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

Ingestion of carbohydrate results in a diphasic activation of the sympathoadrenal system. One component is an insulin-mediated activation of the sympathetic nervous system (SNS). This activation is partly a haemodynamic reflex, but it may cause a weak thermogenic effect via beta 1-adrenoceptors in white adipose tissue, the liver and the heart. The second thermogenic component of carbohydrate occurs later when the blood glucose concentration decreases towards baseline levels. This elicits an increased secretion of adrenaline from the adrenal medulla, and the circulating level exceeds the physiological threshold for thermogenic effect. The target is mainly skeletal muscle where thermogenesis is stimulated via beta 2-adrenoceptors. Also the basal metabolic rate and the thermogenic responses to cold and heat exposure, mental stress and exercise, have facultative components. Inhibition of facultative thermogenesis by beta-blockers such as propranolol, diminishes the daily energy expenditure and promotes weight gain and obesity. Although thermogenesis mediated by the sympathoadrenal system accounts for only a small part of the daily energy expenditure, it is sufficient to explain the positive energy balance and weight gain reported in patients receiving treatment with beta-adrenoceptor blocking agents.
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PMID:Effects of nutrient intake on sympathoadrenal activity and thermogenic mechanisms. 225 41

The impact of 4 antihypertensive drug regimens on blood pressure (BP) during everyday life stress and on BP during experimental stress in the laboratory was examined in an open clinical study. Sixty middle-aged men with mild-to-moderate essential hypertension never previously treated were treated either with low-dose clonidine (n = 10), oxprenolol (n = 20), nitrendipine (n = 20) or enalapril (n = 10). Before therapy, all 4 groups did not differ in age, weight, degree of obesity, BP at work site and casual BP measured in the outpatient clinic. After 6 months of effective therapy (casual BP within the normotensive range), casual diastolic BP was identical among the 4 groups, whereas systolic BP was lower in patients treated with clonidine or oxprenolol than in those who received enalapril. A disparate pattern of antihypertensive efficacy among the 4 groups emerged when stress BP was compared, with average ambulatory BP higher in patients receiving clonidine or enalapril than in those who had oxprenolol or nitrendipine. During ambulatory BP monitoring, patients treated with oxprenolol had the lowest level at each level of physical activity and self-reported emotional arousal. During bicycle exercise, patients receiving clonidine had the highest increase in systolic BP and those administered oxprenolol the lowest, whereas the BP response during mental stress was similar among all 4 therapeutic groups. The analysis of the hemodynamic response pattern during mental stress unmasked further disparities. Oxprenolol provoked an abnormal hemodynamic response during mental stress tests (increase in total peripheral resistance), whereas nitrendipine and enalapril preserved the physiological hemodynamic profile (decrease of total peripheral resistance).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy of four antihypertensive drugs (clonidine, enalapril, nitrendipine, oxprenolol) on stress blood pressure. 254 99

Cardiovascular disorders pose a major health problem for industrialized societies in terms of excess morbidity and mortality. Hypertension (HT) is a major risk factor for coronary heart disease (CHD) and cerebrovascular disease. The impact of psychosocial factors, personality traits, genetic-behavioral interactions, sodium sensitivity, obesity, insulin metabolism, and psychophysiology on HT status is discussed. An understanding of pathophysiologic processes is needed to provide a better basis for risk factor reduction and other aspects of treatment. The study of myocardial ischemia appears to provide an important link between the development of coronary artery disease and the occurrence of CHD. Further studies are needed to assess the clinical significance of stress-induced myocardial ischemia as well as whether mental stress is predictive of future CHD. Associations have been made between behavioral risk factors and CHD, but the exact nature of the relationship remains to be clarified. Hostility has been identified as an important aspect of coronary-prone behavior, but considerable research will have to be completed before a comprehensive understanding of coronary-prone behavior and the manner in which it has an impact on disease can be fully understood.
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PMID:Biobehavioral aspects of cardiovascular disease: progress and prospects. 270 Mar 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.
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PMID:[Clinico-angiographic correlations in myocardial infarction in young people]. 295 73

Although cardiovascular mortality has decreased in recent years, it is still largely due to coronary disease: 1 out of 5 men and 1 out of 17 women are affected by that disease before the age of 60. Among the risk factors involved are lipid disturbances, themselves divided into three factors: LDL-cholesterol, triglycerides and HDL-cholesterol. A plasma LDL-cholesterol level above 150 units is a high risk factor. Triglyceride levels higher than 1.50 g/l, associated with HDL levels lower than 40 mg/dl constitute a new entity, a genetic disease associated with a special fragment on chromosome 11, characterized by high risk low HDL levels (below 40). Another risk factor, even in elderly people, is arterial hypertension. Cigarette smoking, lack of physical activity, diabetes and mental stress remain important factors, whereas obesity has become a separate factor. Finally, such factors as ECG abnormalities, plasma uric acide or plasminogen levels, familial context, etc., may be taken into consideration. All dietetic and therapeutic measures aimed at lowering the cholesterol level show a 2-3 p. 100 fall in the incidence of coronary disease for each 1 p. 100 reduction of blood cholesterol. A new programme, similar to those used in screening for high blood pressure subjects, will be set up in the U.S.A. to identify people with a blood cholesterol level higher than 2.40 g/l, treat them and bring that figure down below 2.00 g/l. The management of arterial hypertension is still based on treatments which do not increase blood cholesterol or increase HDL. They include alpha-blockers, beta-2 agonists and blockers of intracellular contractility. They have the additional advantage of improving capillary perfusion.
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PMID:[Framingham 36 years later]. 311 92

Benign symmetrical lipomatosis of the neck is a rare disease that has to be differentiated from goiter, sialadenitis, obesity or a lymphatic tumor. Most patients are severe alcoholics, but they may have other endocrine disorders, such as diabetes mellitus, hyperuricemia, or hyperlipidemia. Aside from the cosmetic disfigurement and consequent psychological stress, respiratory distress may be the indication for surgical treatment. Excision of the lipomatosis requires technical skill because the extensive and sometimes infiltrative growth makes dissection of muscle and nerves difficult. The computer tomogram provides good information on the extent of the disease. Three of our 5 patients died 2 1/2 to 6 years after the first operation because of their primary disease.
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PMID:Lipomatosis of the neck (Madelung's neck). 327 65

Risk factors for myocardial infarction, sudden coronary death, angina pectoris, stroke and total mortality were analysed in a random population sample of men aged 47-55 years at entry, and followed for 11.8 years. Lipid disturbances, tobacco smoking, elevated blood pressure, diabetes mellitus, obesity, low physical leisure-time activity, psychological stress (for non-fatal events) and excessive alcohol consumption (for fatal events) were the main independent risk factors for coronary heart disease. The attributable risk was also calculated. Uncomplicated angina pectoris was related to dyspnoea during exertion, psychological stress, diabetes mellitus and high relative body weight. Stroke was dependent on elevated blood pressure, tobacco smoking and psychological stress. Quantitatively, the most important risk factors for total mortality were low physical activity during leisure time, tobacco smoking and elevated blood pressure. For patients who had suffered myocardial infarction or angina pectoris, elevated serum cholesterol, elevated blood pressure and tobacco smoking were of prognostic importance. Hypertension, together with lipid disturbances and tobacco smoking, was thus found to be a risk factor both for primary and secondary events, and blood pressure control seems of great importance in preventing these cardiovascular events.
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PMID:Primary and secondary prevention. 347 30

A multiple regression analysis was performed on statistically independent factors derived from blood pressure measurements and possible predictive variables in 618 Utah adults. Nine blood pressure factors obtained in a previous study composed the dependent variables; 35 anthropometric, questionnaire, and biochemical variables were reduced by factor analysis to 10 factors and used as independent variables. Body size and obesity had significant independent effects on different types of blood pressure: body size correlated most highly with systolic blood pressure, while obesity correlated most highly with sitting diastolic blood pressure measurements. Smoking did not correlate with sitting blood pressure but did show a significant positive correlation (after controlling for obesity) with tilt and supine diastolic pressure. Alcohol consumption correlated positively with sitting diastolic pressure when the effects of body size and obesity were controlled. No correlations were found between urinary potassium or sodium excretion and any blood pressure factors, but a significant positive correlation was seen between plasma sodium concentration and several different types of diastolic blood pressure measurements. Psychological stress showed a significant independent positive correlation with systolic blood pressure measurements that was strongest in adults over 35 years of age. The multiple correlation values for the multiple regression equations ranged from 0.19 to 0.52.
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PMID:Factor analysis suggesting contrasting determinants for different blood pressure measurements. 394 76

It is well known that mean blood pressure levels tend to be low in non-westernized tribal peoples and that these levels tend to rise, particularly in the older age groups, among persons of the same origins who come into more contact with modern Western life-styles. That tendency can be attributed to many factors - increased salt intake, increased obesity, acculturation anxiety, information overload, increased competitiveness, envious resentment, etc. Disentangling these various hypothesized factors is virtually impossible when studying patients or population samples from a single sociocultural group, but cross-cultural comparisons may under favorable circumstances permit some such disentangling. Using data from Micronesia, Polynesia, and East Africa, an attempt will be made to assess which types of psychological stress are most likely to conduce to hypertension, and how certain traditional cultures may have been reducing these stresses.
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PMID:Blood pressure and culture. The contribution of cross-cultural comparisons to psychosomatics. 714 72

Fifty men with clinically manifest ischemic heart disease (IHD), fifty men with risk indicators of IHD and fifty healthy men were interviewed about experiences of psychological stress in work, family life and education. They were also examined for the presence of hypertension, hyperlipidemia, hyperglycemia, hyperuricemia, obesity, impaired pulmonary function, smoking and alcohol consumption. The relative risk of developing clinical IHD associated with the experience of psychological stress during the five years prior to onset of symptoms was calculated. It was found to be six times greater with than without such experience. This relative risk was not reduced when controlling for conventional risk indicators by means of a multivariate confounder score. When the IHD group was compared to the group with merely risk indicators, the relative risk related to stress was statistically significant, but not when the latter group was compared to the control group. The results indicate that the experience of stress as it is defined in this study may contribute to the development of clinical manifestations of IHD, irrespective of the presence of conventional risk indicators.
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PMID:Impact of psychological stress on ischemic heart disease when controlling for conventional risk indicators. 737 31


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