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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Platelet aggregation inhibitors have been more extensively and better studied than all other treatments used in the prevention of cerebral ischaemia. It has been demonstrated that both aspirin (300 mg/day) and ticlopidine (500 mg/day) are effective in the secondary prevention of cerebral ischaemic accidents associated with atherosclerosis, with a 20 and 30 p. 100 respectively reduction of risk. At the moment, there is no evidence that these compounds are effective in the primary prevention or treatment of cerebral infarction in the acute phase. The best way of preventing thromboembolic stroke of cardiac origin is to treat the responsible heart disease and prescribe anticoagulants. However, several studies are in progress to evaluate the effectiveness of aspirin in the primary and secondary prevention of cerebral thromboembolism due to non-valvular atrial fibrillation.
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PMID:[Platelet antiaggregants in cerebral ischemic pathology]. 268 44

Observations of significantly lower total cholesterol, low density lipoprotein (LDL) cholesterol and higher levels of high density lipoprotein (HDL) cholesterol among Eskimos as compared to Danes in all age groups and both genders, and the current emphasis on the role of cholesterol in atherosclerosis have stimulated several studies that have examined the effects of dietary fish or fish oil supplements on plasma lipids. Conclusions from these studies suggest a favorable change in the plasma lipids in subjects with higher intake of dietary fish or those receiving fish oil supplements towards a decreased incidence of atherosclerosis and hence the coronary artery disease. This article is an attempt to review the current understanding of the effects of fish oil on blood lipids and its role in the heart disease.
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PMID:Fish oil in heart disease. 269 74

These recommendations for secondary prevention of clinical coronary cardiopathy are the result of a symposium attended by 46 experts belonging to the councils on arteriosclerosis, clinical cardiology, epidemiology, and prevention and rehabilitation of the International Society and Federation of Cardiology. Secondary prevention of coronary cardiopathy refers to measures designed to prevent deterioration or death in patients with clinical manifestations of coronary cardiopathy. Such measures in addition to drugs include health actions that may improve the status of various coronary risk factors: the patient's life style should stress maintenance of proper weight, regular physical exercise, reduction of saturated fats and cholesterol in the diet, and elimination of smoking and excessive alcohol consumption. It is considered reasonable to control hypertension through the most innocuous means possible, but findings of the few existing controlled studies of effects of treatment of hypertension in coronary cardiopathy are complex. Drug treatment may be necessary for most patients, but nondrug measures should be added when possible. Various proofs including results of some controlled studies justify the recommendations for reducing elevated levels of serum cholesterol and low density lipoprotein cholesterol through dietary measures. Optimum plasma cholesterol levels are 5.2 mmol/1 or less, and the upper limit is 5.7 mmol/1. The rules for secondary prevention are the same for diabetics as for nondiabetics, but some special precautions are necessary in diabetics. Habitual and vigorous physical activity has been associated with a decline in the incidence of coronary cardiopathy in different population studies, although there has been no demonstration that exercise can alter the progression of atherosclerosis or improve collateral circulation. Stress should be recognized as a risk factor and included in secondary prevention, but the concept that stress is the key risk factor in coronary events is in conflict with a large body of scientific evidence. Oral contraceptives (OCs) tend to increase boood pressure and weight as well as serum triglyceride levels, and to reduce glucose tolerance and high density lipoprotein cholesterol in some formulations. OCs also affect the integrity of the vascular endothelium and alter blood coagulation, fibrinolysis, and platelet function. These thrombogenic changes are intensified with age, especially after 35, and with smoking. OCs are innocuous in women under 35 with no history of venous or arterial disease or pulmonary embolism and who have normal blood pressure and serum cholesterol levels. Patients using OCs should control their blood pressure and weight and be alert to any symptoms of thrombotic episodes. The risk/benefit ratio of longterm estrogen treatment in meno- and postmenopausal women with coronary cardiopathy has not yet been established. Apart from 1 study in primates, there is no evidence that vasectomy should be considered either indicated or contraindicated for coronary patients. Beta blockers, platelet function inhibitors, anticoagulants, and other drugs are under active study for secondary prevention of coronary cardiopathy.
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PMID:[Recommendations for secondary prevention of the clinical coronary cardiopathy]. 285 11

The prevalence of microscopic atheroma in the proximal left anterior descending coronary artery was studied in thirty young males aged 20 to 29 years, living in Mexico City, who died in urban accidents. All of them were either unemployed or labor workers with a socioeconomical status considered to be representative of the majority of young males living in Mexico City. It was found that coronary atheroma was present in 11 of them (33%) with variable degrees of luminal obstruction. In two of them the luminal obstruction was greater than 75%. The prevalence found in this group was significantly different to that found in younger and older males who also died in accidents. Since the prevalence of coronary atheroma was not related to ventricular hypertrophy, valvular or congenital heart disease our findings indicate that in Mexico City as in other geographical regions, coronary atherosclerosis is not an unusual finding in males in the third decade of life, with a low socioeconomical status.
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PMID:[Prevalence of microscopic coronary atheroma in young adults from Mexico City]. 293 72

One of the leading causes of mortality in diabetics is myocardial disease. In the past few years this subject has generated a significant amount of interest with the result that myocardial problems associated with diabetes are far better understood. Though originally thought to occur as a result of atherosclerosis, various studies have shown that heart disease can occur in the absence of atherosclerosis, suggesting a diabetic cardiomyopathy. Using diabetic animals, it has been possible to characterize diabetes-induced myocardial abnormalities. Diabetic rat hearts do not respond to conditions of high stress as well as controls. The functional depression is accompanied by altered cardiac enzyme systems. A decrease in myosin ATPase activity which appears to be a result of diabetes-induced hypothyroidism is seen. Also, a depression of sarcoplasmic reticular calcium ATPase, along with a depression of calcium uptake by the SR, is seen in diabetic rat hearts. Na+, K+ ATPase activity has also been shown to be depressed and the depression appears to correlate with depressed atrial contractility. High levels of circulating fats in diabetics may alter the integrity of membranes leading to altered enzyme activities. Insulin treatment has been relatively successful at reversing or preventing myocardial changes in the diabetic rat. Other treatments that have been studied include thyroid hormone treatment, since the depression of myosin ATPase can be corrected by such treatment; and carnitine treatment, as the elevation of long chain acyl carnitines (LCAC) and the resulting depression of calcium uptake in the SR can be so normalized. These treatments have not been successful at normalizing cardiac function. A combination of the two treatments normalized function only partially, suggesting that factors besides myosin ATPase and SR calcium uptake are involved. Other treatments that have been tried include vanadate, methyl palmoxirate, and choline and methionine. Vanadate treatment has proved to be encouraging in that it normalizes both function and hyperglycemia. Methyl palmoxirate, a fatty acid analog, normalized only the elevation of LCAC but did not affect function. Methionine and choline were only partially successful in preventing the functional alterations of diabetic rat hearts. The purpose of the present article is to review our understanding of diabetes-induced myocardial problems and their possible causes. Findings from our laboratory and others are described in which attempts have been made to normalize cardiac function.
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PMID:Diabetes-induced abnormalities in the myocardium. 293 41

Dietary fiber has been, for several years, the glamour ingredient in popular nutrition. Based on epidemiological evidence, lack of fiber in the diet has been impugned as a major risk factor for development of colon cancer, heart disease, diabetes and a variety of lesser ills. Animal experiments suggest that some components of the complex mixture of substances called fiber will reduce cholesterol levels to a modest extent and will inhibit atherosclerosis induced by diet. In man the data center on the effects of fiber on plasma cholesterol levels and some fibers such as pectin or guar exert significant hypocholesterolemic effects whereas others, such as bran, do not. The situation is similar with regard to colon cancer. Some types of fiber, bran and cellulose for instance, inhibit experimentally induced colon cancer. There are a number of ways of establishing experimental colon cancer; feeding the carcinogenic agent, injecting it, or instilling it intrarectally. There also exists a variety of carcinogenic agents. The effect of fiber is the sum of the type of fiber and carcinogen used and the mode of establishing the cancer. Different combinations give different results in animal studies. In man the data bearing on this subject are wholly epidemiological. A few case-control studies have provided suggestions that low fiber diets may predispose to colon cancer but these studies point to a dietary life-style in which many components other than fiber vary. The most notable success in wedding practice to hypothesis has been in the area of diabetes. Here it has been shown clearly that increasing dietary fiber results in reductions in lipemia, glycemia and insulin requirement. What remains? More work in the cancer and heart disease fields but mainly a greater effort to identify the specific structure of those fibers which exert a beneficial effect. This will have the two-fold benefit of identification of specifically useful structural types of fiber and of possibly providing clues to mechanism of action or of carcinogenicity. Most experts agree that a modest increase in intake of fiber will have a generally beneficial effect but they can only support these statements with epidemiological proof. Future research must include studies designed to confirm the epidemiological findings and to identify the specific components responsible for them.
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PMID:The role of dietary fiber in health and disease. 301 64

Epidemiologists studying the risk factors of coronary heart disease, as indicated by a heart attack, often presume that these risk factors combine in a susceptible host to increase the risk of the heart attack. The "biological" basis for the interaction of the key risk factors is often not considered in the analysis. A more rational model for the study of clinical heart disease, stroke, and peripheral vascular disease would be to separate the epidemiology of atherosclerosis from that of the clinical event. In the past, this has been extremely difficult because of the absence of techniques for the measurement of atherosclerosis in vivo, especially in well-defined populations. However, in recent years, greater emphasis on the quantification of atherosclerosis and its relationship to specific risk factors has improved our ability to study the underlying pathology that is atherosclerosis. Atherosclerosis is an example of a common-source epidemic. The environmental agent is the intake of cholesterol and saturated fat. The interaction of specific dietary factors and genetic determinants is the key to the evolution of atherosclerosis. There are marked variations in the evolution of the disease in different vascular beds as well as among individuals exposed to similar environmental factors. In the future, we will probably be able to study atherosclerosis as a continuous variable in populations and to relate the rate of progression, the extent of disease at any point in time, and topical distribution of atherosclerosis within individual vascular beds to specific genetic and environmental determinants.
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PMID:The epidemiology of atherosclerosis in 1987: unraveling a common-source epidemic. 304 99

Serum lipids and apoproteins A-I and B were measured in 115 male patients and serum pseudocholinesterase activity (PChE) was determined in 83 patients with 3 vessel coronary artery disease (CAD). The control subjects were matched according to sex, smoking, relative weight and age and were free from heart disease. The CAD patients had significantly higher serum VLDL cholesterol and triglyceride levels and lower HDL cholesterol and apo A-I levels and lower HDL to total cholesterol ratio than the controls. The concentrations of serum total cholesterol and LDL cholesterol were only slightly (6.4% and 8.8%, on an average) higher in CAD patients than in controls. The apo B levels of CAD patients were also slightly lower in patients than in controls. The CAD patients had slightly higher PChE activities than controls. The ratios of apo A-I to PChE and HDL cholesterol to PChE were significantly (about 30%, P less than 0.001) lower in patients than in controls. In discriminant analysis between the groups HDL cholesterol and apo A-I showed the best (74% success in reclassifying the patients to correct groups), and total cholesterol, triglycerides, LDL cholesterol and apo B remarkably weak discriminating power among the single variables of serum lipids and lipoproteins. In discriminating analysis the apo A-I/PChE and HDL cholesterol/PChE ratios showed relatively high (77.1 and 71.1% success from the patients to correct groups) and serum PChE activity weak discriminating power. These results indicate that low levels of HDL cholesterol and apo A-I and the low ratio of HDL cholesterol to total cholesterol are the most potent metabolic risk factors for 3 vessel coronary artery disease in a population with relatively high serum total cholesterol level. The determinations of apo A-I/PChE and HDL cholesterol/PChE ratios may be an additional, valuable tool in discriminating the risk for CAD.
Atherosclerosis 1986 Feb
PMID:Levels of serum lipids, apolipoproteins A-I and B and pseudocholinesterase activity and their discriminative values in patients with coronary by-pass operation. 308 32

Previous results suggested that strains C57BL/6J and C3H/HeJ differed in a single gene for atherosclerosis susceptibility, called Ath-1. Based on data from recombinant inbred strains Ath-1 was tentatively assigned to chromosome 1 linked to Alp-2. In this report, a cross between C57BL/6 and C3H/HeJ was carried out in order to test whether the tentative map position was correct. Parental strains and F1 and F2 progeny were examined. Susceptible alleles of Ath-1, found in C57BL/6, are associated with relatively low levels of high-density lipoprotein (HDL)-cholesterol in animals fed an atherogenic diet; resistant alleles of Ath-1 are associated with relatively high levels of HDL-cholesterol. F1 progeny have HDL levels that are intermediate between these of the two parental strains. Among the F2 progeny, Alp-2 and Ath-1 cosegregated, providing confirmatory evidence that Ath-1 is linked to Alp-2 on chromosome 1. Three mice recombinant for Alp-2 and Ath-1 were found among the 60 chromosomes tested, giving an estimated map distance between these two genes of 5.0 +/- 2.8 (SE) cM. The phenotypic characteristics of Ath-1 resemble a genetic trait in humans, hyperalphalipoproteinemia, which is characterized by elevated levels of HDL-cholesterol, reduced risk of heart disease, and increased longevity.
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PMID:Genetic analysis of murine strains C57BL/6J and C3H/HeJ to confirm the map position of Ath-1, a gene determining atherosclerosis susceptibility. 312 74

We investigated the prevalence of carotid atherosclerosis and its association with serum lipoprotein cholesterol fractions in 412 Eastern Finnish men ages 42, 48, 54, or 60 years who were examined between February and December 1987 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Carotid atherosclerosis was assessed with high-resolution B-mode ultrasonography. Of the participants, 37% had thickening of the intimal or medial layer of the arterial wall, 10% had plaques, 2% had stenosis in the right or left common carotid artery or in the carotid bifurcation, and only 51% were free of any detectable carotid atherosclerosis. The prevalence of atherosclerosis was 14.1%, 32.0%, 67.7%, and 81.9% in the four age groups, respectively. The mean age-adjusted serum low density lipoprotein (LDL) cholesterol concentration was 3.67 mmol/l (142 mg/dl) in men free of carotid atherosclerosis and 4.02 mmol/l (155 mg/dl) in those with at least intimal thickening (p = 0.003 for difference). The mean age-adjusted serum cholesterol concentration in the high density lipoprotein (HDL) fraction was 1.34 mmol/l (52 mg/dl) in the atherosclerosis-free and 1.27 mmol/l (49 mg/dl) in the atherosclerotic men (p = 0.029 for difference). There was a similar difference in both the serum HDL2 and the HDL3 cholesterol levels. Serum LDL and HDL (inverse) cholesterol were significant determinants of severity of carotid atherosclerosis in a multivariate regression model adjusting for age, obesity, plasma fibrinogen, cigarette-years, and duration of hypertension. Our data reveal the high prevalence of atherosclerosis in middle-aged Eastern Finnish men and provide further evidence of the roles of LDL and HDL cholesterol in atherosclerosis.
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PMID:Prevalence of carotid atherosclerosis and serum cholesterol levels in eastern Finland. 319 22


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