufficiency. In renoparenchymal hypertension, ACE-inhibitors may attenuate the progression of renal insufficiency; in addition, proteinuria is lowered. In systolic hypertension in the elderly, one must be aware of a marked first-dose hypotensive effect. ACE-inhibitors decrease exaggerated exercise-induced elevation of blood pressure and heart rate and therefore lower myocardial oxygen consumption. In patients with hypertension and diabetes mellitus, antihypertensive treatment should be initiated for blood pressure levels above 140/90 mmHg, to attenuate the progression of vascular damage in the kidney. In patients with severe left ventricular hypertrophy, ACE-inhibitors reduce left ventricular mass within three months by about 30%. In hypertension and
coronary heart disease
, recent studies report benefits of ACE-inhibitors on coronary circulation. Presently available ACE-inhibitors and those in preparation do not differ in pharmacodynamic, but in pharmacokinetic properties, concerning the beginning and duration of blood pressure lowering. A hypotensive first-dose effect can be observed in diuretic pretreated patients, in severe (malignant) and renovascular hypertension. ACE-inhibitors should not be used during pregnancy or in patients with autoimmune diseases or those undergoing treatment with immunosuppressive drugs, due to the side effects of neutropenia and proteinuria, which are more often seen under these conditions. Results from long-term studies on the influence of ACE-inhibitor treatment on cardiovascular risk in mild hypertension have not been available until now. In the decision to treat mild hypertension with ACE-inhibitors as first-line drug therapy, the costs of therapy in comparison to cheaper antihypertensives must be taken into account.
...
PMID:[The value of angiotensin-converting enzyme inhibitors in the treatment of hypertension]. 306 60
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