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)

In a survey of 3 California communities by the Stanford Heart Disease Prevention Program, we obtained data on blood pressure, medications, age, height and weight, blood for measurement of plasma renin activity (PRA), plasma renin concentration (PRC), plasma renin reactivity (RR), and plasma renin substate concentration (PRS), and urine for measurement of urinary sodium and creatinine. No effect of conjugated estrogens (Premarin) on blood pressure could be discerned when the blood pressure, corrected for age and relative weight, of 575 women on no medication was compared to that of 82 women taking only Premarin. Premarin increased PRA, PRS, and RR, but had no effect on PRC. We also found in both Premarin-treated woman and controls 1) that RR was positively correlated with PRS, and 2) that PRA is dependent on PRC and PRS. These data indicate that the reninrenin substrate reaction of plasma, even at normal substrate concentration, is strongly deprendent on PRS.
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PMID:The effect of conjugated estrogens on the renin-angiotensin system. 19 9

Large prospective studies and intervention trials have identified major risk factors for premature heart disease in men, while the Framingham Heart Disease Study has provided the leading evidence of predictors of cardiovascular disease in women. We evaluated the role of these risk factors in a 13-year follow-up study of 8935 premenopausal and 2716 postmenopausal women in the Walnut Creek Contraceptive Drug Study cohort in Northern California. Elevated cholesterol levels, high blood pressure, smoking, obesity, family history of heart disease, and diabetes were investigated for their contribution to premature death due to all causes and due to cardiovascular disease. In addition, risk factor profiles were developed separately for users and nonusers of Premarin (conjugated estrogen) in the postmenopausal cohort. The results show that the strongest predictors of cardiovascular mortality among premenopausal women were smoking, high blood pressure, and diabetes, with relative risks of 2.8, 10.5, and 11.6, respectively. A disparity between high cardiovascular risk factor prevalence and low rates of premature heart disease indicates that the high relative risks will not be accompanied by large attributable risks. Nevertheless, the study reconfirms the need for screening women for heart disease risk because life-style changes can improve cardiovascular risk factors and can potentially reduce the chance of premature death even further.
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PMID:Cardiovascular risk factors, premature heart disease, and all-cause mortality in a cohort of northern California women. 337 34

With the onset of menopause, women develop increased risk for heart disease, vasomotor instability, and osteoporosis, which is related to estrogen deficiency, and can be corrected with estrogen-replacement therapy (ERT). Menopausal women with a history of breast cancer are advised against estrogen therapy because of concerns that ERT may adversely affect the course of the disease. There have been no prospective studies that address the issue of risk versus benefit for ERT in women with a history of breast cancer. We have initiated a randomized, prospective clinical study to define the influence, if any, of ERT on the clinical course of breast cancer (measure of potential risk) and the efficacy of ERT in the treatment of metabolic bone derangements (measure of benefit). Changes in serum lipids, cardiovascular events, and indices of psychological well-being are compared but do not constitute statistical end points. Eligible women must have had stage I or stage II breast cancer and must have had no evidence of disease for at least 2 years since therapy if estrogen-receptor-negative disease or for at least 10 years if the estrogen-receptor status is unknown. They were randomized to receive ERT (Premarin at 0.625 mg, days 1-25) versus no intervention (study control). Parameters of benefit and risk will be measured to detect a 10% change in disease-free rate for up to 5 years, with interim analyses at 20, 30, and 36 months of patient accrual. This study will allow us to begin the development of safe and effective strategies for the management of estrogen deficiency in patients with breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Randomized prospective trial of estrogen-replacement therapy in women with a history of breast cancer. 799 59

This is a brief review of the rationale for estrogen replacement as prevention of coronary artery disease. Epidemiological data suggest that Premarin (0.625 mg) together with medroxyprogesterone acetate (2.5 mg) can prevent or delay the onset of coronary artery disease in postmenopausal women. The major effects of estrogens are: improving the lipid profile by lowering low-density lipoprotein and raising high-density lipoprotein; acting on vessel walls to reduce intimal damage and plaque formation; dilating vessels by both an endothelial dependent and an independent pathway; and acting as an antioxidant, thereby reducing the oxidation of low density lipoprotein and increasing the production of nitric oxide locally in the blood vessel. Oral estrogens and transdermal estrogens may act differently on coagulation factors and lipids. The role of specific estrogen receptor modulators as possible treatment for postmenopausal women in part will depend on the effect of these drugs in preventing coronary artery disease. The specific estrogen receptor modulators decrease low-density lipoprotein and prevent triglyceride increases but it is unknown if they have estrogenic effects on blood vessel walls. Better compliance with estrogen replacement therapy will depend on educating women about their risk of getting coronary artery disease, and assisting them in decision making, as well as reducing side effects. The Heart and Estrogen/Progestin Replacement Study provides evidence that Prempro (Premarin/ medroxyprogesterone acetate) should not be given to someone who already has heart disease without careful monitoring. (c) 2000 by CHF, Inc.
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PMID:Hormone replacement therapy (estrogen and progesterone): is it necessary for heart disease prevention? 1183 12