Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because of recent heightened epidemiologic interest in persons with very low cholesterol levels, we compared men and women at the lowest and middle deciles of plasma cholesterol in a large population study for multiple sociologic, biologic, and medical attributes. Two sex-specific age groups were studied, 30-54 years and 55-79 years. In general, comparisons between deciles for each of these four age-sex groups revealed only minor differences for demographic variables; systolic or diastolic blood pressure; fasting plasma glucose; weight; height; obesity; cigarette smoking; dietary eggs or milk; medications for hypertension, hyperglycemia, hyperuricemia, or hyperlipidemia; family history of myocardial infarction, diabetes, or stroke; and personal history of myocardial infarction, congestive heart failure, hypertension, or stroke. Thus, the lowest and the middle deciles of plasma cholesterol in this population shared similar sociologic, biologic, and medical profiles. One unexpected finding was somewhat more diabetics in the lowest decile , and greater obesity and triglyceride levels in the lowest decile diabetics compared to either lowest decile non-diabetics or middle decile diabetics, perhaps suggesting a metabolically distinct subset.
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PMID:Characteristics of persons with marked hypocholesterolemia. A population-based study. 671 3

Virgin and breeder, spontaneously hypertensive and stroke prone rats (SHR/SP) were observed from weaning until 130 +/- 10 days of age. Blood pressure rose rapidly, reaching 230--240 mm Hg. After the birth of the second litter of pups, male and female breeders began to die suddenly, due to myocardial necrosis and congestive heart failure. At autopsy, the brains of virgin and breeder SHR/SP were swollen but were free of any pathologic changes. There were no significant alterations in the blood chemistry of virgin rats but breeder SHR/SP had super-normal enzyme levels, CPK, SGOT, SGPT and LDH, hyperglycemia, hyperlipidemia, and hypersecretion of corticosterone. Breeder SHR/SP developed PAN-like lesions of the mesenteric arcades and adrenal cortex along with severe fibrino-hyalin lesions of the testicular and ovarian arteries. It is suggested that alterations in hypothalamic-pituitary-adrenal function associated with the reproductive effort conditioned these SHR/SP to develop myocardial necrosis rather than stroke and the development of unusual hypertensive arteriopathy.
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PMID:Myocardial necrosis induced by breeding in stroke-prone/SHR. 721 76

The purpose of this study was to evaluate the effects of the alpha 1-blocking agent terazosin on blood pressure (BP) and blood lipids in a large, variant population of patients with hypertension. A total of 16,917 patients with hypertension were evaluated at 2214 primary and community care facilities; 7808 of these patients had not been treated previously for hypertension; 3928 were switched to terazosin from another antihypertensive agent; and 5181 received terazosin in addition to an agent that had not controlled their hypertension. Terazosin produced highly significant reductions in systolic (-18.2 +/- 0.2 mm Hg) and diastolic (-13.2 +/- 0.1 mm Hg) BP when used as monotherapy (mean dose, 3.1 mg; range, 2 to 10 mg) without causing a significant increase in heart rate. Equal antihypertensive efficacy was demonstrated in men, women, blacks, and whites of all ages, with particular benefit to elderly patients (> or = 65 years of age) with systolic hypertension. Comparative studies indicated that terazosin had equal antihypertensive efficacy in combination with diuretics, beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors. Patients who had not responded to monotherapy with one of these classes of antihypertensive drugs showed significant reductions of BP after terazosin, in the following average doses, was added to diuretics, 3.1 mg; beta-blockers, 3.4 mg; calcium channel blockers, 3.3 mg; and ACE inhibitors, 3.4 mg. Terazosin produced highly significant reductions in blood levels of total cholesterol (-5.0%), triglycerides (-6.1%), and low-density lipoprotein cholesterol (-7.6%) without change in high-density lipoprotein cholesterol when used as monotherapy. Similar favorable effects on blood lipid levels were demonstrated when terazosin was used in combination with all other classes of antihypertensive drugs. The greatest reductions in blood cholesterol (-9.2%) were observed among patients with hyperlipidemia (total cholesterol > or = 240 mg/dL). Terazosin maintained its antihypertensive efficacy and was well tolerated by patients with a variety of concomitant diseases, including congestive heart failure, peripheral vascular disease, chronic obstructive pulmonary disease, benign prostatic hyperplasia, diabetes, and obesity. Adverse effects occurred in 17.9% of patients and caused 2.2% to drop out of the study. The most frequent adverse effects were dizziness (4.8%), headache (2.5%), and asthenia (2.4%). Only 0.4% suffered syncope and 0.2% impotence. These data demonstrate the usefulness of terazosin as monotherapy or add-on therapy for treatment of hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alpha 1-blockade for the treatment of hypertension: a megastudy of terazosin in 2214 clinical practice settings. 792 16

The prevalence of and risk factors for varicose veins (VV) were studied in elderly persons over 60 years of age who had visited the Tonya and Farabi Hospitals in Trabzon, a city in northeastern Turkey. VV were defined as dilated, tortuous and elongated veins of the lower extremities and were classified into four types. The total prevalence of VV was 36.7% (14.6% in males and 22.1% in females). Segment type varices were observed in 16.5%, saphenous type in 5.6%, reticular type in 4.7%, web type in 2.3%, and combined types in 7.5%. The prevalence of VV increased with age and was greater among those with a family history of the condition in 154 of 312 patients with VV (49.4%). Other factors, such as congestive heart failure, angina pectoris, hypertension, cigarette smoking, diabetes mellitus, height, weight, obesity, or hyperlipidemia, were not found to be associated with the prevalence of VV. However, the factors of age, work posture and childbirth did show an association with prevalence, as reported by others.
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PMID:Prevalence and risk factors of varicose veins in an elderly population. 803

Health services researchers rely heavily on administrative data bases, but incomplete or incorrect coding may bias risk models based on administrative data. The best method for validating administrative data is to collect detailed information about the same cases from independent sources, but this approach may be too costly or technically difficult. We used data on coronary artery bypass surgery from four sites (Duke University; Minneapolis--St Paul; California; and Manitoba) to demonstrate an alternative approach for assessing diagnostic coding and to explore the implications of miscoding. The first two sites have clinical data; the second two have administrative data. The prevalences of 14 comorbidities and the associated risk ratios for short-term mortality were compared across data sets. Some comorbidities could not be precisely mapped to ICD-9-CM. Chronic or asymptomatic conditions such as mitral insufficiency, cardiomegaly, previous myocardial infarction, tobacco use, and hyperlipidemia were far less prevalent in administrative data than in clinical data. The prevalence of diabetes, unstable angina, and congestive heart failure were similar in administrative and clinical data. Estimates of relative risk derived from clinical data equalled or surpassed those derived from administrative data for all conditions. Hospitals should be encouraged to improve reporting of coexisting conditions on discharge abstracts and claims. In the meantime, researchers using administrative data should assess the vulnerability of their risk models to bias caused by selective underreporting.
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PMID:A comparison of administrative versus clinical data: coronary artery bypass surgery as an example. Ischemic Heart Disease Patient Outcomes Research Team. 813 35

After a brief synopsis of the classical antihypertensive drugs a survey is given of the newer therapeutics, such as calcium antagonists, ACE-inhibitors and alpha 1-adrenoceptor antagonists. Experimental drugs, such as imidazoline receptor agonists, renin inhibitors, angiotensin II receptor antagonists, alpha 2-adrenoceptor antagonists, potassium channel openers, ketanserin, endopeptidase inhibitors, and hybrid (multifactorial) drugs are discussed, with special attention for their modes of action. In spite of the ever increasing number of antihypertensive drugs and principles, the large scale of clinical evidence for a beneficial effect of long-term treatment (in particular with respect to protection against stroke) remains limited to diuretics and beta-blockers. In spite of this limitation it seems worthwhile to consider the newer antihypertensive drugs as well, especially for optimal treatment of the individual patient. The newer drugs may in particular offer special advantages in the presence of concomitant diseases, such as diabetes mellitus, hyperlipidaemia, angina pectoris or congestive heart failure.
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PMID:New avenues in antihypertensive drug treatment. 826 86

We analyzed retrospectively the clinical course and prognosis of 565 consecutive patients with acute myocardial infarction (AMI), 117 of them with a previous history of diabetes mellitus. Male/female ration was 7.9/2.1 in non diabetics and 7.0/3.0 in diabetics (p < 0.03). Incidence of hypertension and hyperlipidemia was higher in diabetic patients as well as history of congestive heart failure (13.7% vs 6.5 in non diabetics p < 0.01). The type and location of AMI did not differ among groups, however the incidence of congestive heart failure Killip class III-IV was higher in diabetic patients (31.6 vs 21.2%). Peak CPK values were lower in diabetics (1.270 +/- 1.179 vs 1.648 +/- 1.377 U/l p < 0.01). Cardiac mortality was higher one month and one year after AMI in diabetics (17.1 vs 13.6% and 21.4 vs 17.8% respectively, p < 0.01). Univeriate and multivariate analysis identified new bundle branch block, heart failure and advanced age as independent predictors of mortality in both groups of patients. It is concluded that the worst prognosis of diabetic patients with AMI may be related to a previously depressed ventricular function and that appropriate metabolic control and treatment of associated risk factors, could improve the prognosis of diabetics patients with AMI.
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PMID:[Characteristics of acute myocardial infarction in patients with diabetes mellitus]. 827

To evaluate whether hemostatic abnormalities contribute to the increased risk of stroke, the authors prospectively studied the hemostatic markers (HM) (beta-TG, PF4, FPA, TAT, PIC, D-dimer) in 34 elderly patients with atrial fibrillation (Af) without a history of stroke (mean age 79.2) and 14 age-matched controls. In the Af group FPA was significantly higher than in the control group (p < 0.05). Among them, 8 patients showed a similar abnormal HM pattern as in cardioembolic is chemic stroke and in these, 4/8 patients had valvular disease (VD), 2/8 had hypertension (HT), 2/8 had congestive heart failure (CHF), 1/8 had diabetes mellitus (DM) and 1/8 had hyperlipidemia (HL). Eight patients showed the same abnormal HM pattern as atherothrombotic is chemic stroke and of these, 2/8 had HT as complications. Five patients showed combination of a HM abnormal pattern, that was observed in cardioembolic and atherothromboic ischemic stroke. The other 13 patients showed a normal HM pattern, were in these patients, 4/13 had HT, 1/13 had DM, 1/13 had VD, and 1/13 had CHF. The patients with VD complication tended to have embolic HM abnormality. Contrary to previous reports, nonvalvular Af patients do not necessarily tend to have high risk of cardioembolic stroke. Our data suggest difficulties in clinical diagnosis among Af patients with ischemic stroke whether it is cardio embolic or atherothrombotic.
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PMID:[Alterations of hemostatic markers in elderly patient with atrial fibrillation without a history of stroke]. 833 32

Physicians need to weigh the efficacy, adverse effects and cost of first-line antihypertensive agents. Calcium channel blockers lower blood pressure, improve coronary blood flow and depress cardiac contractility by relaxing smooth muscle and cardiac muscle. They have beneficial or neutral effects in hypertensive patients with angina, asthma, chronic obstructive pulmonary disease, postural hypotension, peripheral vascular disease, depression, sexual dysfunction, diabetes and hyperlipidemia. The major adverse effect of some calcium channel blockers is that they may worsen congestive heart failure in some patients. Because calcium channel blockers are metabolized in the liver, the dosage must be lowered in the elderly and in patients with hepatic disease. Diltiazem, verapamil and nifedipine represent prototypes of the three classes of calcium channel blockers, each with slightly different effects.
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PMID:Calcium channel blockers in the treatment of hypertension. 836 95

1. The primary aim of this study was to assess the impact of renal haemodynamics on the pharmacokinetic behaviour of ibuprofen enantiomers. Thirty-two patients and ten age-matched healthy volunteers participated in this study. These patients had at least one of the following risk factors for cardiovascular disorders: hypertension, diabetes mellitus, hyperlipidaemia and hyperuricaemia with or without consequent complications such as coronary artery disease, congestive heart failure, cerebral vascular disease, and chronic renal failure. Renal function in these patients was thus characterized by unstable renal haemodynamics that might render them susceptible to ibuprofen-incurred renal damage. 2. Each subject received a single oral dose of 800 mg of racemic ibuprofen. The pharmacokinetic parameters of (S)- and (R)-ibuprofen, t 1/2(S), t 1/2(R), AUC(S), AUC(R), V/F(R), and CL/F(R), for each individual were determined from respective plasma concentration-time curves. To assess the effect of individual clinical conditions on the disposition of ibuprofen enantiomers, the arithmetic means of these pharmacokinetic parameters for each disease group were compared with those of the healthy volunteers by a t-test. 3. All of these disease groups showed elevated AUC(S) and higher (S)/(R) AUC ratios. These disease states along with gender and age were analyzed by multiple linear regression to discern significant factors for elevating AUC(S). Of these, advanced age (P = 0.02) and hypertension (P = 0.03) were identified as independent factors contributing to AUC(S) increase in this population. Thus, patients with these two clinical conditions are at particular risk from the adverse renal effect of ibuprofen.
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PMID:Stereoselective disposition of ibuprofen in patients with compromised renal haemodynamics. 852 70


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