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

Psychological stress has been reported to be a risk factor for sudden cardiac death in individuals both with and without underlying structural heart disease. From a group of 80 patients presenting with life-threatening ventricular tachyarrhythmia, six were identified without underlying structural heart disease. Five of these six patients experienced marked psychological stress. Each of these five patients underwent arrhythmia evaluation, demonstrating recurrent rapid monomorphic ventricular tachycardia related to changes in tone of the sympathetic nervous system. Subsequently, solitary beta-adrenergic blocker therapy was given to each patient. During therapy, four of the five patients had a marked reduction of both arrhythmia and symptoms during a follow-up ranging from 29 to 49 (mean, 38) months.
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PMID:Ventricular tachyarrhythmia associated with psychological stress. The role of the sympathetic nervous system. 288 33

Cardiovascular and Renal function were examined in two populations of long-term insulin-dependent diabetics, those with microalbuminuria, a sign of early, subclinical nephropathy and those with clinically manifest diabetic nephropathy. In addition, clinical variables of possible importance for the occurrence and prognosis of diabetic nephropathy were analyzed. Microalbuminuria - a mean of three over-night urinary albumin excretion rates greater than 20 micrograms/min - was found in 16% of Albustix-negative, normotensive, insulin-dependent diabetics. The microalbuminurics had higher supine blood pressures than normoalbuminurics. The albumin excretion rate in microalbuminurics correlated to blood pressure at rest but not to glycosylated haemoglobin. The cardiovascular responses to five different test manoeuvres revealed more evident signs of autonomic nerve dysfunction in microalbuminurics than in normoalbuminurics. The circulatory reactions during mental stress however, were almost identical in the two subgroups. Despite similar glomerular filtration rate and renal plasma flow the albumin excretion during mental stress increased in microalbuminurics, but remained unchanged in normoalbuminurics. It is postulated that a disturbance of glomerular basement membrane permeability is a pre-requisite for the elevated albumin excretion seen in microalbuminurics. Inability to regulate glomerular haemodynamics, due to autonomic nerve dysfunction, may also be a contributing factor. Such dysfunction perhaps even explains why microalbuminurics have higher blood pressures at rest compared with normoalbuminurics. In manifest diabetic nephropathy the rate of renal functional decline correlated to arterial blood pressure, while glycemic control showed no such relation. Patients with rapidly progressive nephropathy showed higher values of growth hormone than slow progressors. In patients with diabetic renal failure, cardiac catheterization revealed reduced stroke work and elevated left ventricular end-distolic pressure during exercise. Autonomic nerve dysfunction and arterial hypertension possibly contributed to the impaired cardiac performance. The existence of a specific diabetic cardiopathy must even be considered. There was a male predominance both in subclinical and manifest diabetic nephropathy. Age at onset of diabetes was lower in micro- as compared to normoalbuminurics. Duration of diabetes had no prognostic implication in subclinical or manifest nephropathy. The mortality rate was high in patients with manifest nephropathy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Studies of cardiovascular and renal function in subclinical and manifest diabetic nephropathy. 316 65

There has been increasing evidence that psychological stress is a risk factor in the development of heart disease. How an individual copes with stress will determine its impact on his or her health. The literature proposes that the effects of stress can be minimized, reduced, or reversed by factors such as goal-directed activity, physical exercise, relaxation, or emotionally supportive relationships. An exploratory study was conducted to compare activity patterns and leisure concepts between matched groups of cardiac and noncardiac subjects. The data indicate trends in the differences between these two groups in activity patterns and in the variety of activities that characterized their leisure time. The results suggest areas for occupational therapy intervention in the treatment of cardiac patients.
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PMID:Use of leisure time by cardiac patients. 368 69

The diagnosis of silent myocardial ischemia is increasing as a result of the widespread use of noninvasive screening techniques. Primary physicians and consulting cardiologists are often unsure how to approach patients with this disorder because its natural history is unknown. There is continuing controversy over proper treatment. This uncertainty, combined with the paradox of having serious heart disease without symptoms, often leads to psychological stress in patients and their families. In a pilot study designed to evaluate the psychological impact of the diagnosis of silent myocardial ischemia, 15 patients were studied. In general, patients and spouses were surprised and concerned by the diagnosis, but most felt that their physicians had been supportive in explaining the problem to them. Because patients trusted their physicians, they not only changed their lifestyles markedly in regard to exercise and diet but also underwent medical or surgical treatment as recommended. Public awareness of the disorder was generally believed to be almost nonexistent. This pilot study provides insight into a subgroup of patients with potentially serious psychological problems and the clinical implications for their physicians.
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PMID:Psychological ramifications of silent myocardial ischemia. 377 29

Mortality data from arteriosclerotic and degenerative heart disease (AHD) and per capita consumption of total fat, saturated fat, sucrose, simple sugars, complex carbohydrates, and protein, and calorie intake for 37 countries were statistically evaluated to investigate possible relationships between dietary factors and incidence of AHD. On a geographical basis, consumption of total and saturated fats is strongly and positively correlated with the death rates, while consumption of complex carbohydrates is negatively correlated. No correlations were found with temporal changes in death rates or with differences within one country. These findings are discussed in the light of the works of many other investigators. It is concluded that the relation of diet to AHD is still controversial, and that the development and severity of the disease cannot be confidently attributed to any single dietary factor nor to blood cholesterol. The contributing effects of other factors, such as physical activity, mental stress, and affluence, are also discussed.
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PMID:Dietary factors and coronary heart disease. 530 8

Mental stress induces changes in hemodynamic variables and in the plasma level of many hormones and plasma peptides. These changes can be modulated by various drugs, eg, beta-blockers. In a double-blind, placebo-controlled crossover study, the authors evaluated the hormonal and hemodynamic changes during psychological stress and the effect of felodipine 10 mg (plain tablet). Eight male volunteers participated. Heart rate, blood pressures, and stroke volume were measured by ECG, mercury sphygmomanometer, and impedance cardiography. Catecholamines and atrial natriuretic factor in plasma were measured by electrochemical and radioimmunoassay techniques. A single dose of felodipine, 10 mg, exaggerates the heart rate decreases the left ventricular ejection time and augments the plasma level increment of noradrenaline. The stress-induced changes in other variables were not influenced by felodipine treatment. In conclusion, acute felodipine treatment influences the reflex activation of the sympathetic nervous system during psychological stress. In the treatment of patients, especially patients with heart disease, these findings could be important but further investigations in patients need to be done.
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PMID:Hormonal and hemodynamic changes following single-dose felodipine treatment during mental stress. 828 74

Mental stress is a disagreeable feeling accompanied by sympathetic overactivity which may mimic heart disorder (panic attack, ...) induce angina pectoris in coronary patients or contribute to trigger acute myocardial infarction. It may be reproduced by mental stress tests (arithmetic test, ...) and used as diagnostic procedure in coronary patients.
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PMID:[Psychosomatic troubles in cardiology]. 899 47

Homocysteine is an amino acid that has been strongly associated with vascular disease. Plasma homocysteine concentrations are known to vary with dietary patterns and to decrease with exogenous estrogen use, but no other behavioral factors have been examined as potential modifiers of this risk factor. Because psychological stress has also been implicated in the development of cardiovascular disease, the purpose of this study was to test the hypothesis that acute psychological stress induces elevations in plasma homocysteine concentrations. A secondary aim was to test potential differences in response between premenopausal and postmenopausal women. Thirty-four healthy women, one-half of whom were naturally postmenopausal with no hormone replacement, participated in this study. The psychological stressors included standard mental arithmetic and speech stressors. Blood samples were taken prior to, during, and after the stressors, and heart rate and blood pressure were also monitored. Results indicated significant elevations in plasma homocysteine during acute psychological stress, with a return to baseline concentrations during recovery. The pattern of findings for blood pressure and heart rate was similar, suggesting that the rise in homocysteine concentrations may have been sympathetically-mediated. No effects of menopausal status or endogenous estrogens were found. The findings provide preliminary evidence that plasma homocysteine may be an important factor in the relationship between psychological stress and risk for heart disease.
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PMID:Plasma homocysteine levels increase in women during psychological stress. 1037 99

Regional sympathetic activity can be studied in humans using electrophysiological methods measuring sympathetic nerve firing rates and neurochemical techniques providing quantification of noradrenaline spillover to plasma from sympathetic nerves in individual organs. Essential hypertension: Such measurements in patients with essential hypertension disclose activation of the sympathetic outflows to skeletal muscle blood vessels, the heart and kidneys, particularly in younger patients. This sympathetic activation, in addition to underpinning the blood pressure elevation, most likely also contributes to left ventricular hypertrophy, and to the commonly associated metabolic abnormalities of insulin resistance and hyperlipidaemia. Antihypertensive drugs, such as moxonidine, which act primarily by inhibiting the sympathetic nervous system, should have additional clinical benefits beyond those attributable to blood pressure reduction, in protecting against hypertensive complications. Obesity-related hypertension: Understanding the neural pathophysiology of hypertension in the obese has been difficult. In normotensive obesity, renal sympathetic tone is doubled, but cardiac noradrenaline spillover (a measure of sympathetic activity in the heart) is only 50% of normal. In obesity-related hypertension, there is a comparable elevation of renal noradrenaline spillover, but without suppression of cardiac sympathetics (cardiac sympathetic activity being more than double that of normotensive obese and 25% higher than in healthy volunteers). Increased renal sympathetic activity in obesity may be a 'necessary' cause for the development of hypertension (and predisposes to hypertension development), but apparently is not a 'sufficient' cause. The discriminating feature of the obese who develop hypertension is the absence of the adaptive suppression of cardiac sympathetic tone seen in the normotensive obese. Heart failure: In cardiac failure, the sympathetic nerves of the heart are preferentially stimulated. Noradrenaline release from the failing heart at rest in untreated patients is increased as much as 50-fold, similar to the level seen in the healthy heart during near-maximal exercise. Activation of the cardiac sympathetic outflow provides adrenergic support to the failing myocardium, but at a cost of arrhythmia development and progressive myocardial deterioration. Psychosomatic heart disease: No more than 50% of clinical coronary heart disease is explicable in terms of classical cardiac risk factors. There is gathering evidence that psychological abnormalities, particularly depressive illness, anxiety states, including panic disorder and mental stress, are involved here, 'triggering' clinical cardiovascular events, and possibly also contributing to atherosclerosis development. The mechanisms of increased cardiac risk attributable to mental stress and psychiatric illness are not entirely clear, but activation of the sympathetic nervous system seems to be of prime importance.
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PMID:Sympathetic nervous system activation in essential hypertension, cardiac failure and psychosomatic heart disease. 1134 14

A cross-sectional survey of the entire membership of the Fukuoka Prefecture Medical Association was conducted in 1983 using a self-administered questionnaire. In this investigation the actual prevalence of smoking among physicians and the relationship between their smoking habits and living habits were studied. The study subjects were divided into two groups: those who smoked (1,737 men and 17 women), and those who did not currently smoke (2,267 men and 169 women). It was realized that there were many who were currently non-smokers among women, subjects with a high body mass index, those with heart disease, those without peptic ulcers, those who underwent health check-ups regularly, those accustomed to an early bedtime, those who were not aware of mental stress, those who took regular exercise, those who consumed plenty of fresh vegetables, yellow and green vegetables and fruit, those who did not consume Japanese pickles, coffee.or green tea, and those who drank alcohol only occasionally and only in small amounts. The results of this study suggested the possibility that physicians who were smokers were a group who smoked little and could easily stop smoking. Moreover, non-smoking physicians were found to have a healthier lifestyle than those who smoked. It was considered that, in developing a smoking cessation program for physicians, it is important for them to establish more health-conscious lifestyles.
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PMID:Smoking behavior and related lifestyle variables among physicians in Fukuoka, Japan: a cross sectional study. 1216 21


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