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

Although several risk factors for heart disease including high blood pressure, diabetes mellitus, and lipid and lipoprotein abnormalities are associated with overweight, overweight is not consistently associated with coronary heart disease risk. Some prospective studies of white men (life insurance cohorts, airline pilots, cancer study volunteers, and the Framingham population) have shown a positive linear relationship of weight to coronary heart disease. Other epidemiologic studies show a negative association, no association, a U-shaped relationship, or a threshold effect. The inconsistencies do not appear to be explained by differences in the definition or distribution of obesity, duration of follow-up, or risk factor distribution. Neither misclassification bias nor confounding by cigarette smoking or chronic disease appears to explain the inconsistencies. No known protective effect of obesity could explain these divergent findings. Inconsistent results with regard to the nature, strength, and linearity of the association between obesity and atherosclerosis do not support the hypothesis that obesity causes atherosclerosis, despite its biological plausibility.
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PMID:Obesity, atherosclerosis, and coronary artery disease. 390 65

In a study conducted in four family practice units in Toronto, Canada, 2001 subjects reported on snoring and medical conditions in members of their households. For spouses the prevalence of snoring increased with age up to the seventh decade, with a higher prevalence of nearly 85% in husbands. For 11 medical problems an association existed between snoring, its frequency, and the presence of the condition. This association continued when the data were corrected for sex, age, and marital state. For hypertension both men and women who snored between the fifth and 10th decades had a twofold increase over non-snorers. The prevalence of heart disease and other conditions, except for diabetes and asthma, also increased in snorers in this age group. When corrected for smoking and obesity the association between snoring, hypertension, and heart disease persisted. These findings extend those of Lugaresi et al, and if they could be confirmed snoring as a risk factor for conditions other than sleep apnoea and sleep disorders might be considered. Methods of alleviating the acoustic annoyance of snoring may also provide direct medical benefits.
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PMID:Snoring as a risk factor for disease: an epidemiological survey. 392 56

The mortality rates from ischaemic heart disease in the Hunter Region of New South Wales are among the highest in Australia. Within the Region substantial differences occur in death rates from heart disease among the five urban local government areas, the highest being in the coal-mining district of Cessnock and the lowest in the resort and dormitory area of Port Stephens. A recent survey in the Region of risk factors for heart disease has revealed prevalence patterns for high blood pressure, serum cholesterol levels, smoking and overweight and obesity which largely parallel the pattern of heart disease mortality. This suggests that changes in life-style in the communities could reduce the intraregional differences in mortality. In addition, the widespread prevalence of an unhealthy diet and a lack of exercise may explain the Region's high death rates from heart disease and suggests that mortality could be reduced by effective preventive measures.
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PMID:Risk factors and heart disease mortality. A regional perspective. 394 15

A silicone collar containing circumferential tape was tied around the cardio-esophageal junction in eight patients with symptomatic, refractory reflux, who were not good candidates for a standard antireflux procedure. A fine polypropylene tie or clip secured the knot. In two patients with large hiatal defects, the crura were approximated loosely. Mean operating time, including one cholecystectomy and one ventral hernia repair, was 51 minutes. Patients who underwent this simple operation had a combination of hypertension, heart disease, obesity and old age, and two had undergone horizontal gastroplasty previously for morbid obesity. The reflux was associated with hiatal hernia in seven of the eight patients. Preoperative studies included barium swallow roentgenography in all eight patients, and endoscopy, manometry and Bernstein test in six. All the studies were repeated postoperatively. Follow-up ranged from 17 to 48 months (mean 37.8 +/- 10.6 months). Postoperatively, there was a significant (p less than 0.01) improvement in symptoms, endoscopic findings and lower esophageal sphincter pressures. No prosthesis has migrated yet.
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PMID:The Angelchik antireflux prosthesis. 397 Dec 43

To determine the effect of obesity on prognosis in hypertensive subjects, a population of 1727 men 50 to 79 years of age was dichotomized by baseline body mass index (less than 27 and greater than or equal to 27 kg/m2) and systolic blood pressure (less than 160 and greater than or equal to 160 mm Hg). After 9 years of follow-up, age-adjusted all-cause, cardiovascular, and ischemic heart disease mortality rates were highest in the nonobese hypertensive subjects. The relative risk for mortality associated with a systolic blood pressure of 160 mm Hg or higher was significantly increased only in the nonobese group, with the largest difference in relative risk between obese and nonobese for ischemic heart disease. Results were consistent after separately excluding those with a history of heart disease, diabetes, current use of antihypertensive medication, and cigarette smoking, and those who died within 2 years of the baseline examination. When the independent effect of risk factors, including age, plasma cholesterol level, cigarette smoking, use of antihypertensive medication, and personal history of heart disease or diabetes was assessed with the Cox model, systolic blood pressure was a significant independent predictor of all-cause, cardiovascular, and ischemic heart disease death only in the nonobese subjects. We do not exclude an adverse effect of raised blood pressure in the obese. However, these data suggest that the prognosis is poorer in leaner hypertensive patients than in those who are overweight.
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PMID:Is hypertension more benign when associated with obesity? 400 36

This paper discusses the nutritional requirements for fat in infants and children in the light of the dietary alterations recently proposed by the Inter-Society Commission on Heart Disease Resources. It is not well known what the requirement for total fat and for serum cholesterol level during the first year of life should be. It is known that the only proved requirement for fat is linoleic acid, and that a logical fat intake would be that supplied by breast milk. 80% of American infants are fed with formulas which are not supplemented with the essential vitamin E. After infancy fat requirements change, and body stores are sufficient to insure against fatty acid deficiency. The dietary intake of American children is high in quantities of saturated fats and cholesterol, possibly leading to atherosclerosis later in life. The question is whether this cholesterogenic diet is harmful to all Americans or to a limited number of clinically discernible subjects, i.e., those children genetically predisposed to hyperlipoproteinimia. Such predisposition could be diagnosed at birth by screening of the umbilical cord blood, and checked again at school age and at adolescence. Thus, although limitation of a cholesterogenic diet to prevent obesity is reasonable, restricting cholestrogenic foods in everyone for the unproved distant goal of reducing atherosclerosis is dubious.
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PMID:Fat nutrition and diet in childhood. 463 20

This is not the place to consider the medical significance of obesity in terms of conditions such as heart disease and hypertension, diabetes, and arthritis. These very complex interrelationships have been dealt with elsewhere (69). We hope that enough evidence has been presented to demonstrate that energy balance is normally maintained by a precise and reliable physiologic mechanism, and that the energy surplus represented by obesity may reflect direct failure of this mechanism or some combination from a variety of neurological, endocrine, enzymatic, and psychological disorders. Environmental conditions as well as genetic and traumatic factors may contribute to the development of obesity. If increasing mechanization brings tus below the level of energy expenditure at which food intake is properly regulated, appropriate habits of exercise will have to be established and maintained.
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PMID:Regulation of food intake and obesity. 488 32

Modern contraceptive methods are discussed, with special emphasis on oral contraceptives, which are regarded as the most effective. They are also regarded as generally safe, although there are contraindications and the drugs should only be prescribed after careful examination. The need for selecting the drug most suitable for the individual patients, mainly on the basis of the characteristics of the menstrual cycle (suggesting a predominance of estrogen or progestin, within safety limits, such as 50 mcg of estrogen), is emphasized. The examinations required include a general clinical, gynecological, and breast examination, cytology tests, evaluation of the menstrual flow pattern, measurements of arterial pressure, weight, glucose, cholesterol and triglyceride levels, and urine tests. They should be repeated at 6-month intervals, or 3-month intervals in the case of high-risk patients (varicose veins, obesity, heavy smokers, high cholesterol and triglyceride levels, history of jaundice, slight heart condition, clinical or potential diabetes, porphyria or predisposition to uterine myoma). Oral contraceptives are contraindicated in cases presenting a history of thromboembolism, phlebitis, cerebral apoplexy; sickle cell anemia, which indicates a predisposition to thromboembolic accidents; serious liver disease or recent hepatitis; serious heart disease; hormone-dependent neoplasia (breast cancer); predisposition to uterine cancer; erythematous lupus; metorrhagia of unknown origin; psychic disorders, especially of a depressive type. They should also be avoided for 3-4 years after puberty, in order to avoid interfering with the development of the hypothalamus and with growth. A carcinogenic effect of the pill and an increase in the risk of giving birth to abnormal children can be ruled out, although the incidence of abortions due to chromosome anomalies after suspending treatment is rather high (due to the previous inhibition of ovulation, a situation similar to repeated pregnancies at short intervals, which involve the same risk).
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PMID:[Current clinical problems of contraception]. 502 53

Hypertension and obesity frequently coexist in the same patient. However, the two disorders disparately affect cardiovascular function and structure. The presence of obesity significantly affects hypertensive target organ involvement. On one hand, obesity may tend to mitigate the harmful effects of a chronically elevated total peripheral and renal vascular resistance and lessen end-organ damage such as nephrosclerosis in essential hypertension. However, since both obesity and hypertension increase cardiac workload, although by different mechanisms, their presence in the same patient results in a double burden to the left ventricle. Congestive heart failure, sudden death, and coronary heart disease are common sequelae of obesity hypertension. Weight loss reduces arterial pressure by a decrease in intravascular volume and cardiac output associated with a fall in sympathetic activity. Intervention in obesity hypertension diminishes the dual hemodynamic burden imposed on the heart and becomes therefore a major objective in the prevention and treatment of heart disease.
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PMID:Obesity in hypertension: how innocent a bystander? 623 45

472 randomly selected men and women from the city of Lund were examined for disease in the heart, lungs and for hypertension. 163 men and 194 women who had no symptom or sign of disease were accepted for the further study. The prevalence of various exclusion criterias, such as symptoms and signs of heart disease, lung disease and other diseases which may possibly affect the ECG are reported as well as the distribution of blood pressures in the sample. A computer-averaged standard 12-lead ECG (leads aVL, I, -aVR, II, aVF, III, V1-V6) was recorded. All measurements of ECG-deflections have been made visually using a magnifying glass (6 times). ST-segments were classified according to the Punsar code by independent visual observers as well as by the computer. The mean frontal QRS-axis shifted to the left with advancing age, but the shift was statistically significant only in men. In both men and women there was a leftward shift of the mean frontal QRS-axis with increased weight, increased chest circumference and increased obesity index. The normal range of axis was found to be 0 degrees to 90 degrees in men and +15 degrees to 90 degrees in women. The problems concerning the definition of the electrical heart position is discussed. The concept of a Q-axis is introduced as an alternative way to indicate electrical heart position. There is a statistical significant relationship between the Q-axis and the QRS-axis in the frontal plane, although this relationship is not always apparent in the individual ECG. The presence or absence of a Q-wave in an individual lead was used to denote a lead as being a left ventricular lead or not. Using the Q-wave as a marker of heart position in the individual lead is more practical than to use the QRS-axis or the transitional zone. Duration and amplitude of the Q-wave have been measured. The upper limit of normal duration exceeded 0.03 s in leads aVL and aVF in men but not in women. The R-wave amplitudes proved to vary with age and heart position in men. In women variation of the R-wave amplitude was found with heart position but not with age.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:On the normal scalar ECG. A new classification system considering age, sex and heart position. 624 Jan 93


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