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

The survival of patients with HIV infection who have access to highly active antiretroviral therapy has dramatically increased. In HIV-infected persons, cardiovascular disease can be associated with HIV infection, opportunistic infections or neoplasias, use of antiretroviral drugs or treatment of opportunistic complications, mode of HIV acquisition (such as intravenous drug use), or with the classic non-HIV-related cardiovascular risk factors (such as smoking or age). Diseases of the heart associated with HIV infection or its opportunistic complications include pericarditis and myocarditis. Pericarditis may lead to pericardial effusion rarely causing tamponade. Cardiomyopathy is often clinically silent with asymptomatic left ventricular systolic dysfunction. Endocarditis is mainly the consequence of intravenous drug abuse, possibly leading to life-threatening valvular insufficiency with the need for cardiac surgery. A further serious condition associated with HIV infection is pulmonary hypertension potentially leading to right heart failure. The cardiovascular complications of HIV infection such as cardiomyopathy and pericarditis have been reduced by highly active antiretroviral therapy, but premature coronary atherosclerosis is now a growing problem because antiretroviral drugs can lead to serious metabolic disturbances resembling those in the metabolic syndrome. Lipodystrophy, a clinical syndrome of peripheral fat wasting, central adiposity, dyslipidemia, and insulin resistance, is most prevalent among patients treated with protease inhibitors. These patients should thus be screened for hyperlipidemia, hyperglycemia, and hypertension, and they may be candidates for lipid-lowering therapies. When initiating lipid-lowering therapy, interactions between statins and HIV protease inhibitors affecting cytochrome P450 function must be considered. Restenosis rate after percutaneous coronary intervention may be unexpectedly high.
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PMID:Cardiovascular disease in HIV infection. 1678 Dec 13

The metabolic syndrome has been referred to as a clustering of cardiovascular risk factors, including abdominal obesity, atherogenic dyslipidemia, increased blood pressure, insulin resistance, proinflammatory state, and a prothrombotic state. The metabolic syndrome has become one of the leading clinical issues discussed by physicians and the media, leading to increased public awareness to this potentially catastrophic multiplex risk factor for cardiovascular disease. With increasing prevalence in the United States, the metabolic syndrome has been equated to cigarette smoking as a contributing factor to premature cardiovascular heart disease and one of the underlying causes of type 2 diabetes. The identification and modification of the root causes, overweight/obesity, physical inactivity, and the closely associated condition, insulin resistance, needs to be one of the initial strategies that are addressed by the clinician.
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PMID:What is the metabolic syndrome? Prediabetes and cardiovascular risk. 1682 82

Gender differences in the treatment of heart disease have a significant impact on the outcomes and mortality for women. From screening and detection, through treatment and intervention, women are less likely than men to receive guideline-based care. Risk factor modification, including lipid management, is critical to all levels of prevention. This article discusses gender differences in the detection and management of dyslipidemia. By identifying the suboptimal recognition and treatment of lipid abnormalities in women, healthcare professionals can revise their practice patterns in an effort to improve the outcomes for women with cardiovascular disease.
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PMID:Missed targets: gender differences in the identification and management of dyslipidemia. 1696 10

Most children who are normal weight for height and otherwise healthy have risk factor levels associated with the absence of heart disease (ie, they do not smoke, do not have diabetes, are physically active, have low-density lipoprotein levels < 110 mg/dL, and have blood pressure < 120/80 mm Hg). However, by adolescence, the earliest lesions in the atherosclerotic process, fatty streaks and raised lesions, are present in the coronary arteries and the abdominal aorta. The severity of early atherogenesis is related to the coexistence of the major cardiovascular risk factors. Most commonly, the associated risk disturbances are mild: borderline hypertension, mild dyslipidemia, insulin resistance, overweight, physical inactivity, and initiation of tobacco use. Rarely, more severe risk factors are present: familial hypercholesterolemia (a genetic disorder of lipid metabolism), diabetes mellitus, secondary hypertension of long standing, or risk factors associated with chronic conditions such as end-stage renal disease. Thus, cardiovascular risk management in this age group has two components: primordial prevention (the prevention of the development of cardiovascular risk in the first place) and primary prevention (more aggressive treatment of identified risk factors in high-risk individuals either through behavioral or pharmacologic means). Trials beginning in adolescence of the primary prevention of atherosclerosis-related diseases have not been undertaken; thus, the decision to initiate pharmacologic management in high-risk adolescents requires careful thought.
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PMID:Cardiovascular risk factors in adolescents. 1703 66

Atherosclerotic coronary heart disease and other forms of cardiovascular disease (CVD) are the major cause of mortality in type II diabetes (T2DM) as well as a major contributor to morbidity and lifetime costs. The purpose of this article is the identification of the biochemical parameters in plasma, which may serve as predisposition factors to CVD in T2DM patients of different ages. The variability of hyperglycemia, dyslipidemia, and inflammation with age progression was also studied for comparison. Four different diabetic groups allocated on the basis of the subjects' age (Group A: 15-25 years old; Group B: 26-40 years old; Group C: 40-60 years old; Group D: 60-80 years old) and consisting of 10 patients each, in parallel with 10 healthy controls matched for age, sex, and ethnic origin were screened for glucose, insulin, lipid profile (total cholesterol, triglycerides, LDL, and HDL), and inflammatory mediators (CRP, IL-6, and TNF-alpha). Significant differences were observed among the expressions of biochemical markers among different age groups. Hyperglycemia showed no variability with age whereas dyslipidemia correlated positively with age progression, as well as obesity, low physical activity, and family history of heart disease or diabetes. Marked inflammation was prominent only in Groups C and D. This article indicates that different biochemical parameters may be used for the assessment of CVD risk in T2DM patients of variable age.
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PMID:Differences in expression of cardiovascular risk factors among type 2 diabetes mellitus patients of different age. 1715

Paying attention to cholesterol at a young age will prevent future atherosclerosis. Clinicians must teach parents that by making the necessary nutritional and lifestyle changes, they can prevent or lower their child's risk for heart disease, hypertension, and diabetes. Recognition of the occasional child with a genetic dyslipidemia will allow more aggressive lipid-lowering treatment at an age when atherosclerosis is first developing.
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PMID:Evaluation of dyslipidemia in children. 1715 27

Polycystic ovary syndrome (PCOS) is the common endocrine disorder of reproductive age women which is characterized by hyperandrogenism, chronic anovulation, and increased risk for infertility, endometrial cancer, developing metabolic dysfunction (type II diabetes, dyslipidemia), hypertension and heart disease. The syndrome is also associated with some skin disorders: hirsutismus, alopecia androgenetica and acne. The successful dermatologic therapy requires the holistic diagnosis of the women with skin disorders described above and use the antiandrogenic treatment with conventional methods and laser depilation in hirsutismus. In this paper we present literature studies and our own experiences.
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PMID:[Polycystic ovary syndrome and hair unit function disturbances in dermatological practice]. 1742 3

In the United States, 18 million adults have diabetes and an additional 16 million have impaired glucose tolerance. Of these patients, 75% will die of some form of heart or vascular disease. Furthermore, recent data suggest that even prediabetic patients are at increased risk for cardiovascular (CV) events. Patients with diabetes often have multiple comorbid CV risk factors (e.g., dyslipidemia, hypertension, hyperglycemia) that synergistically interact to accelerate the pathogenesis of CV disease and dramatically increase the risk for CV events. For example, compared with patients without diabetes, patients with diabetes have a 3- to 5-fold increased risk of death due to congestive heart disease at every cholesterol level and are at increased risk for hypertension and hypertension-related CV events. Patients with diabetes are likely to benefit from intensive therapy incorporating multiple CV risk-reduction strategies. Lipid-modification--primarily reducing levels of low-density lipoprotein cholesterol (LDL-C) and triglycerides and increasing high-density lipoprotein cholesterol (HDL-C) through pharmacologic and lifestyle intervention--is an integral part of such therapy. Patients with diabetes will also benefit from intensive blood pressure-lowering therapy with multiple classes of antihypertensives including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in particular, as well as concomitant antiplatelet therapy. An intensive risk-reduction approach combining these treatments would dramatically reduce the incidence of CV morbidity and mortality in this high-risk patient population.
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PMID:The patient with diabetes: preventing cardiovascular complications. 1743 22

The development of cyclosporine was pivotal in allowing cardiac transplantation to become an accepted treatment for patients with end-stage heart disease. More recently, tacrolimus has become available as a useful alternative to cyclosporine, and has been successfully combined with either azathioprine or the newer anti-proliferative agents, mycophenolate mofetil or sirolimus. Numerous randomized clinical trials have demonstrated that tacrolimus is comparable to cyclosporine in terms of overall patient survival and at least equally effective in preventing acute rejection. In addition, tacrolimus has been particularly effective as a rescue treatment in cases where recurrent rejection has occurred with cyclosporine. The adverse effects of tacrolimus differ from those of cyclosporine, and the drug particularly shows an improved profile with respect to hypertension, dyslipidemia, and long-term renal function. These data have recently led to the regulatory approval of tacrolimus for primary immunosuppression in patients undergoing cardiac transplantation in the US.
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PMID:Tacrolimus in heart transplant recipients: an overview. 1751 9

Abdominal obesity is associated with cardiovascular disease. This study aims to compare two measures of abdominal obesity [waist and wais-to-hip ratio (WHR)] in patients with DM2 to identify cardiovascular risk factors: ischemic cardiopathy, hypertension, dislipidemia, obesity and diabetic nephropathy. A multicentric study was performed in 820 patients with type 2 DM. Waist circumference strongly correlated with body mass index (BMI), for men (r= 0.814; P< 0.05) and women (r= 0.770; P< 0.05). On the other hand, WRH was weakly correlated (r= 0.263, P< 0.05 for men; r= 0.092, P< 0.05 for women). Only waist circumference correlated with systolic pressure (r= 0.211, P< 0.05 for men; r= 0,224, P< 0.05 for women). ROC curve analysis demonstrated the superiority of waist circumference measurement compared to WHR regarding obesity and hypertension for men and women, and dyslipidemia for men. In conclusion, waist circumference is better correlated with cardiovascular risk factor than WRH.
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PMID:[Waist measure and waist-to-hip ratio and identification of clinical conditions of cardiovascular risk: multicentric study in type 2 diabetes mellitus patients]. 1754 44


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