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)

To investigate the prevalence of internal carotid arterial stenosis in an unselected asymptomatic population over 50 years of age, 102 volunteers from one church congregation were studied with ultrasonic arteriography, spectral analysis, and ocular pneumoplethysmography. Fifty subjects were 50 to 59 years old; 33 were 60 to 69 years of age; and 19 were older than 70 years. Forty-five were men and 57 were women. Risk factors included diabetes mellitus (4%), heart disease (9%), hypertension (24%), peripheral vascular disease (20%), and smoking (46%). Disease was found in 11 subjects (10.8%). Of the 204 internal carotid arteries, 13 (6.4%) were abnormal. Two vessels had 20% diameter stenosis; four had stenoses of 20% to 39%; five had stenoses of 40% to 59%; one had a stenosis of 60% to 79%; and one was occluded. Stenoses greater than 40% occurred in 4% of the 50 to 59 years of age group, 6% of the 60 to 69 years of age group, and 11% of the greater than 70 years of age group. Although the prevalence of carotid stenosis was increased in all subjects who had risk factors, only the association with heart disease reached statistical significance. These results indicate that carotid stenosis is present in an appreciable number of asymptomatic subjects over the age of 50 years and suggest that its prevalence is associated with age and other risk factors.
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PMID:Prevalence of extracranial carotid artery disease: a survey of an asymptomatic population with noninvasive techniques. 355 Jan 61

This study analyzed 76 consecutive patients with carotid transient ischemic attacks (TIA) and carotid lesions appropriate to symptoms who underwent endarterectomy during the period 1975-1981. The mean age of the patients was 51.9 +/- 8 years at the time of surgery. Hypertension was present in 32.9%, diabetes mellitus in 13%, ischemic cardiopathy in 8.2% and peripheral vascular disease in 6.6%. Operative mortality was 1.3% and harder morbidity 4%. The average follow-up was 2.6 years (range 1-7 years). The observed 5-year survival rate was 85.2% compared to the expected rate of 92.4% in a normal population. During the follow-up 5 patients had a stroke: the cumulative stroke rate was 4.6% at 1 year and 7.9% at 3 years. 18 patients had further TIAs (13 carotid TIAs and 5 vertebro-basilar TIAs). 6 patients suffered myocardial infarction. The prognosis of TIA patients treated with endarterectomy is difficult to evaluate because the natural history of TIAs is still undefined.
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PMID:Long-term prognosis after carotid endarterectomy. 394 Aug 63

Assessment of the predictive value of preoperative factors in the determination of operative risk in 50 patients who underwent simultaneous aortic and renovascular procedures over a 10-year period is reported. There were six operative mortalities (12%). Factors associated with increased mortal risk were azotemia (43% vs. 7%), associated complex renal or visceral procedures (31% vs. 5%), treatment of aortic aneurysm vs. occlusive disease (17% vs. 5%), positive EKG (19% vs. 4%), age over 60 years (20% vs. 4%), and a history of diffuse peripheral vascular disease (18% vs. 7%). None of these differences, by themselves, had statistical significance. Through discriminate analysis with assignment of weighted scores to the five most powerful predictors of operative death (complex procedure--4, azotemia--4, aortic aneurysm repair--3, positive electrocardiogram--2, history of diffuse vascular disease--2), a weighted score of greater than or equal to 10 predicted operative death with an 83% sensitivity and 93% specificity (p = 0.003). Although advanced age, diabetes, severity of hypertension, and history of heart disease were associated with increased operative risk, they contributed minimal discriminate value to that provided by the preceding five variables. This was because these weaker risk factors were usually found in association with the predictors in the discriminant score. This study suggests that in patients with high weighted discriminant scores (greater than or equal to 10), consideration of operative risk is particularly important in evaluation of the proposed value of combined procedures.
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PMID:Aortic and renal vascular disease. Factors affecting the value of combined procedures. 646 84

This multicenter regional study analyzes survival of a large group of patients who began chronic dialysis or received their first renal transplant during the 5 1/2-year period that ended in June 1983. Survival was determined from the onset of renal replacement therapy, irrespective of changes in treatment modality. Univariate life-table analysis was used to examine more than 35 risk factors. Age of patients at entry into the therapeutic program significantly affected survival. General survival rates were lower for patients with diabetes than for nondiabetics, irrespective of treatment modality, with the exception of those older than 60 years of age. Five-year graft survival was lower for diabetics than for nondiabetics in all age groups, irrespective of source. Patients with systemic lupus erythematosus, focal glomerulosclerosis, or glomerulonephritis had the highest survival rates, whereas those with primary renal malignant lesions, primary hypertensive disease, or diabetes mellitus as the cause of renal failure had the lowest. Concurrent morbid conditions that adversely affected survival included arteriosclerotic heart disease, peripheral vascular disease, noncutaneous malignant lesions, chronic pulmonary disease, and multiple coexisting morbid conditions. Although the objective of this study was to analyze survival for single patient characteristics, irrespective of treatment modality, analyses of survival rates by treatment modality for a control group indicated that minimal differences were evident by the third year among the four treatment groups: in-center hemodialysis, home hemodialysis, living related donor transplantation, and cadaver transplantation; however, recipients of cadaver grafts had lower survival rates than all other groups, even those maintained by in-center hemodialysis (P = 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Survival rates of 2,728 patients with end-stage renal disease. 649 73

We present a retrospective study of 191 carotid artery operations in which a large population of diabetic patients is compared with a smaller nondiabetic group of patients. Of the patients who were studied, 62.3% were diabetic and 37.6% were nondiabetic. The patients with a juvenile-onset diabetes fared poorly, with few of them living long enough to develop carotid artery disease. The patients with adult-onset diabetes differed from the nondiabetic patients only in the increased incidence of associated peripheral vascular disease. The incidence of symptomatic heart disease preoperatively, and the perioperative morbidity from heart disease was the same for both groups. The perioperative stroke rate was 2.6% and 0%, respectively, for asymptomatic patients. Long-term follow-up demonstrated the effectiveness of the procedure, with only two of the patients with transient ischemic attacks developing strokes later. There was, however, a highly significant increased death rate from myocardial infarction among the diabetic patients (55%), compared with the nondiabetic patients (25%).
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PMID:Carotid artery surgery in diabetic patients. 650 26

We examined 178 men for the presence of diabetic retinopathy during 1978-80. They had been part of a group of 205 men from the Jerusalem area, diagnosed as being diabetic or having an abnormal glucose tolerance test in the Israel Ischaemic Heart Disease Project, a 5-year epidemiological investigation of Israeli male government employees. Seventy-four (42%) had diabetic retinopathy as determined by direct and indirect ophthalmoscopy, 3-mirror contact lens examination, and fundus photography. Those with and without retinopathy were compared for clinical, biochemical, behavioural, and biographical variables measured subsequently in 1963, 1965, and 1968. We found no significant differences between the 2 groups with respect to antecedent Quetelet index, blood pressure, peripheral vascular disease, blood lipids, haematocrits, smoking habits, area of birth, and education. Statistically significant differences between men with and without retinopathy were found for severity of carbohydrate metabolic intolerance at identification, duration of the metabolic abnormality, age, casual glucose values, and serum uric acid levels. Low serum uric acid appears to precede the incidence of diabetic retinopathy and to decline further as the disease progresses.
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PMID:Prevalence and 15-year incidence of retinopathy and associated characteristics in middle-aged and elderly diabetic men. 663 10

The survival of 111indium labelled platelets has been determined in a series of 47 subjects comprising nine with cyanotic congenital disease (Eisenmenger's syndrome), seven with congenital heart disease associated with left to right shunts, six with primary pulmonary hypertension, six with peripheral vascular disease, 11 with cardiac disorder associated with low cardiac output and eight normal volunteers. Compared with the value in the normals of 9.5 days, mean survival was significantly shortened in those with Eisenmenger's syndrome (8.4 days) and with peripheral vascular disease (8.5 days). It was normal in patients with left to right shunts (9.5 days). Gamma camera imaging in selected patients failed to reveal any abnormal sites of deposition of labelled platelets except in one patient with peripheral vascular disease who had bilateral abnormal activity in his lower limbs and a shortened platelet survival (8.0 days). From theoretical considerations, it was concluded that the reduction in platelet survival in Eisenmenger's syndrome was such that, had it been the result of pulmonary intravascular platelet deposition, abnormal activity should have been visible on chest scanning with the gamma camera. The absence of scintigraphic evidence of abnormal platelet deposition in the lungs of these patients, combined with the linear configuration of their platelet survival curves, suggests that the accelerated platelet destruction is in the reticuloendothelial (RE) system rather than intravascular. Indirect evidence in favour of increased RE destruction of platelets in Eisenmenger's syndrome was the finding of an approximate doubling of intrasplenic platelet transit time, indicating abnormal platelet pooling within the spleen.
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PMID:Platelet kinetics in congenital heart disease. 712 53

The prevalence of peripheral vascular disease (PVD) was assessed in terms of ankle/brachial index by doppler studies in a large cohort of non-insulin-dependent diabetes mellitus (NIDDM) patients in South India. One hundred and ninety-two out of 4941 patients (3.9%) had evidence of PVD. There was a slight female excess in PVD patients. There was a linear increase in prevalence of PVD with increasing duration of diabetes. Multiple logistic regression analyses showed that serum cholesterol, serum creatinine, systolic BP, duration of diabetes and ishaemic heart disease are strong predictive factors for PVD. The prevalence of PVD in South Indians is lower than that reported in European populations.
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PMID:Peripheral vascular disease in non-insulin-dependent diabetes mellitus in south India. 755 7

The purpose of this study was to determine the impact of transesophageal echocardiography (TEE) on the management of patients with peripheral vascular emboli. We prospectively evaluated the role of TEE in 15 patients with documented peripheral emboli and no evidence of occlusive peripheral vascular disease. The patients were divided in two groups for analysis: group 1 (n = 8) had no clinical evidence of heart disease and group 2 (n = 7) had clinically significant heart disease. TEE provided information regarding the source of embolism in four (50%) patients in group 1, and these findings significantly affected the management of all. Three patients underwent thoracic surgery to remove the source of embolism (aortic valve mass in one and a thrombus in the descending thoracic aorta in two); the other patients was treated with thrombolytic agents. TEE findings had high diagnostic value in all patients in group 2, but the results had a possible effect on clinical management in only two of these patients. TEE provides diagnostic information in most patients with peripheral vascular emboli and this information has a significant influence on management, particularly in those without clinically evident heart disease. TEE should be performed in all patients with documented peripheral embolism.
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PMID:Transesophageal echocardiography in the detection of cardiovascular sources of peripheral vascular embolism. 763 53

Rates of both type 2 diabetes and cardiovascular disease have risen sharply in recent years among Navajo Indians, the largest reservation-based American Indian tribe, but the association between the two conditions is not entirely clear. Rates of cardiovascular disease and some possible associations in several hundred diabetic and non-diabetic Navajos were estimated. Nearly one-third (30.9 percent) of those with diabetes had formal diagnoses of cardiovascular disease--25.3 percent had heart disease, 4.4 percent had cerebrovascular disease, and 4.1 percent had peripheral vascular disease. (The percentages exceed the total because some people had more than one diagnosis. Age-adjusted rates were 5.2 times those of nondiabetics for heart disease, 10.2 times for cerebrovascular disease, and 6.8 times for peripheral vascular disease. Accentuation of risk was most marked in young diabetics and in female diabetics. Hypertensive diabetics had a twofold increase in heart disease and more than a fivefold increase in cerebral and peripheral vascular disease over nonhypertensive diabetics. Age, blood pressure, cholesterol levels, and albumenuria were independent risk factors for cardiovascular disease. Triglyceride levels or body weight were not. Male sex and diabetes duration were independent risk factors for cerebral and peripheral vascular disease but not for heart disease. In view of the impressive segregation of cardiovascular disease in the diabetic Navajo population, the prevention of diabetes through population-based health promotion seems basic to its containment. Over the short term, vigorous treatment of hypertension in subjects who are already diabetic is mandatory.
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PMID:Cardiovascular disease in Navajo Indians with type 2 diabetes. 783 49


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