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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relation between plasma lipid peroxide and coronary heart disease was investigated at Harapan Hospital in Kita Jakarta. Ninety-eight patients (83 males and 15 females), below 75 years old were included in the study. The samples consisted of 47 cases with angina and 22 cases with myocardial infarction which were proven to suffer from coronary atherosclerosis by the presence of clinical symptoms, ECG abnormalities, angiography and myocardial enzyme measurement. Controls were patients who did not show any abnormalities in the parameters used. Controls and patients were classified into several groups based on the presence or absence of risk factors (smoking, hypertension, diabetes mellitus, hyperlipidemia, obesity, family history). The results of the study showed that plasma lipid peroxide in patients with angina and myocardial infarction which were 3.26 +/- 1.07 mumol and 3.20 +/- 0.82 mumol/l, respectively, were significantly higher (p less than 0.05) than controls 2.50 +/- 0.45 mumol/l. There was no differences in total cholesterol, LDL and triglyceride contents between control and patients with coronary heart disease; whereas HDL cholesterol level was significantly higher in the patients with angina, 38.7 +/- 10.5 mg/dl vs 31.5 +/- 6.76 mg/dl in patients with myocardial infarction. Univariate analysis of various risk factors revealed a strong correlation between plasma lipid peroxide and the chance in developing coronary heart disease. The present study showed that plasma lipid peroxide was increased in coronary heart disease and that it might be used as a determinant in the assessment of the severity of the disease. An investigation on the effects of antioxidants in these patients is planned.
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PMID:Plasma lipid peroxides in coronary heart disease. 150 21

Over the past decade we have seen a shift in the strategy for the treatment of hypertension, from stepped therapy--involving a highly structured, unvarying series of steps--to recommendations for more individualized treatment. How shall we accomplish that goal? Severe hypertension provides a clear indication to bypass earlier recommendations. Demographic data such as age, gender, and race, often cited, have proved less helpful. Concomitant medical problems, which are found in greater than 50% of hypertensive patients, are most often the crucial determinants in the selection of antihypertensive therapy. Concurrent coronary artery disease, diabetes mellitus, heart failure, azotemia, asthma, chronic obstructive pulmonary disease, borderline cognitive dysfunction, anxiety, and depression are all common. Each has implications for antihypertensive therapy. Moreover, blood pressure reduction is a surrogate for our real goal, which is reduction of cardiovascular risk. Thus, consideration of concomitant medical problems has extended to left ventricular hypertrophy, obesity, hyperlipidemia, and insulin resistance as additional risk factors in hypertension. Consideration of all of these factors makes it possible to individualize antihypertensive therapy in most patients.
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PMID:Evolution of the treatment of hypertension: what really matters in the 1990s? 151 35

The aim of this study was to compare the causes of death and parameters related to alcohol consumption, between subjects diagnosed as diabetic, clinically by their general practitioner, or glucose intolerant and in particular as diabetic, using the epidemiological criteria of an abnormal glucose level following an oral glucose tolerance test. The subjects in this study were 7035 working men, aged between 44 and 55 years, who attended the first follow-up examination of the Paris Prospective Study, between 1968 and 1973. They were classified as 'clinically diagnosed diabetic' or, following an oral glucose tolerance test and the World Health Organisation criteria, as having 'oral glucose tolerance test diagnosed diabetes', impaired glucose tolerance or normoglycaemia. The relative risk of death by cirrhosis, in comparison with the normoglycaemic group, was 21 (95% confidence interval: 9.1-49) in the group diagnosed diabetic by the oral glucose tolerance test, significantly different (p less than 0.02) from the group diagnosed diabetic clinically 3.1 (0.41-24); factors indicative of excessive alcohol consumption at baseline differed accordingly. In contrast, the relative risks for death by coronary heart disease were similar, 2.1 (1.0-4.1) and 2.7 (1.4-5.4) respectively; all of the factors defining the insulin resistance 'Syndrome X' (hyperglycaemia, hyperinsulinaemia, hypertension, hyperlipidaemia and also central obesity) and predictive of coronary heart disease were elevated in both groups of diabetic subjects. 'Diabetes', as diagnosed by the oral glucose tolerance test, might be the consequence of excessive alcohol consumption which could lead to insulin resistance, then to coronary heart disease, as well as to alcohol-related diseases.
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PMID:Cardiovascular and alcohol-related deaths in abnormal glucose tolerant and diabetic subjects. 154 80

Studies have proven beyond doubt that certain behaviors (smoking, inactivity) and conditions (hypertension, diabetes, obesity, hyperlipidemia) increase the risk of coronary artery disease. In many cases, the risk can be reduced dramatically with nonpharmacologic methods, but if needed, effective medications are available. First, however, patients at risk must be identified and educated about the importance of adopting a healthy life-style. The authors address all of these issues.
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PMID:How to reduce the risk of coronary artery disease. Teaching patients a healthy life-style. 154 8

We discuss how to identify the child at risk for developing or having heart disease. We describe both the child at risk for developing adult-onset heart disease and the child or fetus at risk for having congenital heart disease. With respect to the child at risk for developing adult-onset heart disease, we concentrate on how four risk factors (cigarette smoking, hyperlipidemia, reduced physical activity, and obesity) affect the development of cardiovascular disease, and we review the types of therapy currently being used to modify them. We also discuss the etiological factors related to the risk of developing congenital heart disease, such as single-gene conditions, known cardiac teratogens, chromosomal anomalies, and multifactorial inheritance.
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PMID:The child at risk for developing heart disease. 3. 156 69

One hundred eighty-two cases with 814 aorto-coronary saphenous vein grafts were studied according to coronary risk factors (smoking, hypertension, hyperlipidemia, diabetes mellitus, obesity and family history). The patency rates of all cases were as follows, early-term (within one year after operation): 92.3%, mid-term (within 5 years after operation) 80.7%, long-term (more than 5 years after operation): 66.0%. Coronary risk factors have great influence upon the mid- and long-term patency, especially upon the latter. The long-term patency rate of the grafts complicated with hyperlipidemia was 57.4% and that without hyperlipidemia was 81.8% (p less than 0.01). Hyperlipidemia, complicating 55.5% of all cases, was one of the most influential factors on the patency and also the most difficult one to be controlled. In the United States and Europe, many cases were complicated with hyperlipidemia, and it was considered that the poor patency of the saphenous vein grafts in those countries was due to this fact. Pathological studies revealed that hyperplasia of intima and media, characteristics of venosclerosis, appeared frequently in the saphenous vein grafts having more than three risk factors, and that the factors had effect not only upon arteries but also upon veins. So we conclude that saphenous vein grafts are the materials of good long-term patency, and that the control of the risk factors, particularly hyperlipidemia, is the key to improve the patency.
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PMID:[Long-term patency of aorto-coronary saphenous vein grafts]. 159 59

Insulin-like growth factor-I (IGF-I) and insulin interact with related receptors to lower plasma glucose and to exert mitogenic effects. Recombinant human IGF-I (rhIGF-I) was recently shown to decrease serum levels of insulin and C-peptide in fasted normal subjects without affecting plasma glucose levels. In this study we have investigated in six healthy volunteers the responses of glucose, insulin, and C-peptide levels to intravenous rhIGF-I infusions (7 and 14 micrograms/kg.h) during standard oral glucose tolerance tests (oGTT) and meal tolerance tests (MTT), respectively. Glucose tolerance remained unchanged during the rhIGF-I infusions in the face of lowered insulin and C-peptide levels. The decreased insulin/glucose-ratio presumably is caused by an enhanced tissue sensitivity to insulin. The lowered area under the insulin curve during oGTT and MTT as a result of the administration of rhIGF-I were related to the fasting insulin levels during saline infusion (oGTT: r = 0.825, P less than 0.05; MTT: r = 0.895, P less than 0.02). RhIGF-I, however, did not alter the ratio between C-peptide and insulin, suggesting that the metabolic clearance of endogenous insulin remained unchanged. In conclusion, rhIGF-I increased glucose disposal and directly suppressed insulin secretion. RhIGF-I probably increased insulin sensitivity as a result of decreased insulin levels and suppressed growth hormone secretion. RhIGF-I, therefore, may be therapeutically useful in insulin resistance of type 2 diabetes, obesity, and hyperlipidemia.
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PMID:Effects of insulin-like growth factor-I on glucose tolerance, insulin levels, and insulin secretion. 160 98

Hepatobiliary characteristics of untreated obese patients and those of patients reducing weight through very-low-calorie diets (VLCDs) are reviewed. In untreated obesity, hepatobiliary abnormalities are prevalent. Fatty change is common and may be related to insulin resistance. Moreover, portal inflammation and fibrosis are prevalent findings, also in the absence of alcohol abuse. The liver plays a key role in the hyperinsulinism and hyperlipidemia, and hepatic drug metabolism is influenced by enhanced glucuronidation and sulphatation. Predisposition to gallstone formation can be ascribed to increased biliary cholesterol secretion in concert with changed nucleating factors and altered gallbladder motility. Weight loss by VLCD reduces fatty change but may induce slight portal inflammation and fibrosis. Insulin resistance and pharmacokinetic abnormalities regress. During VLCD the risk of gallstone formation is markedly increased. The deleterious effects described of a rapid weight loss should draw some attention to the liver and biliary tract during VLCD treatment.
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PMID:Liver and gallbladder disease before and after very-low-calorie diets. 161 89

Since the time that coronary artery disease was first described in the transplanted human heart, attempts have been made to define risk factors for its development. Although recent reports have emphasized immunologic and infectious (i.e., cytomegalovirus) mechanisms in the development of transplant coronary disease, the influence of several nonimmunologic risk factors has also been studied. Some of the nonimmunologic risk factors that have been evaluated include recipient characteristics (age, sex, obesity, hyperlipidemia, hypertension, smoking, diabetes mellitus, pretransplantation heart disease), donor characteristics (age, sex), immunosuppressive agents/protocols, and nonimmune mechanisms of endothelial injury (cyclosporine, ischemic time). Studies evaluating the role of these risk factors have produced variable results. One or more studies, however, have suggested an effect of recipient age and sex, donor age and sex, obesity, hyperlipidemia, pretransplantation diagnosis, and ischemic time on the development of transplant coronary disease. The most consistently described relationship has been between hyperlipidemia and transplant coronary disease. Hyperlipidemia is common after heart transplantation, with elevations noted in total cholesterol, low-density lipoprotein cholesterol, and triglycerides. The cause of posttransplantation hyperlipidemia is not well defined, but obesity and the immunosuppressive agents prednisone and cyclosporine play a role. Treatment of posttransplantation hyperlipidemia can be difficult because commonly used lipid-lowering agents have side effects and interactions with immunosuppressive drugs that necessitate caution in their use in the posttransplantation population. Transplant coronary disease almost certainly has a multifactorial cause, with endothelial injury and nonimmunologic risk factors, particularly hyperlipidemia, playing contributory roles. Because hyperlipidemia and the obesity that commonly accompany it are modifiable risk factors, weight loss and treatment of hyperlipidemia are recommended.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transplant coronary disease: nonimmunologic risk factors. 162 91

The role of alcohol as a risk factor for cerebral infarction and hemorrhage has been assesed in 200 middle-aged and elderly stroke patients and 200 controls matched for age, sex and hospital admission date. Computed tomographic brain scans were done in all but 10 of the stroke patients. Alcohol intake was reckoned on the 12 months preceding hospitalization and expressed in grams daily according to a standard nomogram. The Michigan Alcoholism Screening Test was used for the diagnosis of alcoholism. Cerebral infarction was present in 59% of the stroke patients and cerebral hemorrhage in 9%. The role of alcohol as risk factor for stroke proved to be small (Odds Ratio 1.86) and was practically lost after adjustment for the most common risk factors for cerebrovascular disorders (previous strokes, arterial hypertension, diabetes, obesity and hyperlipidemia). Our findings seem to suggest that alcohol is not an independent risk factor for stroke in the middle-aged and elderly. The data are, however, preliminary and are discussed in the light of methological problems.
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PMID:Cerebrovascular disorders and alcohol intake: preliminary results of a case-control study. 162 76


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