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Plasma lipid peroxide concentrations were measured in 100 patients with occlusive arterial disease proved angiographically (50 patients with ischaemic heart disease, 50 with peripheral arterial disease) and compared with values in 75 control patients with no clinical evidence of atherosclerosis. Lipid peroxide concentrations were significantly higher in patients both with ischaemic heart disease (median 4.37 mumol/l (interquartile range 3.85-5.75 mumol/l); p less than 0.001) and with peripheral arterial disease (median 4.37 mumol/l (3.88-5.21 mumol/l); p less than 0.001) than in controls (median 3.65 mumol/l (interquartile range 3.29-3.89 mumol/l). Overall there was a significant but weak correlation between plasma lipid peroxide and plasma triglyceride concentrations (rs = 0.25; p less than 0.001) but not between plasma lipid peroxide and plasma total cholesterol concentrations. Furthermore, hypertension, obesity, diabetes, smoking, positive family history, and intake of beta blockers and thiazide diuretics were not associated with significant differences in lipid peroxide values. This study provides clinical support to experimental data indicating that peroxidised lipids may be important in atherogenesis and its complications and also suggests that peroxidised lipids may provide an index of the severity of atherosclerosis.
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PMID:Lipid peroxides and atherosclerosis. 249 96

Eight studies that examined the relation between snoring and vascular disease were identified. The prevalence of habitual snoring, measured by questionnaire or interview, varied from 3% to 29% of adults and was dependent on age, sex, obesity, and smoking habit. In men, habitual snoring was associated with hypertension and ischaemic heart disease, with adjusted relative risks in the range 1.3-2.0. For women, only one study provided adjusted estimates of relative risk, which were 2.8 for hypertension and 1.2 for angina. Adequately adjusted relative risks for cerebrovascular disease have not been reported, but unadjusted estimates varied from 1.6 to 10.3. These studies had several limitations, including the lack of a standard definition of snoring, the use of unvalidated questionnaires, and failure to account for confounding variables and the possibility of reporting bias. Only one study was prospective. Epidemiological criteria for a causal association between snoring and vascular disease have not been satisfied. The apparent excess risk is probably due to the consequences of sleep apnoea rather than snoring itself.
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PMID:Is snoring a cause of vascular disease? An epidemiological review. 256 56

A baseline examination of all residents aged 40 years and over, in the A-I district, Shibata City, Niigata Prefecture, Japan, was conducted in July 1977. The response rate for this examination was 84.5% for males and 92.6% for females. Nine hundred sixty males and 1,339 females, who were initially free from stroke, constituted the stroke cohort. Similarly 984 males and 1,342 females, who were free from myocardial infarction and angina pectoris on effort, made up the ischemic heart disease cohort. Both cohorts were followed for 10 years through June 1987. It is concluded that, in the agricultural community, the strongest risk factor for not only stroke but ischemic heart disease was hypertension, and that the attribution of hypercholesterolemia and obesity was small. The population that was studied experienced a period of relative economic deprivation before 1950, and there seems to be residual effects from this period to this day. The definition of cerebral infarction used in this study includes several pathologically different types (cerebral infarction of the cortical branches, cerebral infarction of the perforating branches, cerebral embolism and so on), and this may affect the results. On the other hand, the strongest risk factor for ischemic heart disease found in the A-I district is hypertension. This differs from the European/American type of ischemic heart disease, to which hypercholesterolemia and obesity are basic. These results also suggest the possibility that there is a difference not only etiologically but pathologically between the two types.
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PMID:Relationship of risk factors to subsequent development of stroke and ischemic heart disease in a rural community. 262 42

It is clear that the control of plasma fibrinogen levels is complex, involving not only many environmental factors such as alcohol intake, smoking habit, age, obesity and the acute phase response, but also genetic factors as shown by the association of the Bcl I RFLP of the beta-fibrinogen gene with plasma fibrinogen levels. The advent of recombinant DNA technology has made the dissection of the different factors controlling plasma fibrinogen levels a valid proposition, and great progress is already being made. The goals of this research are twofold. First, it may be possible to develop DNA tests to identify individuals who, on the basis of their genotype, are at high risk of ischaemic heart disease. Once identified, the subsequent risk of these individuals can be reduced by modifying life-style or by drug therapy to reduce other known risk factors such as cholesterol levels. Second, once the mechanisms controlling fibrinogen concentration are better understood at the molecular level, it may be possible to develop directed therapeutic strategies that will reduce fibrinogen synthesis in a specific manner, an approach that is not possible at present. In the future, such pharmacological agents may have as wide an impact on reducing ischaemic heart disease as cholesterol-lowering drugs do today.
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PMID:Control of plasma fibrinogen levels. 268 60

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

To evaluate the risk factors for coronary disease, 345 women, aged 35 to 59 years, who had undergone coronary arteriography for suspected coronary disease completed a mail questionnaire, telephone interview, or both. Two hundred eight women with angiographically normal coronary arteries constituted the control group, and 137 with a 70% or more occlusion of one or more coronary vessels were classified as having severe coronary occlusive disease. Age-adjusted odds of severe coronary disease based on the logistic regression model for the risk factors evaluated were as follows: smoking, 5.73 (p less than 0.001); diabetes, 5.09 (p less than 0.001); cholesterol level greater than 240 mg/dl, 2.35 (p less than 0.05); a parental history of death from heart disease before age 60 years, 2.03 (p less than 0.05); and estrogen use for 6 months or longer, 0.50 (p less than 0.01). There were no differences with regard to the presence of obesity and a history of hypertension in women with and without coronary disease. These data support the hypothesis that use of noncontraceptive estrogen significantly reduces the risk of severe coronary disease, whereas smoking, an elevated cholesterol level, and a parental history of heart disease all increase the risk of ischemic heart disease in women.
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PMID:Risk factors and noncontraceptive estrogen use in women with and without coronary disease. 272 50

Cardiovascular diseases are the first cause of death in all developed countries and in many underdeveloped countries (1). In Cuba they have constituted the first cause of death in the last 20 years, with a tendency to increase, with the characteristic that this tendency is due to ischemic heart disease (IHD) (2). The frequency of IHD increases with age, but it has increased in the population under 50 years of age lately (3, 4, 5). Although the cause of atherosclerosis is unknown, in the last years an epidemiologic association has been demonstrated between the atherosclerotic disease (mainly IHD) and a series of pathologies, habits of the population, genetical, biochemical, physiological and environmental factors, which influence directly and indirectly the early development, frequency, severity evolution and prognosis of IHD and have been called coronary risk factors (CRF); at present, the disease is considered to be multifactorial and its magnitude and severity are influenced by the exposure time and the combination of CRF; it has also been demonstrated that it is decreased by the application of measures for the pressure measurements with Hg sphygmomanometer, in the population (1, 5, 6, 7, 8, 9, 10, 11). In our country, a series of studies have been made to ascertain the magnitude and characteristics of cardiovascular diseases (12-14); through these works we will know the incidence of IHD, some of its characteristics and its relation with some coronary risk factors hypercholesterolemia, arterial hypertension, (AH), diabetes mellitus, smoking habit and obesity).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ischemic heart disease. Its incidence and association with risk factors]. 277 23

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 authors examined the relation between 24-hour dietary fiber intake at baseline survey in 1972-1974 and subsequent 12-year ischemic heart disease mortality in a southern Californian population-based cohort of 859 men and women aged 50-79 years. Relative risks of ischemic heart disease mortality in those with dietary fiber intake of 16 gm/24 hours or more compared with those with intake less than 16 gm/24 hours were 0.33 in men and 0.37 in women. A 6 gm increment in daily fiber intake was associated with a 25% reduction in ischemic heart disease mortality (p less than 0.01). This effect was independent of other dietary variables, including calories, fat, cholesterol, protein, carbohydrate, alcohol, calcium, and potassium. Some, but not all, of this effect appears to be mediated through the known cardiovascular risk factors: after multivariate adjustment for age, sex, blood pressure, plasma cholesterol, obesity, fasting plasma glucose, and cigarette smoking habit, the magnitude of the protective effect of fiber was reduced but still significant in both sexes combined. These findings support the hypothesis that high dietary fiber intake is protective for ischemic heart disease mortality.
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PMID:Dietary fiber and reduced ischemic heart disease mortality rates in men and women: a 12-year prospective study. 282 19

It has been postulated that dehydroepiandrosterone (DHEA) and its sulfate ester, dehydroepiandrosterone sulfate (DHEAS), the major secretory products of the human adrenal gland, may be discriminators of life expectancy and aging. We examined the relation of base-line circulating DHEAS levels to subsequent 12-year mortality from any cause, from cardiovascular disease, and from ischemic heart disease in a population-based cohort of 242 men aged 50 to 79 years at the start of the study. Mean DHEAS levels decreased with age and were also significantly lower in men with a history of heart disease than in those without such a history. In men with no history of heart disease at base line, the age-adjusted relative risk associated with a DHEAS level below 140 micrograms per deciliter was 1.5 (P not significant) for death from any causes, 3.3 (P less than 0.05) for death from cardiovascular disease, and 3.2 (P less than 0.05) for death from ischemic heart disease. In multivariate analyses, an increase in DHEAS level of 100 micrograms per deciliter was associated with a 36 percent reduction in mortality from any causes (P less than 0.05) and a 48 percent reduction in mortality from cardiovascular disease (P less than 0.05), after adjustment for age, systolic blood pressure, serum cholesterol level, obesity, fasting plasma glucose level, cigarette smoking status, and personal history of heart disease. Our conclusions are limited by the single determination of DHEAS levels, but the data suggest that the DHEAS concentration is independently and inversely related to death from any cause and death from cardiovascular disease in men over age 50.
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PMID:A prospective study of dehydroepiandrosterone sulfate, mortality, and cardiovascular disease. 294 52


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