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

One-hundred-and-sixty male and 123 female subjects with asymptomatic primary hyperlipidaemia (HLP) selected from a health control centre have been studied with a heart rate (HR) controlled exercise test. Ther serum cholesterol and/or TG at screening were above 350 mg/100 ml and 3.5 mmol/l, respectively. As a reference group 49 male and 60 female age-matched subjects from the same centre with serum cholesterol below 300 mg/100 ml and TG below 2.00 mmol/l were investigated using the same technique. Quantitative lipoprotein (LP) analyses and typing were performed on all HLP and control subjects. The subjects were divided into two age groups, 36-50 and above 50 years of age. Men with all types of HLP had lower working capacity, expressed in W170 or W150, than controls, most pronounced in the younger age group. Younger women with type II A had lower working capacity than their controls. After correction for variation in body weight and age there remained a significantly lower W150, in male types II A (11%) and IV (21%) and female type II A (11%). There was no difference in systolic BP during exercise between controls and HLP. The total exercise time and final HR did not differ in control and HLP subjects. Dynamic spirometry was performed im 102 of the male subjects and a significantly lower vital capacity was found in HLP subjects compared with controls after correction for variation in age, weight and height. No differences were found in the maximal flow values. The observed differences in working capacity between controls and HLP subjects are explained by a difference in stroke volume. The lower stroke volumes in male types II A and IV and female type II A could be explained by a lower degree of physical fitness, by a common genetic factor resulting in HLP and decreased stroke volume or by a less effective myocardial function in HLP subjects.
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PMID:Studies in asymptomatic primary hyperlipidaemia, III. Physical working capacity. 115 24

Despite recent national recommendations to use total cholesterol (TC) measures to screen patients for hyperlipidemia and coronary heart disease (CHD) risk, it is unclear how predictive this approach is for older adults, who tend to have higher high-density lipoprotein-cholesterol (HDL-C) values and therefore higher TC. We looked at lipid profiles of 190 adults with a mean age of 70.8 years (range 51 to 86 years) to determine the value of TC in predicting risk states based on HDL-C. One hundred sixty-two did not have a diagnosis of CHD; 28 had a diagnosis of CHD. Of those subjects without CHD, 13 (8.0%) with a TC under 200 mg/dL were "underscreened" since they had a low HDL-C value under 40 mg/dL. Men were three times more likely to be underscreened on the basis of TC alone. Thirty (18.5%) of the subjects were "overscreened" since they had a TC greater than or equal to 240 mg/dL and a normal HDL-C value greater than 50 mg/dL. Only women were overscreened. For those 28 subjects with CHD, TC values alone also "underscreened" 3 (10.7%) of this cohort, and "overscreened" 3 (10.7%). If a provider decides to screen for hyperlipidemia and CHD risk in older patients, a lipid profile rather than a nonfasting TC test should be ordered. Over 26% of the patients in this study would have been misclassified and inappropriately advised regarding their risk for CHD based on a TC value alone.
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PMID:Screening for coronary heart disease risk in the elderly: total cholesterol versus high-density lipoprotein-cholesterol. 179 30

The records of 36 patients (37 eyes) with central retinal artery occlusion (CRAO, 19 patients, 19 eyes), branch retinal artery occlusion (BRAO, 15 patients, 16 eyes), and cilioretinal artery occlusion (CIAO, 2 patients, 2 eyes) were reviewed with respect to underlying systemic disorders. Hypertension was the most common disorder (58%). Half of the patients had cardiovascular disorders including ischemic heart disease, valvular disease, atrial fibrillation, internal carotid artery obstruction, and atrial myxoma. Seventeen percent of the patients had diabetes mellitus, and 8% had hyperlipemia. Cerebral infarction was detected in a quarter of the patients. The incidence of the disease was one CRAO patient per 1,000 outpatients. Age distribution showed a peak in the seventh decade. Men were twice more frequently affected than women. Right eyes were more commonly involved.
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PMID:[Retinal arterial obstruction and systemic disorders]. 204 31

Current research on lipid alterations and the risk of ischemic cardiopathy is reviewed, and the relationship of such cardiopathy to exogenous hormonal treatment is examined. Most large epidemiological and intervention studies have focused on men. Men and women share some risk factors, including high serum cholesterol levels, adverse lipoprotein profile, smoking, hypertension, diabetes, obesity, advanced age, and according to some studies sedentary life style. Additional factors that may affect women more than men are elevated serum triglyceride levels, natural or surgical menopause, use of oral contraceptives (OCs), and possibly hormonal substitution therapy. Studies have revealed a characteristic female profile of lipids and lipoproteins that follows a predictable course with age and menopause. Average total cholesterol and LDL cholesterol are higher in men than in premenopausal women, but women's levels rise after menopause until they eventually exceed those of men. According to epidemiological study and clinical trials over the past 2 decades, the principal determinants of serum lipid levels and hyperlipidemia are similar for both sexes and include diet, smoking, physical exercise and other habits, and genetic factors. Lipid levels in women are also affected by endogenous estrogens, high-dose OCs, estrogen replacement therapy, and menopause. Several studies have shown that high serum concentrations of total and LDL cholesterol and relatively low levels of HDL cholesterol are correlated with development of atherosclerotic lesions and increased cardiovascular risk in men, and that lowering cholesterol reduces the risk. Thus far there are no conclusive studies demonstrating the benefits of reduced cholesterol levels for women, but studies that included women along with men suggested that they share the benefits. Low levels of HDL cholesterol and elevated serum triglyceride levels appear to be important predictors of ischemic cardiopathy in women. The coronary risk in former OC users does not appear to be higher than that of women who never used OCs. It is likely that the lower-dosed formulations now in use will mitigate the risk. The adverse effect of OCs on lipid levels appears to be related to the androgenicity of the progestin. Most of the progestins used in combined pills are related to the 19-nortestosterone group which tends to decrease HDL level and increase LDL and triglyceride levels. Many studies have demonstrated that postmenopausal use of estrogens alone result in a decrease in LDL and an increase in HDL levels. Most but not all studies have shown that hormonal substitution reduces risks of coronary disease. But the longterm effects of estrogen/progestin use, now recommended to avoid increased risk of endometrial cancer, are not known.
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PMID:[Women and ischemic cardiopathy]. 269 94

In order to study whether the high frequency of exercise ST segment depressions found in primary asymptomatic hyperlipidemia were due to increased plasma fibrinogen levels and blood hematocrit and consequently higher blood viscosity these parameters were determined in fifty-four consecutive hyperlipidemic subjects. Mean plasma fibrinogen as determined by polymerization time was increased in hyperlipidemia. It did not differ between groups with and without exercise ST segment depressions. Mean hematocrit was normal in both men and women. Men with exercise ST segment depressions had lower mean hematocrit than those without (p less than 0.01). The findings speak against the view that the exercise ST segment depressions found in asymptomatic subjects with hyperlipoproteinemia should be due to increased blood viscosity. The most probable cause is a premature, subclinical atherosclerosis.
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PMID:The relation between plasma fibrinogen, blood hematocrit and exercise ST segment depressions in hyperlipoproteinemia. 746 95

A large segment of the population gradually develops insulin resistance, and the related metabolic syndrome is one of the most frequent causes of atherosclerosis. Searching for a practical indicator of insulin resistance, we studied the correlations between fasting serum insulin level, the general manifestations of insulin resistance syndrome, and various aspects of coronary artery disease in 797 men and 322 women. After we classified patients according to the quartiles of serum insulin level, we noted in the top quartile the presence of practically all manifestations of insulin resistance syndrome in persons of both sexes (e.g., increased waist/hip ratio, body mass index, glucose, uric acid, triglycerides, apolipoprotein B and decreased high-density lipoprotein cholesterol levels as well as apolipoprotein A-I/B ratios, and so forth). We also noted a higher prevalence of hypertension, diabetes mellitus, and type IV hyperlipidemia. Significantly more women in the fourth than in the first quartile had angiographically documented significant stenosis of the coronary arteries (p = 0.0016, odds ratio 2.9, 95% confidence interval 1.5 to 5.6) and previous myocardial infarction (p = 0.0297, odds ratio 2.1, 95% confidence interval 1.1 to 4.1). Men in both the first and the fourth quartile had a more disturbed lipid profile and a higher prevalence of significant stenoses of coronary arteries and/or previous myocardial infarction than women; there was a tendency toward a lower prevalence of alcohol consumption (p = 0.0503), a higher prevalence of gout (p = 0.0634), and previous myocardial infarction (p = 0.0791) in men in the fourth than in the first quartile.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fasting hyperinsulinism, insulin resistance syndrome, and coronary artery disease in men and women. 748 1

The first vasectomy operation was carried out 100 years ago in patients with prostate hyperplasia with symptoms. Then it became extensively used for hereditary hygiene purposes/eugenics, especially after the passing of the sterilization law in Denmark in 1935. In Nazi Germany, vasectomies and castrations were also used for forced sterilization of undesired races. Vasectomy has become a popular method of fertility control, especially in the US. In Denmark it is also popular, and since the 1973 sterilization law, approximately 100,000 procedures have been performed with a 95% rate of satisfaction. Vasectomy seems not to be as harmless as previously thought. The blockage of the transport route from the testes does not stop spermatogenesis. Spermatozoa are a certain kind of foreign matter which are first produced in puberty and act as antigens vis-a-vis other organisms. Certain immune complexes are formed that can have implication for a number of autoimmune diseases. Later in life vasectomy can be a potentiating factor in arteriosclerosis according to rhesus monkey experiments. Men with hypertension, hyperlipidemia, or heavy smokers should not undergo vasectomy. On the other hand, a 1990 epidemiological study showed no increased risk of cardiovascular diseases in vasectomized men. Yet the immune complexes could have other, more serious biological consequences. In large cohort studies the connection to testicular cancer has not been proven with certainty, but there may be an increased risk of prostate cancer among the vasectomized. The American Urological Association (AUA) has recently recommended that men over 40 who had been vasectomized should undergo examination and tests for prostate-specific antigen every year for early detection of cancer. There has been no indication of an increased mortality from prostate cancer among vasectomized men in the above epidemiological studies, but the AUA advises counseling patients about the possible connection.
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PMID:[Vasectomy]. 800 96

OBJECTIVE--To determine the prevalence of incipient and overt nephropathy in African-American subjects with non-insulin-dependent diabetes mellitus (NIDDM) attending a hospital clinic. Contributory factors, such as blood pressure (BP), duration and age at onset of diabetes, hyperglycemia, hyperlipidemia, and body mass index (BMI) also were evaluated. RESEARCH DESIGN AND METHODS--We recruited 116 African-American subjects with NIDDM for this cross-sectional, descriptive, and analytical study. BP, BMI, 24-h urine albumin excretion, creatinine clearance, serum creatinine, lipids, and GHb levels were measured. Albumin excretion rate (AER) was calculated, and subjects were divided into three groups: no nephropathy (AER < 20 micrograms/min), incipient nephropathy (AER 20-200 micrograms/min), and overt nephropathy (AER > 200 micrograms/min). Frequency of hypertension and nephropathy was analyzed by chi 2 testing, group means were compared using analysis of variance, and linear correlations were performed between AER and other variables. Multiple regression analysis was used to examine the association of these variables while controlling for the effects of other variables. RESULTS--Increased AER was present in 50% of our subjects; 31% had incipient and 19% had overt nephropathy. Hypertension was present in 72.4%; nephropathy, particularly overt nephropathy, was significantly more prevalent in the hypertensive group. Mean BP and diastolic blood pressure (dBP) were higher in the groups with incipient and overt nephropathy, and systolic blood pressure (sBP) was increased in overt nephropathy. Men with either form of nephropathy had higher sBP, dBP, and mean BP, whereas only women with overt nephropathy had increased sBP and mean BP. Subjects with incipient or overt nephropathy had a longer duration of diabetes, and those with overt nephropathy had a younger age at onset of diabetes. By multiple regression analysis, AER correlated with younger age at diabetes onset, but not with diabetes duration. No correlation with age, lipid levels, or GHb was noted. BMI correlated with AER. CONCLUSIONS--Incipient and overt nephropathy were observed frequently in these African-American subjects with NIDDM. Albuminuria correlated with BP, younger age at diabetes onset, and BMI. Association of albuminuria and increased cardiovascular mortality may place 50% of inner-city African-American patients with NIDDM at risk for developing cardiovascular complications.
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PMID:Incipient and overt diabetic nephropathy in African Americans with NIDDM. 802 85

In 12 weeks of active treatment, we compared the efficacy and safety of a new (micronized) formulation of fenofibrate (F) (200 mg/day) with that of simvastatin (S) (20 mg/day), an inhibitor of hydroxy-methyl-glutaryl coenzyme A (HMG-CoA)-reductase. Men and women with primary hyperlipoproteinemia (HLP) with low-density lipoprotein (LDL) cholesterol level 180-300 mg/dl and triglyceride level < 500 mg/dl had dietary treatment for 8 weeks, and 133 (2 of 3 type IIa, 1 of 3 type IIb HLP) were randomized. The decrease in total cholesterol differed between type IIa patients (F - 17.9 vs. S - 25.8%), the decrease in triglyceride levels between the type II b groups (F - 52.8 vs. S - 14%), whereas the degree of decrease in LDL cholesterol (F - 20.9 vs. S - 34.9%) differed among all patients. Despite the difference in LDL cholesterol decrease, no difference was noted in total apolipoprotein (apo) B lowering (F - 20.8 and S - 26.5%). Increases in high-density lipoprotein (HDL) cholesterol (F + 18.5 vs. S + 15%) differed specifically in type IIb patients (F + 33.6 vs. S + 11.4%), accompanied by a more pronounced increase in apo AI with fenofibrate (F + 10.5% vs. S no change). Improvement in the ratios of total cholesterol/HDL cholesterol and apo AI/apo B occurred similarly with both drugs. Only fenofibrate, not simvastatin, decreased both fibrinogen (-10.3 vs. + 3.6%) and uric acid (-25% vs. no change) in type IIa and type IIb patients. Safety parameters reflected drug-specific known side effects, underscoring the safety of both drugs in addition to their efficacy in lipid lowering. Besides its advantages in type IIb hyperlipidemia, micronized fenofibrate proved a potent drug in decreasing total and LDL cholesterol and in very effectively decreasing apo B-containing lipoproteins, which is a recommendation for its use in primary hypercholesterolemia.
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PMID:Multicenter comparison of micronized fenofibrate and simvastatin in patients with primary type IIA or IIB hyperlipoproteinemia. 884 74

In order to examine the influence of a low-fat diet on iron status, we carried out a study which involved 410 out-patients with hyperlipidaemia, i.e. 256 men and 154 women. Serum iron was positively correlated with protein intake (p = 0.11; p < 0.05) and transferrin saturation was inversely correlated with fat intake (p = - 0.12; p < 0.05). A positive iron balance (serum iron > 27 mumol/l and transferrin saturation > 45%) was found in 1.6% of the male subjects, a frequency which could be explained by the presence of the hemochromatosis genes. A negative iron balance (serum iron < 10 mumol/l and tranferrin saturation < 15%) was found in 13.7% for women aged 21-49 yr, 3.7% for women aged 50-77 yr and 3.5% for men aged 21-77 yr. We found no association between low-fat diet and iron deficiency. Men with iron deficiency had 12% decrease in total calorie intake compared to the Recommended Dietary Allowance. Our results do not provide evidence that hypolipidemic diet is associated with a high frequency of iron deficiency.
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PMID:[Relationship between iron status and diet in 410 hyperlipidemic patients]. 929 78


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