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Query: UMLS:C0018799 (
heart disease
)
34,133
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Relatively few studies have examined the clinical effectiveness of cholesterol-lowering drugs in women as compared with men. Most clinical trials do indicate that cholesterol lowering reduces clinical events equally effectively in both genders. However, high-density lipoprotein cholesterol and triglyceride levels may have more prognostic significance in women. The recent finding of a higher risk of death in younger women as compared with younger men who sustain a heart attack, combined with the high proportion of morbidity and mortality due to
CHD
in older women, emphasizes the need for a better understanding of
heart disease
in women. This review explores the similarities and differences between women and men regarding the management of dyslipidemia.
...
PMID:Optimal management of dyslipidemia in women and men. 1127 70
A number of epidemiological studies have shown an association between beta-carotene and the risk of cardiovascular diseases, whereas only a few studies are available concerning the association of lycopene with the risk of coronary events, and no studies have been undertaken concerning lycopene and stroke. Thus, we tested the hypothesis that low serum levels of lycopene are associated with increased risk of acute coronary events and stroke in middle-aged men previously free of
CHD
and stroke. The subjects were 725 men aged 46-64 years examined in 1991-3 in the Kuopio Ischaemic
Heart Disease
Risk Factor Study. Forty-one men had either a fatal or a non-fatal acute coronary event or a stroke by December 1997. In a Cox' proportional hazard's model adjusting for examination years, age, systolic blood pressure and three nutritional factors (serum folate, beta-carotene and plasma vitamin C), men in the lowest quarter of serum lycopene levels (< or =0.07 micromol/l) had a 3.3-fold (95 % CI 1.7, 6.4, risk of acute coronary events or stroke compared with the others. Our study suggests that a low serum level of lycopene is associated with an increased risk of atherosclerotic vascular events in middle-aged men previously free of
CHD
and stroke.
...
PMID:Low serum lycopene concentration is associated with an excess incidence of acute coronary events and stroke: the Kuopio Ischaemic Heart Disease Risk Factor Study. 1143 Jul 80
Over the past decade, there has been increasing use of cardiac MRI in the evaluation of children with congenital
heart disease
. There has also been an increased number of radiologists and pediatric cardiologists desiring to perform cardiac MRI in the evaluation of these patients. At the present time, the number of pediatric cardiologists and radiologists fully trained in the use of MRI studies for
CHD
is inadequate to provide this modality at all institutions with MRI capabilities. This article describes the collaborative approach between pediatric cardiology and radiology at Madigan Army Medical Center and its implications for patient care and credentialing.
...
PMID:MRI of congenital heart disease: a paradigm of collaboration. new suggestions for a team approach from Madigan Army Medical Center. 1223 8
Though initially challenging, the process of determining appropriate levels of exercise for patients with congenital
heart disease
can be broken down into several practical steps: List 1: Summary of approach to
CHD
patients and exercise Get the records: Surgical reports, diagnostic test results, office visits, admissions [table: see text] Obtain family history: Family members with sudden death increase risk. Thorough physical exam: Special attention to auscultation of murmurs Appropriate diagnostic testing: Noninvasive testing is usually adequate. Review guidelines: 26th Bethesda Conference, 1994 [13] Make recommendation: Be specific about types of exercise allowed. Reassess at least annually: Patients' status may change over time [24]. The use of this algorithm and review of available guidelines, in combination with selected consultation with other specialists, should allow the sports physician to prescribe exercise for the majority of these patients confidently. Examples of several congenital defects of varying severity, and the appropriate exercise prescription, are listed in Table 1.
...
PMID:Congenital heart disease and exercise. 1261 88
Lipoprotein lipase (LPL) plays a central role in triglyceride metabolism, and the LPL gene T495G HindIII polymorphism has been associated with variations in lipid levels and
heart disease
in Caucasians with the more common H+ allele being associated with adverse lipid profiles and increased risk of
CHD
. We investigated this polymorphism in 785 Chinese subjects with varying components of the metabolic syndrome, including 61.4% with early-onset type 2 diabetes (age at diagnosis < or = 40 years), and 167 healthy control subjects using a polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) method. The allele and genotype frequencies were similar in the patients and control subjects. When grouped above or below standard cutoffs for triglyceride levels, the H+ allele was more frequent in hypertriglyceridemic than that in normotriglyceridemic subjects in the total population (81.5% v 76.1%) and early-onset type 2 diabetics (84.4% v 77.4%, both P <.05). Moreover, H+H+ carriers had significantly higher plasma triglyceride and lower high-density lipoprotein (HDL)-cholesterol levels when compared to subjects with the H- allele in the total population, and in patients with early-onset diabetics (both P <.05). In the total population and the early-onset diabetic patients, this relationship was confined to males when gender was considered. We conclude that the H+ allele of the LPL gene HindIII polymorphism is associated with higher plasma triglyceride and lower HDL-cholesterol levels in Chinese patients with early-onset diabetes.
...
PMID:The lipoprotein lipase gene HindIII polymorphism is associated with lipid levels in early-onset type 2 diabetic patients. 1264 73
We compared quality of life among parents of children with congenital
heart disease
(PCCHD, n = 1092), parents of children with other diseases (PCOD, n = 112) and parents of healthy children (PHC, n = 293). We also identified determinants of quality of life among the parents. The parents completed a questionnaire about such areas as quality of life and financial situation. The design was cross-sectional and data were collected during 20 consecutive days. The univariate analyses showed that PCCHD tended to report lower quality of life than PHC. Mothers reported lower quality of life than fathers, with the lowest levels among mothers of children with
CHD
. The multivariate analyses revealed however that variables such as distress, hopelessness and financial situation were more important in explaining the reduced quality of life than parental gender and the presence/severity of the children's heart diseases. We corroborated previous findings and may have provided new insights into the quality of life experiences of parents of children with
CHD
that may be important when considering interventions to improve their situation.
...
PMID:Quality of life among parents of children with congenital heart disease, parents of children with other diseases and parents of healthy children. 1451 75
As the number of
CHD
repairs in adults continues to increase, these operations will be performed in a wider variety of institutions and systems. Unfortunately, not all of these centers will have an optimal environment for correcting
CHD
in adults. This type of surgery is best accomplished in a facility specifically designed for treating adults with
CHD
. Optimal care of these patients is provided by cardiologists who are trained and experienced in pediatric and adult cardiology, by surgeons who are trained and experienced in treating
CHD
, and by anesthesiologists who are experienced in caring for adults with
CHD
. Whatever the setting, cardiac anesthesiologists involved in these cases must be thoroughly aware of the anesthetic implications for the unique pathophysiology of each patient, and they must not rely on their "usual" expectations of either true pediatric
CHD
or acquired adult
heart disease
.
...
PMID:Anesthetic management of the adult patient with congenital heart disease. 1456 71
The ATP III report represents an important advance from previous ATP reports dating back to the late 1980s. The guidelines are more tightly evidence-based than previous reports, partly because of evolution of the guideline process, requiring clearly delineated links between evidence and recommendations and also because of the robust evidence base published over the last decade. An important change in ATP III is the expansion of the high-risk category to include patients without evident vascular disease, but with a level of risk equivalent to those patients with established
CHD
. This group termed "coronary
heart disease
equivalents" now includes patients with diabetes, and those with a 10-year absolute risk of over 20 percent for
CHD
events. With the ATP III report, the Framingham risk score is formally introduced into the guideline process. The scoring system allows for easy calculation of the absolute risk for an individual of having a "hard"
CHD
event (myocardial infarction, or
CHD
death). The report also discusses in detail concepts of lifetime or long-term risk. ATP III has broadened recommendations for lifestyle change termed "therapeutic lifestyle change (TLC)," and eliminated the step 1 and step 2 diet approach. Finally, the report details established approaches to improve adherence and provides patients and clinicians with a set of implementation tools to enhance use of the guidelines and compliance with the guidelines' recommendations. It is hoped that by improved understanding, recognition of a firm evidence base, and education through multiple channels, that adherence with the new ATP III guidelines will improve the care of our population by more effectively targeting lipid factors that lead to the development and progression of atherosclerotic cardiovascular disease.
...
PMID:Report of the Adult Treatment Panel III: the 2001 National Cholesterol Education Program guidelines on the detection, evaluation and treatment of elevated cholesterol in adults. 1462 53
PPARgamma, a nuclear transcription factor, is expressed in various cells within the vasculature and in cardiomyocytes. It has been suggested that PPARgamma is involved in atherogenesis and in cardiac hypertrophy. Therefore, we sought to quantify PPARgamma mRNA in coronary arteries, the aorta and left ventricular specimens from patients with ischaemic (
CHD
) and dilated cardiomyopathy (CMP). Using real-time PCR, we were able to demonstrate the expression of PPARgamma in all of the human specimens. The lowest expression of PPARgamma was detected in the aorta specimens of both groups (this was set to one). In comparison, the expression in coronary arteries was 2.32-fold in
CHD
- and 3.78-fold in CMP specimens and in the left ventricle specimens, 2.12-fold in
CHD
- and 3.51-fold in CMP. Samples from
CHD
patients showed a higher expression of PPARgamma in all of the samples compared to those from CMP patients (aorta: 1.99-fold; coronary arteries: 1.35; left ventricles: 1.23). PPARgamma levels were not significantly correlated to CD 36 expression values in any group, suggesting that higher levels of PPARgamma are not principally due to increased PPARgamma expression in macrophages. This was confirmed by immunohistochemical analysis, which showed that PPARgamma is also located in the smooth muscle layer and in cardiomyocytes. In conclusion, our observations of increased PPAR mRNA expression in the coronary arteries and left ventricles from
CHD
and CMP patients suggest an important function of this nuclear receptor in the pathogenesis of
heart disease
.
...
PMID:Quantitative analysis of peroxisome proliferator-activated receptor gamma (PPARgamma) expression in arteries and hearts of patients with ischaemic or dilated cardiomyopathy. 1467 51
Lingzhi (Ganoderma lucidum) is a woody mushroom highly regarded in traditional medicine and is widely consumed in the belief that it promotes health and longevity, lowers the risk of cancer and
heart disease
and boosts the immune system. However, objective scientific validation of the putative health benefits of Lingzhi in human subjects is lacking, and issues of possible toxicity must be addressed. The present double-blinded, placebo-controlled, cross-over intervention study investigated the effects of 4 weeks Lingzhi supplementation on a range of biomarkers for antioxidant status,
CHD
risk, DNA damage, immune status, and inflammation, as well as markers of liver and renal toxicity. It was performed as a follow-up to a study that showed that antioxidant power in plasma increased after Lingzhi ingestion, and that 10 d supplementation was associated with a trend towards an improved
CHD
biomarker profile. In the present study, fasting blood and urine from healthy, consenting adults (n 18; aged 22-52 years) was collected before and after 4 weeks supplementation with a commercially available encapsulated Lingzhi preparation (1.44 g Lingzhi/d; equivalent to 13.2 g fresh mushroom/d) or placebo. No significant change in any of the variables was found, although a slight trend toward lower lipids was again seen, and antioxidant capacity in urine increased. The results showed no evidence of liver, renal or DNA toxicity with Lingzhi intake, and this is reassuring. The present study of the effects in healthy, well-nourished subjects provides useful, new scientific data that will support controlled intervention trials using at-risk subjects in order to assess the therapeutic effect of Lingzhi in the promotion of healthy ageing.
...
PMID:Ganoderma lucidum ("Lingzhi"), a Chinese medicinal mushroom: biomarker responses in a controlled human supplementation study. 1475
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