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

During the last three decades studies on the pathogenesis of atheroma have highlighted successively lipids, lipoproteins and apolipoproteins. The undisputed role of cholesterol has been widened by taking into account the nature and composition of lipoproteins in addition to their plasma levels. The concept of relative atherogenicity of lipoproteins and a better understanding of the role played by apolipoproteins have thrown more light on the formation of atheromatous plaques in the absence of hyperlipidaemia. On this point must be mentioned studies that associate LDL apo-B with coronary risk, and apo-A1 abnormalities which predispose to atheromatosis. More recently, attention has been focused on apo-E as a genetic factor that may interact with the environment to modulate blood cholesterol and triglyceride levels and secondarily influence individual tendencies to develop atherosclerosis. The three major forms of apo-E (E2, E3, E4) are encoded by three alleles (E2, E3, E4) and act on the same locus of chromosome 19 to determine 6 apo-E phenotypes in the population. We now know that the E2 allele is associated with lower levels, and the E4 allele with higher levels, of LDL-cholesterol than the E3 allele. E4 is a risk factor which predisposes to coronary atherosclerosis. It follows that the E2 allele should have protective powers, provided no other factor, ecological or hereditary, intervenes to foster the development of an atherogenic hypertriglyceridaemia.
Arch Mal Coeur Vaiss 1987 Apr
PMID:[The predictive value of apolipoproteins in atheroma]. 311 95

Atherogenic hyperlipidemias are the commonest types of primary hyperlipidemia and include pure hypercholesterolemia, endogenous hypertriglyceridemia and mixed hyperlipidemia. They affect almost 4% of the population.
J Mal Vasc 1988
PMID:[Detection and treatment of of atherogenic hyperlipidemias]. 319 38

The results of a consecutive series of 24 patients reoperated for coronary bypass grafting between May 1977 and February 1983 are reported. The overall incidence of reoperation was 1.4 p. 100 (24 out of 1 716 cases); the incidence is tending to increase (2.3 p. 100 in 1982). Preoperative assessment revealed the persistence of cardiovascular risk factors: 75 p. 100 of patients had continued to smoke; 61 p. 100 had persistent hyperlipidaemia. The usual presenting syndrome was recurrence of chest pain (21 out of 24 cases) leading to control coronary arteriography on the results of which the surgical indication was based. The average time between the two operations was 38.7 months. The patients were classified into two groups; early reoperation (6 cases) for a technical problem or incomplete revascularisation, and late reoperation (8 cases) for disease of the graft and atherosclerosis. Progression of coronary atherosclerosis was the major long-term cause of occlusion of the saphenous graft (10-14 cases). The arteries most commonly bypassed at reoperation were the left anterior descending and right coronary arteries (12 times each). Reoperation comprised single bypass (13 cases), double bypass (10 cases) and triple bypass (1 case) with an average of 1.5 grafts per patient. The most commonly used vein was the internal saphenous vein (32 out of 36 grafts). Myocardial protection was insured by cardioplegia (13 cases) and intermittent clamping (10 cases) after cooling (general hypothermia at 22 degrees C). Global reoperative mortality (4 p. 100) was higher than for elective primary coronary surgery (2.3 p. 100). The incidence of perioperative infarction was 8 p. 100.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1985 Jan
PMID:[Reoperation after saphenous aortocoronary bypass]. 391 77

Two young women on oral contraceptives for 4 and 6 years respectively died of severe myocardial infarction and shock. Autopsy discovered in both patients multiple thromboses in the coronary, intracardiac, and in the collateral aortic circulation. Since smoking, hyperlipidemia, hypertension and coronary atherosclerosis were not risk factors, oral contraception seems to have been the only cause for both thrombotic accidents.
Arch Mal Coeur Vaiss 1980 Apr
PMID:[Oral contraceptive and coronary thrombosis. Two clinicopathological cases]. 677 45

The follow-up (3 to 20 years, mean = 8,9 yrs) of 145 patients with intermittent claudication showed the high incidence of tobacco use (86%) hyperlipidemia (43%) elevated blood pressure (45%) and glucose intolerance (30%), two or more of these factors were present in 66% of cases. A statistically significant higher rate of fairly reduced risk factors was noted in 57 patients improved functionally (based on the maximal walking distance on treadmill and arm/ankle systolic pressure ratio) versus 45 functionally impaired patients, and in 55 patients free of CHD, compared with 54 patients with coronary events (p 0.001). A group of 26 patients with cerebro-vascular insufficiency exhibited a higher incidence of non reduced hypertensive cases.
J Mal Vasc 1980
PMID:[Long term follow up of patients with intermittent claudication and correlated with the management of risk factors (author's transl)]. 678 60

Aseptic osteonecrosis is observed in 25% of cases after renal transplantation. This etiological variety of osteonecrosis is unusual in that it is frequently bilateral and has multiple localisations. Apart from the classical radiological signs, attention in attracted by isolated images of osteocondensation in the metaphyses and/or the diaphyses suggesting massive bony infarction and the appearances of fatigue fractures observed frequently (14%). In 43% of cases, the obvious necrosis was proceeded by early bone pain, around the 7 th day, during massive administration of corticosteroids in the prevention or cure of graft resection. This finding suggested to us that the best time to observe ischemia of the bone or marrow is very early and led us to undertake an experimental study in the rabbit. Two series of New Zealand White rabbits were treated with massive doses of corticosteroid and sacrificed between the 3rd and the 21st day. The treated animals presented an early peak of hyperlipemia from the 7th day onwards, and diffuse lesions of hepatic and renal steatosis. Fat emboli associated with appearances of parietal thrombosis were observed in most cases. In the same animals, there were also appearances of stage I or stage II necrosis. Referring to the description of bone marrow necrosis in stages by Arlet and Ficat, there was observed in all the series, a frequency of marrow lesions of all stages much higher in treated animals (16 out of 20) than in controls. Only one lesion of stage I was observed in controls; the difference was highly significant. (0,000001 < p < 0,00001). If one only considers necroses of stage II and III (10/20 in the treated group nil in controls) the frequency was still significant p < 0.001. The preliminary results of the fixation of tetracycline are reported.
Rev Rhum Mal Osteoartic 1980 Dec
PMID:[Cortisone-induced osteonecrosis: knowledge acquired from observations in man and comparison with the results of animal experimentation]. 700 46

Between 1977 and 1990, 64 premenopausal women, under 50 years of age (42 +/- 5.6 years), were admitted for typical acute myocardial infarction with pathological Q waves. Twenty one patients had attempted myocardial revascularisation either by intravenous thrombolysis or primary angioplasty (n = 3). All patients underwent coronary angiography with selective left ventriculography during their hospital admission. This group of 64 women was characterised by the association of coronary risk factors (2.8 per patient): smoking (89%), hyperlipidaemia (67%), diabetes (45%) and oral contraception (35%). Coronary angiography showed single vessel occlusion in 86% of patients receiving oral contraception, multiple vessel disease in 36.5% and single or double vessel disease in 31.7% of the other patients. There were 3 deaths during the hospital period (4.6%), 12 cases of left ventricular failure, 2 ventricular aneurysms, 2 operated ischaemic mitral regurgitations and 9 recurrences of pain treated by angioplasty. During follow-up (36.5 +/- 4 months), 22 patients were readmitted to hospital and there were 3 further deaths, 12 cases of persistent cardiac failure, 10 cases of latent ventricular dysfunction and 9 ischaemic reoccurrences treated by angioplasty or surgery. The results in this group of patients suffering from myocardial infarction at an unusually early age for women showed that although the mortality was similar to that observed in men of the same age (9%) there was a very high morbidity and a high risk of cardiac failure. The prognosis of myocardial infarction in women, though better than 10 years ago, should improve with immediate revascularisation, the correction of cardiovascular risk factors and the rapid application of all techniques of modern cardiology.
Arch Mal Coeur Vaiss 1995 Jun
PMID:[Myocardial infarction in non-menopausal women. Coronary lesions and prognosis]. 764 94

The concepts of acceleration of atherosclerosis with fat rich diets and the regression or at least stabilisation of atherosclerosis by suppressing the cholesterol, introducing exercise programmes or administering calcium antagonists or aspirin, have been validated in the animal model. In the clinical situation, repeat coronary angiography has demonstrated that hyperlipidemia and the interval between two investigations are the main factors influencing the progression of atherosclerosis. However, the factors underlying the appearance and progression of atheromatous plaques remain unknown. Interventional trials based on the principle of introducing treatment after reference angiography have been undertaken. The results were assessed after variable time intervals. The general conclusion is that there is a direct relationship between the lowering of plasma cholesterol, the intensity of exercise and the slowing of progression of atherosclerosis as far as can be evaluated by repeat angiography. The data concerning the effect of calcium antagonists is confusing. The main criticism of these trials is the instrument of measurement and the practical significance or even the reality of the observed changes. In the present state of our knowledge, trials of the regression of atherosclerosis can not replace longitudinal studies of the long-term effects of drugs on cardiovascular and general morbidity and mortality.
Arch Mal Coeur Vaiss 1993 Jan
PMID:[Regression of coronary atherosclerosis evaluated by angiography. A review of principal trials and critical study]. 821 78

Within certain limits, it is not possible to screen for asymptomatic early atherosclerotic lesions with the aim of prevention. The effectiveness of different screening tests varies. A vascular murmur has little predictive value. Coronary or aorto-iliofemoral calcifications sometimes occur early. ECG or exertion thallium scan and low distal pressure at rest or during exercise can provide indirect clues as can continuous Doppler or the carotids or peripheral vessels. Pulsed Doppler and color-Doppler are the best screening tools for detecting wall thickening or a silent plaque. Arteriography is essential for patients with coronary artery disease and is often required for carotid or abdominal vessels, but is unfortunately an invasive method and underestimates lesions which do not give a defect image. Angioscopy and endoechography are difficult to manipulate and interpret and cannot be used in routine screening. No biological or genetic markers have been identified as formal indicators of atherosclerosis. Screening is justified in young patients at risk (high blood pressure, intensive smoking, major hyperlipidemia, diabetes, severe family history) because early lesions would lead to a more adapted treatment which can be expected to stabilize or even improve early lesions, or even reduce the risk of plaque rupture. In addition, carotid or iliofemoral lesions increase the risk of coronary artery disease.
J Mal Vasc 1996
PMID:[Early detection of atherosclerosis]. 875 91

Hyperlipidemia is a widely acknowledged side effect of thiazide diuretic therapy, but it is often dismissed as a short-term effect of high-dose therapy. Large clinical trials usually show no lipid change during late follow-up. These large trials use intention-to-treat analysis which masks the lipid effect. On-treatment analysis regularly reveals the persistence of hyperlipidemia during 4-5 years of treatment. Studies of low-dose thiazide therapy give conflicting results. Meta-analysis of these studies reveals hyperlipidemia of a milder degree than with high-dose thiazide treatment. However, a trade-off of effects is apparent because systolic blood pressure is lowered less well with low doses. Thus, thiazide effects on blood pressure and lipids are dose-dependent. Similar meta-analysis of indapamide 2.5 mg daily shows no adverse lipid effect and a lowering of blood pressure equivalent to 50 mg of hydrochlorothiazide. Regarding clinical events, low-dose thiazide treatment exerts primary prevention of coronary heart disease but provides less benefit against stroke and congestive heart failure than does high-dose therapy. Thus, an evidence-based therapeutic strategy for further reducing cardiovascular risk is as follows: initiate antihypertensive therapy with low-dose diuretics. Add beta-blockers and dihydropyridine-type calcium channel blockers for further antihypertensive effect, if needed. Hypertension resistant to a 3-drug regimen should be treated with high-dose thiazides. Lipids should be monitored at each step and treated with diet and statin drugs to maintain lipid goals. Risk factor control is an old concept that has yet to be effectively implemented.
Arch Mal Coeur Vaiss 1998 Sep
PMID:Hyperlipidemia of diuretic therapy. 980 66


<< Previous 1 2 3 4 Next >>