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 topic relative to the differential psychobiological mechanisms between cancer and coronary illness has been showing for the last years. In this sense, some theoretical models which have been formulated by relevant authors have suggested the possibility of differentiating cancer and cardiovascular disease, both the onset and the progression, from coping strategies, personality variables and affective states, as well as the different categories of psychosocial stress. Likewise, the implication of psychological distress, such as anxiety, anger and depression for the occurrence of somatic disease has been reported frequently. This research was designed to analyze the psychosocial patterns which could explain the incidence of heart disease, cancer and anxiety based disorders. Measures of life events and stress reactivity were obtained from a total of 109 patients diagnosed as having breast cancer (37), infarct (37), and anxiety (35), and from 72 normal control subjects. Our data tend to show that the cancer group was strongly predicted by lost and illness events, while the coronary group was more associated with work events. The anxiety disorders group lacked a life events dimension, but shared the same category of the infarct group. We also found a strong relationship between depressive reactions and cancer in contrast to the anxiety-anger variable that was more relevant in the infarct patients. The interaction between internal and external stress factors in the etiology of disease is also discussed.
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PMID:Life events and stress reactivity as predictors of cancer, coronary heart disease and anxiety disorders. 784 64

Menopause, according to contemporary American and European understanding, signifies the end of menstruation, a universal experience among human females. This definition of menopause is recent in origin, and is not one which is widely accepted, comparatively speaking. Research has shown that meanings and subjective experience, including symptoms, associated with menopause vary cross-culturally. Menopause may not be recognized as a concept, or alternatively is not closely associated with the end of menstruation, nor is it usually considered a difficult time. This anthropological research is briefly summarized followed by a discussion of the results of survey research conducted in Japan, comparable with Canadian and American surveys. Symptom reporting in Japan among a nonclinical, naturally menopausal population is significantly lower and different from the North American samples. In addition Japanese women have a longer life-expectancy and lower rates of heart disease, osteoporosis, and breast cancer than do North American women. These findings will be contextualized in light of cultural differences with respect to diet, exercise, and attitudes towards this part of the female life cycle. The significance of these findings are considered with respect to research questions to be posed in the future.
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PMID:Menopause in cultural context. 792 51

With the onset of menopause, women develop increased risk for heart disease, vasomotor instability, and osteoporosis, which is related to estrogen deficiency, and can be corrected with estrogen-replacement therapy (ERT). Menopausal women with a history of breast cancer are advised against estrogen therapy because of concerns that ERT may adversely affect the course of the disease. There have been no prospective studies that address the issue of risk versus benefit for ERT in women with a history of breast cancer. We have initiated a randomized, prospective clinical study to define the influence, if any, of ERT on the clinical course of breast cancer (measure of potential risk) and the efficacy of ERT in the treatment of metabolic bone derangements (measure of benefit). Changes in serum lipids, cardiovascular events, and indices of psychological well-being are compared but do not constitute statistical end points. Eligible women must have had stage I or stage II breast cancer and must have had no evidence of disease for at least 2 years since therapy if estrogen-receptor-negative disease or for at least 10 years if the estrogen-receptor status is unknown. They were randomized to receive ERT (Premarin at 0.625 mg, days 1-25) versus no intervention (study control). Parameters of benefit and risk will be measured to detect a 10% change in disease-free rate for up to 5 years, with interim analyses at 20, 30, and 36 months of patient accrual. This study will allow us to begin the development of safe and effective strategies for the management of estrogen deficiency in patients with breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Randomized prospective trial of estrogen-replacement therapy in women with a history of breast cancer. 799 59

Millions of menopausal women are taking hormone supplements. Observational studies suggest that unopposed estrogens reduce the risk of cardiovascular disease and fractures and increase the risk of endometrial cancer and, possibly, breast cancer. In the absence of information from randomized trials, how much of the apparent beneficial effect on heart disease is due to the tendency of healthier women to use these drugs is unknown. The effect on the cardiovascular system of estrogen taken with a progestin is unknown, and this regimen may increase the risk of breast cancer. An approach to health and illness that focuses on a single cause or preventive and on single organ systems is severely limited. Alternative ways to improve cardiovascular and skeletal health that do not increase the risk of cancer are available. A reconsideration of the appropriate use of hormone supplements is needed.
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PMID:Hormone replacement therapy: the need for reconsideration. 825 91

Dietary assessment plays a crucial role in our ability to detect relationships between dietary exposure and disease causation. Nutritional problems are at the root of major mass diseases that are impediments to progress toward national and international health goals. This is true for chronic undernutrition and famine as well as many of the chronic diseases afflicting middle-aged and elderly people in industrialized and developing countries. High-quality dietary assessment provides a sound scientific foundation for the primary prevention of mass diseases, whereas inadequate assessment can produce false-negative results and result in apparent inconsistencies between cross-population and within-population findings for a particular disease. The critical role of dietary assessment in the elucidation of disease causation is discussed with regard to high blood pressure, heart disease, breast cancer, and several other major chronic diseases. Improved approaches to dietary assessment need to be made more widely known, not only among research scientists and health practitioners, but also among policymakers who require high-quality dietary data for establishing nutrition goals and making policy decisions.
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PMID:Assessing diets to improve world health: nutritional research on disease causation in populations. 827 13

This is a review of epidemiologic studies, which suggest that comorbidity (e.g., diabetes and heart disease) has an adverse effect on survival among women with incident, invasive breast cancer, adjusting for chronological age and stage of breast cancer at diagnosis. As part of this review, recent results are presented from a series of 463 breast cancer cases, identified through the Metropolitan Detroit Cancer Surveillance System. Women with two or more concurrent health conditions were 2.2 times more likely than breast cancer cases without comorbidity to die from their breast cancer over a four-year period (95% CI: 1.13, 4.18). Limiting heart disease was especially problematic. Recommendations are made for future research in this area.
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PMID:Aging, comorbidity, and breast cancer survival: an epidemiologic view. 836 27

There are 470 million women aged 50 years and older living in the world today, in other words, older than the average age of natural menopause throughout recorded history. Only 50 years ago, even in developed countries, the average women did not live to be 50 years of age. The result of this increased survival is that more and more women are living for longer and longer periods of time after their menopause. What are the implications of prolonged life after the menopause? Most of the current interest in the menopause is prompted by its possible relation to chronic diseases, most notably reproductive cancers, osteoporosis, and heart disease. All of these conditions are more common in women after the menopause, and two of them are directly influenced by the use of replacement estrogen. Thus, estrogen replacement reduces the risk of osteoporotic fractures by about 50%, and unopposed estrogen doubles or triples the risk of endometrial cancer. The risk of these conditions without treatment differs in different countries and populations, and consequently the benefit of hormone replacement will differ. The largest potential benefit of estrogen replacement therapy is the prevention of heart disease. In countries with a relatively high risk of heart disease, observational studies suggest that estrogen reduces this risk by 50%. In other areas, where heart disease in women is much less common, the use of estrogen to prevent heart disease in otherwise healthy women is inappropriate given the uncertain relation of long-term estrogen therapy to the risk of breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiology and the menopause: a global overview. 849 61

Data was compiled from a wide variety sources in order to construct a demographic profile of elderly women in Latin America. Data was organized into a cross-classification matrix based on three age groups (midlife, young old, and old old) and three country types (highly rural, mixed, and highly urban). The macro-level overview takes into account such factors as education, family structure, and employment. Smaller reports and research project reports of micro conditions are used to help explain the macro trends. Women older than 40 represented 9-20% of the population of the region (of 21 Latin American and Caribbean countries). 6-14% of midlife women were widowed, with the highest concentrations in urban countries. Widows and single women comprised about 20-35% of midlife women and 50-65% of older women. Female household headship increased with age from 9-23% in midlife to 24-41% among women 60 years and older. In all countries with the exception of Uruguay, women had less primary schooling than men. Women's salaried employment in the formal sector decreased rapidly with increasing age. For example, in highly urban countries the range of employment was from 34% of women in midlife to only 4% among women 65 years and older. Women were working, but often in the informal sector or as prostitutes or beggars. Women's health conditions included 12-37% with chronic anemia and many with signs of premature aging (early onset of diabetes, hypertension, and osteoarthritic joint changes). Depression among older women may have been as high as 40%. The strain of maintaining a double work load of child care and housekeeping and employment is unmeasured. Regardless of the level of development, older women suffered primarily from heart disease. Breast cancer was more common in urban countries. Highly rural or mixed countries had greater incidence of cervical cancer. Chronic liver disease was appearing in some countries. In highly rural countries infectious diseases and malnutrition still contributed significantly to causes of death. Most women did not have social security coverage. Evidence points to women's remarkable responses (creativity, initiative, and persistence) to fulfilling survival needs.
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PMID:Older women in Latin America: the health and socioeconomic situation of this important subgroup. 857 13

The continuing growth of female life expectancy has resulted in a marked increase of women in years beyond the menopause. Women can nowadays expect to live one-third of their lives in a potential hormonal deficiency state. Women over 50 comprise 17% of the total population of any country in the modern western world. Any decision regarding their health issues will have a great impact on our limited health care resources. There is no doubt that estrogen replacement therapy effectively mitigates hot flushes and other vasomotor symptoms and more effectively so than other treatment modalities. Vasomotor symptoms affect more than half of the female population around the menopause with a mean duration of 2-3 years. When used to treat vasomotor symptoms hormone replacement therapy has repeatedly been shown to be cost effective. It is also well documented that hormone replacement therapy effectively prevents bone loss and osteoporotic fractures as well as heart disease. The majority of cases of both fractures and heart disease occur at ages over 75 and concern has been expressed if treatment from the menopausal age to the onset of fractures or heart disease is cost effective with regard to the perceived increase in risk of side effects, especially breast cancer. One important aspect in this scenario is the control system that we impose on women on HRT. Given our present preparations women are recommended an annual check-up. If the number of office procedures and visits to the clinic cannot be substantially reduced long-term therapy with HRT is not cost effective. An exception from this rule is the treatment of urogenital estrogen deficiency using low dose vaginal estrogens. Systemic concentrations of estrogens following such administration are negligible. Hence, low dose estrogen topical applications can be made an OTC preparation. As no control system is needed this therapy seems to be highly cost effective. The pharmaceutical industry is urged to produce better products so that side effects such as bleeding problems leading to a number of visits to the clinic and fear of cancer among women can be avoided. Recent data also imply that estrogen treatment may confer protection against Alzheimer's disease. Breast cancer is the remaining controversy even if recent data imply that estrogens could be given to women operated on for breast cancer without increasing the risk of a relapse.
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PMID:The menopause revisited. 858 12

A woman spends about one-third of her life in her postmenopausal years. Some women supplement this period of decreased estrogen production with estrogen replacement therapy (ERT). Since the 1970s, we have evaluated the long-term risks and benefits of ERT in one population of women, the Leisure World retirement community. ERT is the most effective method for preventing osteoporotic bone loss and fractures in postmenopausal women. In Leisure World, ERT reduced the risk of hip fractures about 50 %. The effect is greatest in long-term users but may be lost after discontinuation. Postmenopausal osteoporosis affects the bones of the jaws as well as other skeletal bones. Bone loss in the jaws may result in tooth loss. In Leisure World, estrogen users retain more natural teeth than nonusers. Cardiovascular disease is the leading cause of hospitalization and death in women. In Leisure World, ERT reduced the risk of fatal and nonfatal myocardial infarction, ischemic heart disease, other heart disease, and stroke by 20-40 %. The reduction is greatest in long-term and/or current users. ERT is effective in women with and without cardiovascular disease risk factors. A most feared aspect of aging is Alzheimer's disease. In Leisure World, women who had used ERT had a reduced risk of Alzheimer's disease. Risk both increaseng dose and decreased with increasing duration of use. Estrogen use, however, is not without risk. Unopposed estrogen increases risk of endometrial cancer. Risk increases with increasing years of use and remains high after discontinuation. The most important potential risk of ERT is breast cancer. In Leisure World, women who had used a total accumulated estrogen dose of 1500 mg or more had nearly twice the risk of breast cancer compared with nonusers. Short-term low-dose users showed no substantial increased risk. The Leisure World Study shows risks and benefits of ERT similar to other reports in the literature. For postmenopausal women generally, the benefits of ERT--preventing osteoporotic fractures, reducing heart disease, decreasing mortality, and possibly reducing risk of Alzheimer's disease-out-weigh the risks of endometrial and breast cancers. A woman must be fully informed of the risks and benefits of hormone therapy and play an important role in deciding whether to take hormones and which regimen to use.
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PMID:Estrogen replacement therapy in the elderly. 870 21


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