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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the past few years major advances have changed the way we think about atherosclerosis. Treatments for hyperlipidaemia not only regress angiographic stenosis and reduce coronary mortality; in meta-analysis, and in large trials of secondary prevention, they appear to reduce overall mortality. Reduction in events precedes regression of stenosis, partly through stabilization of plaque, and partly by reversal of the endothelial dysfunction caused by oxidized LDL. The study of lipid disorders has been advanced by new understanding of the role of apolipoproteins and lipoprotein (a). Significant advances have also been made in the understanding of effects of angiotensin, fibrinogen, homocysteinaemia, platelets, genetics of atherosclerosis, autoimmunity, flow disturbances and wall stress. Most importantly, because of a revolution in our understanding of the endothelium, we can now begin to make sense of some of the effects of risk factors such as lipids, menopause, flow disturbances, and pressure, to begin to understand atherosclerosis, arterial remodelling and the protective effect of oestrogen in a new light. These changes will profoundly affect the way we practise vascular medicine and neurology, and will give us powerful new ways to help our patients.
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PMID:Advances in atherosclerosis. 749 17

Intracellular free calcium activity is in part determined by a calmodulin-regulated plasma membrane Ca(2+)-pump. Since changes in Ca2+ permeability have been implicated in atherosclerotic plaque formation, we initiated a lipid hyperalimentation protocol during which we measured various erythrocyte calcium flux parameters and early atheroma development. Adolescent New Zealand White rabbits were fed a diet with 0.5% cholesterol and 2.5% lard over a 3-month period. Plasma cholesterol and triacylglycerols increased on average 18.7- and 13.9-fold respectively, while erythrocyte membrane cholesterol content decreased 18% and total phospholipids by 54%. After 3 months of lipid hyperalimentation, 22% of the aortic arch was covered with large, early-stage, raised atheroma. Basal and calmodulin-activated (Ca2+ + Mg2+)-ATPase activities in erythrocyte membranes increased by 31% and 123%, respectively at 2 months, with a concomitant increase in calmodulin affinity (Km) from 15.6 to 4.2 nM. These differences were transient on account of changes in the control animals which exhibited a slowly developing sensitivity to calmodulin during maturation. Basal Ca2+ transport and passive Ca2+ permeability increased about 7-fold during the hyperlipidemic phase. This suggests that overt hyperlipidemia, leading to atherosclerotic plaque development, alters plasma membrane Ca2+ regulatory mechanisms including passive Ca2+ permeability. The changes in enzymatic function, membrane composition, and Ca2+ permeability seen in this red cell model system may be a reflection of early changes in cells that are directly involved in the development of atherosclerotic plaques.
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PMID:Regulation of rabbit erythrocyte Ca(2+)-pump sensitivity to calmodulin in experimental hyperlipidemia. 763 51

To study the effect of hyperlipidemia on vascular permeability, serial anterior chamber fluorophotometric examinations were carried out on 33 control rabbits (group 1) and 32 diet-induced hypercholesterolemic (group 2) rabbits. Changes in the blood-aqueous barrier function associated with total serum cholesterol (CHO) and triglyceride (TG) levels were studied at the beginning of the study and every 2 weeks thereafter for up to 16 weeks following 0.5% cholesterol-enriched diet feeding. Concurrently, a slit-lamp biomicroscope was used to examine the iris for evidence of atheromatous plaque. In group 1, the CHO level decreased slightly during the first 6 weeks and remained rather steady thereafter. The status of the blood-aqueous barrier correlated significantly with serum CHO and TG levels (r = .46, P < .001; r = .23, P = .01, respectively). In group 2, CHO and TG levels increased significantly after 2 and 8 weeks of cholesterol-enriched diet feeding, respectively. The blood-aqueous barrier also became more permeable than that in group 1 after 2 weeks' and increased above its baseline level after 6 weeks' feeding. Both CHO and TG levels correlated well with the degree of blood-aqueous barrier breakdown (r = .51, P < .001; r = .25, P < .001, respectively). The first evidence of iridic lipid-streak deposition was noted at 7.6 +/- 0.7 weeks, while definite iridic atheromatous plaque appeared 11.2 +/- 0.7 weeks after feeding. The change in the blood-aqueous barrier also correlated well with the semiquantitative score of iridic plaque (r = .58, P < .001) and usually preceded visual evidence of plaque formation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Early change of vascular permeability in hypercholesterolemic rabbits. 774 66

More than 30,000 strokes occur each year in Texas, even though most strokes can be prevented by currently available and well-tolerated therapies. Antiplatelet therapy with aspirin or ticlopidine reduces stroke by about 25% in many patients with transient ischemic attack or initial stroke. Warfarin should not be used routinely for primary cerebrovascular disease but is useful to prevent cardioembolic stroke. Carotid endarterectomy is highly beneficial for patients with symptomatic, high-grade carotid stenosis, but its value for lesser degrees of symptomatic carotid plaque and for asymptomatic stenosis is less clear. Patients with nonvalvular atrial fibrillation have a substantial risk for stroke; most should be treated with warfarin. Risk-factor management (eg, control of hypertension, cessation of smoking, and treatment of hyperlipidemia) is as important as antithrombotic or surgical therapies for most patients with threatened stroke. Treating isolated systolic hypertension in elderly patients reduces stroke risk. Determining the cause of threatened stroke strongly influences preventive management. The tools are at hand to prevent most strokes; the challenge remains to apply them optimally.
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PMID:What's new in stroke? 777 51

A 7-year-old boy with a 5-year history of steroid-unresponsive nephrotic syndrome due to minimal change disease presented with acute myocardial infarction. Angiography was suggestive of a dissected atherosclerotic plaque at the initial and mid portions of the right coronary artery, as well as a lesion in the mid portion of the circumflex artery. The child had a long history of extreme hypercholesterolemia and hypertriglyceridemia, along with apolipoprotein-E 4/3 phenotype. The mother, who also has apolipoprotein-E 4/3 phenotype, has mild hypercholesterolemia. The case suggests that children with long-lasting nephrotic syndrome and even mild familial propensity for hyperlipidemia may be at increased risk for ischemic cardiovascular events. The literature is reviewed regarding the relationship between nephrotic syndrome and the incidence of ischemic heart disease.
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PMID:Acute myocardial infarction in a young boy with nephrotic syndrome: a case report and review of the literature. 791 53

Statins are a family of compounds which act on cells by inhibiting hydroxymethylglutaryl (HMG) CoA reductase, an enzyme that blocks the intracellular cholesterol synthesis and stimulates the formation and action of LDL receptors. Experience of 3 years after they were introduced in France and 10 years for studies of the first compound (lovastatin) has demonstrated that these drugs are potent hypercholesterolaemia-lowering agents, fairly well tolerated but possibly with some toxicity to muscles. In severe forms of pure hypercholesterolaemia they may be prescribed either alone or combined with biliary acid chelating resins. Their use in mild forms of hypercholesterolaemia will be justified when low-dose preparations are reimbursed by the French Social Security. In mixed hyperlipidaemia, statins are more effective than fibric acid derivatives on cholesterol but weaker on triglycerides. They provide an alternative to fibric acid derivatives when these fail, but they are not indicated in hypertriglyceridaemia. Studies are being carried out to demonstrate that statins have a preventive effect on cardiovascular diseases, in either clinical regression trials or atheromatous plaque regression studies.
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PMID:[Hypocholesterolemic statins. Evaluation and prospects]. 1032 34

In this study we have considered the possibility of inducing vascular damage in Yoshida Pittsburg (YOS) rat, an inbred strain which has endogenous hyperlipidemia without vascular atherosclerotic damage. Cholesterol-enriched diet (4% cholesterol plus 1% cholic acid and 0.5% thiouracil) was administered to YOS rats, in order to induce atherogenesis. The results indicate that, despite significant increase in serum (about 2-fold) and aortic tissue cholesterol (about 6-fold), no morphological damage occurred. A reduction in acetylcholine-mediated relaxation (of about 37%) was observed. No inhibition of ATP- or sodium nitrite-induced relaxation, or of contraction induced by norepinephrine was seen. Serum triglyceride concentration did not vary after administration of a cholesterol-enriched diet. Our results suggest that in heritable hyperlipidemic Yoshida rat, after 2 months of cholesterol-enriched diet, despite increased serum cholesterol levels, no atheromatous plaque developed on the aortic wall. Impaired vascular function and reductions in the response to acetylcholine were related to changed endothelial cell function. Administration of a high cholesterol diet to YOS rat may represent a new model of mixed endogenous and exogenous hyperlipidemia that can resemble many human dislipidemic diseases and therefore may become a useful tool for the study of isolated endothelial dysfunction.
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PMID:Effect of cholesterol-supplemented diet in heritable hyperlipidemic Yoshida rats: functional and morphological characterization of thoracic aorta. 801 7

Progression of atherosclerotic lesion of the carotid artery is suggested to induce the development of cerebrovascular events. We evaluate the risk factors related to carotid artery, wall thickness by ultrasonography. A total of 159 patients, who had received no medication for hypertension or hyperlipidemia were enrolled in this study. The wall thickness of carotid artery was evaluated as an intima-media (IM) complex measured by B-mode ultrasonography with a 7.5 MHz probe. Simple regression analysis demonstrated significant correlation between the IM complex and both age and systolic blood pressure, but not with fasting levels of plasma glucose, hemoglobin A1c, total and HDL cholesterol, triglyceride or gender. Stepwise regression analysis showed age and systolic blood pressure contribute to IM thickness (r = 0.623). However, in patients aged 60 or over, blood pressure did not contribute to the IM wall thickness. Smoking was not a risk factor for IM thickness, but the Brinkman Index (daily consumption of cigarettes x years smoking) was significantly higher in patients with plaques in the carotid artery than those without it. These results suggest that high blood pressure is a risk factor for mild atherosclerotic lesions of the carotid artery for those aged under 60. Smoking may contribute to the formation of plaque, which may consequently lead to the ischemic cerebrovascular disease.
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PMID:[Risk factors related to the wall thickness of carotid artery assessed by ultrasonography]. 804 Oct 25

Cerebrovascular accidents are responsible for killing or disabling half a million Americans every year and are the third leading cause of death in this country. Finding cost-effective means of decreasing stroke mortality and morbidity is of great humanitarian and economic importance. Panoramic dental radiography was done on 19 white men who had a recent cerebrovascular accident and who were hospitalized at a Department of Veteran Affairs medical center. Inclusion criteria included clinical suspicion or imaging study evidence that the stroke arose from atheroembolic disease of the carotid artery bifurcation. Women were omitted from the study because of their paucity in the patient pool, and African-Americans and Asian-Americans were omitted because strokes in those groups usually develop as a result of disease of intracranial vessels. Carotid arterial calcifications appearing as a radiopaque nodular mass adjacent to the cervical vertebrae at or below intervertebral space C3-4 were noted in seven persons (37%). These patients had an average age of 65 years and demonstrated multiple risk factors (prior transient ischemic attacks, prior stroke, hypertension, obesity, tobacco and alcohol abuse, hyperlipidemia) associated with occurrence of a stroke. We concluded that some white men at risk for a cerebrovascular accident may be identified in the dentist's office by appropriate review of the panoramic dental radiograph and medical history. The presence of carotid artery calcifications demands an expeditious referral to an appropriate practitioner who can assist in the control of risk factors and arrange prophylactic surgical removal of the carotid arterial plaque, which are both safe and reliable methods of reducing the incidence of stroke.
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PMID:Prevalence of detectable carotid artery calcifications on panoramic radiographs of recent stroke victims. 806 36

Amaurosis fugax has frequently been related to carotid artery disease. In order to determine the relationship between amaurosis fugax and significant carotid artery stenosis, we prospectively studied 81 consecutive patients presenting to an ophthalmologist with this symptom. Neurologic and vascular evaluation with PPG and Duplex-scan were performed. A stenosis of greater than 70% was regarded as significant. DSA was performed in patients with significant stenosis (55 of 81). The presence of risk factors such as hypertension, diabetes, coronary artery disease, tobacco and hyperlipidemia was considered. Mean age was 64.96 years. There was a high prevalence of hypertension, smoking and previous CVA/TIAs. Patients with significant carotid stenosis were endarterectomized. Carotid atheromata plaques were classified in three groups: hemorrhagic plaque (5), dystrophic calcification (8) and ulcerated plaque (42). There was a high correlation (0.87) between ulcerated plaque and amaurosis fugax. We conclude that amaurosis fugax is an important symptom to allocate patients with high risk of carotid disease, specially carotid stenosis complicated with ulcerated plaque. Carotid duplex scan must be done if this symptom is present.
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PMID:Amaurosis fugax as a symptom of carotid artery stenosis. Its relationship with ulcerated plaque. 812 72


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