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 order to determine whether low levels of high-density lipoprotein cholesterol (HDL-C), which are predictive of ischemic heart disease in the general population, can also predict death from ischemic heart disease among diabetic men, we contrasted lipoprotein and other heart disease risk factors in 62 men with non-insulin-dependent diabetes mellitus, 14 of whom died of ischemic heart disease during a 12-year follow-up period. Compared to all other diabetic men, those who died of ischemic heart disease were older, had higher levels of fasting plasma glucose (FPG) total plasma cholesterol, and triglycerides, lower HDL-C levels, and higher low-density lipoprotein cholesterol (LDL-C) levels and were more likely to have been cigarette smokers; only total cholesterol, LDL-C, and the LDL/HDL ratio were statistically significant. Age, FPG, total plasma cholesterol, and LDL-C were all independently predictive of fatal heart disease by multivariate analysis. Neither HDL-C nor the LDL/HDL ratio predicted ischemic heart disease death better than the total plasma cholesterol or LDL-C. The use of HDL-C, LDL-C, or total plasma cholesterol level in the model did not eliminate the significant association with FPG, which suggests that the noxious effect of hyperglycemia is independent of the changes in blood lipids.
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PMID:Lipoproteins as predictors of ischemic heart disease in non-insulin-dependent diabetic men. 345 58

Children starting their schooling were given a questionnaire asking about the occurrence of premature (before 50 years of age in men, 55 years in women) coronary heart disease (CHD) in first degree relatives. 1,920 of 2,069 questionnaires were answered, 140 of the 7-year-old children were reported to have a first degree relative with premature CHD, 84 of these 140 families agreed to participate in our study. In 79 of the 84 families both the child and the parent at 'high risk' were tested. In the initial test 19 of 84 children had total cholesterol (TC) levels above the 95th percentile (greater than 5.35 mmol/l). In the repeat test 12 of the 19 TC tests remained abnormal and all 12 also had LDL-cholesterol (LDL-C) levels above the 95th percentile (greater than 3.40 mmol/l). None had abnormal HDL-cholesterol or triglyceride levels. Among the high risk parents, 12 of 79 had abnormal initial blood lipid tests. In the repeat test 10 parents had both TC and LDL-C levels above the 95th percentile. In five families both the child and the parent had abnormal TC and LDL-C levels. In conclusion, a considerable proportion of children and parents with family histories of premature CHD have TC and LDL-C concentrations above the 95th percentile (in the present study, about 40 individuals in 140 high-risk families, if the parent and child considered at high risk all had agreed to participate). Prevention of heart disease should begin in childhood when patterns of life-style are developed. Identification by obtained family histories as in the current study may be a method of choice.
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PMID:Hyperlipidemia in school children with family histories of premature coronary heart disease. 359 Dec 96

A dominant major locus (allele frequency of .0025 +/- .0014), resulting in low levels of high density lipoprotein cholesterol (HDL-C), was revealed by likelihood analysis on 2,170 persons in 55 Utah pedigrees. This allele was expressed through HDL-C levels ranging from 20 to 30 mg/dl in seven persons in two pedigrees. Early coronary heart disease was associated with the allele in one pedigree, but not in the other. In the pedigree without associated heart disease, HDL subfractions HDL2 and HDL3 were both low in individuals with the low HDL-C allele. No other major locus determining either high or low levels of HDL-C was identified in our sample. Polygenic heritability as part of the mixed model was estimated as .561 +/- .035.
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PMID:A re-examination of major locus hypotheses for high density lipoprotein cholesterol level using 2,170 persons screened in 55 Utah pedigrees. 370 13

A large pedigree (N = 356) with a high prevalence of heart disease and associated adverse lipoprotein phenotype was studied. The adverse lipoprotein phenotype is characterized by both low levels of high-density-lipoprotein cholesterol (HDL-C) alone (16.3%) and in combination with other adverse lipoprotein levels (12.8%). In all, 44.2% of all pedigree members had at least one adverse lipoprotein level. Analysis of mating types showed that all lipids and lipoproteins possess familial clustering with 25-36% of offspring above median levels when both parents had levels below the median, while 67-83% had levels above the median when both parents had levels above the median. Using adjusted lipid and lipoprotein levels, a statistically significant linear trend was found between the degree of relationship to pedigree members with heart disease, and both the low-density-lipoprotein cholesterol/high-density-lipoprotein cholesterol (LDL-C/HDL-C) ratio (P less than .05), and the very-low-density-lipoprotein cholesterol (VLDL-C; P less than .01) level. A similar analysis using the prevalence of adverse lipoprotein levels as the dependent variable and degree of relationship to heart diseased pedigree numbers as the independent variable showed significant (P less than .05) relationships with VLDL-C and the LDL-C/HDL-C ratio. Further genetic analyses of this pedigree may reveal genetic mechanisms responsible for the familiality of lipoprotein levels in this pedigree.
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PMID:Description of a large pedigree with an adverse lipoprotein cholesterol phenotype: the Bogalusa Heart Study. 374 21

Age- and sex-related differences were observed in the plasma cholesterol level, the plasma concentrations of certain lipoprotein components, and the HDL lipid phase fluidity in miniature swine from post-weaning (6 weeks) through puberty (6 months), maturity (2-6 years), and old age (10-12 years). Age effects were more dominant in the males, with VLDL protein; LDL protein, triacylglycerol, and phospholipid; and HDL triacylglycerol, phospholipid, cholesterol, and polyunsaturated fatty acids showing statistically significant negative correlations with age. These effects were not observed in females. HDL cholesterol was positively correlated with age in females. Total plasma cholesterol decreased with age in males only, but plasma triacylglycerol was not influenced by age in either sex. Higher concentrations of all lipoprotein lipids were observed in the female minipigs regardless of age. HDL lipids became less fluid with age in the males alone suggesting a physical chemical basis for the lower incidence of heart disease among females. The more fluid HDL circulating in the female may be more capable of mobilizing peripheral tissue cholesterol for catabolism thus protecting her from developing atherosclerotic lesions.
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PMID:Influence of age and sex on composition and lipid fluidity in miniature swine plasma lipoproteins. 398 17

Portacaval shunt was performed in ten patients with homozygous and two with heterozygous familial hypercholesterolemia (FH). Total serum cholesterol was lowered by 20% to 55.4% during follow-up periods of 14 months to almost 9 years, with commensurate decreases in LDL cholesterol. The effect on HDL cholesterol and triglyceride levels was variable. Tendinocutaneous xanthomas diminished or disappeared. Growth and development in children proceeded or accelerated. There was no detectable emotional or intellectual deterioration. Hepatic failure did not occur, although blood ammonia concentrations and serum alkaline phosphatase levels increased relative to preoperative values. Cardiac symptoms were often improved, but evidence of reversal of cardiovascular lesions was inconclusive. Three patients with pre-existing heart disease died of cardiac complications after 4 months, 18 1/2 months, and 30 months. Portacaval shunt has been effective therapy for patients with FH who were refractory or intolerant to medical treatment; it should be performed before the development of irreversible cardiovascular damage.
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PMID:Portacaval shunt in patients with familial hypercholesterolemia. 661 51

High density lipoprotein cholesterol (HDL-chol) is negatively associated with coronary heart disease. Environmental heart disease risk factors may partially be related to coronary heart disease through alterations in HDL-chol concentrations. Little is known about the underlying mechanisms by which environmental factors are related to HDL-chol. The authors investigated a possible mechanism: changes in liver function as a mediating link between risk factors and HDL-chol concentrations in marathon runners, alcoholics, and participants in the Multiple Risk Factor Intervention Trial. Liver function, as measured by liver enzymes, was related to both coronary heart disease risk factors and alcohol consumption, suggesting that the increased levels of HDL-chol associated with alcohol were primarily the result of changes in liver function. The relationship of obesity to HDL-chol could not be explained by the alterations in liver function.
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PMID:Environmental determinants, liver function, and high density lipoprotein cholesterol levels. 683 55

This study evaluated the influence of a family history of coronary heart disease (CHD) and CHD risk factors on the total serum cholesterol/high density lipoprotein (TChol/HDL) and the low density lipoprotein/HDL (LDL/HDL) ratios of 84 black children (ages 7-11 years) and adolescents (ages 12-15 years). Fasting lipid determinations were measured on all subjects. A questionnaire was administered to each subject's parent to determine the frequency of myocardial infarction, heart disease, hypertension, stroke, atherosclerosis, diabetes, and obesity in first- and second-degree blood relatives. Based on three-way analysis of variance tests, significant stroke and age, diabetes and age, and obesity and age interactions in TChol/HDL and LDL/HDL were found. There was also an obesity and age and sex interaction effect on T.Chol/HDL. The results indicated that a family history of stroke, diabetes, or obesity can have an unfavorable effect on the TChol/HDL and LDL/HDL ratios in black adolescents.
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PMID:The influence of a family history of CHD risk factors on serum lipoprotein levels in black children and adolescents. 714 44

As part of the National Exercise and Heart Disease Project, 223 postcoronary men, aged 30 to 64, were randomly assigned to moderate exercise or control groups. Levels of total plasma cholesterol, high- and low-density lipoprotein (HDL and LDL) cholesterol, and triglycerides were measured. At baseline, alcohol intake, weight, and skin-fold thickness but not treadmill work capacity correlated with triglyceride or HDL cholesterol levels. After one year, no clinically important change in lipid levels was observed in either group. Using multiple regression analysis of the combined groups, changes in several independent variables, including work capacity change, were not predictive of changes in lipid levels. Thus, changes in levels of fitness and/or regular exercise did not substantially influence HDL cholesterol or other lipid levels.
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PMID:Effect of long-term moderate physical exercise on plasma lipoproteins. The National Exercise and Heart Disease Project. 714 70

Hypercholesterolaemia therapy should begin with implementation of a suitable diet in order to achieve optimum weight and reduce the intake of saturated fats. Often, however, a dietary regime is not sufficient to decrease cholesterol levels in hypercholesterolaemic patients and drugs must also be used. Some of the pharmacological options available act principally on LDL cholesterol, whereas others have more effect on triglyceride rich particle. HMGCoaA reductase inhibitors exert the greatest effect on plasmatic LDL cholesterol levels and are therefore recommended in cases of moderate or severe hypercholesterolaemia, particularly in the secondary prevention of ischaemic cardiopathy. Comparing the three statin drugs, lovastatin, pravastatin and simvastatin, the latter has recently been shown in study 4S to be effective in reducing global and coronary mortality in patients with a history of coronary heart disease. In addition to their action on LDL cholesterol, these drugs also increase HDL cholesterol, reduce triglycerides and have a beneficial effect on some of the fundamental mechanisms involved in the development of arteriosclerosis. Ion-exchange resins moderately reduce cholesterol levels, thus are used in young people or in combination with other drugs when a further reduction of LDL cholesterol is required. Their main drawback, however, is that they can often cause digestive intolerance. Primary prevention trials have shown that fibrates also reduce mortality by coronary heart disease but have no effect on global mortality. They are well tolerated and are used in the treatment of mixed hyperlipaemia. Other products, such as probucol and oestrogens, are also used but only under specific circumstances.
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PMID:[The pharmacological treatment of hypercholesterolemia]. 749 38


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