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)

Diuretics have been used to treat hypertension since 1958. The doses used were relatively high. Dose-dependent side effects and the increasing availability of other drugs such as beta- and alpha-blockers, calcium-entry blockers, and angiotensin-converting enzyme (ACE) inhibitors, with equal antihypertensive efficacy but additional effects in cardiovascular diseases, led to a decrease in diuretic use. In controlled trials, little or no protection against coronary artery disease (CAD) was discussed as being due to the diuretics' side effects. The main side effects are hypokalemia, hyperglycemia, and hyperlipidemia. Hypokalemia occurs most often (up to 30%) in thiazide-treated hypertensive patients, and may cause arrhythmias in patients with CAD. This side effect is clearly dose-dependent and may be avoided by comedication with antikaliuretics. Glucose intolerance may develop in about 3% of diuretic-treated men and is reversible after discontinuation of the diuretic. This side effect is functionally correlated with hypokalemia and therefore is not seen when patients are given a comedication (for example, spironolactone prevents hypokalemia). Hypercholesterolemia was first reported in 1964 during long-term diuretic treatment. During the first 12 weeks of treatment, low-density lipoprotein (LDL) cholesterol increased 5-15% in men and postmenopausal women. After 1 year of therapy, the levels decreased to pretreatment values. However, in placebo-controlled trials, the placebo groups exhibited cholesterol levels falling below the diuretic group. Although the mechanisms and the clinical implications of these side effects are not completely understood, the perception grew that diuretics per se may have been at least partially responsible for the lack of protection against CAD.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol 1993
PMID:The role of low-dose diuretics in essential hypertension. 750 54

Endothelin-1 (ET-1) is a potent vasoconstrictor whose serum concentration increases with the development of atherosclerosis. Coronary artery-vein bypass grafts are susceptible to vasospasm and to the development of accelerated atherosclerosis. Although ET-1 is thought to play a role in coronary vasospasm, the effect of ET-1 in atherosclerotic vein grafts is unknown. The responses of veins, arteries, and vein bypass grafts from normolipidemic and hyperlipidemic animals to ET-1 were therefore investigated. Vein bypass grafts were placed in the carotid position of 12 New Zealand White rabbits. Seven were fed a 1% cholesterol diet for 4 weeks before surgery and thereafter until harvest (hyperlipidemia), and five were fed a normal diet (normolipidemia). Vein grafts, contralateral common carotid arteries, and jugular veins were harvested 4 weeks after surgery. Whereas there were no histologic changes in veins or carotids, normolipidemic vein grafts developed intimal hyperplasia and hyperlipidemic vein grafts developed atherosclerosis. Isometric tension studies with ET-1 (10(-12) to 10(-6) M) showed that hyperlipidemia increased the maximal tension generated to ET-1 in the veins (660 +/- 80 to 1,110 +/- 140 mg, mean +/- SEM; p < 0.05), carotids (150 +/- 30 mg to 540 +/- 120 mg; p < 0.05), and vein grafts (180 +/- 20 to 450 +/- 60 mg; p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol 1993
PMID:Endothelin and vein bypass grafts in experimental atherosclerosis. 750 84

The effect of the angiotensin-converting enzyme (ACE)-inhibitor perindopril on serum lipids and apolipoprotein concentrations were assessed in a multicenter, randomized, double-blind, placebo-controlled study in 51 hyperlipidemic patients treated for mild hypertension. Perindopril was given as a single morning dose (4 mg) for 6 weeks. During the treatment period, blood pressure (BP) was significantly (p < 0.001) reduced from 159/99 to 148/90 mm Hg by verum treatment and from 158/101 to 151/95 mm Hg (NS) by placebo treatment. Neither total cholesterol and triglycerides nor high-density-lipoprotein and apolipoprotein AI and B levels were significantly altered by drug treatment as compared with placebo. Although perindopril had good antihypertensive effect in patients with mild hypertension and hyperlipidemia, it had no adverse effects on lipid metabolism in these patients. Therefore, perindopril is recommended for antihypertensive treatment, especially in hypertensive patients with concomitant hyperlipidemia.
J Cardiovasc Pharmacol 1994 Apr
PMID:Effects of perindopril on serum lipids in hypertensive patients with hyperlipidemia. 751 14

We investigated serum and aortic tissue lipid content, in vitro aortic response to drugs, and morphology of thoracic aorta in Pittsburgh Yoshida rats (YOS), a new animal model of endogenous hyperlipidemia. Experiments were performed on 2-, 6-, and 18-month-old rats. Normolipidemic Brown Norway rats (BN) were used as controls. Both serum cholesterol and triglycerides increased significantly with age in YOS rats, but remained constantly low in the control group. In YOS rats, absolute serum concentration of high density lipoprotein (HDL)-cholesterol increased significantly with age, although HDL-cholesterol/total-cholesterol ratio decreased. In contrast, no difference in cholesterol content in aortic tissue was detected between the two animal strains or among different age groups. The contractile force generation of thoracic aorta to norepinephrine (NE) and serotonin increased with age in both strains of animals. The endothelium-dependent relaxation induced by acetylcholine (ACh) was significantly reduced in 6- and 18-month-old YOS as compared with 2-month-old YOS but not in BN. ATP-induced relaxation was significantly impaired in YOS thoracic aorta. In contrast, the relaxation induced by NaNO2 acting in smooth muscle did not vary with age in either YOS or BN. Only alterations in endothelial cells, not typical atheromatous injuries in thoracic aorta wall were detected in YOS even at age 18 months. Our data indicate that despite high serum lipid levels, YOS do not develop typical atheromatous lesions or functional and morphologic damage of smooth muscle cells in thoracic aorta, whereas YOS show decreased endothelium-dependent relaxation and morphologic alteration of endothelial cells.
J Cardiovasc Pharmacol 1994 Aug
PMID:Functional and morphologic characterization of thoracic aorta in heritable hyperlipidemic Yoshida rats of different ages. 752 53

Fourty-seven patients with a least one heart valve operation each who underwent reoperations (Gr. I) were analyzed with special regard to risk factors influencing the perioperative mortality and compared to 203 patients operated for the first time (Gr. II) during the same time period. Mean age was 57.1 years in Gr. I and 64.1 years in Gr. II (p < 0.05). There were no differences between the groups with regard to sex, smoking, obesity, or concomitant peripheral vascular disease. Hypertension, hyperlipidemia, and diabetes were more frequently seen in Gr. I, p < 0.05. A significantly higher number of patients in the redo group (Gr. I) belonged preoperatively to NYHA class III or IV, p < 0.001 and needed emergency surgery more often, p < 0.01, but left-ventricular function did not differ between the groups. There was no significant difference in the position of valves operated or the number of multiple valve replacements/repairs between the groups, and no difference in aortic cross-clamping or cardiopulmonary bypass time. Most patients were referred from other hospitals. Overall perioperative mortality for Gr. I was 6.4% and Gr. II 4.4% (n.s.). Mortality after first reoperation was 5.0%, after second or more 14.3%. Perioperative mortality was related to age, preoperative NYHA class, and urgency of operation in both groups, and to multiple valve replacement/repair in Gr. I. Elective reoperation carried a mortality of 4.8% but emergency reoperation 20%; reoperation mortality was 2.6% for single valves and 25% for multiple valves.(ABSTRACT TRUNCATED AT 250 WORDS)
Thorac Cardiovasc Surg 1994 Dec
PMID:Valve reoperations--identification of risk factors and comparison with first-time operations. 753 50

We studied the effects of 6-week treatment with nifedipine (35 mg/kg/day orally, p.o.) on streptozotocin (STZ)-induced diabetic rats. Injection of STZ [45 mg/kg intravenously, (i.v.) single dose] produced a significant increase in blood pressure (BP), bradycardia, hyperglycemia, hypoinsulinemia, hyperlipidemia, hypothyroidism, depression in left ventricular developed pressure (LVDP), cardiomyopathy, and nephropathy. Treatment of diabetic rats with nifedipine normalized the BP and prevented bradycardia. Insulin levels were decreased after nifedipine treatment in diabetic as well as nondiabetic rats. However, serum glucose levels were also partially decreased in diabetic animals by nifedipine treatment. In control animals as well, glucose levels were in the normal range despite lower insulin levels observed after nifedipine treatment. Nifedipine treatment significantly prevented STZ-induced increase in cholesterol and triglyceride levels. Nifedipine treatment significantly prevented STZ-induced hypothyroidism and also prevented STZ-induced cardiac depression and cardiomyopathy. Our data indicate that nifedipine increases insulin sensitivity and has some beneficial effects on cardiovascular parameters. It may therefore be considered a preferred drug in the treatment of hypertension associated with diabetes mellitus.
J Cardiovasc Pharmacol 1995 Jul
PMID:Effects of chronic nifedipine treatment on streptozotocin-induced diabetic rats. 756 66

With the improvement of survival rates following cardiac transplantation, the probability of recipients developing extracardiac disease is increased. Three cases are reported of abdominal aortic aneurysm successfully operated on in cardiac allograft recipients 1 to 4 years after transplantation. Indications for transplantation were valvular, idiopathic and ischaemic cardiomyopathy. Post-transplant hypertension and hyperlipidaemia may have played a role in the rapid growth of the aneurysms. Cardiac function and the incidence of graft atherosclerosis were assessed before surgery by coronary angiography. All three patients were discharged from hospital. Abdominal aortic aneurysm resection may be a safe procedure in cardiac transplant patients. In view of the rapid increase in the size of the aneurysms in transplanted patients, careful screening should be performed during follow-up.
Cardiovasc Surg 1995 Jun
PMID:Successful abdominal aortic aneurysm resection in long-term survivors of cardiac transplantation. 765 49

Hypertension is a major contributor to cardiovascular disease, which imparts a threefold increased risk over that of normotensive persons the same age. It accelerates atherogenesis-promoting premature coronary disease, now its most common sequela. The effect of elevated blood pressure on cardiovascular disease morbidity and mortality in general and on coronary disease incidence in particular is independent of the influence of other predisposing atherogenic cofactors but is greatly affected by them. Elevated blood pressure is more often than usual associated with hyperlipidemia, hyperglycemia, hyperuricemia, excessive weight, elevated fibrinogen, and electrocardiogram (ECG) abnormalities, which enhance its impact. Hypertensive coronary candidates usually have an increased low-density lipoprotein/high-density lipoprotein (LDL/HDL) cholesterol ratio, impaired glucose tolerance. ECG abnormalities, or a cigarette smoking habit. These coexisting risk factors exert a greater influence than the character of the blood pressure elevation. Those at risk for hypertensive stroke have left ventricular hypertrophy (LVH), atrial fibrillation, cardiac failure, coronary disease, diabetes, or a cigarette habit. Cardiovascular risk ratios for hypertension diminish with advancing age, but this is offset by a higher absolute risk, making hypertension an important precursor of cardiovascular disease in the elderly.
J Cardiovasc Pharmacol 1993
PMID:Hypertension as a risk factor for cardiac events--epidemiologic results of long-term studies. 769 48

Although myocardial ischemia causes angina pectoris, angina and the severity of coronary artery stenosis in individuals do not correlate. However, changes in anginal status over time correlated with changes in the severity of coronary artery stenosis as determined by repeated coronary arteriograms has not been previously studied. Coronary arteriograms, done both at entry into the Program on the Surgical Control of the Hyperlipidemias (POSCH) and 3 years later, were blindly graded for changes in overall severity of coronary artery stenosis according to protocol by the POSCH Arteriography Review Committee. Arteriographic and clinical data from 376 control subjects (347 men, 29 women) were analyzed. There was no statistically significant relation over a long-term (3 year) period between the absence, presence, development, or disappearance of angina pectoris and changes in coronary artery stenosis severity as determined by coronary arteriography.
Cathet Cardiovasc Diagn 1994 Aug
PMID:Relation between changes in severity of coronary artery stenosis and anginal patterns. 798 12

The incidence of renal artery stenosis (RAS) in patients with coronary artery disease (CAD) has not been well documented. Over a 9-month period, 196 patients who underwent coronary angiography because of clinically suspected CAD had routine nonselective renal cine or digital subtraction angiography. There were 68 females and 128 males with a mean age of 63 years (range 35-85). Angiographically significant CAD was present in 152 patients (78%). Of the total patient cohort, 29 patients (15%) had mild RAS (< 50%), and 36 patients (18%) had significant RAS (> or = 50%). In patients with normal coronary arteries, only three patients (7%) had RAS. Thirty-three patients (92%) with severe RAS also had CAD. Of these 33 patients, 45% had hypertension, 30% had hyperlipidemia, 24% had diabetes mellitus, 24% had renal insufficiency (creatinine > or = 1.5), and 51% were smokers. In addition, it was noted that 20 of these patients (61%) had two or more of the above-listed clinical parameters. However, univariate analysis using the chi-square test revealed that only CAD (22% P < 0.03) and renal insufficiency (29% P < 0.15) were reliable clinical predictors of RAS. In conclusion, RAS is a frequent finding in patients with CAD, particularly when renal insufficiency is also present.
Cathet Cardiovasc Diagn 1994 May
PMID:High incidence of renal artery stenosis in patients with coronary artery disease. 803 26


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