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

Loss of normal autonomic nervous system control of heart rate and rhythm is an important risk factor for adverse cardiovascular events. After myocardial infarction, reduction in beat-to-beat heart rate variability, a measure of cardiac autonomic innervation by the brain, is a strong predictor of death. With loss of vagal innervation, as is noted in patients with severe neuropathy and in heart transplant recipients, there is loss of heart rate variability. It is speculated that decreased parasympathetic innervation exposes the heart to unopposed stimulation by sympathetic nerves. Individuals with high hostility scores and patients with anxiety or depressive disorders have low heart rate variability and may be at increased risk for cardiovascular death associated with coronary heart disease and arrhythmias. After myocardial infarction, depressed patients exhibit higher mortality rates compared with nondepressed patients. Men with "phobic anxiety," a construct that appears to overlap substantially with panic disorder, also have higher rates of sudden cardiac death and coronary artery disease than control populations. The reduction in autonomic nervous system control to the heart may be one link between psychopathology and heart disease. Although tricyclic antidepressants reduce heart rate variability, at least one study has suggested that, in patients with panic disorder, treatment with the selective serotonin reuptake inhibitor paroxetine normalizes heart rate variability. Hence there is potential for the treatment of psychiatric disorders to affect positively the development and course of cardiovascular disease.
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PMID:Heart rate variability in depressive and anxiety disorders. 1101 52

Numerous studies show that the health gap between whites and minorities is increasing, with whites experiencing lower rates of death due to various diseases, including heart disease. Public health officials blame a lack of access to health insurance and treatment for the higher death rates. The Men of Color Health Initiative, created in an attempt to alleviate this problem, has found that minority men often distrust the health care system. Further research showed that hospitals are often insensitive, inefficient, and biased in treating male minorities. To address these issues, system-wide changes have been installed, including the expansion of community health centers and treatment programs. However, funding for these initiatives has either declined or has been completely removed.
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PMID:The health gap for men of color. 1136 44

The aim of this study was to determine if aortic root dimension and blood flow velocity correlate with clinical and echocardiographic characteristics of healthy individuals. To assess the aortic root dimension and blood flow velocity in a healthy population, 503 subjects (253 women and 250 men) aged 18 to 66 years (mean, 36.9+/-11.9 years) who were normotensive, free of clinically apparent heart disease and any drug at the baseline examination were included in the study. M-mode echocardiographic measurements were performed according to the criteria recommended by the American Society of Echocardiography. Aortic blood velocity was obtained by pulsed wave Doppler echocardiography. Correlations between aortic root dimension and blood flow velocity and age, gender, body surface area, waist/hip ratio, and echocardiographic parameters such as left ventricular mass, ejection fraction, and left ventricular systolic and diastolic dimensions were evaluated by using regression analysis and Student's t test. Men had greater aortic root dimension (p<0.001). There were correlations between aortic root dimensions and age, body surface area, waist/hip ratio, and left ventricular mass in both genders (p<0.05). No correlation was found with left ventricular dimensions and ejection fraction. Aortic blood flow velocity correlated only with age (r=0.32, p<0.001). There was no gender difference in aortic blood flow velocity. This study shows that age, gender, body surface area, and waist/hip ratio should be considered in the evaluation of aortic root dimension. However, only age has an important impact on aortic blood flow velocity in both genders.
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PMID:Clinical characteristics influence aortic root dimension and blood flow velocity in healthy subjects. 1151 84

The study aim is to quantify the variation in prescribing rates of secondary preventative therapies for Ischaemic Heart Disease (IHD) across regions, age and gender. Patients receiving any prescriptions for a nitrate during a one year period (September 1999-August 2000) were considered using a national primary care prescribing database. Age-sex standardised prescribing rates of four secondary preventative therapies for IHD (Ace inhibitors, beta-blockers, aspirin, statins) were calculated for each region. Wide variations between regions were observed with significantly higher variability for Ace inhibitors compared with aspirin (F-ratio=22.8, p<0.001). Men were more likely to prescribed these therapies and the elderly were less likely (except Ace inhibitors). The study suggests that access to secondary preventative therapy is not equitable across regions, gender and age in Ireland. The wide variability may be due to uncertainty in prescribing secondary preventative therapies and/or variability in clinical need between regions.
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PMID:Inequalities in prescribing of secondary preventative therapies for ischaemic heart disease in Ireland. 1247 7

The San Francisco Men's Reproductive Clinic in Chinatown has been disseminating general health and contraceptive information as an adjunct to the women's family planning clinic at Health Center 4. Most of the diverse group of patients are in their 20 's, 15% are over 40. The men receive checkups, sex counseling, contraceptive devices, vasectomy referrals, treatment of sexually transmitted diseases, and general information on blood pressure, heart disease, cancer, nutrition and occupational health. The clinic operates one day a week at two locations under a grant from HEW. Response from males in the community has been enthusiastic, especially in how staff has responded to their needs. The clinic's outreach program has had no trouble locating men in the community.
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PMID:Breaking the stereotype. 1227 55

Erectile dysfunction (ED) and depression are highly prevalent conditions and frequently occur concomitantly in predisposed individuals. Men with ED and depression are also likely to have other comorbid conditions, including diabetes, hypertension, and heart disease. Because ED is also a common adverse effect of some medications for these conditions, patients are frequently noncompliant with treatment. Sildenafil citrate (Viagra) is effective in treating ED of a broad range of etiologies, suggesting that it may be equally beneficial in patients with ED that is associated with depressive symptoms and in those with ED resulting from serotonergic reuptake inhibitor (SRI) antidepressant treatment. We review the results of 3 randomized, placebo-controlled trials and a retrospective analysis of data pooled from 10 clinical trials that examine the efficacy of sildenafil in treating ED associated with depression and as an adverse effect of SRI treatment. The results suggest that sildenafil is efficacious as a first-line treatment for ED in men with untreated minor depression, in men with ED that is refractory to successful SRI treatment of depression, and in those whose depression was successfully treated but who developed ED as a consequence of SRI treatment. Given the complex interrelations among ED, depression, and other comorbid conditions, the key to proper management is a comprehensive evaluation, including sexual function, and an accurate differential diagnosis.
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PMID:Depression, antidepressant therapies, and erectile dysfunction: clinical trials of sildenafil citrate (Viagra) in treated and untreated patients with depression. 1241 34

The purposes of this study were to estimate the prevalence of household food insufficiency in Canada, to identify sociodemographic characteristics of households most likely to report food insufficiency and to examine the relationship between food insufficiency and physical, mental and social health. These objectives were achieved through an analysis of data from the 1996/1997 National Population Health Survey. An estimated 4% of Canadians, 1.1 million people, were found to be living in food-insufficient households. Single-parent families, households reporting their major source of income as welfare, unemployment insurance or workers' compensation, those who did not own their own homes and households in Western Canada were more likely to report food insufficiency. The likelihood of reporting food insufficiency increased dramatically as income adequacy deteriorated. Individuals from food-insufficient households had significantly higher odds of reporting poor/fair health, of having poor functional health, restricted activity and multiple chronic conditions, of suffering from major depression and distress, and of having poor social support. Individuals in food-insufficient households were also more likely to report heart disease, diabetes, high blood pressure and food allergies. Men in food-insufficient households were less likely to be overweight; after adjusting for potentially confounding variables, no other associations were found between food insufficiency and body mass index. These findings suggest that food insufficiency is one dimension of a more pervasive vulnerability to a range of physical, mental and social health problems among households struggling with economic constraints.
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PMID:Household food insufficiency is associated with poorer health. 1251 78

Why are men more susceptible to heart disease than women? Traditional risk factors cannot explain the gender gap in coronary heart disease (CHD) or the rapid increase in CHD mortality among middle-aged men in many of the newly independent states of Eastern Europe. However, Eastern European men score higher on stress-related psychosocial factors than men living in the West. Comparisons between the sexes also reveal differences in psychosocial and behavioral coronary risk factors favoring women, indicating that women's coping with stressful events may be more cardioprotective. Men's greater susceptibility to heart disease, particularly observable in many Eastern European countries, poses unique threats to public health and points to solutions in the behavioral and social arena.
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PMID:The gender gap in heart disease: lessons from Eastern Europe. 1460 37

There are insufficient data on the effects of alpha-blockers and finasteride on erectile function in men who have other risk factors for erectile dysfunction (ED). This study was conducted to compare the relative effects of these medications on ED in men who may be on other medications or have other risk factors for ED. Patients attending urology and primary care clinics were asked to complete an IRB-approved questionnaire that combined the validated Sexual Health Inventory for Men (SHIM) and a detailed medical history. A total of 123 patients completed the questionnaire. The age range was 28-88 years (mean: 68 years). Eighty-one per cent of patients had SHIM scores <21, indicating some degree of ED. The average SHIM scores in a population of patients with similar age and risk factors who had been on finasteride or alpha-blockers indicated the presence of ED but did not reveal a significant difference between the two groups. The scores were no different from an age-matched group of patients who were not on either medication, demonstrating the relatively greater importance of various other risk factors for ED. There was an inverse linear relationship between the number of ED risk factors and SHIM scores. There does not appear to be a significant difference between alpha-blockers and finasteride as independent risk factors for ED. Age and other risk factors (heart disease, diabetes, hypertension, smoking, and hypercholesterolaemia) tend to have a much stronger influence on the severity of ED as assessed by SHIM scores.
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PMID:Comparison of finasteride and alpha-blockers as independent risk factors for erectile dysfunction. 1291 87

Age and gender dependence of the 3 major variables--left atrial (LA) dimension, effective refractory period (ERP), and atrial conduction--that govern the development of atrial fibrillation (AF) were examined in 76 women and 39 men without structural heart disease. A significant positive correlation was found between age and LA dimension, mainly because of a strongly positive correlation in women not taking hormone replacement therapy but not in women on hormone replacement therapy. Men had a significantly greater average LA dimension than women. Neither ERP nor atrial conduction estimated by normalized P-wave duration demonstrated any significant correlation with either age or gender. It was concluded that LA size is greater in the elderly and in men, which may increase their risk for AF.
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PMID:Age- and sex-related atrial electrophysiologic and structural changes. 1527 10


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