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

Odds ratios (ORs) were estimated for the prevalence of antecedent endocrine, metabolic, or vascular diseases among 45 patients with amyotrophic lateral sclerosis from the Rochester, Minn, population compared with 90 control subjects matched for sex, year of birth, period of observation, and residence. Hypertension occurred less frequently in male patients with amyotrophic lateral sclerosis (4%) than in control subjects (30%; OR = .10). Because of small population size, no conclusions can be drawn with respect to the following antecedent conditions: thyroid disease (OR = 1.61), coronary artery disease (OR = .58), obesity (OR = .52), diabetes (OR = 1.00), cerebrovascular disease (OR = .21), and peripheral vascular disease (OR = 1.23). The heterogeneity of antecedent thyroid disease makes it highly unlikely that any specific thyroid lesion is causally associated with most cases of amyotrophic lateral sclerosis. Hypertension may be a marker for protective factors against the development of amyotrophic lateral sclerosis in men.
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PMID:Antecedent medical diseases in patients with amyotrophic lateral sclerosis. A population-based case-controlled study in Rochester, Minn, 1925 through 1987. 200 Nov 86

Diabetes mellitus and hypertension constitute two powerful independent risk factors for cardiovascular, renal and atherosclerotic disease. The frequent occurrence of the two diseases in the same individual doubles the risk of cardiovascular death, as well as substantially increasing the frequency of transient ischemic attacks, strokes, peripheral vascular disease with lower extremity amputations, as well as end-stage renal disease and blindness. Although hypertension usually occurs in IDDM in association with renal disease, in NIDDM the evolution of hypertension appears to be multifactorial and independent of renal disease. Obesity appears to be dissociable from hypertension and NIDDM with a common link between obesity, hypertension and NIDDM appearing to be hyperinsulinism and insulin resistance. It has been suggested that hyperinsulinism and insulin resistance may lead to hypertension through altered intracellular calcium metabolism, enhanced renal sodium reabsorption, or through an effect of insulin upon lipid and/or catecholamine metabolism. Further, insulin itself may have a direct effect upon the atherosclerotic process in the hypertensive diabetic patient. These considerations have been taken into account in the structuring of antihypertensive therapy in Type I and Type II Diabetes Mellitus.
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PMID:Diabetes and hypertension. 207 56

The prevalence of various diabetic complications, their association with each other and with many risk factors, has been assessed in 2,337 newly diagnosed Type 2 diabetic patients. The patients entered into the UK Prospective Diabetes Study were aged between 25 and 65 (mean age 52 yr) and 33% had either an abnormal ECG or retinopathy. Different macrovascular complications such as strokes, heart attacks or abnormal ECG, and peripheral vascular disease showed little association one with another, and each was associated predominantly with different risk factors, e.g., strokes with hypertension, heart attacks with hypertriglyceridaemia and peripheral vascular disease with smoking and a low HDL cholesterol. Retinopathy was associated with reduced vibration perception but not with other complications. Reduced vibration perception and absent reflexes were associated with absent foot pulses and ischaemic skin changes, raising the possibility of a macrovascular, as well as microvascular, contribution to peripheral neuropathy. Microalbuminuria was associated with hypertension, which might be a factor predisposing to renal microvascular disease or be a consequence of it. Microalbuminuria was also associated with an abnormal ECG. Retinopathy, with exudates and or haemorrhages rather than just microaneurysms, was associated with hyperglycaemia. The occurrence of a particular complication in a diabetic patient is probably dependent on a combination of specific risk factors, many of which are related to, and probably affected by, potentially avoidable factors such as hyperglycaemia, obesity, smoking and hypertension.
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PMID:UK Prospective Diabetes Study 6. Complications in newly diagnosed type 2 diabetic patients and their association with different clinical and biochemical risk factors. 209 90

Coexisted peripheral vascular disease (PVD: ankle/brachial pressure index A/PBI less than 0.75) or carotid artery disease (CTD: Brochenbrough's supraorbital Doppler flow analysis) were diagnosed by non-invasive testings, and correlated with clinical pictures and coronary backgrounds in 121 consecutive patients with confirmed coronary artery disease. PVD were found in 16.5%, CTD in 33.1% and both PVD and CTD in 9.9%. The mean age of PVD(+) patients was significantly higher than that of PVD(-) patients, furthermore CTD(+) patients displayed a significantly larger number of coronary risk factors than CTD(-) patients. Concerning the subjective symptoms, 20% of PVD(+) patients and 45% of CTD(+) patients were asymptomatic regarding PVD or CTD symptoms. However the degree of calcification of the aortic arch on the chest X-film (n = 104) significantly correlated with A/BPI. In patients with AMI, PVD patients showed significantly higher peak CK and CK-MB values than those in PVD(-) patients, which suggested large infarct size in coexistent PVD patients. With respect to the relationship between coronary risk factors, there was a statistically significant difference between PVD(+) patients and PVD(-) patients in terms of the obesity ratio in males as well as hypercholesterolemia ratio and obesity ratio in females. In CTD patients, significant differences between CTD(+) and CTD(-) patients were found with respect to the smoking ratio and obesity ratio in males as well as the smoking ratio in females. In whole study patients, A/BPI with lowered and A.I. (atherogenic index) increased significantly when patients possessed coronary risk factors equal or more than 4 items, which suggested the progression of PVD with increasing number of coronary risk factors.
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PMID:[Clinical picture and background for progression of peripheral arteriosclerosis in Japanese patients with coronary artery disease]. 236 97

During a prospective cohort-study of several year's duration the results of a survey regarding prevalence of arterial occlusive disease, as well as classical risk factors and rheological profile of patients suffering from vascular disease were examined. 364 patients out of a total of 2,498 individuals suffered from vascular disease. 168 (6.7%) had cardiovascular, 151 (6.0%) cerebrovascular and 109 (4.4%) peripheral vascular disease. Compared to to healthy individuals, the patients showed a significant accumulation of classical risk factors (elevated cholesterol and triglyceride values, decreased HDL-cholesterol concentration, obesity, smoking, high blood pressure, gout or diabetes mellitus). Only 30.2% of the healthy controls presented two or more risk factors, whereas the angiological patients showed two or more risk factors in 71.9%. Rheological parameters measured in the survey were: Plasma viscosity, erythrocyte and platelet aggregation, erythrocyte rigidity and hematocrit. Only 14.2% of the healthy individuals had two or more rheological parameters exceeding the 1-s range, whereas 56.6% of the patients showed two or more elevated rheological parameters.
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PMID:Prevalence, risk factors and rheological profile of arterial vascular disease; first results of the Aachen study. 246 78

448 Sudanese diabetics were included in this study. 30% of patients were in the age group 40-50 years and only 6.3% had childhood diabetes. The predominant sex was female (64.5%). Obesity was found in 39% of patients, a positive family history in 66.5% and a history of diabetic ketoacidosis in 25.2%. 100 patients (below the age of 40) had a plain X-ray abdomen done but none had evidence of pancreatic calcification. Percentages of diabetic complications in this study were as follows: neuropathy 28.1%, retinopathy 18.5%, cataract 14.7%, hypertension 12.9%, nephropathy 11.6%, peripheral vascular disease 6.2%, coronary heart disease 4.2% and pulmonary tuberculosis 2.7%. The majority of our patients were uncontrolled, only 16.7% had normoglycaemia (FBG less than 140 mg%).
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PMID:Pattern of diabetes mellitus in the Sudan. 263 51

A study was conducted to evaluate the efficacy of family history factors as screening criteria for childhood hypercholesterolemia. When they were seen for routine care at one of eight office practices, 1005 prepubertal children underwent random serum cholesterol determinations. Parental and grandparental histories of cardiovascular risk factors and atherosclerotic complications prior to 55 years of age were also obtained. Of the initial group, 274 children had total cholesterol levels greater than or equal to 175 mg/dL, and 175 of these children returned for retesting after an overnight fast. A total of 88 children were found to have low-density lipoprotein-cholesterol (LDL-C) values greater than or equal to 90th percentile for age and sex. Maternal and paternal histories of hypercholesterolemia were significantly associated with elevated LDL-C (odds ratio = 7.3 and 2.9, respectively), but had extremely low sensitivities (0.09, 0.15) despite modest positive predictive values (0.42, 0.22). Grandparental histories of sudden death, peripheral vascular disease, and gout were associated with elevated LDL-C, but sensitivities and positive predictive values for all of these factors were less than 0.22. Family history factors most commonly recommended as criteria for cholesterol screening in children did not identify half of all the children with elevated LDL-C and did not selectively identify the most severely affected children. Adding information concerning the presence of childhood obesity did not result in appreciable improvement in LDL-C detection beyond that achieved by family history factors alone. It was concluded that if thorough identification of young children with elevated LDL-C is desired, inclusive population screening rather than a family history-based strategy would be the most effective approach.
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PMID:Family history evaluation as a predictive screen for childhood hypercholesterolemia. Pediatric Practice Research Group. 274 69

Peripheral arterial occlusive disease has been described frequently as a disease affecting predominantly men. There is only a few information available concerning peripheral vascular disease in the female. Therefore, the aim of the present study was to examine risk factors in relation to localisation and symptoms of peripheral arterial occlusive disease in female patients. A retrospective study has been performed in 48 female patients (52-82 years with a mean age 69.5 years). Finally 45 patients were witheld because they had all a doppler examination and an oscillography of the lower limbs. The majority of the patients, namely 22 patients (49%) had combined ileofemoral and distal lesions. There were 15 patients (33%) who had isolated distal lesions, while only 8 patients (18%) had isolated ileofemoral vascular lesions. With respect to the symptoms the population could be divided in three groups: 16 patients (36%) were asymptomatic, 19 patients (42%) had intermittent claudication and 10 patients (22%) had rest pain and necrosis. Smoking was not the predominant risk factor in this group. Diabetes mellitus seemed to enhance distal vascular lesions, while arterial hypertension, obesity and lipids were predictive risk factors in peripheral vascular disease in the female. A high incidence of cardiovascular disease (31 patients, 69%) and cerebrovascular disease (13 patients, 29%) was concomitant.
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PMID:Localisation and risk factors of peripheral arterial occlusive disease in the female. 276 56

Due to the recent knowledge that the distribution of fat deposits would be a better predictor of cardiovascular disease than the degree of obesity, some risk factors for atherosclerosis were evaluated in middle age type II male diabetics and in obese subjects with and without glucose intolerance. In non-insulin dependent diabetes, abdominal adiposity reflected by the waist/hip-circumference (WHR) was related to parameters of metabolic control, lipid parameters, blood rheology, insulin status, hypertension and known vascular complications in three different groups. In the groups with abdominal obesity, the mean annual HbA1 is significantly (p less than 0.01) higher than the group without an abdominal fat mass distribution. Atherogenic index is significantly increased in the group with the highest WHR. HDL-cholesterol levels are significantly decreased in both groups with upper body fat distribution. A highly significant (p less than 0.001) correlation was present between WHR and HDL-cholesterol and WHR and total/HDL-cholesterol ratio; this significant correlation remains after correction for body mass index. Whole blood and plasma viscosity and fibrinogen levels are significantly (p less than 0.05) increased in diabetics with upper body fat accumulation and could be compared to patients with proven coronary ischemic heart disease. The frequency of peripheral vascular disease, coronary ischemic heart disease and hypertension is most prominent in diabetics with an abdominal fat mass distribution. Systolic blood pressure even seems to be increased in non-obese diabetics with the highest WHR. A correlation could be found between WHR and both systolic and diastolic blood pressure. When corrected for body mass index the same significant correlation between WHR and blood pressure remained. Both fasting and postprandial insulin and C-peptide values may be the link between abdominal fat deposits and all metabolic disturbances. These results confirm the negative effect of an excess of abdominally located fat cells, even without manifest obesity, on diabetes metabolic control, lipid fractions, hypertension, insulin behaviour, blood rheology and cardiovascular complications. In obese patients with upper body fat accumulation a higher prevalence of glucose intolerance and diabetes is present, in contrast to their counterparts with lower body fat deposit. Both fasting glycemia, insulin and insulin area are significantly (p less than 0.005) increased in the group with the greatest WHR.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Body fat mass distribution. Influence on metabolic and atherosclerotic parameters in non-insulin dependent diabetics and obese subjects with and without impaired glucose tolerance. Influence of weight reduction. 280 Jun 85

The role of percutaneous transluminal angioplasty in treating advanced peripheral vascular disease is unknown. The authors therefore reviewed the experience of Sunnybrook Medical Centre in Toronto with 85 consecutive patients who had rest pain, ulceration, pregangrene or gangrene as a result of peripheral vascular disease and who underwent percutaneous transluminal angioplasty. Seventy-four percent were smokers and 91% were at increased risk due to one or more of the following: coronary or cerebral ischemic disease, diabetes mellitus, obesity and hypertension. Thirty-six patients underwent dilatation of iliac lesions, 46 of superficial femoral or popliteal and 3 of more distal lesions. In nine patients angioplasty was repeated on the same lesion. In 16 patients, the procedure was technically unsatisfactory. The morbidity and 30-day mortality were 5% and 2%, respectively. When the procedure was technically satisfactory, surgery was avoided and the limb was salvaged at 1, 2 and 5 years in 69%, 62% and 54% of cases, respectively (life-table analysis). The authors conclude that percutaneous transluminal angioplasty is acceptable treatment for patients with advanced peripheral vascular disease, because the morbidity and mortality are low and the long-term results are good.
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PMID:Transluminal angioplasty: results in high-risk patients with advanced peripheral vascular disease. 315 87


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