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

Left ventricular (LV) dysfunction is a frequent finding in chronic alcoholic subjects. LV function's relation to alcohol use in the general population, where low and moderate consumption predominate, was studied in this work. A random sample of 120 people born in 1954 was invited to participate in the study, and 93 (42 men and 51 women) enrolled. Ethanol use was studied by 2-month daily recording of all alcoholic drinks; smoking and physical activity were quantified likewise, and salt intake by 7-day food records. Subsequently, subjects underwent an LV examination by M-mode echocardiography, and a transmitral flow velocity study by pulsed Doppler ultrasound. The relations of LV measurements to alcohol use were studied by multiple linear regression adjusting for sex, body size, blood pressure, heart rate, smoking, physical activity and dietary salt intake. No subject had clinical heart disease. The average daily ethanol consumption ranged from 0 to 1.2 g/kg of body weight (median 0.2). Statistically significant associations with square-root daily ethanol use were found for LV end-systolic diameter (regression coefficient [b] +/- SE 4.0 +/- 1.5 mm/square root of g/kg; p < 0.01), fractional shortening (b = -3.9 +/- 1.8%/square root of g/kg; p < 0.05), peak early transmitral velocity (b = -8.9 +/- 3.5 cm/s/square root of g/kg; p < 0.05), and peak atrial transmitral velocity (b = -4.9 +/- 1.9 cm/s/square root of g/kg; p < 0.05). No interactions with sex were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Relation of left ventricular function to habitual alcohol consumption. 825 37

Obesity can result in alterations in cardiac structure and function even in the absence of systemic hypertension and underlying organic heart disease. Increased total blood volume creates a high cardiac output state that may cause ventricular dilatation and ultimately eccentric hypertrophy of the left (and possibly the right) ventricle. Eccentric left ventricular (LV) hypertrophy produces diastolic dysfunction. Systolic dysfunction may ensue due to excessive wall stress if wall thickening fails to keep pace with dilatation. This disorder is referred to as obesity cardiomyopathy. The presence of systemic hypertension in obese individuals facilitates development of LV dilatation and hypertrophy. Congestive heart failure may occur in such individuals, and may be attributable to LV diastolic dysfunction or to combined LV diastolic and systolic dysfunction. The sleep apnea/obesity hypoventilation syndrome occurs in 5% of morbidly obese individuals and is potentially life-threatening. Treatment of obesity cardiomyopathy consists of weight loss, salt restriction, and diuretics. Digitalis and vasodilators may be useful in selected cases. Central obesity is probably a risk factor for the development of coronary heart disease. Alterations in lipid and insulin metabolism may facilitate development of coronary heart disease in obese patients.
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PMID:Obesity and the heart. 836 92

Head-up tilt test has been useful in evaluating children with neurocardiac syncope. In this study patients with positive baseline and isoproterenol tests had repeat tilt testing done after normal saline infusion. If the symptoms persisted, the test was then repeated with phenylephrine infusion. Of the 101 patients studied, 58 (57%) had a positive tilt sign. Normal saline infusion was given to 53 patients. Three patients were excluded because of structural heart disease. Fifty patients (aged 14 +/- 4 years) comprised the study group. Forty-two (84%) of 50 patients had a negative repeat tilt sign after normal saline infusion, and these patients were treated with 0.5 to 1 gm of salt three times a day and/or fludrocortisone (20 patients). Of the 8 (16%) patients who did not respond to normal saline infusion, 5 had negative results when given phenylephrine and were treated with pseudoephedrine. Follow-up data on 42 patients (range 4 to 40 months, median 18 months) showed that all 35 patients who responded to normal saline were either asymptomatic or had improved. Two patients were successfully treated with pseudoephedrine; however, two patients in this group required pacemaker therapy. We conclude that (1) normal saline infusion mitigates the hemodynamic effects of neurocardiac syncope, (2) high-salt diet treatment in these patients was economical and effective, and (3) failure to respond to normal saline test may indicate a less favorable prognosis.
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PMID:Usefulness of tilt table test with normal saline infusion in management of neurocardiac syncope in children. 861 15

Several rapid assessment surveys were carried out during the period 1988-1991 to determine the food habit of preschool children, adolescent girls and mothers in Muscat (the capital) and southern region in Oman. Data were collected from health centers, hospitals and households. There have been differences in dietary habits between the people in the two regions. These differences were more evident in breastfeeding practices, meal patterns of adolescent girls and food frequency intake of mothers. Geographical location, occupation of inhabitants, cultural and ethnic factors may be responsible for the variation in dietary habits between the two regions. Several unsound food practices during pregnancy and puerperium were reported in both regions. In general, dietary patterns of mothers and children have changed dramatically during the past two decades. Duration of breastfeeding has declined and infant formula as well as commercial weaning foods were introduced at an early time of infants' lives. The trend of consumption of food for infants, adolescent girls and mothers is in the direction of unhealthier eating habits, as foods rich in fat, cholesterol, refined sugar and salt are commonly consumed. This food pattern may contribute to diet-related chronic diseases such as obesity, diabetes, hypertension, heart disease and dental caries. A nutrition education programme to promote a healthy diet and to correct unsound food beliefs and habits is urgently needed.
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PMID:Food habits of mothers and children in two regions of Oman. 881 82

MORTALITY FROM MYOCARDIAL INFARCTION: Primary prevention of coronary heart disease in hypertension is important because the mortality among those who have suffered a myocardial infarction is around 50% within 1 month of the infarction. Although the mortality of those who reach hospital has about halved over the last decade (to about 8%), prevention is the only way to affect coronary mortality overall. OVERALL PREVENTION OF CORONARY HEART DISEASE: There are several proven strategies, involving both drugs and lifestyle changes. Stopping smoking is the most powerful, but exercise and reduction of dietary fats and salt are also important; the latter will need co-operation with the food industry. TREATING HYPERTENSIVES WITH A CORONARY RISK: Lipid-lowering drugs will be needed for some, but not all hypertensives, depending on the coronary risk. Some drug treatments which lower blood pressure (e.g. short-acting formulations of nifedipine) may not reduce the coronary risk; further data or newer preparations are awaited. Potassium-sparing diuretics (particularly in elderly patients) and/or beta-blockers remain the first choice for primary prevention. If a calcium channel blocker is needed, verapamil or diltiazem are useful in patients with no left ventricular dysfunction.
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PMID:Primary prevention of coronary heart disease in hypertension. 893 76

In a study of 1700 members of the UK general public in 1992 in which face-to-face interviews were conducted, factors thought important in a healthy diet were (in descending order) more fiber, less sugar, less fat, less salt, and more starchy foods. Of common nutritional terms there was most confidence in explaining the meaning of fiber and least in the meaning of monounsaturated fatty acids. Most nutritional information came from the media but the credibility of this information was low. Fifty-three percent said that a conversation with their general practitioner (GP) was a source of advice they trusted. In a survey of 150 GPs and 50 practice nurses in 1992, lack of confidence was found to be common concerning the meaning of several nutritional terms, especially extrinsic sugars, NSP (nonstarch polysaccharide), and trans fatty acids. GPs were confident they could explain the link between diet and heart disease but were not sure about the value of starch in the diet. Both GPs and practice nurses were dissatisfied with their training in nutrition, both before and after registration. General practice staff thought that personal ill health was the most important motivator for dietary change among their patients. They thought that apathy and dietary conservatism were the most common barriers to people changing their diet. However, the public positioned lack of knowledge as the biggest obstacle. Surveys reported here showed that people's knowledge of sources of fat, calcium, and iron is often unreliable.
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PMID:Food and nutrition: attitudes, beliefs, and knowledge in the United Kingdom. 917 8

The purpose of this study was to investigate the association of health and dietary characteristics with the use of vitamin and mineral supplements in community-dwelling, cognitively intact elders aged in their 60s (n = 89), 80s (n = 92), and 100s (n = 76) who resided in Georgia in the southeastern United States. Elders who were physically active (p = 0.008), had stomach problems (p = 0.042), or used arthritis medication (p = 0.015) were more likely to take a nutritional supplement than elders without these characteristics. Physically active elders were more likely to take calcium (p = 0.004), vitamin E (p = 0.022), and vitamin C (p = 0.046) than non-physically active elders. Compared to non-users, supplement users were also more likely to comply with nutritional health seeking behaviors such as avoiding too much salt, fat, cholesterol, sugar, caffeine, and eating enough fiber, vitamins and minerals from food or supplements, and calcium in foods or supplements. The observation that the use of certain vitamin or mineral supplements is associated with dietary fat intakes, dietary protein intakes, and patterns of alcohol, decaffeinated coffee, and tea consumption suggests that supplement use is one of a cluster of health behaviors. Thus, it may be important that future investigations concerning the impact of supplement use on diseases, such as heart disease or cancer, control for the effects of dietary patterns and physical activity.
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PMID:Health and dietary characteristics of supplement users in an elderly population. 920 79

The management of unexplained syncope begins with the patient's history and physical examination, which are oriented to help separate benign from serious causes. Malignant etiologies are more likely to occur with exertional syncope. Cardiac causes should be considered, particularly cardiomyopathy, postoperative congenital heart disease, right ventricular dysplasia, anomalous coronary artery, pulmonary artery hypertension, myocarditis, long QT syndrome, and Wolff-Parkinson-White syndrome. Neurological and metabolic disorders may underlie a syncope episode. After malignant causes of syncope have been excluded and the diagnosis of neurocardiac syncope has been established, treatment strategies include behavior modification, salt and increased fluids, and pharmacological agents. Efficacious agents include beta-blockers, dysopyramide, fludrocortisones, and alpha agents. Yet, behavior modification alone may be as effective as salt or pharmacological therapy. Because the natural history of neurocardiac syncope in children is spontaneous resolution, it is appropriate to try the simple measures before introducing drug therapy.
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PMID:Unexplained syncope: clinical management. 927 5

We have critically reviewed the available information on iodine-induced hyperthyroidism (IIH) from published sources and other reports as well as the experience of the authors in Tasmania, Zaire, Zimbabwe, and Brazil. Administration of iodine in almost any chemical form may induce an episode of thyrotoxicosis (IIH). This has been observed in epidemic incidence in several countries when iodine has been given as prophylaxis in a variety of vehicles, but the attack rate as recorded has been low. IIH is most commonly encountered in older persons with long standing nodular goiter and in regions of chronic iodine deficiency, but instances in the young have been recorded. It customarily occurs after an incremental rise in mean iodine intake in the course of programs for the prevention of iodine deficiency, or when iodine-containing drugs such as radiocontrast media or amiodarone are administered. The biological basis for IIH appears most often to be mutational events in thyroid cells that lead to autonomy of function. When the mass of cells with such an event becomes sufficient and iodine supply is increased, the subject may become thyrotoxic. These changes may occur in localized foci within the gland or in the process of nodule formation. IIH may also occur with an increase in iodine intake in those whose hyperthyroidism (Graves' disease) is not expressed because of iodine deficiency. The risks of IIH are principally to the elderly who may have heart disease, and to those who live in regions where there is limited access to medical care. More information is needed on the long-term health impact of IIH or "subclinical" IIH, especially in the course of prophylaxis programs with iodized salt or iodinated oil in regions where access to health care is limited.
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PMID:Iodine-induced hyperthyroidism: occurrence and epidemiology. 949 58

International research, particularly as part of US/Japan programs, has led to major advances in knowledge of causes of heart disease, stroke, many types of cancer and diabetes, showing that individual lifestyle is associated with these diseases. In Japan, a major health problem is high blood pressure and stroke, and cancer of the stomach, from excessive use of salt and salted, pickled foods, and the relative low intake of protective fruits and vegetables. We identified a likely gastric carcinogen, 2-chloro-4-methylthiobutanoate, in salted, pickled fish. In the Western world, heart disease and cancer of the breast, colon, rectum, prostate, pancreas, ovary and endometrium relate to a nutritional tradition too high in total fat and fried or broiled meats, and too low in fiber, vegetables and fruits. The cooked meats contain genotoxic chemicals, heterocyclic amines, causative elements in heart disease and the nutritionally linked cancers. Decreasing total fat intake, from 40 to 20% of calories and a greater use of starches such as rice, pasta, potatoes and whole grain bread, as well as daily intake of five to nine vegetables and fruits would be beneficial. Adults should consume 2.5 l of fluids per day. Green or black tea and fruit juices have health promoting properties. Regular exercise contributes to good health, and to the avoidance of obesity, a major problem in the USA and of increasing importance in Japan. Avoidance of a risky lifestyle would likely prevent diseases important not only for the individual and his family, but with major impact in lowering medical care costs. Tobacco and cigarette use, particularly on a Western diet, involve a high risk of heart attacks, and cancers of the lung, pancreas, kidney, urinary bladder, and cervix, accounting for 35% of medical care expenditures.
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PMID:Worldwide prevention of cancer and other chronic diseases based on knowledge of mechanisms. 967 32


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