Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Left ventricular hypertrophy (LVH), an increase in the muscle mass of the left ventricle, has been identified as a powerful risk factor for future cardiovascular morbidity and mortality. The risk of acute myocardial infarction, congestive heart failure, sudden death, and other cardiovascular events increases six- to eightfold with the presence of LVH. The increase in myocardial mass lowers coronary reserve and enhances cardiac oxygen requirements, gives rise to ventricular ectopy, and impairs left ventricular filling and contractility. Hypertension, obesity, advanced age, valvular heart disease, and other disorders that cause an increase in the hemodynamic burden can lead to LVH. Left ventricular hypertrophy and its sequelae can be reduced by specific antihypertensive therapy but, despite these promising findings, future epidemiological studies are necessary to document the clinical benefits of a reduction of LVH.
 ...
PMID:Left ventricular hypertrophy: an independent risk factor. 172 10

Our aim was to analyze the predictive value of a variety of preoperative risk factors on operative outcomes. We reviewed all colorectal resections performed in a single hospital between January 1985 and May 1990. Nine hundred seventy-two resections were performed on 825 patients. We studied 17 preoperative risk factors generated from various medical risk categories. Using the multivariate discriminant function analysis, we calculated that 11 of the 17 risks were of significance in predicting outcomes (all with P less than or equal to 0.031). These factors included emergent operation, age greater than or equal to 75 years, congestive heart failure (CHF), prior abdominal or pelvic radiation therapy, corticosteroid use, albumin less than 2.7 g/dl, chronic obstructive pulmonary disease (COPD), previous myocardial infarction (MI), diabetes, cirrhosis, and renal insufficiency. The classification function generated by the discriminant analysis was used to categorize patients into one of four risk groups depending on their "risk score." The index used to develop each patient's "risk score" ranged from six points for an emergency operation to one point for diabetes. The mortality rates for the various risk groups were as follows: Group 1, zero to four points, 1 percent; Group 2, five to eight points, 10 percent; Group 3, 9 to 13 points, 19 percent; Group 4, greater than 13 points, 33 percent. In contrast to previous reports, we showed that age greater than or equal to 75 years alone is not a major preoperative risk factor but, rather, acts as a modifier for the other predictors of postoperative complications. We then assessed clinical questions concerning specific preoperative risks, such as steroid use, obesity, inflammatory bowel disease, COPD, and prior laparotomy, and their associated specific postoperative complications and have developed prevention strategies based on these findings. Through the use of the risk index, we also were able to assess an individual patient's operative risk more accurately.
 ...
PMID:Multifactorial index of preoperative risk factors in colon resections. 173 12

Congestive heart failure (CHF) is a major cause of mortality and morbidity, and has a prognosis similar to that of several malignancies. There are increasing trends in both prevalence and incidence rates of CHF which points towards CHF becoming a major community health problem. Early detection of CHF is dependent upon criteria to define the initial stages of a condition which progresses slowly over many years. In western countries the dominant causes of CHF are hypertension and coronary heart disease, which account for more than 75% of the cases. Other precursors are diabetes and rheumatic heart disease. Independent risk factors for CHF are hypertension, smoking, obesity, and psychological stress. Early detection of CHF through identification of early symptoms such as dyspnea on exertion, treatment of known heart diseases, and treatment of risk factors may prevent its progress. Epidemiological data indicate that primary preventive efforts should be directed against hypertension, smoking and obesity. A multiple risk factor interventional approach seems to yield the best result since these risk factors act synergistically.
 ...
PMID:Epidemiology and prognosis of heart failure. 179 25

Data from 30 years of follow-up of the original Framingham Study cohort of 5,070 men and women aged 30-62 years who were first examined during the period 1948-1952 and who were free of cardiovascular disease reveal that blood pressure is a strong and consistent predictor of the development of coronary heart disease, stroke, transient ischemic attack, and congestive heart failure. Other factors related to blood pressure like obesity, left ventricular hypertrophy as demonstrated on electrocardiograms, and heart enlargement as shown by x-ray radiography made several selective additional independent contributions to risk; heart enlargement by x-ray radiography was the best predictor of congestive heart failure.
 ...
PMID:Blood pressure as a risk factor for cardiovascular disease. The Framingham Study--30 years of follow-up. 249 Aug 26

Subacute bacterial endocarditis is associated with significant morbidity and mortality. Valvular destruction, congestive heart failure, embolic phenomena, failure of medical therapy, and death are all more common in patients with echocardiographically discernible valvular lesions. Transthoracic echocardiography is often unsatisfactory for evaluation of vegetations in patients with chest wall deformities, lung disease, obesity, or prosthetic valves. The transesophageal approach affords uniformly high-quality images with excellent structural resolution. We present a case of suspected subacute bacterial endocarditis in a patient with equivocal diagnoses of vegetations on three separate transthoracic echocardiograms in whom transesophageal evaluation revealed obvious large vegetations that involved the aortic and mitral valves. Subsequent autopsy confirmed this diagnosis. The case illustrates the utility of a new imaging method for the detection of valvular vegetations. In view of the prognostic implications of detected vegetations, transesophageal echocardiography probably should be performed on all patients with suspected subacute bacterial endocarditis and equivocal results by transthoracic study.
 ...
PMID:Use of transesophageal echocardiography for improving detection of valvular vegetations in subacute bacterial endocarditis. 262 41

Hypertension and obesity are two disorders that are closely related; each occurs more frequently with the other than in an otherwise normal population. These two disorders, however, exert disparate effects on cardiovascular structure and function. The hallmark of essential hypertension is an increased total peripheral resistance, and hypertensive patients have a contracted intravascular volume and normal cardiac output but an increased left ventricular stroke work due to a high afterload. In contrast, obese patients have an increased intravascular volume, left ventricular filling pressure, cardiac output and a lower total peripheral and renal vascular resistance. Left ventricular adaptation will consist of eccentric hypertrophy in obesity regardless of the level of arterial pressure and concentric hypertrophy in lean hypertensive patients. Although obesity may mitigate the harmful effect of a chronically elevated total peripheral and renal vascular resistance and lessen target organ damage in essential hypertension, the combination of obesity and hypertension presents a double burden to the left ventricle and is associated with systolic and diastolic dysfunction and a propensity for high grade ventricular dysrhythmias. It is not surprising that congestive heart failure and sudden death are common sequelae of obesity hypertension. Weight reduction reduces arterial pressure by decreasing intravascular volume and cardiac output associated with a fall in sympathetic activity and reversal of cardiac hypertrophy. Therefore, weight loss unloads the heart from the two-fold burden caused by obesity and hypertension and should become a major goal in the prevention and treatment of heart disease.
 ...
PMID:Cardiovascular adaptation to obesity and hypertension. 294 41

We report 41 patients with myocardial infarction who were less than forty years old and that had been studied by coronary angiography. 97.5% were male mostly in their thirties. Coronary risk factors in this group were similar to the old one; excepting for mental stress present in 75% of our patients. There was not predominant infarction site. We observed different disturbances of the cardiac rhythm but no patient had congestive heart failure or cardiogenic shock. Mortality due to the infarct itself was none .61% of the cases had univascular lesions or normal coronary angiography and only 12% had trivascular lesions. The patients with normal coronary angiography had no significant difference in the mayor coronary risk factors and in our group we found patients with arterial hypertension, hyperlipidemia, cigarette smoking and obesity. We suggest that mental stress is an important coronary risk factor; the evolution of these patients is favorable and the mortality is low as compared with previous reports.
 ...
PMID:[Clinico-angiographic correlations in myocardial infarction in young people]. 295 73

Left ventricular hypertrophy (LVH) has assumed an important role in clinical medicine as a result of the clinical implications of this often asymptomatic finding. Epidemiological data from the Framingham Heart Study have permitted an examination of prevalence, incidence, underlying predisposing factors and prognosis of LVH. Although LVH is an infrequent finding on the electrocardiogram, it is a forerunner of coronary disease, congestive heart failure, stroke and even peripheral arterial disease. Despite being strongly related to hypertension, LVH remains associated with excess risk for adverse cardiovascular morbid and fatal outcomes, even after adjusting for blood pressure. The risks associated with LVH are comparable with those of myocardial infarction. The recent introduction of echocardiography at the Framingham Heart Study has permitted the development of new criteria for LVH based on M-mode determined left ventricular mass. Unlike its electrocardiographic counterpart, echocardiographically determined LVH is a common finding, occurring in over 15% of the general population. Echocardiographic LVH is related to hypertension, obesity, valvular heart disease, coronary disease and advancing age. Ambulatory ECG results in subjects with echocardiographic LVH demonstrate increased risk for ventricular arrhythmias, which have been shown in other clinical settings to predict risk for sudden cardiac death. Preliminary data from Framingham and elsewhere suggest that echocardiographic LVH is associated with increased risk for cardiovascular disease morbidity and all-cause mortality.
 ...
PMID:Left ventricular hypertrophy. Epidemiological insights from the Framingham Heart Study. 297 14

To assess the meaning of hospital-associated death rates, we studied whether mortality within 30 days of hospital admission (30-day mortality) is more informative than inpatient mortality and whether detailed assessment of additional discharge diagnoses helps in understanding death rates. We examined hospitalizations for elderly Medicare patients with principal diagnoses of stroke, bacterial pneumonia, myocardial infarction, and congestive heart failure; these conditions account for 30.8% of Medicare 30-day mortality. Average hospital stays for these conditions were 99.0% longer, and inpatient mortality was 25.0% higher in New York than in California, but 30-day mortality was 1.6% higher in California. We conclude that inpatient death rates depend on length-of-stay patterns and give a biased picture of mortality. Additional diagnoses such as shock and pneumonia were strongly associated with increased mortality, but Medicare data do not reveal which patients had these conditions at the time of admission. Recorded diagnoses of chronic diseases such as hypertension, diabetes mellitus, obesity, benign prostatic hypertrophy, and osteoarthritis were commonly associated with reduced risk of death; such reduced risk is not clinically plausible. Several lines of evidence suggest that chronic disorders are underreported for patients with life-threatening disorders. We recommend great caution in using discharge diagnoses of comorbid conditions to adjust hospital death rates for clinical differences in the patient populations.
 ...
PMID:Assessing hospital-associated deaths from discharge data. The role of length of stay and comorbidities. 270 88

A three-decade examination of the prevalence, incidence, secular trends, and prognosis of cardiac failure in the Framingham Study provides insights into its epidemiology. Annual incidence of CHF is observed to increase from 3 to 1000 at ages 35-64, to 10 per 1000 at ages 65-94. There is a slight male predominance, owing to a higher rate of coronary disease, which conferred a fourfold risk of cardiac failure. Most cardiac failure is on the basis of long-standing hypertension or CHD. Silent infarctions were as predisposing for CHF as symptomatic MIs surviving 1 year. Hypertension is a major predisposing factor that at least triples the CHF risk, the systolic component being more predictive than the diastolic component. Correctable predisposing risk factors for CHF include: elevated blood pressure, impaired glucose tolerance, elevated cholesterol, low HDL-cholesterol, obesity, and a high hematocrit. Risk factors reflecting deteriorating cardiac function also were highly predictive, including: an enlarged heart, poor vital capacity, sinus tachycardia, and ECG-LVH. Commonly encountered ECG abnormalities such as intraventricular block, nonspecific repolarization abnormality, and ECG-LVH are all associated with a substantial risk of CHF. ECG-LVH carries a higher risk than x-ray enlargement. Sudden death was a common feature with CHF, occurring at 5 times the general population rate, even excluding those with overt CHD. Using the standard cardiovascular risk factors (age, systolic blood pressure, cholesterol, glucose, cigarettes, and ECG-LVH) jointly, it is possible to identify one tenth of the population from which 40% of CHF events evolve, in the absence of interim CHD or RHD.
 ...
PMID:Epidemiology and risk profile of cardiac failure. 315 46


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>