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

From January 1, 1974, to January 1, 1976, 15 premenopausal women aged 35-48 years were treated for complaints of intermittent claudication. The pain generally occurred in the calves, and none felt pain at rest. All the patients used an oral contraceptive composed of a progestative and an estrogenic component, with average duration of use of 7 years. All the women were of small stature with normal weight. A systolic souffle could be heard above the bifurcation of the aorta. In all patients an angiographic examination revealed local obstruction in the distal aorta, a gracile vascular system, and the absence of defects of the arteries outside the distal part of the aorta. No defects were found in other vessels, and there were no indications that hypertension, excessive smoking, hypercholesterolemia, or hyperlipidemia played a role in the cases. Local end-artereictomy of the distal aorta via a median laparotomy was the treatment. The part of the aorta wall that was removed showed signs of arterioschlerosis obliterans. There were no complaints of symptoms during the follow-up which ranged from 3 months to 2 years. A correlation is suggested between the defects of the distal aorta and prolonged use of oral contraceptives.
J Cardiovasc Surg (Torino)
PMID:Intermittent claudication in premenopausal women. A correlation with the long-term use of oral contraceptives? 86 65

Mild-to-moderate essential hypertension is the most common medical problem seen by physicians in Western populations, and pharmacologic antihypertensive therapy is now usually undertaken. Clinical trials have shown that lowering of elevated blood pressure using diuretics and beta-blockers reduces cardiovascular morbidity and mortality. Despite these benefits, the trials have provided no convincing evidence that the incidence of coronary artery disease or its complications is reduced: Treated hypertensive patients remain at increased cardiovascular risk compared with untreated normotensive subjects. Possible explanations for this disappointing outcome are that the drugs used may themselves have negative effects on serum lipids, glucose, and insulin resistance, thereby outweighing their antihypertensive benefits. An equally important role in this respect may be played by the diseases and therapies most commonly found in association with mild-to-moderate hypertension: hyperlipidemia, type II diabetes, coronary artery disease, left ventricular hypertrophy, cardiac arrhythmias, peripheral arterial disease, and nephropathy. Such conditions may be potent determinants of what constitutes the optimal first-line choice of antihypertensive therapy. Furthermore, the negative effects that antihypertensive drugs can have on quality-of-life factors may result in noncompliance and ineffective long-term treatment. Therefore, in a new therapeutic approach to the treatment of high blood pressure, it would be logical to base antihypertensive therapy on strategies that not only lower the blood pressure but that have beneficial impacts on hemodynamics, vascular and cardiac structure, metabolism, and quality-of-life issues.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol 1992
PMID:Antihypertensive therapy: new strategies beyond blood pressure control. 128 82

The past decade has seen a shift in the strategy for hypertension treatment from stepped therapy--a highly structured monolithic series of steps--to recommendations for a more individualized selection of treatment. Severe hypertension is a clear indicator to bypass traditional steps. Demographic factors, such as age, gender, and race, are often cited, but have proved to be less helpful. Concomitant medical conditions and problems are very common and are more often the crucial determinants in the selection of antihypertensive therapy. Coronary artery disease, diabetes mellitus, heart failure, azotemia, asthma, and chronic obstructive pulmonary artery disease, anxiety, and depression are all common, and each has implications for the selection of antihypertensive therapy. Blood pressure reduction is a surrogate for reduction of cardiovascular risk, and therefore, consideration of concomitant medical problems has extended to left ventricular hypertrophy, obesity, mild hyperlipidemia, and insulin resistance, as additional risk factors in hypertension. Consideration of all these factors makes it possible to individualize antihypertensive therapy in most patients today.
J Cardiovasc Pharmacol 1992
PMID:Treatment of hypertension: the place of angiotensin-converting enzyme inhibitors in the nineties. 128 28

Hypercholesterolemia is seen as an important risk factor for coronary artery disease (CAD), as the incidence of CAD is strongly correlated with the level of serum cholesterol in epidemiological studies. However, hypercoagulability and reduced fibrinolytic capacity, often seen in survivors of myocardial infarction, are associated with hypertriglyceridemia (possibly concomitant with low levels of high-density lipoprotein cholesterol) and not with increased levels of total or low-density lipoprotein cholesterol. The important role of thrombogenesis in CAD is supported by the fact that initial high levels of plasma fibrinogen, coagulation factor VII (VIIc), and plasminogen activator inhibitor (PAI-1) are all independent risk factors for CAD or recurrent myocardial infarction as found in multivariate analyses of epidemiological studies. Furthermore, high plasma levels of VIIc and PAI-1 are associated with hypertriglyceridemia, reduced glucose tolerance, overweight, and hyperinsulinemia. The contribution of thrombogenic risk factors to the metabolic cardiovascular syndrome (MCVS) is thus established. Diet intervention is preferable for the normalization of hypercoagulability and hypofibrinolysis associated with MCVS. In familial combined hyperlipidemia, however, and especially with concomitant thromboembolic disease, diet alone is often not sufficient, and drug treatment with anticoagulants and/or lipid-lowering drugs may be necessary.
J Cardiovasc Pharmacol 1992
PMID:Hypercoagulability and reduced fibrinolysis in hyperlipidemia: relationship to the metabolic cardiovascular syndrome. 128 67

The incidence of perioperative complications after coronary artery surgery was investigated by a retrospective study of all 502 patients undergoing coronary artery bypass graft (CABG) surgery in our Department between January 1st and December 31st of last year (1990). Furthermore, the influence of obesity on the early results of surgery was assessed and the effect of preoperative weight reduction on perioperative complication rates examined. Obese patients had a greater incidence of left-stem coronary artery stenosis (p less than 0.001), hyperlipidaemia (p less than 0.05), hypertension (p less than 0.05), diabetes mellitus (p less than 0.02), and were in general younger at the time of operation (57.9 +/- 8.4 vs. 60.8 +/- 8.5 years). There were no differences in the surgery performed and in operative mortality, but there were some in perioperative morbidity. Obese patients had higher rates of infection (p less than 0.02), sternal dehiscence (p less than 0.02), arrhythmias (p less than 0.02) and myocardial infarction (p less than 0.02). No significant differences were identified in obese patients with or without preoperative weight reduction, although there was a trend of better postoperative recovery and results in patients having undergone preoperative weight reduction. Analysis of our results demonstrated obesity to be an independent risk factor for perioperative complications, hospital morbidity, and length of hospitalization.
Thorac Cardiovasc Surg 1992 Jun
PMID:The influence of obesity on perioperative morbidity: retrospective study of 502 aortocoronary bypass operations. 141 77

Patients presenting with symptoms suggestive of amaurosis fugax, or with findings of Hollenhorst plaques on fundoscopy are frequently referred for duplex evaluation to detect possible carotid artery disease. To better determine the reliability of monocular visual loss and the presence of Hollenhorst plaques for predicting the presence or significance of carotid artery stenosis, we prospectively studied 66 patients with these ocular signs and symptoms. After evaluation, the patients were categorized as follows: 34 of 66 (52%) patients had amaurosis fugax, 23 (35%) had asymptomatic Hollenhorst plaques, 7 (11%) had retinal artery occlusion, and 2 (3%) had venous stasis retinopathy. All patients were evaluated ophthalmologically, with carotid duplex scanning and spectral analysis. A stenosis of greater than 60% was regarded as significant. The presence of risk factors including hypertension, diabetes, a history of CVA or TIA's, tobacco use and hyperlipidemia was recorded. There were no statistically significant differences (p greater than 0.05) in the incidence of atherosclerotic risk factors between the four groups. Patients with amaurosis fugax were more likely to have a significant carotid artery stenosis than those with asymptomatic Hollenhorst plaques or retinal artery occlusion (53% vs 9% vs 0% respectively) (p less than 0.006). We conclude that routine carotid duplex scanning is indicated in all patients with amaurosis fugax in view of the frequent association with significant carotid stenosis (53%). However, the presence of Hollenhorst plaques in the absence of visual symptoms appears not to have a significant association with carotid disease and may not necessarily require routine screening unless other risk factors for carotid stenosis are present.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Surg (Torino)
PMID:Correlation of ophthalmic findings with carotid artery stenosis. 152 43

This article discusses a recent study in which current total cholesterol values of 295 adults were compared to baseline (childhood) values obtained 16 years earlier when subjects participated in a school health screening and intervention program. Results demonstrated that adult total cholesterol values were significantly related to childhood values. Findings do not support limiting pediatric cholesterol testing to children with positive familial histories of either hyperlipidemia or early manifestations of coronary artery disease. Current recommendations regarding pediatric cholesterol testing may soon require reevaluation.
J Cardiovasc Nurs 1992 Apr
PMID:Pediatric cholesterol testing. 155 89

To study the results of bypass surgery in young adults, 221 patients undergoing myocardial revascularisation aged 40 or less (1979-1989) were reviewed. The study included 200 men and 21 women. Mean age was 36.2 years. Risk factors were essentially cigarette smoking (69.6%) and hyperlipidaemia (52%). One-hundred and eighteen patients (53.4%) had a history of previous myocardial infarction (MI) and 16 were operated on after an episode of preinfarction angina. One-hundred and twenty-nine patients had three-vessel disease, 59 had double-vessel disease and 33 single-vessel disease. Twenty-three had left main stem coronary artery lesions. Four-hundred and forty-six saphenous vein grafts and 79 internal mammary artery grafts were performed, an average of 2.3 grafts per patient. Operative mortality was 2.7% (6 patients). Deaths were caused in 4 cases by MI. Twelve patients (5.5%) had a non fatal perioperative MI. One-hundred and ninety-nine patients were followed up for a mean of 7.4 years (4838 patients-years). Seventeen late deaths occurred. Six were from cardiac causes. Overall survival was 84% at 9 years. Five patients underwent cardiac reoperation at a mean interval of 6.4 years after the primary procedure. Eighty-five% of patients were free of angina and 11.5% were in an improved condition. In conclusion, coronary revascularisation can be performed at a reduced risk in younger patients. Long-term prognosis seems similar to that of the overall group of patients undergoing bypass surgery.
J Cardiovasc Surg (Torino)
PMID:Results of coronary artery surgery in young adults. 160 9

Many lipoprotein abnormalities are seen in the untreated, hyperglycemic diabetic patient. The non-insulin-dependent diabetic (NIDDM) patient with mild fasting hyperglycemia commonly has mild hypertriglyceridemia due to overproduction of TG-rich lipoproteins in the liver, associated with decreased high-density lipoprotein (HDL) cholesterol levels. The more hyperglycemic untreated NIDDM and insulin-dependent diabetic (IDDM) patient have mild to moderate hypertriglyceridemia due to decreased adipose tissue and muscle lipoprotein lipase, (LPL) activity. These patients also have decreased HDL cholesterol levels associated with defective LPL catabolism of TG-rich lipoproteins. Treatment of diabetes with oral sulfonylureas or insulin corrects most of the hypertriglyceridemia and some of the decrease in HDL cholesterol. The abnormality in adipose tissue LPL activity corrects slowly over several months of therapy. The treated IDDM patient often has normal lipoprotein levels. The treated NIDDM patient may continue to have mild hypertriglyceridemia, increased intermediate-density lipoprotein levels, small dense low-density lipoproteins (LDL) with increased apoprotein B, and decreased HDL cholesterol levels. The central, abdominal distribution of adipose tissue in IDDM is associated with insulin resistance, hypertension, and the above lipoprotein abnormalities. Improvement in glucose control, in the absence of weight gain, leads to lower triglyceride and higher HDL cholesterol levels. In addition, the diabetic patient is prone to develop other defects that, in themselves, lead to hyperlipidemia, such as proteinuria, hypothyroidism, and hypertension, treated with thiazide diuretics and beta-adrenergic-blocking agents. When a diabetic patient independently inherits a common familial form of hypertriglyceridemia, he might develop the severe hypertriglyceridemia of the chylomicronemia syndrome.
J Cardiovasc Pharmacol 1990
PMID:Pathophysiology of hyperlipidemia in diabetes mellitus. 171 Jul 39

The effects of a sustained-release preparation of bezafibrate (Bezalip Mono) 400 mg once daily and placebo administered for 3 months were compared in 36 patients with stable type 1 diabetes and hypercholesterolemia and/or hypertriglyceridemia. There was a significant decrease in fasting glucose levels with bezafibrate, but not in glycosylated hemoglobin. The serum cholesterol concentration decreased on bezafibrate [from 7.1 +/- 0.2 (mean +/- SEM) to 6.3 +/- 0.3 mmol/L; p less than 0.05] predominantly due to a reduction in low-density lipoprotein (LDL) cholesterol [from 4.8 +/- 0.3 to 4.2 +/- 0.3 mmol/L; p less than 0.05. There was also a decrease in fasting serum triglycerides with bezafibrate [1.82 to 1.26 mmol/L (geometric mean)] and in very-low-density lipoprotein (VLDL) cholesterol. Plasma fibrinogen decreased significantly with bezafibrate (from 4.1 +/- 0.2 to 2.9 +/- 0.2 g/L; p less than 0.001). Serum apolipoproteins B and A showed no statistically significant changes. Overall, there was no change in high-density lipoprotein (HDL). However, in patients who were initially hypertriglyceridemic, there was a significant increase in the cholesterol content of total HDL and the HDL2 subfraction (both p less than 0.05). It is concluded that in insulin-dependent diabetic patients with hyperlipidemia, bezafibrate is effective in lowering both serum VLDL and LDL. In addition, it has a potentially important action in decreasing plasma fibrinogen levels.
J Cardiovasc Pharmacol 1990
PMID:Bezafibrate retard in patients with insulin-dependent diabetes: effect on serum lipoproteins, fibrinogen, and glycemic control. 171 Jul 43


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