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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Examination of the fibrinolytic system of 221 diabetics with varying grades of under- and overweight revealed not only an elevated fibrinogen level and a significantly decreases spontaneous and stimulated fibrinolytic activity in obesity, but also a highly significantly decreased activity of plasminogen activator of the vessel walls in these patients. Similar, but less marked, changes were found in obese non-diabetics. Thes changes imply a decreased ability to remove fibrin deposits within the lumina of small and large vessels and thus an increased risk of thrombosis, and they may be closely related to the high frequency of late complications in diabetes mellitus.
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PMID:Effect of obesity on endogenous fibrinolytic activity in diabetes mellitus. 5 14

As part of a study to determine the extent to which the haemostatic system is implicated in the onset of clinically manifest ischaemic heart disease, characteristics influencing fibrinolytic activity (FA) and plasma fibrinogen concentrations were examined in 1601 men aged 18-64 and 707 women aged 18-59 in several occupational groups in North-west London. In men FA noticeably decreased till the age of about 58, when there was a small rise. In women a small increase in FA between 18 and about 40 was followed by a slightly larger fall between 40 and 59. There was a pronounced negative association of FA with obesity. FA was significantly less in smokers than non-smokers, though the effect was not large. FA increased with alcohol consumption. FA in men appeared to be greatest in the lower social classes, and men on night shift had poorer FA than those on day work. FA was greater in women using oral contraceptives than in those not using these preparations. In both sexes FA increased with exercise, but there were no associations between any of the characteristics studied and the increase. Plasma fibrinogen concentrations increase with age and obesity, are higher in smokers than non-smokers, and fall with alcohol consumption. In women the concentrations are higher in those using oral contraceptives. The general epidemiology of FA and plasma fibrinogen concentrations suggests that they may well be implicated in the pathogenesis of ischaemic heart disease.
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PMID:Characteristics affecting fibrinolytic activity and plasma fibrinogen concentrations. 42 Sep 98

The use of labelled fibrinogen in 106 patients with thromboembolic risk led to the detection of thrombosis of deep veins of lower limbs in 25 patients (23,58%) as compared with a single patient (0,94%) who showed all the clinical signs. The thromboses were identified more frequently (in 60% of the cases) in patients whose age was above 60 years. In 80% of the cases the thromboses were detected in the first 24 h after surgery. Most frequently involved were the veins of the leg (64%), and especially in the IV-th area, corresponding to the upper third of the leg (23,80%). Surgery performed in the pelvic area gave a high percentage of thromboses. Advanced age, the existence of varicose veins, the presence of diabetes, of obesity, as well as previous surgical interventions, increase the risk of thrombosis and of embolies. Due to existing possibilities for an early diagnosis of thromboses in deep veins following surgery, for detecting latent clinical thrombosis, as well as for assessing the evolution of an already formed thrombus, it appears that the test with labelled fibrinogen is a highly useful clinical investigation.
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PMID:[Possibilities of early detection of postoperative venous thromboses]. 49 75

The rise in cardiovascular disease (CVD) risk after menopause may be reduced by hormone replacement therapy (HRT) although the mechanism is unclear. Because little is known about the potential role of hemostatic factors, fibrinogen level and other coagulation parameters were measured in a study on the change in CVD risk factors through the climacteric (the Healthy Women Study). Of 239 subjects measured to date, 32 taking aspirin or other medications thought to alter coagulation were excluded from analyses. Results (adjusted for age and obesity) showed that women taking HRT had lower plasma concentrations of fibrinogen and higher levels of plasminogen and factor VIIc than did postmenopausal subjects not taking HRT. Pre- as compared with postmenopausal women had lower plasma levels of fibrinogen, factor VIIc, and antithrombin III. Adjusting for cigarette smoking did not change the findings. Thus, among women aged 49 to 55, selected hemostatic measures varied (within normal ranges) by menopausal status and were altered by HRT. These findings generally support a hypothesis of hemostatic change contributing to the increase of CVD after menopause. The fact that subjects taking HRT showed no increase in fibrinogen relative to premenopausal women is consistent with an observed decreased risk of CVD among women taking HRT, while the implication of an elevation in factor VIIc among these women is uncertain.
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PMID:Hemostatic factors according to menopausal status and use of hormone replacement therapy. 134 95

Mounting data support a causal connection between high-normal fibrinogen levels and atherosclerotic cardiovascular disease. There is clearly a thrombogenic component to atherosclerosis and the onset of clinical manifestations. This offers the possibility to better identify high-risk candidates and also to protect them by reducing blood fibrinogen concentration or blocking its action. The relationship of antecedent fibrinogen to the subsequent development of cardiovascular disease is examined, based on 18 years of surveillance of a cohort of 1274 men and women aged 47 to 79 years who participated in the Framingham Study. The association with the development of peripheral arterial disease and cardiac failure is now examined in addition to previously studied relationships to coronary heart disease and stroke. In men and women, there is a significant age-adjusted relationship of fibrinogen level to coronary heart disease and to cardiovascular disease in general. In women, a significant relationship to cardiac failure and peripheral arterial disease, but not to stroke, was also found. These data on women are unique as they are not available elsewhere. Age-adjusted cardiovascular, all-cause, and coronary heart disease mortality were all related to fibrinogen in both sexes. In men, fibrinogen impact was the greatest for stroke and the least for peripheral arterial disease. For women, the impact on coronary heart disease was greatest. The absolute risk for an elevated fibrinogen level was greatest for coronary heart disease in both sexes. Average fibrinogen values are higher in women and in persons with other risk factors, including hypertension, cigarette smoking, diabetes, obesity, and elevated hematocrit. However, there is an independent contribution of fibrinogen to cardiovascular disease in general and coronary disease in particular, on adjustment for coexistent risk factors. Fibrinogen enhances the risk of cardiovascular disease in hypertensives, diabetics, and cigarette smokers. About half the cardiovascular risk of cigarette smoking appears due to the higher fibrinogen values. Now, five prospective studies document the excess incidence of cardiovascular events in persons with elevated fibrinogen levels within the "normal range." Each standard deviation increase in fibrinogen is associated with a 30% increment of coronary heart disease in men and a 40% increase in women. Fibrinogen should be added to the list of major cardiovascular risk factors. Trials of intervention to lower fibrinogen in high-risk coronary candidates are needed.
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PMID:Update on fibrinogen as a cardiovascular risk factor. 134 96

Hypertension is a powerful predisposing risk factor for cardiovascular disease at all ages and in both sexes. Epidemiological assessment indicates the largest risk ratios for stroke and congestive heart failure (CHF), but coronary heart disease (CHD) is the most common and most lethal sequela of hypertension. Examination of the risk of cardiovascular sequelae in the hypertensive population indicates that this is not uniform and varies over a 10-fold range, depending on the associated risk factors. Systolic pressure merits greater consideration than the diastole pressure because isolated systolic hypertension is a powerful cardiovascular risk at all ages. Furthermore, recent trials have indicated the benefit of therapy for systolic-based hypertension in the elderly, even using a diuretic, for coronary disease as well as stroke. Persons with hypertension have a high prevalence of associated cardiovascular risk factors, including elevated cholesterol, reduced HDL-C, diabetes, left ventricular hypertrophy (LVH), and obesity. About 9% under the age of 65 years have an associated overt cardiovascular disease; above age 65 about 30% are so afflicted. Each of these risk factors can double the risk associated with hypertension. Because they are so common, a large fraction of the disease sequelae of hypertension is attributable to these associated risk factors. The high risk of coronary disease in hypertensive patients is concentrated in those with a high total/HDL-cholesterol ratio, impaired glucose tolerance, high fibrinogen, ECG abnormalities, and cigarette smokers. Stroke risk in hypertensive persons is concentrated in those with cardiovascular disease, diabetes, atrial fibrillation, LVH and cigarette smoking.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Potency of vascular risk factors as the basis for antihypertensive therapy. 148 3

Obesity in adults is evoked by several authors as a risk factor for thrombosis and vascular diseases. There are also some reports in the literature describing hemorheological disturbances associated with obesity. However, the majority of these studies have been performed on obese populations with another concomitant pathology which can interfere on the measured rheological parameters. The present study was therefore devoted to the effect of obesity on the rheological properties of blood in the absence of any associated pathology. Results showed a significant increase in erythrocyte aggregation in obese population when compared to the controls while the red blood cell deformability was significantly decreased. The increase of aggregation was accompanied by significant increases in plasma viscosity and fibrinogen level. By contrast, albumin level was found to be decreased. The red cell aggregation differences between normal and obese subjects can be explained mainly in terms of the effects of altered fibrinogen concentration and albumin level. These results lead one to conclude that the plasma proteins metabolism and consequently erythrocyte aggregation could be altered only because of weight excess. These disturbances may also be considered as a risk factor promoting vascular diseases in obese patients.
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PMID:[Hemorheological parameters in isolated obesity]. 156 36

It is known that during the postoperative period about 25-50% operated patients develop postoperative venous thrombosis. The mechanism of development of postoperative thrombosis is promoted in surgical patients by the so-called "wound healing process" with an enhanced synthesis of fibrinogen, inhibitors of fibrinolysis and other proteins of the acute phase for release of various cytokins (IL-1, IL-6, TNF, TGF and others). The development of thrombosis is promoted also by other risk factors: advanced age, extensive surgical trauma, infection, immobility, obesity etc. Preventive administration of so-called small doses a of heparin or rather so-called low molecular heparin (LMWH) substantially reduces the risk. The authors submit also a list of drug with an antithrombotic action and rheologics.
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PMID:[Prevention of thromboembolic complications in surgery]. 158 31

Of the major risk factors for atherosclerosis, high factor VII and fibrinogen levels, genetic predisposition, gender and age cannot be influenced. Reduction of high blood pressure reduces the cerebral but not the coronary vascular risk and correction of dyslipidaemia correlates with cardiovascular risk. Other major risk factors (tobacco consumption, obesity, sedentary lifestyle and diabetes) can also be modified. Aspirin in doses of approximately 300 mg/day may be recommended for the primary prevention of myocardial infarction (MI), but only in those patients with a moderate to high risk of cardiovascular disease. Aspirin reduces the risk of fatal and nonfatal MI by about 50% and also decreases the overall mortality rate among patients with unstable angina. A lower dose of aspirin (150 mg/day) also reduces mortality by 23% in the acute phase of MI. In doses of 300 mg/day, aspirin is useful in the secondary prevention of MI and reduces the overall mortality rate by 15%. Various antiplatelet agents, including aspirin (alone or combined with dipyridamole) and ticlopidine, have proved useful in the prevention of thrombosis in aorto-coronary grafts, provided treatment begins at the latest 6 hours after surgery. The usefulness of antiplatelet drugs has been well established in the prevention of immediate reocclusion following coronary angioplasty, but not in the prevention of late reocclusion. Aspirin and ticlopidine are also beneficial in extracorporeal circulation techniques. In patients with a synthetic cardiac valve prosthesis, antivitamin K-anticoagulants are still indispensable lifelong, but their antithrombotic effect can be reinforced by dipyridamole or aspirin. Diuretics probably provide the best primary protection against cerebrovascular accidents, although medium doses of aspirin may be considered in elderly people at high risk of such accidents. Aspirin (alone or combined with dipyridamole) and ticlopidine may be recommended for the secondary prevention of cerebral ischaemic accidents. Aspirin (with or without dipyridamole) and ticlopidine reinforce the treatment of obliterative arterial disease in the lower limbs.
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PMID:Risk factors, interventions and therapeutic agents in the prevention of atherosclerosis-related ischaemic diseases. 172 14

It is well known that in thrombotic disease the alteration of biological factors such as antithrombin III, protein C, and protein S deficiency, and congenital disfibrinogenimias and displasminogenemias are determining factors being the acquired alterations not so well known. With this in mind was studied 85 patients with arterial thrombosis and 196 with venous thrombosis, who were again divided into three groups: unique or of repetition, less or more than 35 years and with or without immediate apparent cause. The general clinical-biological profile in patients with thrombosis in whom a congenital deficit is not detected, can help establish prognosis and treatment in these patients. In our patients, together with the importance of factors such as obesity, hyperlipemia, and tabaquism, an increase in fibrinogen (Fg), antigenic Factor VII (vWF:Ag), total protein S is observed as well as a decrease in total fibrinolytic activity related to an increase in the inhibitor of the plasminogen tissue activator (PTA).
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PMID:[Hemostasis profiles in thrombotic disease]. 178 55


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