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

Several studies have well demonstrated that obesity is associated with changes in cardiovascular vagosympathetic activity. The aim of the present work was to evaluate this activity in normotensive and in mildly hypertensive obese patients, and to correlate this activity with clinical and biological indexes of insulin resistance. Heart rate (HR) and systolic blood pressure (sBP) were examined by spectral analysis in 70 normotensive obese patients (group 1), 32 mildly hypertensive obese patients (group 2), and 21 controls. The high frequency peak of HR variations at a controlled breathing rate (vagal activity) was significantly reduced in both groups (p < 0.001). The mid frequency peak of sBP in the standing position (sympathetic activity) was similar in both groups and in the control group. In groups 1 and 2, the high frequency peak correlated negatively with age (p = 0.005 and 0.034 respectively). In group 1, the mid frequency peak correlated positively with fat mass, fasting plasma insulin and triglyceride levels, and insulin resistance index (p < or = 0.03). In group 2, the mid frequency peak correlated positively with fasting insulin and insulin resistance index (p = 0.006 and 0.007 respectively). This study shows that, in obese patients: 1. cardiac vagal activity is reduced in normotensive and mildly hypertensive subjects; 2. vascular sympathetic activity is unchanged in means but may be increased as a consequence of adiposity, hyperinsulinemia and insulin resistance, and this increase is likely to be involved in the increase of blood pressure.
Arch Mal Coeur Vaiss 2001 Aug
PMID:[Relationship between vasosympathetic activity and insulin resistance in normotensive and mildly hypertensive obese patients]. 1157 36

Several studies have reported the penetration and impact of national and international recommendations on the management of dyslipidaemia, a major cardiovascular risk factor. Most of them were carried out on patients participating in clinical trials or on in-hospital cases. The PRAGMA study was developed in order to evaluate management of this condition in general practice, at the heart of the health care system. From September to December 1998, 1,717 general practitioners were chosen randomly and included 6,623 patients considered to have a lipid disorder. In this sample, the prevalence of the main risk factors was as follows: hypertension: 39.6%, diabetes: 11.6%, obesity: 19.6%, past or present smokers: 33.8%. The main lines of management consisted in prescribing lipid lowering drugs (96.6%) with dietary recommendations (95.8%) and a fall lipid profile (59.9%). The main factors spontaneously cited by the general practitioners as being decisional were: the total cholesterol level (47.8%), diet (40.8%), body weight (29.4%) and drug therapy (19.2%). The cardiovascular risk factors were rarely taken into account in their totality. These results suggest that the management of dyslipidaemia patients by general practitioners is far from being optimal. Efforts should be made to change attitudes to take into consideration the global cardiovascular risk factors of patients with lipid disorders.
Arch Mal Coeur Vaiss 2001 Oct
PMID:[Management of dyslipidemias diagnosed in general practice in France--The PRAGMA Study]. 1172 9

Many acquired risk factors may be identified to avoid the scholarly nature of these interminable lists, they may be reclassified with respect to their originality or their mechanism of action and those of current interest, whose data is still often hypothetical but recent, can be underlined. The following order may be proposed: risk factors which cannot be changed: age (which remains the principal factor) and gender (women being at higher risk than men); true acquired risk factors such as cancer, dysimmune conditions (more specifically, the antiphospholipid syndrome) and hormone replacement therapy (oestroprogestative contraception which has been updated by the debate about "third generation pills" and the risk related to progesterone-like substances themselves; hormone replacement therapy of the menopause which still has no clinical trials to assess "our" forms with natural hormones administered transdermally or transmucosally). Smoking has also been accused of being a risk factor for venous thrombosis in the latest clinical trials. Metabolic factors increase the risk of thrombosis: this is established for obesity, still suspected for hyperhomocystonaemia, the abnormalities being the result of complex gene-environment interactions. Other dysmetabolic conditions (diabetes, hypercholesterolaemia, hypertriglyceridaemia), responsible for arterial complications, are not clearly related to increased venous thromboembolic risk although a preventive effect of statins (yet another I) has just been reported. Similarly to these metabolic factors, the origin of which, genetic or environmental, is difficult to establish, interest has recently been shown in quantitative and functional changes in blood clotting factors. This has been established for arterial disease for fibrinogen but, in addition to this factor which slightly increases the risk of venous thrombosis, increases of factor VIII independent of inflammatory conditions, of blood group and Von Willebrand factor, which all influence the level of factor VIII, an increase by 150% of the normal increases the risk of venous thromboembolic disease by 3 or 4 times. As for factor VIII, increases in factor IX, factor XI, and resistance to activated C protein (independently of the Leiden mutation on the gene for factor V), are also associated in increased venous thromboembolic risk. Without knowing into which category to classify them, previous personal and family history of thromboembolic disease, in the absence of the already mentioned hereditary risk factors, must be noted. Finally, amongst the acquired risk factors, the authors also list conditions of blood stasis and vascular lesions with or without hypercoagulability (surgery, prolonged hospital stays, cardiac failure, paralysis, pregnancy...). Of these acquired conditions which increase the risk of thrombotic complications, particular attention has been given over the last few years to forced immobilisation in uncomfortable positions as in certain forms of transport. Although clinical reports have discordant results, it would seem that the risk is increased and the benefits of supportive elastic stockings have been confirmed. If the acquired risk is identified and quantified for a patient, it allows evaluation of global risk and the installation of appropriate therapeutic measures.
Arch Mal Coeur Vaiss 2001 Nov
PMID:[Venous thromboembolic pathology. New acquired risk factors or new data on acquired risk factors]. 1179 76

The cases of 160 patients (126 men, mean age 57.5 +/- 13.3 years) operated consecutively as an emergency for a Stanford type A dissection of the aorta between 1980 and 2000 were reviewed. The cumulative follow-up was 716.7 patient-years with an average follow-up of 4.51 +/- 5.6 patient-years. The risk factors for early postoperative mortality (up to 3 months), late mortality (> 3 months) and reoperation (cardiac and/or vascular) were determined by multivariate analysis. The hospital mortality was 27.5%. Older ages, obesity, previous cardiac surgery, preoperative shock, medullary, renal or mesenteric ischaemia were significant risk factors for early mortality. The probability of actuarial survival was 66.1 +/- 3.8%, 57.7 +/- 4.2%, 52.2 +/- 4.6% and 45.3 +/- 5.5% respectively at 1, 5, 10 and 15 years. Chronic obstructive airways disease and a more recent operation date were significant risk factors for late mortality. Thirty patients underwent 37 reoperations after an average of 5.7 +/- 4.5 years. The actuarial probability for no reoperation was 96.9 +/- 1.8%, 74.7 +/- 5.3%, 60.8 +/- 6.8% and 39.3 +/- 9.1% at 1, 5, 10 and 15 years respectively. The presence of severe preoperative aortic regurgitation was the only significant risk factor for reoperation. Type A acute dissection of the aorta continues to have a high early mortality and a significant incidence of late complications. Patients with severe aortic regurgitation before surgery are at high risk for reoperation and should probably have more radical aortic repair at the initial operation.
Arch Mal Coeur Vaiss 2001 Dec
PMID:[Long-term results of surgery for type A acute aortic dissection]. 1182 22

There is no data available on the cardiovascular risk of children under 18 years of age in Tunisia, although it is well known that these risk factors present themselves in childhood. The authors performed an epidemiological study based on a representative sample of 793 schoolchildren in the rural region of Sousse, in Tunisia, to determine the incidence of the following risk factors: hypertension, hypercholesterolaemia and other lipid disorders, obesity and smoking. The main results show that the prevalence of hypertension is 11.2% with no statistically significant difference between the sexes. The prevalence of hypercholesterolaemia (2.9%), of hyper-LDL cholesterolaemia (0.6%) and hypertriglyceridaemia (1%) were comparable in boys and girls. Obesity (BMI > 30) was observed in 1.8% of the study population and was as common in girls (1.7%) as in boys (1.9%). Smoking was recorded in 4% of the study population and was commoner in boys (7.3%) than in girls (1.2%). This cardiovascular risk profile is encouraging and efforts should be made to maintain these levels until adulthood. This data will form the basis of a regional programme for the promotion of cardiovascular health in schools.
Arch Mal Coeur Vaiss 2001 Dec
PMID:[Cardiovascular risk in schoolchildren in rural Sousse, Tunisia]. 1182 23

The objectives of our study were to evaluate the perception and the knowledge of cardiovascular risk factors (CVRF) by the population and their management by health care workers (HCW) in Burkina Faso. The survey targeted specific socio-professional groups representative of Burkina Faso. The survey team administrated a questionnaire and measured some constants. The sampling method was empiric selection by quotas. The sample was composed of 2,000 subjects: 1,073 men, 927 women, 1,800 represents of the general population and 200 HCW. Of 1,800 non health workers, 1,475 had ever heard about hypertension. The representation of hypertension as "a disease" decreased with instruction level while its reprentation "a risk factor" increased with instruction level (p < 0.001). The main sources of information on CVRF were talks with parents and friends, radio broadcasting and discussion with HCW. One hundred and forty of 200 HCW defined hypertension as an elevation of blood pressure, mainly systolic (130 cases) according to WHO criteria. Hypertension was classified after alcohol, tobacco smoking, obesity as the fourth CVRF. One hundred and seventy seven of 302 cases of hypertension were previously unknown: 97 of the 125 old cases were treated and 74 had not normal blood pressure levels. Hypertension and other CVRF are not well-known in Burkina Faso population and are not well-managed by HCW. Political decision makers and donor institutions should pay more attention on the public health problem represented by hypertension and other CVRF in developing countries because of they are not communicable.
Arch Mal Coeur Vaiss 2002 Jan
PMID:[Knowledge and perception of cardiovascular risk factors in Africa South of the Sahara]. 1190 84

The object of this study was to assess the prevalence of modifiable cardiovascular risk factors and their association in 61,108 subjects over 15 years of age who volunteered for a systematic medical check-up, free of charge, and performed in a health centre in central France. The risk factors were defined as follows: hypertension, diabetes, hypercholesterolaemia, hypertriglyceridaemia: medical treatment or value above the upper limits of normal defined by national or international recommendations. obesity and android fat distribution as defined by the principal recommendations. The commonest risk factor was hypercholesterolaemia (60% of men and 64% of women) followed by android obesity. The prevalence of hypertension was greater in men than in women (44 vs 33%). Twenty eight per cent of men and 17% of women admitted to smoking. The percentage of smokers was higher in people under 30. Diabetes was observed in 3% of men and 2% of women. The association of risk factors was observed at an older age in women than in men. The association of 3 risk factors was four times greater in men than in women in the whole population. In conclusion, this study shows that cardiovascular risk factors are very common in persons undergoing a medical check-up and that these factors are often associated at an earlier age in men than in women.
Arch Mal Coeur Vaiss 2002 Apr
PMID:[Cardiovascular risk factors in France. Prevalence and association]. 1205 61

Obesity is a cardiovascular risk factor in adults. Poorly is known about effect of obesity on cardiovascular system in children. Mechanical properties of a great elastic trunk, the common carotid artery (CCA) and endothelium function of the brachial artery were studied in 130 obese children (age: 12 +/- 3 years, body mass index (BMI): 29 +/- 5.5 kg/m2, without hypertension (115 +/- 19/58 +/- 8 mmHg). These patients had a vascular high resolution echographical analysis. Cross sectional compliance (CSC), cross sectional distensibility (CSD) and incremental elastic modulus (Einc) were analysed at the CCA site. The brachial artery dilation was measured after hyperthemia (flow mediated dilation, FMD), an endothelium dependent function and after sublingually glyceryl trinitrate (GTNMD), an independent endothelium function. Fat mass composition and distribution were assessed by dual-energy X-ray absorptiometry in 70 patients. In 50 obese patients an oral glucose tolerance test was done to determine insulin resistance. The obese children had significantly lower CSC and CSD than the healthy controls (respectively 0.12 +/- 0.04 vs 0.14 +/- 0.05 mm2.mmHg-1; p < 0.05 and 0.5 +/- 0.2 vs 0.8 +/- 0.4 mmHg(-1).10(-2); p < 0.001). Obese children had higher value than the controls for Einc (2.4 +/- 0.4 vs 1 +/- 0.24 mmHg.10(3); p < 0.001) that correlated poorly with fasting insulin concentrations (r = 0.34; p < 0.06) and BMI (r = 0.34; p < 0.01). FMD was significantly lower in obese children than in controls (6 +/- 3 vs 8 +/- 4%, p < 0.01) without modification of GTNMD (17 +/- 6 vs 18 +/- 7%, NS). These two parameters were respectively correlated with the android fat distribution (r = 0.36; p < 0.01; r = 0.49; p < 0.001). The CCA stiffness of obese children is linked to the amount of the overweight and to insulin resistance. The android fat distribution is related to endothelium dysfunction.
Arch Mal Coeur Vaiss
PMID:[Arterial rigidity and endothelial dysfunction in obese children]. 1236 70

High fat diet (HFD) induces both arterial hypertension and tachycardia in dogs. Changes in heart rate occur early and are in part due to a decrease in the parasympathetic drive to the heart secondary to down-regulation of atrial muscarinic M2 receptors (Pelat et al. Hypertension 1999; 340: 1066-72). These data suggest that HFD is able to modify genic expression at atrial level. Thus, the aim of this work was to perform a systematic study of the genic expression profile in dogs made obese and hypertensive by 9 weeks of HFD. Blood pressure and heart rate were measured by telemetry implanted 15 days before starting regimen in 6 HFD and in 6 control dogs. HFD was the normal canine diet administered to controls but mixed with 300 g of beef fat. At the end of the experience, animals were sacrified and right atria were collected. Gene regulation was assessed in pooled tissue samples from both groups using suppressive substractive hybridization and microarray analysis. Genes with induction or repression rates of at least 20% when compared to controls were sequenced. As previously reported HFD induced a significant increase in body weight, blood pressure and heart rate when compared to controls. The results of SSH experiments led to the identification of 32 genes which are differentially regulated in atria from HFD dogs. Most are genes encoding proteins which have been previously shown to be regulated during various cardiopathies (MMP9, Na/K-ATPase 3...). These changes indicate the existence of early remodeling processes of atrial myocardium secondary to HFD. Other group of genes encodes proteins with no role identified in heart up today (lec-3, ERK-3, TRIP1, nucleophosmin...) or which function remains totally unknown. This work confirms that HFD is associated with early changes in gene expression in atrium. These changes are unlikely to be related to ventricular hypertrophy which is observed only during long-term HFD. Further studies are necessary to demonstrate the role of these modifications in the pathophysiological mechanisms leading to the increase in heart rate in this model of obesity-related arterial hypertension.
Arch Mal Coeur Vaiss
PMID:[Early atrial gene regulation of obesity-related arterial hypertension]. 1236 82

Major developments in molecular biology in invertebrates have recently shown the determining effect of genetics on aging. The first finding was that artificial selection can highlight the genetic aspect of the aging process, demonstrating the polygenetic property of longevity. Another finding showed that certain gene transfers can modulate the lifespan of an organism. Recent progress has been made in three fields: genetic markers of aging, biological basis of cell maintenance, and hereditary factors contributing to late onset genetic disease. These new developments open new avenues of research in clinical biology. In regard to genetic markers of aging, it has been demonstrated that the ends of the chromosomes, telomeres, play a role in cell senescence. Telomeres can be viewed as markers of aging. Shortened telomeres are associated with replicative senescence and antitumor action. DNA anomalies are also more frequent: simple or double breaks, additions and base substitutions. Data on the biological basis of cell maintenance obtained in invertebrates show the polygenetic property of aging involving four significant mechanisms, control of metabolism, resistance to stress, chromatin-dependent gene regulation of genetic homeostasis. Finally, recent studies have shown that late onset hereditary diseases would be linked with particular genes, some of which have been identified. Two non-exclusive mechanisms could be involved: an adaptive mechanism involving gene selection during the evolutionary process, for example in obesity; and non-adaptive accumulation of gene expression during the post-reproductive phase, for example in Alzheimer's disease. These findings open a new era for the biology of aging.
J Mal Vasc 2002 Jul
PMID:[Fundamental aspects of extreme aging]. 1259 89


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