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 majority of prospective studies have shown no independent effect of triglyceride on the prediction of cardiovascular disease after the effects of cholesterol and other heart disease risk factors have been accounted for statistically. Because the association of borderline elevation of triglyceride levels (250-499 mg/dl) with cardiovascular risk might be obscured by its strong correlation with hypercholesterolemia, we examined the relationship in healthy men without hypercholesterolemia. In a population sample of 1,589 healthy fasting men ages 30-79 without known cardiovascular disease or categorical hypercholesterolemia, the prevalence of borderline hypertriglyceridemia was 4.2%, and was unrelated to age. There was no significant excess of borderline hypertriglyceridemia in men with systolic hypertension, or in men who reported use of antihypertensive drugs, current cigarette smoking, or a family history of heart attack before or after age 50. Only obesity, a personal history of diabetes, and fasting hyperglycemia were significantly more common in men with borderline hypertriglyceridemia. Moreover, hypertriglyceridemia was a relatively weak marker for those with diabetes or obesity, being present in only 9% of the former and 6% of the latter. A 12-year follow-up of these men showed no significant association of hypertriglyceridemia with all-cause or cardiovascular death either by univariate analysis or after adjusting for risk factors. These data support the conclusion that borderline hypertriglyceridemia is a poor marker for cardiovascular risk in healthy older men without hypercholesterolemia.
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PMID:Borderline fasting hypertriglyceridemia: absence of excess risk of all-cause and cardiovascular disease mortality in healthy men without hypercholesterolemia. 382 8

A randomized trial was conducted of dexamethasone therapy in infants with bronchopulmonary dysplasia who were dependent on respirators and were not progressing clinically despite conventional treatment. Babies were admitted to the study if they had a roentgenogram and clinical diagnosis of bronchopulmonary dysplasia, were 2 to 6 weeks in age, weighed less than 1,500 g, had made no progress in weaning for the preceding five days, and were free of sepsis, patent ductus arteriosus, and congenital heart disease, and had had no intravenous fat for at least 24 hours. After parental consent was obtained, infants were randomly assigned to control or treatment groups. The study hypothesis was that with steroid treatment, babies could be weaned from the respirator within 72 hours and would show a significant improvement in lung compliance within that time. Sequential analysis exceeded criterion (P less than .05) when seven consecutive untied pairs showed weaning with dexamethasone and failure to wean in control infants. Pulmonary compliance improved by 64% in the treated group and 5% in the control group (P less than .01). No significant intergroup differences were noted in mortality, length of hospital stay, sepsis, hypertension, hyperglycemia, or electrolyte abnormalities. Study design permits the conclusion that dexamethasone can produce substantial short-term improvement in lung function, often permitting rapid weaning from the respirator, but long-term efficacy and safety must be demonstrated by further investigations.
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PMID:Controlled trial of dexamethasone in respirator-dependent infants with bronchopulmonary dysplasia. 388 Aug 79

To examine the relation of short- and long-term changes in glucose metabolism to cardiac function, radionuclide cineangiography and echocardiography were performed in 10 young insulin-dependent diabetic patients without clinical evidence of heart disease. Cardiac assessments were performed before and after both acute variations in blood glucose, and induction of chronic "tight glucose control" involving normalization of hemoglobin A1 concentrations. In diabetic patients, left ventricular (LV) ejection fraction (EF) at normal blood glucose concentration was indistinguishable from values in 11 normal subjects. However, during hyperglycemia (about 300 mg/dl), the average EF at rest was 61%, significantly higher than that during normoglycemia (56%, p less than 0.001). No significant change in LV diastolic dimension was noted in association with shifts between high and normal blood glucose concentrations. Normalization of hemoglobin A1 was achieved within 6 to 25 weeks. This alteration had no significant effect on LVEF, mitral valve E-F slope, or the response of systolic function to blood glucose levels. In addition, no correlation was found between LVEF and hemoglobin A1 concentrations in 4 of 5 evaluation periods. Thus, in young insulin-dependent diabetic patients without overt heart disease, variation in blood glucose concentration is associated with small but significant variation in EF at rest; normalization of hemoglobin A1 has no significant effect on LVEF or the response of systolic function to blood glucose levels.
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PMID:Relation of hemoglobin A1 and blood glucose to cardiac function in diabetes mellitus. 405 Jul 2

A review of case series of patients with insulin-dependent diabetes mellitus (IDDM) shows an excess frequency of cardiovascular death and probably myocardial infarction. The excess risk is not well quantitated, not clearly associated with poor control of hyperglycemia, and probably not explained by conventional heart disease risk factors. High-density lipoprotein cholesterol levels are not consistently lower in patients with diabetes than in those without diabetes. The relationship of described abnormalities of the coagulation system in diabetes to cardiovascular disease is unknown. Physiologic and pathologic abnormalities are seen in some younger patients without macrovascular disease, but their importance in relation to the excess cardiovascular morbidity and mortality is obscure.
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PMID:Insulin-dependent diabetes mellitus and ischemic heart disease. 405 56

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

The majority of previously reported studies of borderline hyperglycemia as a risk factor for cardiovascular disease are based on post-challenge glucose levels, are limited to men, and show either no significant association or a possible threshold effect. In order to determine whether fasting plasma glucose (FPG) in the normal range (less than 140 mg/dl) predicts mortality, we prospectively studied a geographically defined Southern California community of 3625 nondiabetic men and women aged 40-79, 99.5% of whom were followed for 9 years. Levels of FPG were significantly associated with levels of most heart disease risk factors. After adjusting for these risk factors, FPG, analyzed either as a continuous or categorical variable, was independently and significantly associated with all-cause, cardiovascular and ischemic heart disease mortality in men in proportional hazard models. An excess of all-cause mortality with the highest levels of FPG (130-139 mg/dl) was the only statistically significant association seen in women. The absence of a significant linear association in women may reflect true sex differences or a lack of power owing to the relatively small numbers of deaths in women. The independent linear glucose mortality association in men found here differs from previous studies, and may reflect both the larger number of events and the use of FPG, which has less intra-individual variability and less potential for misclassification bias than post-challenge glucose.
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PMID:Is borderline fasting hyperglycemia a risk factor for cardiovascular death? 650 49

Two previous population-based US studies that examined the sex differential for heart disease mortality in diabetics showed an independent effect of diabetes on fatal heart disease only in women. This paper reports sex-specific ischemic heart disease mortality rates and relative risks for a geographically defined population in southern California of men and women aged 40-79 years, 99.5 per cent of whom were followed prospectively for seven years. When the 212 men and 131 women who had diabetes defined by personal history and/or fasting hyperglycemia were compared with 2104 nondiabetics defined by fasting euglycemia and a negative personal and family history of diabetes, the age-adjusted relative risk of death in diabetics attributed to ischemic heart disease was 2.5 for diabetic men and 3.4 for diabetic women. The sex difference increased only minimally after adjustment for heart disease risk factors when the Cox regression model was used: the adjusted risk ratio was 2.4 for diabetic men and 3.5 for diabetic women. In both men and women, diabetes, along with age and plasma cholesterol, was a statistically significant independent predictor of ischemic heart disease mortality. Among diabetics, male sex made a significant independent contribution to the prediction of fatal ischemic heart disease.
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PMID:Sex differential in ischemic heart disease mortality in diabetics: a prospective population-based study. 663 76

It is well known that mean blood pressure (BP) is higher in obese subjects. However, the nature of the relationships between hypertension and obesity is not fully understood; this concerns especially the role of carbohydrate metabolism and sympathetic activity. The aim of this study is to compare hypertensive (systolic BP > or = 160 mmHg) to normotensive men at different levels of body mass index (BMI). We analyzed data from the Paris Prospective Study I concerning 6,424 men aged 40-53 years at entry, who were not treated for hypertension, diabetes and had no sign of heart disease. The biological parameters were glucose and insulin levels, both assessed fasting (G0, I0) and two hours after a 75-g oral glucose load (G2, I2), free fatty acids and cortisol levels. Hypertensive subjects had significantly higher G0 and G2 levels in all BMI tertiles (p < 0.001). On the contrary, I0 was significantly higher only in the third BMI tertile, and the difference in I2 level between hypertensive and normotensive subjects increased with BMI. Free fatty acids level was significantly higher in hypertensives in all BMI tertiles, however, it showed a significant negative trend with BMI (p < 0.0001) which was not present in normotensives. Morning cortisol level showed the same tendency as well and the mean difference between hypertensive and normotensive men decreased with increasing BMI. In conclusion, (1) relative hyperglycemia is present in subjects with systolic hypertension at all BMI levels, while hyperinsulinemia is found only in the more corpulent ones, and (2) free fatty acids and cortisol levels are particularly elevated in lean hypertensive men.
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PMID:[Biological characteristics of arterial systolic hypertension in relation to the degree of obesity in a middle aged active population]. 812 23

Microscopic quantitative cardiomyopathy was previously reported in spontaneous diabetic biobreeding (BB) rats, but the nature of the lesions remains obscure. To further study the specificity of cardiomyopathy in streptozotocin-diabetic rats and discuss the existence of diabetic heart disease, we compared 40 streptozotocin-diabetic rats (D group) with 40 normal control rats (C group) at various durations in plasma glucose, fructosamine, plasma lipid, left ventricular enzyme contents and alterations of myocardial cells and coronary artery tree under electron and light microscope respectively. In 4 weeks, D rats showed myocardial mitochondrial swelling and degeneration, whereas at 8 weeks, myocardial enzyme contents markedly decreased, and myocardial lesions were more conspicuous with disruption of myocardial cells, formation of myocardial contraction bands, dilatation of intercalated discs, deposition of glycogen granules, etc. At 11 weeks, microscopic changes were essentially similar, whereas the decrease of enzyme contents became more conspicuous. During the 11 weeks, persistent and marked hyperglycemia and elevation of fructosamine were observed, however, no abnormalities were found along the coronary artery tree in the D rats. The results indicated that cardiomyopathy is diabetes specific, and exists independently as one of the three important components of diabetic heart disease.
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PMID:Streptozotocin induced cardiomyopathy in diabetic rats. 822 99

Correlates of the size of infarcts, the time from stroke to death, and the mechanisms of death were studied in 77 consecutive patients who died from infarction in the middle cerebral artery territory. The area of infarcts was assessed by planimetry on schemas of representative brain levels and the results were expressed as a ratio of infarcted area on the whole MCA territory. No clear relationship was found between the size of infarcts in the MCA territory, and any of the characteristics of the patients, but extensive infarcts were more frequent when the internal carotid artery was occluded. No evidence was found of an adverse effect of age, diabetes or initial hyperglycemia on the size of infarcts. The mechanisms of death were not linked to sex, age, high blood pressure, diabetes, blood glucose level at admission, presence and location of an arterial occlusion, or etiology of the infarct. On the contrary, they varied as a function of interval from stroke to death. Transtentorial herniation, the main cerebral cause of death, occurred mainly in the first week and was related to the large size of infarcts. Rare recurrences of stroke and frequent extracerebral mechanisms of death (mainly pneumonia, pulmonary embolism and cardiopathy) occurred later on.
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PMID:Infarcts in the middle cerebral artery territory. Pathological study of the mechanisms of death. 833 39


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