Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The impact of long-term estrogen support following hysterectomy was studied in 1016 women (22-78 years of age) who were followed for a total of 14,318 patient/years. Patients received conjugated estrogen, 1.25 mg/day. A marked drop in deaths from all causes was seen in this group of patients. This was primarily due to a decrease in the number of deaths due to heart attack or cancer. Those causes of deaths unrelated to hormone therapy showed the expected number of mortalities. Nulliparous women seem to be at a higher risk of cancer during the first 10 years of estrogen therapy. There is a marked improvement in the clinical evidence of osteoporosis. In this group there is an increased incidence of breast cancer over the expected but a lower mortality from this cancer than the anticipated mortality. A discussion focuses on further research into this area of study but implies that estrogen therapy has favorable results over figures for the expected incidence of cancer and heart disease.
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PMID:The impact of long term estrogen support after hysterectomy. A report of 1016 cases. 19 50

The treatment of operable breast cancer in eighty-two patients older than seventy years was analyzed. The cancers were treated at an advanced stage and the axilla was involved as frequently as in younger women. The factors influencing survival differ because of competing mortalities from heart disease and stroke. The risks are discussed in relation to life expectancy and treatment method.
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PMID:The treatment of operable breast cancer in the elderly female. 20 62

Two nationwide registers, the Finnish Cancer Registry and a register of persons entitled to free drugs for hypertension, were linked in a case-control study of the association of breast cancer and use of rauwolfia. Cases were all hypertensive patients in whom breast cancer was diagnosed in 1973. To test the association specifically with rauwolfia, controls were hypertensive women matched with the cases for age and geographic area and approximately matched for duration of treatment for hypertension. There were 109 case-control pairs. Use of any physician-prescribed drugs during the year prior to diagnosis of breast cancer was ascertained from original prescriptions. In the first set of analyses the patients were classified according to the drug used during most days of the year ("main antihypertensive agent"). In the second set a person qualified as a user of the respective drug regardless of the amount taken. The relative risks in the use of rauwolfia, methyldopa, another synthetic antihypertensive or a diuretic as main antihypertensive agent all ranged between 0.90 and 1.11. The results based on use of a drug in any amount were similar. Next, pairs in which duration of treatment for hypertension was different for cases and controls were excluded. The relative risk associated with use of rauwolfia as main antihypertensive agent then increased from 1.00 to 1.30 and the risk associated with use of any amount of rauwolfia from 1.16 to 2.14. Simultaneously, the relative risk in the use of digitalis was raised from 1.33 to 2.67 and of nitroglycerin from 1.00 to 1.71. Cases also used more types of antihypertensive agents simultaneously than controls. There was no association between rauwolfia-use and breast cancer in analyses limited to pairs in which neither case nor control used digitalis. Thus, there was not a consistent drug-specific association between rauwolfia-use and breast cancer in hypertensive patients. An underlying association of hypertension, heart disease or its treatment (digitalis) and breast cancer may have confounded some of the results of this and earlier studies. In conclusion, it is unlikely that use of rauwolfia increases the risk of breast cancer.
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PMID:Breast cancer and use of rauwolfia and other antihypertensive agents in hypertensive patients: a nationwide case-control study in Finland. 99 4

In order to increase awareness of strategies to prevent osteoporosis and heart disease we designed a clinic offering education and screening to all women aged 40-60 years on our practice list of 8600 patients, starting in January 1988. Screening and supervision of HRT users occurred at a weekly clinic run by the doctor and nurse. Audit in August 1991 showed that there were 260 present users of HRT (20%) of our population of 1322 women aged 40-60 years. Seventy-eight percent had taken HRT for over a year and 15% for more than 5 years. Ex-users totalled 117, of whom 52% had taken HRT for over a year and 14% for over 5 years. Examination of the clinic registers and responses to postal questionnaires showed that 681 (51.5%) of patients attended the health education clinic. Of the clinic attenders, 25% took HRT compared with 10.8% of non-attenders. Compliance with long-term therapy measured by audit of repeat prescriptions varied between 84% and 92% over a period of 5 years. Reasons for stopping treatment were anxiety over possible side-effects, especially breast cancer and dislike of bleeding.
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PMID:Can we improve compliance with long-term HRT? 147 47

Estrogen replacement therapy (ERT) is suggested for women with symptomatic estrogen deficiency, but patients with breast cancer are advised against ERT because of concerns that ERT may precipitate cancer recurrence. The attitudes of women with breast cancer regarding ERT is critical in the design of appropriate strategies for the management of their menopause. A randomly selected group of 224 women with breast cancer responded to an anonymous survey that addressed the presence of menopause, antecedent therapies, symptoms related to estrogen deficiency, concerns about osteoporosis or heart disease, attitude about ERT, and perception about ERT-related cancer risk. Among women who completed the survey, 77% were postmenopausal and 81% had had multimodality therapy. Of menopausal women, 27% believed they needed some treatment for menopause and 8% had taken ERT since cancer diagnosis. Most women were afraid that ERT may precipitate cancer recurrence (78%) but they also were concerned about the menopause-related risk of osteoporosis (70%) and heart disease (72%). Overall, 44% of menopausal women were willing to consider ERT under medical supervision. Those treated with surgery alone were distinct in that 71% would consider ERT (p < 0.04). Premenopausal women were more concerned about osteoporosis (82% vs. 66% for postmenopausal), heart disease (92% vs. 73%), and the possibility that ERT may precipitate cancer recurrence (98% vs. 73%). Yet, at the same time, they were more willing to consider ERT under medical supervision (59% vs. 40% for menopausal). The present study underscores that women with breast cancer are very aware and concerned about the adverse health consequences of estrogen deficiency and would consider ERT under medical supervision.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Estrogen replacement therapy in women with breast cancer: a survey of patient attitudes. 147 53

Down syndrome (DS) is a major cause of congenital heart and gut disease and mental retardation. DS individuals also have characteristic facies, hands, and dermatoglyphics, in addition to abnormalities of the immune system, an increased risk of leukemia, and an Alzheimer-like dementia. Although their molecular basis is unknown, recent work on patients with DS and partial duplications of chromosome 21 has suggested small chromosomal regions located in band q22 that are likely to contain the genes for some of these features. We now extend these analyses to define molecular markers for the congenital heart disease, the duodenal stenosis, and an "overlap" region for the facial and some of the skeletal features. We report the clinical, cytogenetic, and molecular analysis of two patients. The first is DUP21JS, who carries both a partial duplication of chromosome 21, including the region 21q21.1-q22.13, or proximal q22.2, and DS features including duodenal stenosis. Using quantitative Southern blot dosage analysis and 15 DNA sequences unique to chromosome 21, we have defined the molecular extent of the duplication. This includes the region defined by DNA sequences for APP (amyloid precursor protein), SOD1 (CuZn superoxide dismutase), D21S47, SF57, D21S17, D21S55, D21S3, and D21S15 and excludes the regions defined by DNA sequences for D21S16, D21S46, D21S1, D21S19, BCE I (breast cancer estrogen-inducible gene), D21S39, and D21S44. Using similar techniques, we have also defined the region duplicated in the second case occurring in a family carrying a translocation associated with DS and congenital heart disease. This region includes DNA sequences for D21S55 and D21S3 and excludes DNA sequences for D21S47 and D21S17.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Down syndrome: molecular mapping of the congenital heart disease and duodenal stenosis. 153 Nov 66

Heart disease is the number 1 cause of death among women in the US, yet health providers, the public, women's health organizations, and women overlook this fact. Risk factors and the progression of cardiovascular disease (CVD) are different in women than in men. For example, women are more likely to develop and succumb to heart disease at more advanced ages than men. This may be due to the protective effect of estrogen that occurs to at least middle age when menopause occurs. The clinical studies examining means to prevent CVD in the 1960s and 1970s basically included only middle aged or older men. Yet scientists have since learned that reproductive hormones do not allow them to extrapolate the results of these studies to women. For example, some interventions identified in those trials do not as effectively affect lipoprotein levels in women as they do in men. These interventions include diet, weight loss, and exercise. Instead, cholesterol screening and management, hormone replacement therapy for cardiovascular indications, and public health messages promoting a low fat diet can be effective in women. As is the case with men, women often have a genetic predisposition for dyslipoproteinemia. High density lipoprotein cholesterol is a more significant CVD risk factor in women than in men while low density lipoprotein is more significant in men than in women. Even though estrogen therapy may prevent heart attacks, its price may be too high since it increases the risk of breast cancer. Many obstetrician-gynecologists feel confident of their ability to screen for cholesterol, yet they are not as confident in their ability to provide dietary counseling or managing drug therapy.
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PMID:Lipids and cardiovascular disease: do the findings and therapy apply equally to men and women? 161 6

The evidence that estrogen protects against coronary heart disease is biologically plausible, consistent, and strong. These benefits have not been established by a randomized trial, however, so that the degree of protection against heart disease might have been overestimated because estrogen users tend to be healthier than nonusers. A randomized trial to determine whether estrogen alone or in combination with progestin protects against coronary heart disease should be given a high priority. Progestins generally attenuate the effects of estrogen on the concentrations of HDLC. It is not known whether this effect also limits the beneficial effects of estrogen on the risk of coronary heart disease. Recent studies suggest that estrogen may protect against coronary heart disease in other ways besides favorably altering serum concentrations of lipoproteins and that progestins might not have adverse effects on the risk of heart disease. Currently, theoretical concerns that progestins might be harmful seem outweighed by the evidence that they protect against endometrial cancer in women who have a uterus. For these women, some may find the side effects of progestins to be so bothersome that they prefer to take estrogen alone. This approach is reasonable so long as the patient has periodic endometrial biopsies for early detection of pre-malignant or malignant endometrial changes. Women without a uterus should take estrogen alone. Women who take long-term estrogen therapy appear to have about a 30% greater chance of developing breast cancer. On the other hand, breast cancer that develops while taking estrogen therapy might have a slightly better prognosis. Quantitative comparisons of fatal conditions suggest that the benefits of long-term therapy outweigh the risks. But these comparisons assume that all causes of deaths are equally important and do not adequately take account of other psychologic and physical effects of hormone therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluating the benefits and risks of postmenopausal hormone therapy. 175 Apr 10

A cumulative effect has been calculated by Henderson et al. concerning the estimated changes in mortality with estrogen therapy. Even assuming a twofold increase in the risk of breast cancer, the benefits derived from reduction of osteoporotic fractures and the decreased risk of heart disease, demonstrate a 41% decrease in mortality in women who receive estrogen therapy. Since cardiovascular disease is the major cause of morbidity and mortality in postmenopausal women, and since the beneficial effects of estrogen outweigh the documented and perceived risk of estrogen use, estrogen ought to be considered as prophylactic therapy, particularly in women at risk of heart disease.
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PMID:Extraskeletal effects of estrogen and the prevention of atherosclerosis. 139 65

In summary, oral estrogens are often prescribed to relieve menopause symptoms. They should not be used in women who have had breast cancer, thrombophlebitis, hypertension, gallstones, or undiagnosed abnormal genital bleeding. Hormone replacement therapy has proven to be very useful in preventing osteoporosis, hot flashes, night sweats, and vaginal dryness. More information is needed before they should be recommended for the prevention of heart disease in postmenopausal women.
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PMID:Estrogen replacement therapy. 185 17


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