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

Hypertension is a cardinal risk factor in the genesis of cardiovascular morbidity and mortality. The presence of concomitant risk factors greatly increases the incidence of vascular events, and associations of age, hypertension, obesity and smoking are particularly lethal combinations. Accelerated atherosclerotic change characterizes sustained hypertension, and ischaemic heart disease, aortic dissection, stroke and multi-infarct dementia are major sequelae. Major studies in the United States, Australia and the United Kingdom have shown that treatment of hypertension significantly reduces the occurrence of strokes. Obesity and excess alcohol consumption closely correlate with hypertension. The relative importance to hypertension of type II diabetes and obesity is difficult to evaluate.
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PMID:Hypertension and associated diseases in elderly patients. 306 91

The identification of risk factors, such as a raised cholesterol level, hypertension, cigarette smoking, and obesity, permits the prediction of the possible development of ischaemic heart disease and has led to attempts at its prevention through modification of these factors. A high risk of developing ischaemic heart disease is also associated with age, specific socioeconomic groups, a family history of ischaemic heart disease, and preexisting evidence of the disease. Preventive strategies have either sought to reduce the average levels of risk in the general population or to identify by population screening individuals or groups who are at particular risk and to reduce their level of risk. Differing methods of risk-factor identification and modification are appropriate for each of the high-risk groups. For a number of strategies that are directed at either the whole population or high-risk groups we have estimated the costs of identification and risk-factor modification and the probable benefits of undertaking such a strategy. A strategy which educates the whole population by way of the media costs considerably less than does any strategy that involves the identification of individuals at high risk. At a medium cost estimate, with a reduction in risk of only 1%, such an approach costs approximately $8000 per case that is prevented; when risk reduction approaches 3% it actually results in a saving of health-care expenditure within five years. The costs of the other strategies vary between $12,000 and $26,000 per case that is prevented in a five-year period.
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PMID:A cost-effectiveness analysis of alternative strategies for the prevention of heart disease. 312 81

The findings after the first year of the study are presented. The study population is 282,052 men and women aged 25-64 years, current residents of rural Tarnobrzeg Voivodeship. The population is characterized by a declining linear trend in ischemic heart disease (IHD) mortality in men aged 35-44 years. The myocardial infarction (MI) incidence (per 100,000 residents) is 233 in men and 68 in women. The MI death rates (per 100,000 residents) are 128 for men and 29 for women. The MI 28-day case fatality is 44% for men and 41% for women. The most frequent risk factors are: smoking in men (58%) and obesity in women (40%). Around one-quarter of the men and of the women are hypertensive. The rates for hypercholesterolemia are 9% in men and 13% in women.
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PMID:Pol-MONICA Cracow on-going study: initial findings. 320 19

One hundred three patients with ischemic heart disease (IHD) were compared with 29 patients with organic heart disease and normal coronary arteries (OHD) and with a control group of 101 patients free of heart disease and matched for age and sex. Twelve patients in the control group, 4 in the OHD group, and 34 patients in the IHD group were found to have hearing loss (HL) of different degrees, cause, and duration (P = 0.0003). Of the HL-IHD group, 19 of the 34 patients had no underlying etiologic factor compared with 4 of the 12 patients in the control group (P = 0.0005); age was not an important factor. Multiple logistic regression analysis suggests that the probability of a patient with HL of unknown etiology to have IHD is eight times greater than in individuals with normal hearing. In the HL groups (12 controls and 34 with IHD), there were no significant differences in sex, hypertension, obesity, or smoking, but there was a lower incidence of diabetes and a higher incidence of family history in the HL-IHD group than in the HL-control group. Two patients in the HL-IHD group had families with many members affected by both deafness and IHD, suggesting a heredofamilial disease. HL always preceded the clinical manifestation of IHD and appears to be an important "early marker" of a vascular or generalized arteriosclerotic process.
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PMID:Hearing loss and ischemic heart disease. 320 30

The purpose of this study was to elucidate the relationship between two genetic factors associated with raised blood cholesterol, i.e. familial hypercholesterolemia (FH) and apolipoprotein (apo) E4. A group of 50 unrelated heterozygous FH patients aged 33-71 years were studied together with 129 normolipidemic subjects. A significantly higher frequency of apo E4 phenotypes was found in FH patients (30.0%) than in normolipidemic subjects (15.5%). FH patients were divided into two groups with and without apo E4. Plasma total cholesterol (Chol) and triglyceride (TG) levels were significantly higher, and plasma low density lipoprotein-cholesterol (LDL-Chol) level tended to be higher in FH patients with apo E4 than in those without apo E4. In addition, the prevalence of ischemic heart disease (IHD) was significantly higher in FH patients with apo E4 (73.3%) than in those without apo E4 (31.4%). No significant difference was noted in age and in the prevalence of obesity, diabetes, hypertension and smoking between the FH groups with and without apo E4. These results suggest that apo E4 is associated with higher levels of total Chol and TG and, at least in part, contributes to the predisposition to IHD in FH.
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PMID:Familial hypercholesterolemia and apolipoprotein E4. 321 64

There are marked associations between social class and mortality from ischaemic heart disease (IHD). Using data from the Caerphilly and Speedwell Collaborative Heart Disease Studies the relationships between a number of known risk factors for IHD and social class are explored. The overall conclusions are that lipids and obesity are unlikely to play any part in explaining social differences in ischaemic heart disease. Blood pressure, particularly stystolic pressure, could be involved but the two data sets are inconsistent and associations are only shown in Speedwell. There are marked differences in the haemostatic related variables in the various social classes and the pattern of these is similar in Caerphilly and Speedwell. It is possible therefore that the class pattern of IHD is generated, in part at least, by differences in haemostatic mechanisms. These differences in haemostatic function are almost entirely due to the large social class differences in smoking habit. It is possible therefore that the class differences in IHD result from differences in smoking habit.
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PMID:Haemostatic and other risk factors for ischaemic heart disease and social class: evidence from the Caerphilly and Speedwell studies. 322 82

As part of the World Health Organization MONICA Study, the prevalence of cardiovascular risk factors was estimated for Auckland (1982), Perth (1983) and Newcastle (1983). Measurements of blood pressure, blood lipid levels, the prevalence of cigarette smoking, obesity and other factors were obtained by similar methods in each centre from random samples of men and women aged between 35 and 64 years whose names were drawn from the electoral rolls. These risk-factors levels were then compared with official statistics on mortality of all causes and of ischaemic heart disease for the three populations around the same time. There were substantial differences in mortality among the three centres. Death rates of all causes and of ischaemic heart disease were lowest in Perth and highest in Newcastle (except for all-causes mortality for women, which was highest in Auckland). Compared with Perth, differences in the mortality rates of ischaemic heart disease were 27% higher for men and 35% higher for women in Auckland, and 44% and 95% higher, respectively, in Newcastle. Levels of risk factors showed the same pattern for Perth (lower) and Newcastle (higher) but were somewhat inconsistent for Auckland. The relative magnitudes of the differences in risk factors were less than for the differences in mortality. Thus, other risk factors, socioeconomic differences and differences in medical care may also contribute to the differences in ischaemic heart disease mortality rates and further explanations should be sought for the large differences among these cities.
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PMID:Risk-factor levels and mortality of ischaemic heart disease in three Australasian centres. Auckland, Newcastle and Perth MONICA Centres. 325 89

Hypertension is a major risk factor for cardiovascular morbidity and mortality. Antihypertensive therapy consistently reduces complications from stroke and congestive heart failure, whereas benefits from the treatment of ischemic heart disease events are variable. Several plausible explanations, including hemodynamic hypotheses, have been put forth to account for the failure of treatment to more favorably influence mortality from ischemic heart disease. The effect of hypertension on coronary heart disease is probably much more complex than a simple elevation of arterial pressure. Some of these complexities include the potential separate risks of high total peripheral resistance, high cardiac output, increased myocardial power that reflects pressure times flow, and several structural and functional vascular changes. These factors may act in concert to unfavorably alter the balance between myocardial oxygen supply and demand. Several of these factors will be highlighted in an attempt to offer alternative or adjunctive pathophysiologic examinations for the high-risk subgroups of obesity and the failure of antihypertensive therapy to normalize the rate of coronary heart disease events.
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PMID:The importance of hemodynamic considerations in essential hypertension. 329 3

Because recent knowledge indicates that the distribution of fat deposits in men may be a better predictor of cardiovascular disease than the degree of obesity alone, some risk factors for atherosclerosis were evaluated in 51 middle-aged men with non-insulin-dependent diabetes mellitus. Abdominal adiposity (waist/hip ratio, WHR) was related to parameters of metabolic control, lipid parameters, and known vascular complications in three different groups. In groups with abdominal obesity, mean annual hemoglobin A1 was significantly (P less than .01) higher than in patients without an abdominal fat distribution. Atherogenic index was significantly increased in the group with the highest WHR and high-density lipoprotein cholesterol (HDL-chol) levels were significantly decreased in both groups with upper-body fat distribution. The frequency of peripheral vascular disease, coronary ischemic heart disease, and hypertension was most prominent in diabetic subjects with an abdominal fat mass distribution. A highly significant (P less than .001) correlation was present between WHR and HDL-chol and WHR and the total-cholesterol/HDL-chol ratio; this significant correlation remains after correction for body mass index. A similar correlation could be found between WHR and systolic and diastolic blood pressures. These results demonstrate an association of excess abdominal fat, even without manifest obesity, with worse diabetes metabolic control, cardiovascular complications, and blood lipid levels actually considered to play an important role in atherogenesis.
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PMID:Relationship of body fat distribution pattern to atherogenic risk factors in NIDDM. Preliminary results. 338 30

Overweight and obesity have been examined in 7735 middle-aged men in 24 British towns. Half the men exceeded the body mass index (BMI) range associated with minimum mortality (20-25 kg/m2). Social class differences in BMI were marked and obesity was more marked in manual workers. The association of reduced BMI with cigarette smoking and of increased BMI with stopping smoking was most clearly seen in manual workers. With increasing alcohol intake, BMI increased progressively, but the effect in the heaviest drinkers was probably diminished by concurrent heavy smoking. Mean BMI decreased with increasing levels of physical activity. There was considerable variation in the rate of obesity between the towns, from 11 to 28 per cent, determined to some extent by social class. Positive associations were observed between BMI and the presence of ischaemic heart disease, high blood pressure, gout, arthritis and gallbladder disease but not with diabetes mellitus. Peptic ulcer was inversely related to BMI and bronchitis showed a curvilinear relationship. For these men, overweight or obesity is virtually 'normal', and a considerable health education effort will be needed to produce a leaner, healthier society.
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PMID:Overweight and obesity in middle-aged British men. 338 26


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