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

Previous studies have shown that the increased risk of cardiovascular disease in adults with diabetes is independent of heart disease risk factors and have suggested that the effect of these risk factors is similar in diabetics compared with nondiabetics. To determine whether there was interaction between diabetes and the classic heart disease risk factors (cholesterol, blood pressure, and cigarette smoking) in the prediction of cardiovascular death, the etiologic fraction due to interaction was assessed in a nine-year follow-up of 2,620 older Caucasian adults (60-79 years) who resided in Rancho Bernardo, California, 8.7% of whom had diabetes by history of fasting hyperglycemia. In these older adults, the frequency of categoric hypertension, hypercholesterolemia, or current cigarette smoking did not differ significantly among diabetics compared with nondiabetics. Overall, the age-adjusted relative cardiovascular mortality risk among diabetics was similar to that in nondiabetics for all risk factors except cigarette smoking, for which the relative risk for diabetics was 2.2 compared with 1.2 for nondiabetics. High cholesterol and systolic blood pressure levels showed no interaction with diabetes, but cigarette smoking had a large and significant interaction with diabetes, such that an estimated 65% of the cardiovascular disease deaths among diabetics could be attributed to the interaction of diabetes and cigarette smoking. If confirmed, these data have important implications for the prevention of cardiovascular death in older diabetics.
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PMID:Interaction between cigarette smoking and diabetes mellitus in the prediction of death attributed to cardiovascular disease. 649 47

108 women aged 28 to 74 years underwent cardiac angiography for evaluation of chest pain or other heart disease. 29 were found to be free of coronary disease and formed a control group. Multi-variable analysis indicated that hypercholesterolemia, hypertension, familial coronary disease and diabetes were the most relevant atherogenic risk factors.
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PMID:[Risk factors in coronary arteriosclerosis in women]. 667 37

The radiographic features of five patients with arteriohepatic dysplasia are presented. These patients had congenital intrahepatic cholestasis with elevated serum bile acids, vertebral body abnormalities of shape and/or segmentation, shortened digits, and congenital heart disease, particularly peripheral pulmonic stenosis. They also had dysmorphic facies, eye abnormalities, hypercholesterolemia, and mild fat malabsorption. Some of the patients had neurologic, endocrine, and/or renal abnormalities as well, and they may have had hoarse voices due to vocal cord nodules. Variability in expression of the syndrome and vertical transmission suggest an autosomal dominant pattern of inheritance.
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PMID:Arteriohepatic dysplasia: radiologic features of a new syndrome. 677 28

In 1979, a community-wide hospital surveillance system was established in Monroe County, New York (population 702,000), to investigate the continuing contribution of uncontrolled high blood pressure (HBP) to the occurrence of stroke. This paper reports findings among 200 consecutive strokes in persons under 71 years of age. Average age was 58. There was a prestroke history of HBP in 129 (65 per cent) cases. Two-thirds of the 129 had other predisposing conditions (heart disease, diabetes, previous cerebrovascular accident) and 95 per cent had one or more other cardiovascular risk factors (smoking, elevated cholesterol, obesity). Over 90 per cent had visited a physician during the year prior to stroke (average of four visits). Elevated pressures (DBP greater than or equal to 95 or SBP greater than or equal to 160) were recorded at half or more of the visits for 45 per cent of the patients; these cases were classified as uncontrolled. Reduction of "unnecessary" strokes in persons under age 71 should be achievable by giving increased attention to those already under medical care for hypertension who have co-existing stroke risk conditions and cardiovascular risk factors.
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PMID:Community surveillance of stroke in persons under 70 years old: contribution of uncontrolled hypertension. 682 12

Hyperlipidemias represent one of the most important risk factors for the development of premature atherosclerotic disease. If prevention of ischaemic cardiovascular disease, which is responsible for about 50% of the deaths in Western Europe, should be successful, diagnosis and treatment of hyperlipidemic states should start as early as possible. A short overview concerning the composition and the metabolism of the lipoproteins is given and theoretical and practical aspects for the classification of the different forms of hyperlipoproteinemia during childhood are pointed out. Laboratory determinations are described and therapeutic approaches of the main pediatric hyperlipidemias are given: polygenetic and combined familial hyperlipidemias should be treated by diet alone, whereas familial hypercholesterolemias request drug treatment: cholestyramine, given in doses between 4 and 8 g seems to be the drug of choice. Possible future aspects of drug treatment are discussed, even those who are shown to increase the number of LDL-receptors, which are blocked in that disease. Finally, efforts are emphasized to screen all children of families, in which premature heart disease or hypercholesterolemia occur.
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PMID:[Diagnosis, clinical features and treatment of hyperlipidemias in children]. 717 16

Elevated levels of cholesterol synthesis are reported for several young children with homozygous familial hypercholesterolemia (HFH) and are considered to contribute directly to their hypercholesterolemia. In contrast, increased cholesterol production has not previously been found in adult patients with HFH. Using the fecal steroid balance technique, we studied rates of cholesterol and bile acid synthesis in a 24-yr-old man who had severe hypercholesterolemia typical of HFH and who lacked skin fibroblast low density lipoprotein (LDL) receptor activity. On an average diet (45% carbohydrate, 40% fat, 15% protein) mean +/- SEM cholesterol (24.8 +/- 1.4 mg/kg per d) and bile acid (11.1 +/- 1.6 mg/kg per d) excretion were approximately threefold higher than normal. When an isocaloric high carbohydrate, low fat diet (90.5% glucose oligosaccharides, 1.3% safflower oil, 8.2% crystalline amino acids was substituted, mean cholesterol (13.0 +/- 0.5 mg/kg per d) and bile acid (8.6 +/- 0.4 mg/kg per d) fell markedly. The decline in fecal steroid excretion was accompanied by modest reductions in plasma total and LDL cholesterol concentrations and by a softening of cutaneous xanthomata. Although the patient phenotypically and biochemically resembled the HFH state, his family pedigree was not noteable for hypercholesterolemia. While the patient's father had premature cardiovascular disease, his mother had no evidence of heart disease, had normal plasma total and LDL cholesterol levels, and had normal fibroblast LDL receptor activity. Likewise, the plasma cholesterol levels of three other members of the patient's family were normal. Despite the unusual genotypic background of this individual, however, the fecal balance data shows that elevated cholesterol and bile acid synthesis may occur in adult, as well as juvenile, patients with HFH and may be responsive to dietary control.
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PMID:Elevated cholesterol and bile acid synthesis in an adult patient with homozygous familial hypercholesterolemia. Reduction by a high glucose diet. 729 45

The Belgian Heart Disease Prevention Project is a controlled multifactorial preventive trial. It is basal on the well-documented epidemiologic notion of major coronary risk-factors: hypercholesterolemia, hypertension, smoking and obesity. This Project has been executed in industries, in males aged 40-59 yrs at the base-line screening. It is part of the WHO European Collaborative Trial including the United-Kingdom, Italy, Poland and Spain. This trial should verify a double work-hypothesis: 1 degree it is possible to modify significantly the coronary risk profile in middle-aged males through a comprehensive intervention program, 2 degrees this modification should, in turn, significantly reduce total mortality as compared to a control group. The authors discuss the pros and cons of a preventive trial in industry and review the numerous problems raised by the difficulties in modifying well-established life-styles as well as those related to the follow-up morbidity and mortality. Final screening took place in 1979-80 and results regarding incidence should be available by 1981.
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PMID:[The Belgian Heart Disease Prevention Project (author's transl)]. 730 12

Sixty male survivors of acute myocardial infarction in the week after the Chicago blizzard of Jan 15, 1979, were matched by hospital and sex with 60 myocardial infarction survivors from a week without snowfall to determine whether a history of previous heart disease or of cardiac risk factors increased the risk of a postblizzard myocardial infarction. Cases did not differ significantly from control subjects with respect to age, percentage working full time, or percentage with a history of heart disease, hypertension, smoking, diabetes mellitus, obesity, or gout. Hypercholesterolemia was four times as common among cases as among controls.
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PMID:Risk factors for myocardial infarction associated with the Chicago snowstorm of jan 13- 15, 1979. 745 33

Hypercholesterolaemia therapy should begin with implementation of a suitable diet in order to achieve optimum weight and reduce the intake of saturated fats. Often, however, a dietary regime is not sufficient to decrease cholesterol levels in hypercholesterolaemic patients and drugs must also be used. Some of the pharmacological options available act principally on LDL cholesterol, whereas others have more effect on triglyceride rich particle. HMGCoaA reductase inhibitors exert the greatest effect on plasmatic LDL cholesterol levels and are therefore recommended in cases of moderate or severe hypercholesterolaemia, particularly in the secondary prevention of ischaemic cardiopathy. Comparing the three statin drugs, lovastatin, pravastatin and simvastatin, the latter has recently been shown in study 4S to be effective in reducing global and coronary mortality in patients with a history of coronary heart disease. In addition to their action on LDL cholesterol, these drugs also increase HDL cholesterol, reduce triglycerides and have a beneficial effect on some of the fundamental mechanisms involved in the development of arteriosclerosis. Ion-exchange resins moderately reduce cholesterol levels, thus are used in young people or in combination with other drugs when a further reduction of LDL cholesterol is required. Their main drawback, however, is that they can often cause digestive intolerance. Primary prevention trials have shown that fibrates also reduce mortality by coronary heart disease but have no effect on global mortality. They are well tolerated and are used in the treatment of mixed hyperlipaemia. Other products, such as probucol and oestrogens, are also used but only under specific circumstances.
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PMID:[The pharmacological treatment of hypercholesterolemia]. 749 38

We studied the frequency of heart disease and association with other coronary risk factors in 243 consecutive patients (124 male and 119 female) suffering from arterial hypertension (Group HT). The mean age was 67.5 +/- 9.6 years. This group was compared to a group of 357 subjects (217 male and 140 female) without arterial hypertension (Group noHT) and mean age of 63.5 +/- 13 years. In our group the patients with arterial hypertension presented smoking habits in 35%, hypercholesterolemia in 22%, left ventricular hypertrophy (LVH) in 18%, alcoholic habits in 15%, hypertriglyceridemia in 12%, diabetes in 9% and hyperuricemia in 7%. 15% of the patients suffering from arterial hypertension turned out with coronary heart disease (62% angina and 38% myocardial infarction), 19% with atrial fibrillation and 13% with heart failure. Compared to the patients without hypertension we found significant statistical correlation with the age (67.5 +/- 9.6 HT and 63.5 +/- 13 no HT, p < 0.001), the LVH (18% HT and 4% no HT, p < 0.001) and number of coronary risk factors (2 +/- 1 HT and 1.1 +/- 0.9, p < 0.001). The percentage of people without cardiac disease is lower among the group with arterial hypertension (53% HT and 71% noHT, p < 0.001), showing as well a higher incidence of atrial fibrillation (19% HT and 11% noHT, p < 0.05) and heart failure (13% HT and 7% noHT, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Study of associated risk factors and prevalence of heart diseases in patients with arterial hypertension]. 754 43


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