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

Over one quarter of the risk of death due to the sudden infant death syndrome (cot death) is attributable to maternal smoking. Maternal smoking during pregnancy and infancy is one of the most important avoidable risk factors for infant death. Nicotine is a drug of addiction. Many young smokers are addicted to nicotine and develop withdrawal symptoms on stopping. Smoking is an important marker for other types of drug abuse, e.g. alcohol, cannabis and cocaine. The earlier children start smoking, the greater the risk of lung cancer and heart disease. Smoking affects immunity and has been associated with an increased risk of acquiring human immunodeficiency virus-1 infection.
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PMID:Smoking and the young. 146 39

One hundred sixty-eight opiate addicts, whose hearts were submitted for necropsy study, were examined with prime focus on modes of death and types of cardiac abnormalities. Twenty various modes of death were identified: active infective endocarditis or its consequences in 67 (40%), drug overdose in 39 (24%), coronary artery disease in 14 (8%), pulmonary granulomatosis in 7 (4%) and 15 various diseases (7 cardiac and 8 noncardiac) in the remaining 41 (24%) patients. Of the 168 hearts examined, only 7 (4%) were normal. Although infective endocarditis (active, healed or both) was most common (80 [48%] patients), there was a broad range of other cardiac abnormalities present: cardiomegaly in 114 (68%) (including 22 patients without another cardiac abnormality), coronary artery disease in 35 (21%), acquired valvular heart disease in 16 (10%), myocardial heart disease in 14 (8%) and a congenital cardiac anomaly in 19 (11%). Of the 35 hearts with various coronary artery diseases, 28 had significant (greater than 75%) narrowing of the cross-sectional area of 1 or more of the 4 major (left main, left anterior descending, left circumflex and right) epicardial coronary arteries by atherosclerotic plaque. Of 112 coronary arteries in these 28 hearts, 52 (46%) were significantly narrowed (a mean of 1.9 of the 4 major coronary arteries/patient). In 27 of these 28 cases, each 5-mm segment of the 4 major coronary arteries was examined histologically. Of the 1,435 five-mm segments examined, 189 (13%) were narrowed 76 to 100% in cross-sectional area by plaque; 347 (24%), 51 to 75%; 336 (23%), 26 to 50%; and 563 segments (39%) were narrowed 0 to 25% in cross-sectional area by plaque. The percents of 5-mm segments narrowed 76 to 100% in cross-sectional area were greater in those patients with (128 of 793 [16%]) than without (61 of 642 [9%]) clinical evidence of myocardial ischemia (p = 0.001). In this study a very high frequency of cardiac abnormalities (161 [96%]) was found at necropsy and most deaths (97 [58%]) were related to cardiac disease. Although death was most often due to diseases whose association to opiate addiction is well recognized (such as infective endocarditis, drug overdose and pulmonary granulomatosis from the venous injection of talc), several other modes of death were present. Most prominent among these was coronary artery disease (14 patients [8%]).
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PMID:Modes of death and types of cardiac diseases in opiate addicts: analysis of 168 necropsy cases. 280 61

Based on a large US representative cohort with detailed baseline interview and examination data, the relationship between alcohol consumption and all-cause mortality is examined over a period of 15 years follow-up. Results show a significant linear relationship for females and males under 60 years of age at baseline, and a non-significant U-shape for the older ones. Both results remain stable for different kinds of adjustment including adjustment for nutritional variables and smoking. Excluding people with heart disease history at baseline leads to an even more pronounced linear relationship for both males and females under 60 years of age. Furthermore, it is shown that the curvilinear relationship for men found in previous research is partly due to the age groups examined.
Addiction 1995 Apr
PMID:Alcohol consumption and all-cause mortality. 777 6

Information concerning tobacco smoking was obtained in a survey of 16,483 students aged 18-30 years from 21 European countries. Belief in the benefits to health of not smoking were also assessed. Risk awareness was measured in terms of knowledge of the links between smoking and disease. The overall age-adjusted prevalence of smoking was 33.1% in men and 29.0% in women, but wide variations were observed across country samples. Significant sex differences were found in only a minority of cases. The inclusion of respondents who stated that they had sometimes smoked in the past substantially reduced variations in prevalence across country samples. Beliefs in the health benefits of not smoking were consistently associated with smoking behaviour. Awareness of the link between smoking and lung cancer was uniformly high, but awareness of the role of smoking in heart disease varied considerably across country samples, and averaged only 64.4% in men and 62.9% in women. In the majority of countries, risk awareness was greater among smokers than non-smokers. The results suggest that in this selected sector of the population of young adults in Europe, sex differences in smoking are relatively minor, robust associations between attitudes and smoking behaviour can be identified, and there are major gaps in risk awareness.
Addiction 1995 Apr
PMID:Tobacco smoking in young adults from 21 European countries: association with attitudes and risk awareness. 777 20

This study examined the records of 252 admissions to an inpatient drug rehabilitation program for African American women between July 1989 and July 1991 to determine the prevalence and treatability of the medical conditions found on screening evaluation. All but 0.7% of subjects were on General Relief, Medicare, Medicaid, or had no payment source. The results showed a high prevalence of problems related to life style such as sexually transmitted diseases, anemia, and dental disease. Significant medical illness such as heart disease, abdominal surgical conditions, and breast masses were also found along with a high level of somatic discomfort of a subacute nature. Only 58% of patients referred to specialists kept the initial appointment. These results suggest that medical evaluation of impoverished African American women seeking rehabilitation for addiction may reveal many other health problems but that non-compliance severely limits the effectiveness of treatment. The role of the medical screening evaluation in determining fitness to participate in an inpatient program, detecting undiagnosed medical conditions, and patient education is discussed.
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PMID:Medical evaluation of African American women entering drug treatment. 829 38

Smoking tobacco contributes to and exacerbates many chronic diseases of aging, including hypertension, stroke, COPD, heart disease, and atherosclerosis. It is also associated with an increased risk of peptic ulcers and of cancers of the lungs and oral cavity. Older patients generally continue to smoke because of physiologic and psychological addiction to nicotine. Nicotine administration through gum or patch eases the symptoms of nicotine withdrawal for highly-tolerant patients. Detecting and treating alcohol abuse, depression, or life stress may then make it easier to motivate the patient to quit smoking. Physician advice combined with follow-up visits and phone calls has been shown to be one of most effective methods of getting patients to stop smoking.
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PMID:Smoking cessation: clinical steps to improve compliance. 838 53

The fact that the cardiovascular risk of ex-smokers approximates that of non-smokers after two years of abstinence, implies that accelerated atherogenesis is not the chief mechanism of smoking-related heart disease. Indeed, smoking or nicotine have adverse effects on blood rheology, thrombotic risk, coronary blood flow, and risk for arrhythmias. Omega-3-rich fish oils can be expected to correct or compensate for a remarkable number of the adverse impacts of smoking/nicotine: increased plasma fibrinogen, decreased erythrocyte distensibility, increased plasma and blood viscosity, increased platelet aggregability, increased plasminogen activator inhibitor levels, vasoconstriction of the coronary bed, reduced fibrillation threshold, increased triglycerides, reduced high-density lipoprotein cholesterol, and increased production of superoxide by phagocytes. Smokers who cannot overcome their addiction should be encouraged to substitute nicotine aerosols/gum for tobacco and advised to use supplementary fish oil and other cardioprotective nutrients.
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PMID:Fish oil may be an antidote for the cardiovascular risk of smoking. 873 61

The causes of intrauterine growth retardation (IUGR) are multiple, involving many different factors. Studies in humans and animals have shown that the maternal environment is the most important determinant of newborn weight, accounting for more similarity in birth weights of siblings than does genetic affinity. In addition to a direct relationship with the degree of maternal plasma volume expansion, many clinical factors are associated with IUGR. These factors include multiple gestation; fetal, genetic, and chromosomal anomalies (Down's syndrome and Turner's syndrome); infections such as TORCH syndrome (acronym for toxoplasmosis, rubella, cytomegalic disease, and herpes); and various maternal disorders including anemia, severe chronic asthma, chronic renal disease, heart disease and hypertension. Maternal stress factors, including narcotic addiction, cigarette smoking and chronic alcoholism, are associated with IUGR. Placental anomalies including hemangiomas, placental infarcts, single umbilical artery, and small placental size are also associated with intrauterine growth retardation. Poor nutritional status of the mother at conception and inadequate energy and protein intakes during pregnancy can also result in IUGR. Because IUGR children are not a homogeneous group, they have a broad spectrum of growth, health, and developmental outcomes. In general they have higher rates of subnormal growth, morbidity, and neurodevelopmental problems. The biomedical mechanisms reflected in nutritional, infection-related, hormonal, and metabolic parameters are not likely to be independent causative factors of IUGR, but important mediating factors of a pathologic process set in motion by other agents and insults. This paper focuses mainly on the possible negative effects that a deficient maternal diet might have on fetal development and growth.
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PMID:Biological mechanisms of environmentally induced causes of IUGR. 951 Oct 16

Tobacco use is a global health care problem. Repetitive exposure to nicotine produces neuroadaptation resulting in nicotine dependence. Cigarette smoking is particularly addictive due to the repeated delivery of bolus doses of nicotine to the bloodstream. Although compulsive tobacco use is sustained by nicotine addiction, it is the toxic combustion products in tobacco smoke such as carbon monoxide and oxidant gases that adversely affect the cardiovascular system. Smoking cessation produces significant health benefits and is a very cost-effective intervention. Evidence that nicotine is the addictive component of tobacco provides the rationale for using nicotine replacement therapy to aid cessation. Nicotine replacement therapy doubles successful smoking cessation rates and evidence-based guidelines for the treatment of tobacco addiction recommend routine use of nicotine replacement therapy, particularly in heavily dependent smokers. Success rates of up to 40% can be achieved in specialist clinics. Despite early concerns regarding the safety of nicotine replacement therapy in smokers with heart disease, it is now clear that the health risks of using nicotine replacement therapy to assist such patients to stop, or significantly reduce, smoking far outweigh any treatment-related risks.
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PMID:Diagnosis and treatment of nicotine dependence with emphasis on nicotine replacement therapy. A status report. 1068 82

Descriptive statistics, Chi square analysis, and multivariate logistic models were used to examine the factors related to infant mortality in Shanghai city proper and the suburbs in 1990. Mortality samples included 309 cases of infant mortality and 309 controls (same sex, same hospital, and within 5 days of the same birthday) from the city and 223 cases and 223 controls from the suburbs. Data was obtained from the annual mortality reports of the Shanghai Sanitation and Antiepidemic Station. 60.71% (323) of infant deaths were males, of whom 62.46% (193) were from the city proper and 58.30% (130) were from the suburbs. In the city, 61.50% were neonatal deaths (under 28 days) and 45.7% of all infant mortality were early neonatal deaths (under 7 days). 74.2% of total neonatal deaths were early. The respective percentages in the suburbs were 67.2% for neonates and 76.6% for early neonates. The percentage of neonatal and early neonatal deaths out of total infant mortality was higher in the suburbs. The neonatal mortality in the city reflected a decline from preceding years. 18.8% of infant mortality was due to pneumonia, and 17.55% was due to suffocation. Suburban mortality was most often from pneumonia (16.6%) and suffocation (15.2%), followed by premature birth, congenital malformation, and congenital heart disease. Premature births were higher in the suburbs. Rankings in the city were similar to the suburbs: pneumonia, suffocation, neonatal diseases, premature birth. 82.5% infant deaths from the city and 75.7% of infant deaths from the suburbs had received treatment as in or out patients. About 20% received no treatment. Higher mortality was found to related to low birth weight, twin pregnancy, premature birth, medication during pregnancy, few prenatal visits, placenta previa, and infant postnatal diseases. Unrelated factors included parents' age, and maternal height, weight, and addiction to smoking or alcohol. Logistic analysis showed significant factors for city deaths were birth weight, gestational cycle, birth defect, and paternal education. Suburban explanatory factors were birth weight, gestation cycle, maternal occupation, medical system, and maternal prenatal visits. Colinearity was found in the suburban model between maternal occupation in farming, self-financed medical care, and low frequency of prenatal visits.
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PMID:A comparative case study on the factors affecting infant mortality in Shanghai. 1228 71


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