Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

Decreased levels of high-density lipoproteins (HDL) are related to a risk of ischaemic heart disease and are measured as HDL-cholesterol (HDLc), whereas little attention has been paid to HDL-phospholipids (HDLph). Regarding HDL subfractions (HDL2, HDL3) and risk of ischaemic heart disease, there are few studies in the literature and these are contradictory, especially those performed in subjects that were in their second decade of life. This study consisted of 322 healthy volunteers between 11 and 19 years of age. The HDL fractions and HDL3 subfractions were separated by precipitation with polyethylene glycol at defined pH and concentration. Concentrations of cholesterol and triglycerides were measured by enzymatic methods, except for HDL2c and HDL2ph, which were calculated by subtraction. Forty-two percent of the children with parental history of ischaemic heart disease, but only 26% of the children without parental history of heart disease, exhibited HDL3ph levels lower than 0.95 mmol/l (74 mg/dl). Levels of HDLc, HDL3c and HDL2c are relatively constant in girls after puberty and levels of HDLph and HDL3ph are increased; levels of HDLph are relatively constant in boys after puberty while levels of HDLc, HDL3c and HDL2c are decreased. Our results suggest that serum levels of HDL3ph are potential markers for a risk of ischaemic heart disease, together with other more classic risk factors.
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PMID:[Cholesterol and phospholipids in high density lipoproteins and their subfractions in a population in its second decade of life. The Burgos study]. 148 23

We examined the relations of gender and lipoproteins to subclasses of high density lipoproteins (HDLs) in a cross-sectional sample of moderately overweight men (n = 116) and women (n = 78). The absorbance of protein-stained polyacrylamide gradient gels was used as an index of mass concentrations of HDL at intervals of 0.01 nm across the entire HDL particle size range (7.2-12 nm). At least five HDL subclasses have been identified by their particle sizes: HDL3c (7.2-7.8 nm), HDL3b (7.8-8.2 nm), HDL3a (8.2-8.8 nm), HDL2a (8.8-9.7 nm), and HDL2b (9.7-12 nm). Men had significantly higher HDL3b and significantly lower HDL2a and HDL2b than did women. Correlations of HDL subclasses with concentrations of other lipoprotein variables were generally as strong for gradient gel electrophoresis as for analytical ultracentrifugation measurements of HDL particle distributions. In both sexes, high levels of HDL3b were associated with coronary heart disease risk factors, including high concentrations of triglycerides, apolipoprotein B, small low density lipoproteins, intermediate density lipoproteins, and very low density lipoproteins and low concentrations of HDL2 cholesterol and HDL2 mass. Plasma concentrations of HDL3 cholesterol were unrelated to protein-stained HDL3b levels. HDL3 cholesterol concentrations also did not exhibit the sex difference or the relations with lipoprotein concentrations that characterized HDL3b. Thus, low HDL3b levels may contribute in part to the low heart disease risk in men and women who have high HDL cholesterol. Measurements of HDL3 cholesterol may not identify clinically important relations involving HDL3b.
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PMID:Associations of lipoproteins and apolipoproteins with gradient gel electrophoresis estimates of high density lipoprotein subfractions in men and women. 154 92

The authors investigated the association of serum copper concentration with the risk of acute myocardial infarction in 1,666 randomly selected men aged 42, 48, 54, or 60 years who had no symptomatic ischemic heart disease at entry. Baseline examinations in the Kuopio Ischaemic Heart Disease Risk Factor Study in Eastern Finland were done during 1984 to 1988. In Cox multivariate survival models adjusting for age, examination year, ischemic electrocardiogram in exercise, maximal oxygen uptake, diabetes, family history of ischemic heart disease, cigarette-years, mean systolic blood pressure, serum high density lipoprotein (HDL) cholesterol subfraction HDL2 and low density lipoprotein (LDL) cholesterol concentrations and blood leukocyte count, serum copper concentration in the two highest tertiles (1.02-1.16 mg/liter and 1.17 mg/liter or more) associated with 3.5-fold (95% confidence interval (Cl) 1.3-9.4, p less than 0.05) and 4.0-fold (95 percent Cl 1.5-10.8, p less than 0.01) risk of acute myocardial infarction. These data indicate that high copper status, reflected by elevated serum copper concentration, is an independent risk factor for ischemic heart disease.
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PMID:Serum copper and the risk of acute myocardial infarction: a prospective population study in men in eastern Finland. 159 83

Heart disease, a major women's health issue, is responsible for 28% of mortality among US females. Combined oral contraceptives (OCs) have been shown to interfere with the 3 phenomena--lipid metabolism, carbohydrate metabolism, and the hemostatic system--most involved in the coronary heart disease process. Disturbances in these systems are believed to underlie the general risk markers of heart disease, although it is not known to what extent OC-induced changes in these systems increase the likelihood of disease. Also unknown is whether there is a residual risk of heart disease in past users of OCs. Both low density lipoprotein (LDL) and high density lipoprotein (HDL) levels are predictive of coronary heart disease in women. Impaired glucose tolerance and hyperinsulinemia are associated with other biochemical and physiological disturbances that increase the risk of heart disease, including changes in serum lipids and lipoproteins. High levels of fibrinogen and factor VII are additional important independent predictors of coronary heart disease. Depending on the sex hormone dose and the OC's composition, the pill has been shown to produce changes such as lowered HDL and HDL2 cholesterol levels, raised LDL cholesterol, impaired glucose tolerance, and increased insulin levels--metabolic disturbances common in those at increased risk of myocardial infarction. REcent studies have found that impaired glucose tolerance and hyperinsulinemia are associated with a set of biochemical and physiological disturbances--known as syndrome X--that occur regularly in OC users. The lowering of the estrogen and progestin dose in newer OCs, as well as the development of progestins intended to reduce metabolic effects, represent major advances. Continued evaluation of the various OCs in terms of risk markers is recommended, however.
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PMID:Oral contraceptives and coronary heart disease. 204 75

Controversy as to which lipoprotein subfraction of high-density lipoprotein (HDL) increases during alcohol consumption prompted the current study of the effects of two alcohol doses over varying time intervals on plasma lipoproteins and lipolytic enzymes. Measurements were made in 49 healthy men before and after three weeks of abstinence from alcohol and after consumption of one or three 12-ounce cans of beer per day. We found that HDL (10%), HDL2 (14%), and HDL3 (9%) cholesterol, and apolipoprotein A-I (7%) decreased with abstinence from alcohol and then increased with its consumption. These increases were not significant until after 3 weeks of daily alcohol intake, but they were significant in both the one-can and three-cans of beer per day groups. In the 23 inactive subjects HDL and HDL2 cholesterol decreased with abstinence but did not increase significantly with alcohol intake. Lipolytic enzymes were not changed by alcohol manipulation, but the level of lipoprotein lipase was higher and that of hepatic lipase was lower at each measurement point in the 26 habitually active versus the 23 inactive subjects. Adjustment for weight or skinfold thickness did not affect lipoprotein changes over time within groups but did eliminate many of the differences between activity groups. Alcohol consumption seems to be related to possibly beneficial influences on plasma HDL and HDL2 cholesterol, and may thus impact the risk of heart disease.
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PMID:Effect of alcohol dose on plasma lipoprotein subfractions and lipolytic enzyme activity in active and inactive men. 210 42

The cardiovascular effects of oral contraceptives, as predicted by studies on serum lipid changes in users, are based on the progestin dose, androgenic potency and biologic effect of the estrogen in the pill. Women suffer 250,000 deaths per year in the U.S. resulting from cardiovascular disease, almost half as many as men. They have the same risk factors: high cholesterol, high blood pressure and smoking, and also have more risk from diabetes than men do. The serum HDL, especially HDL2, correlates closely and inversely with heart disease risk. Exogenous estrogens raise HDL and HDL2, and lower LDL, conferring protection against coronary disease, in direct proportion to dose. Progestins usually have adverse effects, in proportion to dose, but progestin potency and type also determine their effects. The estrane progestins norethindrone, norethindrone acetate and ethynodiol diacetate are less potent and much less androgenic, while the gonanes norgestrel and especially levonorgestrel are 5-20 times as potent and androgenic. Each pill needs to be considered as a unit. Several comparative studies are reviewed, corroborating the prediction that pills with higher progestin potency have adverse effects on serum lipids, compared to those with higher estrogen effect. For new lower dose multiphasics, the effects either way are minimal, but HDL2 is still significantly lowered by pills containing levonorgestrel. Progestin-only pills lower HDL2 17- 21%. It is prudent to follow and treat the long-term effects of oral contraceptives on blood lipids.
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PMID:Oral contraceptives and cardiovascular risk. Taking a safe course of action. 220 2

The risks and benefits of the newer oral contraceptives are evaluated, considering cancer, teratogenicity, drug interactions, cardiovascular risks, and carbohydrate metabolism. Oral contraceptives confer the lowest mortality risk of all contraceptives, except sexual abstinence, in all women under 30 and in nonsmokers through age 40 in developed countries. In less developed countries where maternal mortality can be as high as 5-10%, the risks of even nonmedically supervised oral contraceptives are dwarfed. The pill protects against ovarian cancer even after the pill is discontinued because it suppresses ovulation, and endometrial cancer because it blocks estrogen receptors. The relationship of oral contraception to breast cancer is still in dispute, but no good evidence exists for increased risk, especially with new low- dose pills. There may be a slightly increased risk of cervical cancer, although it is difficult to separate out other risk factors co-existing in pill users, such as earlier sexarche, more partners and more frequent screening. The incidence of pelvic inflammatory disease, functional ovarian cysts and ectopic pregnancy is reduced by pills. There is only 1 report of increased incidence of congenital heart disease in infants whose mothers took pills during pregnancy. Drug interactions are common, and must be managed by the physician. Among currently popular pills, only the norgestrel and levonorgestrel-containing multiphasic pills are said to decrease HDL2 and impair glucose tolerance, because they are androgenic enough to overcome the low dose of estrogen.
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PMID:Oral contraceptives: a reassessment. 267 44

To evaluate the effectiveness, tolerance and safety of simvastatin (MK 733), a new HMG-CoA reductase inhibitor, a 28-week, single blind study with placebo was carried out on 10 patients suffering from primary hypercholesterolaemia. All patients followed the AHA Phase 1 or Phase 2 diet and underwent active treatment for 24 weeks with increasing doses of simvastatin from 10 to 40 mg in a single evening administration. A reduction in plasma levels of total cholesterol (-29%, p less than 0.001 and -41%, p less than 0.001), LDL cholesterol (-35%, p less than 0.001 and -49%, p less than 0.001), VLDL cholesterol (-9%, ns and -38%, ns), Apo-B (-27%, p less than 0.005 and -37%, p less than 0.001), Apo-A2 (-3%, ns and -3%, ns), and triglycerides (+2%, ns and -10%, ns), was obtained in the VIth and XXIVth week. There was also an increase in HDL cholesterol (+4%, ns and +17%, p less than 0.05), HDL2 subfractions (+9%, p less than 0.05 and +36%, p less than 0.05), HDL3 (+3%, ns and +11%, ns) and Apo-A1 (+7%, ns and +4%, ns). In all patients, simvastatin was generally tolerated and there were no clinical, laboratory or ophthalmological side-effects related to the drug. If long-term studies confirm its safety, simvastatin will offer excellent prospects for the prevention of ischaemic cardiopathy.
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PMID:[Effects of simvastatin on plasma levels of lipids, lipoproteins and apolipoproteins in primary hypercholesterolemia]. 269 57

We investigated the prevalence of carotid atherosclerosis and its association with serum lipoprotein cholesterol fractions in 412 Eastern Finnish men ages 42, 48, 54, or 60 years who were examined between February and December 1987 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Carotid atherosclerosis was assessed with high-resolution B-mode ultrasonography. Of the participants, 37% had thickening of the intimal or medial layer of the arterial wall, 10% had plaques, 2% had stenosis in the right or left common carotid artery or in the carotid bifurcation, and only 51% were free of any detectable carotid atherosclerosis. The prevalence of atherosclerosis was 14.1%, 32.0%, 67.7%, and 81.9% in the four age groups, respectively. The mean age-adjusted serum low density lipoprotein (LDL) cholesterol concentration was 3.67 mmol/l (142 mg/dl) in men free of carotid atherosclerosis and 4.02 mmol/l (155 mg/dl) in those with at least intimal thickening (p = 0.003 for difference). The mean age-adjusted serum cholesterol concentration in the high density lipoprotein (HDL) fraction was 1.34 mmol/l (52 mg/dl) in the atherosclerosis-free and 1.27 mmol/l (49 mg/dl) in the atherosclerotic men (p = 0.029 for difference). There was a similar difference in both the serum HDL2 and the HDL3 cholesterol levels. Serum LDL and HDL (inverse) cholesterol were significant determinants of severity of carotid atherosclerosis in a multivariate regression model adjusting for age, obesity, plasma fibrinogen, cigarette-years, and duration of hypertension. Our data reveal the high prevalence of atherosclerosis in middle-aged Eastern Finnish men and provide further evidence of the roles of LDL and HDL cholesterol in atherosclerosis.
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PMID:Prevalence of carotid atherosclerosis and serum cholesterol levels in eastern Finland. 319 22

Plasma levels of total high density lipoprotein cholesterol (HDL) and its subfractions (HDL2 and HDL3) were measured in 366 healthy Caucasian males; these values were related to a number of coronary risk factors. On univariate statistical analysis, total HDL was negatively correlated with cigarette consumption, body mass index, and serum triglycerides, and positively associated with level of physical activity and alcohol consumption. HDL2 showed an inverse relationship with cigarette consumption, body mass index, triglycerides, and systolic blood pressure and a positive relationship with age. HDL3 was negatively correlated with cigarette smoking, body mass index, and triglycerides and positively associated with exercise level and alcohol consumption. Total HDL and HDL2 were inversely related to coronary risk rating, but HDL3 showed no significant correlation. Many of these relationships became nonsignificant after allowing for the effects of other variables. In particular, none of the HDL measurements correlated significantly with risk score after allowing for the effect of triglycerides. There is insufficient evidence at present to recommend the inclusion of HDL subfractions as routine screening tests for heart disease.
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PMID:High density lipoprotein subfractions and coronary risk factors in normal men. 360 61


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