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)

Adrenomyeloneuropathy (AMN), a clinical variant of child adrenoleukodystrophy (ALD), is an adult-onset progressive disorder which presents spastic paraparesis with peripheral nerve involvement and affects mainly the pyramidal tracts from the brainstem to the spinal cord. We report a case of AMN in which serial MRI showed unusual development of areas of high signal in the right striatum. The patient was in good health until the age of 12, when he began to lose his hair. At age 25 he started to have progressive gait disturbance and erectile impotence. In his first admission to our hospital at age 33, he showed diffuse baldness. He was intelligent but childish. His cranial nerves were normal. Muscle strength was weak (3-4/5) in the lower extremities. Deep tendon reflexes were hyperactive in the lower extremities while normal in the upper extremities. Babinski signs were elicited bilaterally. Pinprick and vibratory sensation was impaired in the lower legs. Proprioceptive sensations were normal. Co-ordination was intact. There were urinary incontinence and impairment of erection with preserved libido and ejaculation. Routine laboratory data including hematological studies, serum chemistry and urinalysis were all normal except for mild hyperlipidemia. Serum cortisol response to ACTH was low and serum levels of very long chain fatty acids were increased. Nerve conduction studies were abnormal and consistent with peripheral polyneuropathy. A biopsy specimen of left sural nerve revealed a mild loss of myelinated fibers with thinning of the myelin. These findings and the clinical features confirmed the diagnosis of AMN. MRI in SE2000/40 scans at age 34 disclosed areas of high signal in the bilateral internal capsules.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Striatal involvement on MRI in adrenomyeloneuropathy]. 165 65

The value of the vascular examination cannot be over-estimated. Symptoms of vascular disease present in the foot and lower extremity may actually be manifestations of severe life-threatening disease. Symptoms, their location, and the frequency and quality of the patient's pain often provide valuable clues for the clinician's diagnosis. Central nervous system symptoms, ocular disturbances, cardiac symptoms, impotence, or constitutional disturbances may all indicate systemic arterial disease. Risk factors for this disease include smoking, hypertension, hyperlipidemia, genetic predisposition, diabetes, emotional stress, and physical inactivity. Those factors attributable to hypercoagulability and venous disease are birth control pill use, estrogen chemotherapy, obesity, prolonged immobilization, paralysis, previous thrombotic episodes, venous stasis disease, and varicose veins. An accurate bilateral assessment of blood pressure, pulses, and capillary perfusion is of critical importance. Careful inspection of the extremity for trophic changes, skin color, texture, temperature, edema, ulceration, atrophy, or paresis, will provide clues of vasculopathy. A relatively accurate assessment of circulatory status may be obtained without the use of exotic instruments. Simple tests such as the elevation and dependency tests, capillary bed return test, venous filling time test, along with blood pressure, pulse, and possibly oscillometry data are valuable in arterial evaluation. Such venous tests as inspection, percussion, Homan's sign, Trendelenburg, and Perthes' tourniquet are useful in the determination of the presence of venous disease. Fortunately, over the past few years tremendous advances have been made in the technology of the vascular laboratory. If symptoms are discovered during the vascular history and physical examination, the complete noninvasive study will provide impressive data to quantitate and specifically establish the diagnosis.
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PMID:The vascular history and physical examination. 173 54

The distribution of four main arterial risk factors (ARF) (diabetes, smoking, hyperlipidaemia (HLP), and hypertension) was investigated in 440 impotent men (mean age 46.8) in whom the penile blood-pressure index (PBPI) (ie, the ratio of the lowest systolic pressure in one of the four main arteries of the penis to the systolic pressure in the arm) was measured. In 222 the cause (organic or functional) of impotence was sought by further investigations, such as cavernosonography. 80% of this subgroup had organic impairment of erection. In 53% of these there was evidence of an arterial lesion. Smoking (64%), diabetes (30%), and HLP (34%) were all significantly more common in the 440 impotent men than in the general male population of a similar age. Whenever two or more ARFs were present mean PBPI was significantly lower. The frequency of organic impotence increased from 49% in the absence of any ARF to 100% in patients with 3 or 4 ARFs. It is concluded that increase in the frequency of impotence with age is mainly related to arteriosclerotic changes for the arteries of the penis and that the ARF and PBPI should be evaluated first in any patient complaining of impotence.
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PMID:Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men. 285 64

Thiazide diuretics have been the 'mainstay' of antihypertensive therapy for three decades. They reduce arterial pressure, initially through a fall in plasma volume and cardiac output. However, in time, output returns towards pretreatment levels, thereby accounting for a long-term fall in pressure through decreased vascular resistance. At present, the precise mechanism for this reduced resistance remains unknown. Although the fall in arterial pressure is not due to direct vasodilation, it is not unlikely that it may operate, in part, indirectly through reduced vascular responsiveness, induced prostacyclins and other mechanisms. Attendant unwanted biochemical effects include hypokalaemia, hyperuricaemia, hyperglycaemia, reduced renal excretory function and hyperlipidaemia. Orthostatic hypotension and, of more recent emphasis, sexual impotence are among the more common side effects. A question has been raised as to whether hyperlipidaemia might explain the failure of some multicentre studies to prevent myocardial infarction or progression of coronary heart disease but this is more a 'non issue' although it must be considered. The present data continue to support the conclusion that diuretics are safe, effective and economical for the treatment of hypertension, and they remain a major cornerstone of initial as well as multipharmacological therapy, particularly in volume-dependent forms of essential hypertension, steroid-dependent hypertensions, renal parenchymal disease and in special patient groups (black, obese and elderly.
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PMID:Diuretics in hypertension. 331 27

An X-linked adult-onset neurogenic muscular atrophy, chiefly proximal, with late involvement of the distal musculature and medulla oblongata was present in 4 members of a single kindred. Associated in all patients were gynecomastia, impotence and essential tremor. Frederickson type IV hyperlipemia was present in 1 patient. Hormonal stimulation tests in 2 patients elicited a borderline low testicular response in the younger of the 2 and a pathological response in the older patient. On the evidence of these and previously reported cases, Kennedy disease would appear to be characterized by an X-linked proximal neurogenic amyotrophy of adult onset and by a testicular endocrine deficit.
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PMID:Kennedy disease in an Italian kindred. 369 69

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

Perycit (Pentaerythriol Tetranicotinate), a slow releasing drug, is one of the drugs used for treating hyperlipemia. Patients with erectile dysfunction (impotence) associated with hyperlipemia increasingly seek help at urological services. This study investigates the clinical effect, both objective and subjective of Perycit on anti-hyperlipemia as well as on impotence. Twenty patients with a more than one year history of impotence with hyperlipemia were enrolled in this randomized, single-blind study. Decrease of total cholesterol, and triglyceride, as well as the increase of high density lipoprotein cholesterol in the study group (Perycit, 500 mg, tid, for 3 months) were significantly different from the pre-treatment period and in the control group (Trental, 100 mg, tid, for 3 months) (p < 0.05 or p < 0.01). Moreover, improvement in sexual function was shown to be better in the study group than in either the pretreatment period and control groups, objectively and subjectively (p < 0.05 or p < 0.01). Tolerable facial flush was found in 3 of these 20 patients, but no major side effects were encountered. In conclusion, this study indicates Perycit is effective for anti-hyperlipemia as well as for aiding improvement of sexual dysfunction. Since it is a slow-releasing preparation, the side effect is minimal. It is recommended for patients with hyperlipemia alone, or those who suffer from combined erectile dysfunction.
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PMID:[The clinical effect of slow releasing nicotinate on hyperlipemic impotent patients]. 825 18

The release of mediator substances of the arachidonic acid cascade is closely related to the functional state of the endothelium. A significant lower prostacyclin/thromboxane A2 ratio in penile plasma of organogenic impotent patients in comparison to patients with psychogenic erectile dysfunction has been described in the literature. We observed the time-related liberation of prostacyclin, thromboxane A2 and the vasoactive peptide endothelin for 16 minutes of a drug-induced erection. We compared kinetics of patients with penile deviation and transsexualism, to patients suffering from severe organogenic impotence. We assessed the usefulness of the prostacyclin-to-thromboxane A2 ratio as a possible indicator of corporal degeneration. An animal model has been created to observe differences between rabbits under 100 days of standard diet alimentation, rabbits under cholesterol enriched diet and rabbits with hereditary hyperlipidemia type II A. Hyperlipidemia is suspected to be one possible factor causing organogenic impotence. Enzyme-immuno-assays were used for the determination of all substances. The systemic prostacyclin-to-thromboxane A2 ratio differed significantly between control rabbits and rabbits with hyperlipidemia. Prostacyclin, thromboxane A2 and endothelin in corpus cavernosum plasma showed a typical profile during spontaneous and drug-induced erection. A significant difference between groups of patients suffering from organogenic or psychogenic impotence could not be found. The value of the determination of the studied substances in differential diagnosis seems to be dubious.
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PMID:Intracavernosal kinetics of eicosanoids and endothelin during erection. Data from human and animal studies on intrapenile and systemic prostaglandins. 834 10

The objective of this study was to assess whether there is an association between impotence and treatment with hypolipidaemic drugs. We asked patients referred to a lipid clinic for primary hyperlipidaemia whether they were complaining of erectile dysfunction. All the patients with a previous cardiovascular history were excluded. The main cardiovascular risk factors and the treatments currently being taken were carefully recorded to analyse their association with erectile dysfunction. The population consisted of two groups (treatment group and control) of 339 age-matched men (mean age: 48 +/- 9.5 years). Our results revealed that there were more impotent men in the group of patients treated with hypolipidaemic drugs (12% vs. 5.6%, P = 0.0029). Multivariate analysis showed that erectile dysfunction was dependent on treatment with fibrate derivatives (odds ratio: 1.46; 1.27-1.68) and statins (odds ratio: 1.51; 1.26-1.80). We conclude that erectile dysfunction is a frequent disorder in hyperlipidaemic men. Our results suggest that this symptom could be a side-effect of hypolipidaemic drugs. If further studies confirm our data, the search for the mechanism and the consequences of this possible side-effect will be useful and important.
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PMID:Men treated with hypolipidaemic drugs complain more frequently of erectile dysfunction. 880 45

Erectile dysfunction (ED, formerly referred to as impotence, is a common (especially in diabetic and older men) and distressing condition. Several risk factors have been identified; among these are smoking, hyperlipidaemia, hypertension and diabetes mellitus. These risk factors are shared with atherosclerotic vascular disease (e.g. ischaemic heart disease). This observation underlies a common vascular pathology. Smoking may cause ED by several mechanisms, including adversely affecting intrapenile blood flow. It is important to be aware of the link between smoking and ED since this information may motivate some male smokers to quit. In this context, it is important to be aware of the link between smoking and ED since this information may motivate smokers to quit. In this context, it is relevant that there is evidence that quitting may restore/improve erectile function.
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PMID:Cigarette smoking and erectile dysfunction. 1007 52


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