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

The drug treatment of chronic coronary insufficiency in diabetic patients is now well defined. Platelet antiaggregants, especially aspirin, must be prescribed in the long-term or even indefinitely. Other drugs (beta-blockers, calcium channel blockers, nitrates, etc.) can be used in the same way as in the absence of diabetes. Angioplasty gives immediate favourable results in diabetics, very similar to those obtained in the absence of diabetes. In contrast, the longer term prognosis is less favourable, as the mortability, myocardial infarction, restenosis and bypass graft rates are significantly higher. First-line stenting lowers the restenosis rate to a level comparable to that observed in non-diabetics. However, instrumental revascularization is less complete than surgical revascularization and the number of redilatations and/or secondary bypass grafts remains high. The indications, mortality and early complications of coronary surgery are now identical to those observed in the absence of diabetes. Its long-term results are significantly more favourable than those of medical treatment or even angioplasty, although this issue is still controversial. The improved prognosis observed in operated diabetic coronary patients is due to the more frequent use of arterial bypass grafts. The maintenance of blood glucose control and correction of the frequently associated cardiovascular risk factors (obesity, sedentary lifestyle, smoking, HT, dyslipidaemia) increase the efficacy of treatment of coronary insufficiency in diabetic patients. This goal can only be achieved by permanent, unfailing collaboration between cardiologists and diabetologists.
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PMID:[Treatment of coronary insufficiency in diabetics. Part 3: chronic coronary insufficiency]. 1255 83

The year 2004 was not marked by major pharmacological advances, but by confirmation of previous "evidence". Several innovative drugs for stable angina (ranolazine, ivabradine), some interesting results in acute coronary syndrome (PROVE IT study), some classic concepts (cannabinoid receptors and their antagonists such as rimonabant) applied to novel indications (treatment of obesity), hopes for the "sartans" revived in the light of new evidence (VALUE study), advances in the management of diabetes and hypertension (ASCOT and CARDS studies), nebivolol which is not just a betablocker but also produces the NO radical (is this why it decreased the mortality of heart failure in the elderly in the SENIOR study?). In contrast, although Chronadalate did not live up to expectations for coronary insufficiency, the year was marked above all by the much heralded withdrawal of Vioxx for increasing cardiovascular risk. The old adage: primum non nocere springs to mind.
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PMID:[The best of clinical pharmacology in 2004]. 1571 64

It is not surprising that cardiovascular diseases such as congestive heart failure and coronary insufficiency can give rise to varying degrees of sleep impairment; it is less readily appreciated that certain physiologic events occurring during sleep-as well as long-term unsatisfactory sleep-may cause or increase the risk of cardiovascular conditions such as hypertension, atherosclerosis, stroke, and cardiac arrythmias. Heart rate abnormalities during sleep in normotensive subjects predict later cardiovascular disease, and their early identification alerts the physician to undertake preventive measures. Maneuvers, such as induction of hypoxia, can elicit abnormal blood pressure responses during sleep, and such responses have been used to identify impending cardiovascular problems that could become therapeutic targets. The spontaneously hypertensive rat has been used to examine the effect of sympathetic nervous system (SNS) activity on the heart under a variety of experimental conditions, including quiet and paradoxical sleep. The results have disclosed significant differences between the responses of spontaneously hypertensive rats and normal rats to SNS stimulation. Exploration of other pathophysiologic pathways affected by exposure to light and dark, including those responsive to the cyclic production of melatonin, will improve our understanding of the effect of disruptions of the circadian cycle on cardiovascular function. There is growing evidence that melatonin can influence important processes such as fluid, nitrogen, and acid-base balance. Human subjects whose nocturnal arterial blood pressure fails to show the "normal" decrement during sleep ("nondippers") are also prone to sleep poorly, exhibit increased SNS activity during sleep, and have an increased risk of total and cardiovascular disease mortality. Chronic sleep deficit is now known to be a risk factor for obesity and may contribute to the visceral form of obesity that underlies the metabolic syndrome. The rising prevalence of obstructive sleep apnea and central sleep apnea is linked to the modern-day epidemic of obesity. Obstructive sleep apnea is associated with an enhanced risk of having a new stroke or a transient ischemic attack.
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PMID:Sleep and vascular disorders. 1697 27

Type 4 cardiorenal syndrome is a growing societal problem as the aging population, with increasing incidence of chronic kidney disease (CKD), diabetes, obesity, hypertension, and other cardiovascular risks, leads to higher numbers of individuals suffering the complications of this bidirectional disorder. In this review, the immense burden of cardiovascular risk faced by patients on dialysis, as well as lesser degrees of CKD, will be examined, with emphasis on rates of acute coronary syndrome/coronary insufficiency, congestive heart failure/left ventricular hypertrophy, and cardiac arrhythmia/sudden cardiac death.
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PMID:The burden of cardiovascular risk in chronic kidney disease and dialysis patients (cardiorenal syndrome type 4). 2162 89

The obesity dependence of selected clinical and instrumental characteristics of 10 male patients with arterial hypertension (AH) was evaluated Group I included 79 patients with grade II hypertensive disease (HD), normal body weight and waist circumference. Group 2 comprised 61 patients with grade II HD and abdominal obesity. Patients of both groups showed high frequency of left ventricular (LV) hypertrophy (59.2 and 73.8% respectively). Concentric LV hypertrophy prevailed in group I and eccentric hypertrophy in group 2. 24 hr ECG monitoring showed that signs of relative coronary insufficiency were recorded more frequently in group 2 and cardiac rhythm disturbances in group I.
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PMID:[THE INFLUENCE OF ABDOMINAL OBESITY ON LEFT VENTRICULAR MYOCARDIALREMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION]. 2659 63


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