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34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Groups of patients such as the elderly, the diabetic and women have been studied to evaluate the effectiveness of coronary revascularization. In this report 77 patients under age 40 years undergoing coronary revascularization were studied. There was a high prevalence rate of predisposing factors. Sixty-eight percent reported a family history of heart disease and 27 percent a history of diabetes; 57 percent were hypertensive, 43 percent were overweight, 91 percent smoked, 5 percent were diabetic and 16 percent had abnormal glucose tolerance curves. Sixty-four percent had hypercholesterolemia (cholesterol 250 mg/100 ml) and 56 percent hyperlipidemia. Forty-four percent had had a previous myocardial infarction; 95 percent had angina pectoris, 12 percent preinfarction angina and 9 percent congestive cardiac failure. There were no operative deaths. The incidence rate of perioperative myocardial infarction (new Q waves in the electrocardiogram) was 4 percent. The mean length of of follow-up was 26 months (range 6 months to 5 years). The late mortality rate was 4 percent. Eight percent had a late myocardial infarction. Overall graft patency was 85 percent. Sixty-seven percent of patients were free of angina, and 17 percent were in improved condition. Seventy-one percent returned to work, while 29 percent remained unemployed. This study shows that in young patients, coronary revascularization is associated with low mortality and morbidity rates and that, despite the wide prevalence of predisposing factors, the prognosis and graft patency rate of these patients are similar to those of other groups.
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PMID:Coronary revascularization under age 40 years. Risk factors and results of surgery. 62 35

A blood pressure measurement was part of a cardiovascular screening examination of 8397 middle-aged men taking part in the intervention section of the United Kingdom Heart Disease Prevention Project. Standardised training techniques reduced observer bias to acceptable limits in four out of a total of five observers. The time of day and room temperature both made significant differences to the blood pressure measurement. High room temperatures in particular apparently had a marked effect in reducing the level of blood pressure. There were consistent and large positive associations with increasing age and overweight. The survey revealed a poor degree of blood pressure control in the community at the time of screening--only 7% of the "hypertensive" population had their diastolic pressure controlled to below 100 mm Hg.
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PMID:Blood pressure measurement in the United Kingdom Heart Disease Prevention Project. 74 12

Though there has been increased emphasis on women's health and on community participation in the development of health policy, 'ordinary women' have seldom been asked about their major health concerns. This paper reports on a survey of a stratified random sample of 356 women in Hamilton. Among their main worries regarding health were various cancers and heart disease. The health problems they had experienced in the previous six months which had bothered them most were stress, arthritis, being overweight, migraines/chronic headaches and tiredness. On the basis of these and similar data presented here, it is argued that such community surveys provide an important source of data. They identify somewhat different priorities than approaches which rely on the opinions of experts and other key informants.
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PMID:Women's views of their main health problems. 147 66

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

Being overweight is a risk factor for cardiovascular heart disease and other medical problems. The purpose of this study was to examine the effect of a community-wide cardiovascular risk reduction trial (the Stanford Five-City Project) on body mass index. In the Stanford Five-City Project, two treatment cities (n = 122,800) received a 6-year mass media and community organization cardiovascular risk reduction intervention. Changes in the treatment cities were compared with two control cities (n = 197,500) for changes in knowledge of risk factors, blood pressure, plasma cholesterol level, smoking rate, body mass index, and resting pulse rate after 5-1/3 years of the education program. Both cohort and cross-sectional (independent) samples were used in the study. In the independent surveys, subjects in the treatment communities gained significantly less weight than subjects in the control communities (0.57 kg compared with 1.25 kg) over 6 years. In the cohort, there were no significant overall differences. The study provides some evidence that a community health education program may help reduce weight gain over time, but more effective methods must be developed if this important risk factor is to be favorably affected in broad populations.
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PMID:Effect of long-term community health education on body mass index. The Stanford Five-City Project. 187 83

Twenty-eight patients (19 females, 9 males) were evaluated pre- and posttransplant to determine the frequency and find predictors of excessive weight gain after orthotopic liver transplant. Posttransplant, 21 patients gained and 7 patients lost weight as compared with their pretransplant dry weight. The majority of weight gain occurred between 2 and 16 months; 64.3% of patients (18/28 pts.) became overweight. All patients overweight prior to transplant (11 pts.) were more overweight posttransplant (P less than 0.005). Overweight and nonoverweight patients were similar in age, female predominance, etiology of liver disease, hypercholesterolemia, and hypertriglyceridemia pretransplant, as well as diabetes mellitus and medications including prednisone posttransplant. Overweight patients more commonly had a family history of diabetes mellitus, arteriosclerotic heart disease, and hypertension. They also had more hypertension, hypercholesterolemia, hypertriglyceridemia, abnormal physical findings related to the liver, and abnormal results of hepatic tests posttransplant. Mean rate of weight gain for overweight patients compared with nonoverweight ones during the first 16 months after transplant was 1.5 kg/month +/- 0.9 vs 0.4 kg/month +/- 0.4 for those not overweight. After 16 months mean rate of increase was slower for overweight patients (0.3 kg/month +/- 0.3), whereas weight appeared to stabilize in the nonoverweight ones. We conclude that excessive weight gain after liver transplant is common and occurs early. Since obesity may contribute to, as well as be a separate cause, of hepatic abnormalities, confusion may result when interpreting abnormal results of hepatic tests. Obesity prior to transplant predicts excessive weight gain posttransplant, although all patients may be at risk.
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PMID:Excessive weight gain after liver transplantation. 201 32

Cholesterol (CH) and triglyceride (TG) levels were determined in blood drawn after an overnight fast from 388 school children aged 5-19 years from private schools in Karachi. The mean CH levels ranged from 4.4 to 4.6 mmol l-1 (170.1 to 177.9 mg dl-1) for boys and 4.4 to 4.8 mmol l-1 (170.1 to 185.6 mg dl-1) for girls. The range of TG levels was 1.0 to 1.2 mmol l-1 (88.6 to 106.3 mg dl-1) and 0.9 to 1.1 mmol l-1 (79.7 to 97.4 mg dl-1) for boys and girls respectively. Sixty-two per cent of the girls and 54% of the boys had cholesterol values greater than or equal to 4.4 mmol l-1 (170 mg dl-1), a level at which dietary intervention is recommended for children. Thirty-two per cent of all the children had triglyceride levels above the 90th percentile of the levels for similar age groups in North America. The mean cholesterol intake was 469 mg/day for girls and 518 mg/day for boys. Overweight and inactivity were associated with raised serum cholesterol levels. Forty per cent of the girls and 25% of the boys reported a strong family history of hypercholesterolaemia and/or heart disease. The results show that the prevalence of hypercholesterolaemia is high in well-to-do Pakistani school children and factors which can be modified to lower serum cholesterol levels are identified.
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PMID:Factors associated with elevated serum cholesterol levels in well-to-do Pakistani schoolchildren. 202 90

Mortality data indicate that Native Hawaiians have higher death rates when compared with the US all-races population, and full-blooded Native Hawaiians are likely to have the highest mortality rates from heart disease in the nation. However, to date no comprehensive population-based study of risk factors in Native Hawaiians has been conducted. In this study of 257 Native Hawaiian adults, 62.8% of the women and 65.5% of the men were greater than or equal to 20% overweight by the second National Health and Nutrition Examination Survey (NHANES II) standards. Thirty-four percent of the women and 47% of the men were severely overweight. The mean body mass index (BMI, in kg/m2) was 30.3 in women and 30.9 in men. Women aged 45-54 y were heaviest with a mean BMI of 31.6. Of the men aged 25-34 y, 79.2% were overweight. The mean waist-to-hip ratio was 0.85 for women and 0.95 for men in this sample.
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PMID:Prevalence of obesity in a Native Hawaiian population. 203 87

This paper examines the level of cardiovascular risk knowledge in the general population and the relationship between such knowledge and behavior. The following questions are addressed: (1) How informed is the general population about what persons can do to reduce their risk of cardiovascular disease? (2) How do sociodemographic factors, self-perceptions of health, and cardiovascular risk factors relate to knowledge? (3) Is there a relationship between knowledge and behavior? (4) What might explain apparent inconsistencies between knowledge and behavior? The data used in this paper derive from a random sample of 732 men and women form the greater Boston area. We assessed cardiovascular risk factor knowledge by asking respondents what specific steps a person could take to make a heart attack or stroke less likely. Risk factors (including physiological measures), sociodemographic factors, and self-perceptions of health also were measured. Results showed that respondents were most knowledgeable about the relationships of exercise and cholesterol to heart disease. Knowledge was related positively to education, being female, and exercising. When we compared knowledge with behavior, results showed that for smokers and those who were overweight, risk was related to awareness, thus suggesting that knowledge does not lead necessarily to risk-reducing behavior. Implications of these results in terms of education and prevention are discussed.
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PMID:Is cardiovascular risk factor knowledge sufficient to influence behavior? 239 37

Obesity, defined as an excess of body fat, can be measured with a variety of techniques, but in most epidemiologic studies it is estimated from height and weight or from skinfold thickness. The "gold standard" for body fat is the body density from which fat and fat-free body mass can be calculated. The new technique of bioelectric impedance analysis may substantially improve the estimation of total body fat. For estimating regional fat distribution, either waist to hip circumference ratio or subscapular skinfold have been most useful. Using the body mass index, defined as weight in kilograms divided by the square of the height in meters (kilogram per square meter), the National Health and Nutrition Examination Survey estimated that 26%, or 34 million, adult Americans aged 20 to 75 were overweight. The prevalence of severe overweight (a body mass index above 30 kg/m2) is higher in the United States and Canada than in Great Britain, the Netherlands, or Australia. Obesity results from an increase in energy intake relative to expenditure. Total daily energy expenditure includes energy used during resting metabolism, energy associated with the ingestion of food, and energy needed for physical activity. The obese are often observed to be less active, but since carrying a heavier load requires more energy, their total energy expenditure may not be low. A low resting metabolic rate has been suggested as a predictor of future risk of becoming obese. Adipose tissue is the major site for fat storage and may contain more than 90% of total energy stores. The increase in body mass index or degree of body weight is associated with an increased risk of heart disease, hypertension, gall bladder disease, and diabetes mellitus. When fat is centrally located in either males or females, the risk for these diseases is also increased, and may be a more important risk factor than total overweight itself. Genetic factors form the background from which obesity develops. The best estimates suggest that these genetic factors may be of less importance than environmental events in determination of total body fat and its distribution. Obesity can be classified on the basis of the total number of fat cells and regional fat distribution by using the etiological factors which caused the obesity or by determining the age at which the obesity began. Regardless of the cause, treatment for obesity should be based on an evaluation of the individual's risk from obesity as compared with the risk of the treatment under consideration. (ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Obesity: basic considerations and clinical approaches. 266 91


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