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

The purpose of this study was to consider gender differences in laypeople's beliefs about and explanations of cancer. Over 700 adults answered a questionnaire about their perceptions and explanations of the disease. The majority of respondents identified cancer as the most fearful disease. Women were more frightened of cancer than were men, whereas men were more frightened of heart disease than were women. The greatest fear of cancer was its perceived incurability and the associated suffering, whereas the greatest fear of heart disease was perceived susceptibility. Men were more likely than women to hold a more negative attitude toward cancer information. Factor analysis of the perceived causes of cancer identified four causal factors, which were labelled Stress, Environmental, Health-related, and Behavioural. Men were more likely to identify behavioural items as important whereas women were more likely to rate heredity as important. Fear of cancer was highly correlated with the health beliefs but not with the perceived causes of cancer. However, a regression analysis found that these health beliefs explained only a small proportion of the variance in cancer fear. The findings are discussed with reference to cancer education.
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PMID:Gender differences in perceptions of cancer. 848 11

The effect of smoking on platelet aggregation appears to produce conflicting results, with some studies indicating an enhancement and others a decrease of aggregation. This epidemiological study of 120 male smokers, a subset of the Caerphilly Heart Disease Study, examined the relationship of two dimensions of smoking (time proximity of last cigarette before venepuncture and serum nicotine concentration) with threshold dose of adenosine diphosphate (ADP) necessary to induce platelet aggregation in whole blood. Means (range) of ADP threshold dose and nicotine concentration were 1.66 (0.5-2.5, censored) microM and 12.2 (0-35.2) ng/ml. Men smoking within 30 min of venepuncture demonstrated lower ADP threshold doses (-0.48 microM lower [95% C.I.: -0.95, -0.02])--reflecting increased sensitivity. Men with higher nicotine concentration had higher ADP threshold doses (Regression Coefficient: +0.032 microM per ng/ml [95% C.I.: 0.003, 0.062])--reflecting decreased sensitivity. Men smoking 30 min or more before venepuncture who also had high nicotine concentration (25-30 ng/ml) demonstrated the highest ADP threshold doses compared to never smokers and to men smoking the previous day (approximately 2.20 vs 1.86 and 1.81 microM). Relations involving nicotine concentration do not necessarily reflect a pharmacological effect although the potential for a short term nicotine mediated tolerance effect cannot be dismissed. These observations support an hypothesis suggesting a temporal sequence of platelet sensitization and desensitization during smoking.
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PMID:Cigarette smoking sensitizes and desensitizes impedance-measured ADP-induced platelet aggregation in whole blood. 858 14

THE HEART DISEASE MORTALITY RATES of the Chippewa and Menominee, who reside in the upper Midwest, are higher than the rates of most other tribes in the United States. Little is known, however, about the prevalence of hypertension, diabetes, and obesity among these communities. The Inter-Tribal Heart Project (ITHP) was designed to determine the prevalence of risk factors for heart disease and to implement community-based heart disease prevention programs. Age-stratified random samples of active users of the tribal-Indian Health Service (IHS) clinics, ages 25 and older, were drawn from three communities within the Bemidji Service Area. Between September 1992 and June 1994, 1396 people completed an extensive questionnaire and underwent a physical exam for heart disease risk factors. Preliminary data indicate mean blood pressure levels of 126 mmHg for systolic blood pressure (SBP) and 74.4 mmHg for diastolic blood pressure (DBP). Mean SBP and DBP were higher among men than women. Mean body mass index (BMI), which did not vary by gender, was 30.6 mmHg. The prevalence of hypertension was 33%; and diabetes, 33%. Men had a higher prevalence of hypertension than women, but there was little gender difference in the prevalence of diabetes. These preliminary data suggest that the prevalences of hypertension, diabetes, and obesity in these communities are higher than the recent estimates for the total United States. The next stage of the ITHP will focus on policies and programs to prevent and treat these conditions.
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PMID:Blood pressure, diabetes, and body mass index among Chippewa and Menominee Indians: the Inter-Tribal Heart Project Preliminary Data. 889 70

CHD is the number one killer of men and women. Men and women need to be educated about the warning symptoms of CHD and MI to assist in earlier diagnosis and treatment. Women need to be taught about the variety of factors that may affect their risk for CHD. All women should be counseled about the importance of primary and secondary prevention, as those with low probability of disease may some day have some form of cardiovascular illness, and those with high probability of disease may prevent or lessen the effects from an infarction. The Women's Health Initiative (WHI) is a study that may answer many of the unresolved questions about women and MI. The WHI was established by the National Institutes of Health (NIH) in 1993 to address negligence of women's health by the major federal research agencies. It is the largest study ever funded by NIH. Forty centers throughout the United States will follow 163,000 women for a 10-year-period to determine how to prevent heart disease, breast and colon cancer, and osteoporosis in postmenopausal women. The age range of women is from 50 to 79 years old. This study will have a major impact upon care of women for these varied conditions. While waiting for the answers to questions about treatment and prevention, we must use what information is available to us now. Women report for care later than men and often do not receive the same therapies and treatments, thus we need to become advocates for the female patient. We need to also assess the social support and caregiver availability that women have at home. If the situation is inadequate then community resources need to be accessed. In addition, follow-up care is essential. Because many women have complications of CHF and shock with their infarcts, we need to assure adequate follow-up. Transportation for the follow-up may also need to be provided or arranged since women's caregivers may be unable to drive their spouses to the doctor's office. Also, single, older women may be unable to use public transportation with ease. We can address the needs of the female population with CHD if we make a thorough assessment and individualize their plan of care. In today's world of health care, meeting an individual's needs is an ongoing challenge because the length of stay is shortened and resources are tighter. Creativity is often needed to adequately meet the assessed needs. In the future, MI may not be the number one killer of women. Preventing the onset of the disease or decreasing the risk of a reinfarction by empowering women may have an impact. It is hoped that the information given in this article could help the health care worker educate and empower women about this disease.
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PMID:Myocardial infarction. The number one killer of women. 944 72

The medical literature is limited regarding current wilderness morbidity and mortality statistics. Available studies concentrate on selected wilderness activities. This study retrospectively examines wilderness injuries, illnesses, and mortality based on case incident report files from eight National Park Service parks within California over a three-year period. Data were extracted regarding type of illness or injury, body area affected, age, gender, month in which the event occurred, and activity in which the victim was involved at the time of the event. The overall occurrence of nonfatal events was 9.2 people per 100,000 visits. More than 70% of all nonfatal events were related to musculoskeletal or soft-tissue injury. The most frequently involved body area was the lower limbs (38%). Seventy-eight mortalities occurred during the three years studied, resulting in an overall mortality rate of 0.26 deaths per 100,000 visits. Men accounted for 78% of the deaths. Heart disease, drowning and falls were the most common causes of death. The information and statistics on morbidity and mortality in California wilderness areas that this study provides may be used to guide future wilderness use, education, and management. A standardized, computerized database would greatly facilitate future evaluations, decisions, and policies.
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PMID:Morbidity and mortality in the wilderness. 958 62

This study examined the role of several personal characteristics in the association between low job control and coronary heart disease among male and female British civil servants. The logistic regression analyses were based on a prospective cohort study (Whitehall II), comprising 6,895 men and 3,413 women, age 35-55 years. Men and women with low job control at baseline had 1.5 to 1.8 higher risks of new heart disease during the 5.3-year follow-up. Psychological attributes, such as hostility, negative affectivity, minor psychiatric disorder, and coping, affected this association very little. The personal characteristics were not confounders, intermediate factors, or effect modifiers. Hence, increasing job control could, in principle, lower risks of heart disease for all employees.
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PMID:Job control, personal characteristics, and heart disease. 980 84

Heart disease is the primary killer among American women. Differences in referral for cardiac rehabilitation, as well as compliance rates, have been reported between male and female cardiac patients. This study explored the use of Phase I and Phase II cardiac rehabilitation programs by male and female patients. In particular, the study aimed to investigate the relationship between eligibility and subsequent referral to Phase II cardiac rehabilitation in both men and women, as well as their compliance rates in completing Phase II. In addition, for those patients who never started a Phase II program, their reasons for nonparticipation were explored. Structured patient interviews and chart audits were used to explore cardiac rehabilitation eligibility criteria, referral and completion rates. The sample consisted of 87 patients (46 women and 41 men) who were admitted with a medical diagnosis of angina, myocardial infarction, coronary artery bypass grafting, or valve replacement surgery. Men had higher eligibility rates for Phase I, whereas women had higher eligibility rates for Phase II; more men received a referral for Phase II from their physician than women did. Men had a higher completion rate with Phase II compared with women. For those patients who chose not to start a Phase II program, the most common reasons cited included transportation problems, insurance issues, and having exercise equipment at home. Although women are being referred for cardiac rehabilitation, fewer complete the programs. Continued education is essential to teach women the importance of cardiac rehabilitation to overall recovery and adaptation to an acute cardiac event. In addition, cardiac rehabilitation programs must be structured to meet the unique needs of women and thereby remove obstacles that have prevented higher participation rates by women in the past.
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PMID:Women and cardiac rehabilitation: referral and compliance patterns. 1009 8

Nocturnal oxygen desaturation and sleep apnea may provoke myocardial ischemia and arrhythmias in patients with coronary artery disease (CAD). Additionally, these factors may accelerate coronary atherosclerosis in the long term and they may play a role in the progression of the disease process. On the other hand, studies related to this subject are limited. This study was conducted to investigate the nocturnal oxygen desaturation and apneas during sleep in patients with CAD and to assess the possible association of these factors with CAD. We studied 22 male patients with CAD confirmed by coronary angiography who did not have symptomatic pulmonary disease and fourteen male healthy controls without known heart disease. Patients were randomly selected from men undergoing coronary angiography. Controls were age and sex matched and selected from the population registry. The normal controls were of similar body mass index to the patients. None of them were obese. The patients and controls underwent standard polysomnography. Men with CAD and controls had a similar apnea-hypopnea index (2.3 +/- 3.8 vs. 1.2 +/- 1.7). Mean oxygen desaturation index was higher among patients than controls (2.1 vs. 0.5, p < 0.05). Patients with CAD spent 3.1% (9.7 +/- 13.6) of total sleep time desaturated, while the same proportion in controls were 0.5% (1.9 +/- 4.1)(p < 0.05). Although both groups of patients were of similar heart rates at initial, the development of bradycardia during sleep was significantly higher in patients compared with controls (43.3% vs. 25.3%, p < 0.05). The results demonstrate that sleep disordered breathing, in particular nocturnal oxygen desaturation, occurs more common in patients with CAD compared to controls. Additionally, patients are at higher risk of developing bradycardia during sleep. This findings suggest that oxygen desaturation during sleep might contribute to the progression of CAD.
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PMID:Nocturnal oxygen desaturation in coronary artery disease. 1037 Mar 94

Images of patients in advertisements can reflect and influence readers. Since studies have shown discrimination against women and minorities in health care, images of patients in nursing practice magazine advertisements (n=446) were assessed for their reflection of reality. More male than female images were found. Men were shown more frequently as critically ill or with cardiac disease than women. Most patients were Caucasian and under 65 years old. These findings, at variance with reality, may influence nursing care. Nursing magazine readers may perceive women as less critically ill and with less heart disease than men. The underrepresentation of minorities and the elderly negates their health care presence.
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PMID:Patients' images in nursing magazine advertisements. 1041 57

The purpose of this study was to determine whether cognitive adaptation theory (i.e., cognitively responding to challenges to world assumptions) would predict positive adjustment to heart disease in the face of a recurrent event. Men and women who were treated for a coronary event with percutaneous transluminal coronary angioplasty (N = 278) were interviewed in the hospital and then 6 months later. Indicators of cognitive adaptation theory (self-esteem, optimism, mastery) and adjustment were assessed. In general, cognitive adaptation indicators predicted positive adjustment, sometimes showing stronger relations for those who faced a recurrent event. In addition, patients' cognitions were robust over time, meaning that they were not affected by recurrent events. Patients' beliefs about the angioplasty decision, however, showed differential relations to adjustment, depending on whether they sustained a recurrence.
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PMID:Applicability of cognitive adaptation theory to predicting adjustment to heart disease after coronary angioplasty. 1061 29


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