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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The essential implication of the notion of risk factor is that preventive action should be undertaken if certain factors, predisposing to cardiovascular diseases are present in an individual or in a group. Risk factors are thus categorized from the pragmatic point of view, according to the relative ease and practicability of prophylactic intervention -- and their justification. A brief review of the risk factors of the major cardiovascular diseases (coronary heart disease, hypertension, chronic pulmonary heart disease, stroke, rheumatic heart disease and congenital malformations) shows that the risk factor concept is the basis of preventive cardiology.
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PMID:[Use of the risk factor concept in cardiovascular diseases (author's transl)]. 100 56

A case-control study was performed to investigate the significance of arteriosclerosis, heredity and some infections in the etiology of Parkinson's disease. The study group consisted of all traceable patients with Parkinson's disease living in a defined area, a total of 444 patients, and of control subjects for each patient, matched in sex and age, chosen from among the general population residing in the same area. No significant differences were found between the patients and the controls concerning the occurrence of cardiac insufficiency, coronary heart disease, or stroke. The Parkinsonian patients, however, had a significantly lower incidence of clinical arterial hypertension when compared with the controls. In addition, the patients more often had low systolic blood pressures and more rarely high pressures than the controls. Even the mean systolic blood pressure was significantly lower in the patients than in the controls. The low blood pressure seems to be an effect of Parkinson's disease itself with a minor contribution of levodopa therapy. The observations above are considered to indicate that arteriosclerosis and Parkinson's disease are probably only concurrent disorders and not in etiological relationship with each other. There was no statistically significant difference in the proportion of the patients and the controls with relatives with Parkinson's disease or essential tremor, which suggests that genetic factors do not have a significant role in Parkinson's disease and on the other hand that essential tremor and Parkinson's disease are two separate disease entities. No other encephalitis than a lethargic one was found to precede Parkinson's disease and the occurrence of meningitis was rare both among the patients and the controls. The history of Spanish influenza was found to be as frequent in the patients as in the controls, thus not supporting the idea that influenza has etiological importance in Parkinson's disease.
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PMID:Arteriosclerosis, heredity, and some previous infections in the etiology of Parkinson's disease. A case-control study. 100 13

In summary, a prognostic and therapeutic evaluation of 227 patients first seen from 1967 to the end of 1969 with a follow-up of 4-7 years was made. The results are indeed depressing. In spite of close follow-up and systematic treatment with modern antihypertensive agents, the mortality of patients having hypertension with superimposed arteriosclerosis was 27% (15 to 56) for males as contrasted to 3% (2 of 75) for females. Since the last casual blood pressure in both living and deceased patients of the mixed group were similar, the level of blood pressure following treatment could not be incriminated for the deceased patients. An exaggerated systolic and pulse pressure cold pressor response emerged as an important indicator of presence of arteriosclerosis alone. When hypertension and arteriosclerosis coexisted there was also exaggeration in diastolic cold pressor response. A further exaggeration in systolic and diastolic cold pressor response was seen in the decreased as compared to living male patients, a finding which appears to have grave prognostic significance for coronary heart disease and stroke. Thus a marked exaggeration in both systolic and diastolic cold pressor response in males might prove to be the single most important predictor of premature death from atherosclerotic vascular disease. A further analysis of the deceased male patients having hypertension and superimposed arteriosclerosis, indicates that treatment of hypertension may prevent oeath from stroke but not form coronary heart disease. Two-thirds of the deaths occur suddenly and only one-third of the deceased patients reached the hospital befor dying. In view of these distressing findings a plea for early detection and treatment of hypertension, prior to the development of superimposed arteriosclerotic changes, particularly in males, is made.
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PMID:Prognostic and therapeutic considerations in pure hypertension vs hypertension and superimposed arteriosclerosis. 112 46

Electrocardiographic patterns of left axis deviation and left anterior hemiblock, defined by a frontal plane QRS axis of minus 30 degrees to minus 44 degrees and minus 45 degrees to minus 90 degrees, respectively, with normal QRS duration, were found to be fairly common (2.6 and 1.5 percent, respectively) in a community population of 8,000 Japanese-American men aged 45 to 69 years. More than 60 percent of men with these electrocardiographic patterns had no other cardiovascular abnormalities, and the incidence of fatal or nonfatal coronary heart disease and stroke in this group during observation periods of 3 to 6 years was not significantly different from that of control normal men. A significant association was found between these electrocardiographic patterns and the prevalence of hypertension, myocardial infarction and stroke. However, the association of myocardial infarction with left anterior hemiblock appeared to be coincidental and was attributed largely to the similarity of the electrocardiographic manifestations of left anterior hemiblock and inferior wall myocardial infarction. Men with left axis deviation were fatter and had higher blood pressure than the control population. No such difference could be demonstrated for men with left anterior hemiblock although this group was significantly older than control subjects and men with left axis deviation. The results of our study suggest that there are qualitative differences between the causative mechanisms and clinical features of left axis deviation and those of left anterior hemiblock.
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PMID:Left axis deviation and left anterior hemiblock among 8,000 Japanese-American men. 113 Feb 90

Seven patients with coronary heart disease (CHD) but no angina pectoris had hemodynamic studies at rest and during submaximal and maximal exercise levels 2 mth after an acute uncomplicated myocardial infarction. The hemodynamic study was repeated after 3 mth of regular physical training. Maximal oxygen intake (VO2max) increased by 16.1% after physical training while maximal heart rate unsignificantly decreased (minus 3.3%). Higher VO2max after training resulted from an increase in maximal cardiac output (+7%) and stroke volume (+9.2%) and from a widening of the maximal arterio-venous oxygen (A-VO2) difference (+7.3%). The fall in stroke volume observed from submaximal to maximal exercise level was not affected by training. During submaximal exercise, the lower heart rate after training was attended by both a greater stroke volume and a wider A-VO2 difference; the cardiac output slightly decreased. We conclude that the increase in VO2max observed with early physical training in CHD results on one hand from an increased stroke volume whose specificity is not established, and on the other hand from a wider maximal A-VO2 difference; the latter is entirely due to a greater extraction of oxygen from the blood by the working muscles during maximal exercise.
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PMID:Early hemodynamic adaptations to physical training in patients with healed myocardial infarction. 114 68

Mortality from all causes, from coronary heart disease, and from stroke in the US was studied in relation to solar activity as measured by the geomagnetic index, Ap, on a daily basis for the years 1964-66 and on a monthly basis for the years 1964-71. The data did not support previous assertions by Soviet researchers of an association between solar activity and cardiovascular mortality.
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PMID:Solar activity and mortality in the United States. 118 74

Stroke, coronary heart disease (CHD) and total mortality are evaluated from death certificates in enumerated cohorts of 45-64-year old Japanese men in Hiroshima and Nagasaki (1965-1970), in Homolulu (1966-1970), and in the San Francisco area (1968-1972). Total mortality is highest in Japan with no consistent differences between Japanese Americans in Homolulu and San Francisco. Age-specific CHD death rates are markedly lower in all three Japanese groups than in American whites. The CHD rates are consistently and significantly lower in Japan that in American Japanese. Stroke death rates for American Japanese men appear equivalent to figures for US white men of the same age, but are significantly lower than in the Japan cohort for the 60-64-year-old group. The number of stroke deaths below that age are too few as yet for analysis. Validation of mortality ascertainment and of the accuracy of death certification has been carried out in Japan and in Hawaii. The international differences in mortaltiy do not appear to be due to certification or other methodologic artifact.
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PMID:Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: mortality. 120 50

Blood pressure measurements were made on three Japanese populations residing in Japan, Honolulu, and Northern California. A common protocol was utilized in an effort to standardize inter-observer variability. Zero terminal digit preference varied among the three areas and there was differential clustering of diastolic values at 80 mm Hg and 90 mm Hg in Hawaii and California, respectively. Diastolic blood pressure did not rise with age in any of the three populations while systolic blood pressure rose in each. Blood pressure levels in Japanese in Japan were intermediate to those in Hawaiian and Northern California Japanese, California having the higher blood pressure levels. Since the relative weights of the Japanese migrants to Hawaii and California were substantially higher than the relative weights of the non-migrant populations in Japan, the blood pressures were adjusted for these differences. When this was done, most of the differences among the various study subgroups were explained. The findings indicate that the blood pressure distributions of the Japanese populations residing in Japan, Hawaii, and Northern California cannot of themselves account for the observed differences in coronary heart disease and stroke occurrence among these populations in which there is a gradient from high stroke rates in Japan to low rates in California and a reverse trend for coronary heart disease.
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PMID:Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: blood pressure distributions. 120 52

Hemodynamics measures and indices of myocardial contractility were determined in 110 patients with coronary heart disease. In comparison to a normal group (n=20) right heart pressures (right ventricle, arteria pulmonalis) were increased in coronary heart disease by 48-71%. Systolic aortic pressure was increased by 20-22%. Left ventricular enddiastolic pressure was consideraibly increased by 130%, dependent on the severity degree of coronary artery disease. Cardiac output and cardiac index were decreased at comparable heart rate by 20-33%, dependent on an effective decrease of stroke volume. Isovolumic indices of myocardial contractility (dp/dtmax, t-dp/dtmax, dpmax/IP) WERE REDUCED IN CORONARY HEART DISEASE PARALLEl to the severity degree of coronary artery stenosis. All the hemodynamic chances were most pronounced in a group with left ventricular aneurysm. The results demonstrate that myocardial performance in coronary heart disease is characterized by decreases of pump function and contractility in correlation with the severity degree of coronary artery stenosis.
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PMID:[Coronary disease. I. A correlative study on hemodynamics and contactility in 110 patients]. 121 May 19

Left ventricular pressure-volume relationships as well as diastolic compliance were determined in 110 patients with coronary heart disease during routine right and left heart catheterization, coronary angiography and ventriculography. 1. Enddiastolic and endystolic volume of the left ventricle were increased in severe coronary heart disease dependent on the degree of coronary stenosis; left ventricular ejection fraction was consecutively reduced. 2. Left ventricular enddiastolic pressure, diastolic pressure difference and diastolic rate of pressure rise were increased in corrleation with coronary artery stenosis. In contrast, last diastolic volume inflow into the left ventricle was nearly the same in all groups. Left ventricular stiffness, expressed as dP/dV, was significantly increased dependent on the severity degree of coronary artery disease. 3. Diastolic pressure-volume relationships revealed greater steepness in coronary artery disease, significantly dependent, on the corresponding severity degree. 4. Hemodynamic measures (stroke volume, cardiac index, ejection fraction) were decreased parallel to the increased left ventricular wall stiffness. The results demonstrated decreased left ventricular compliance in coronary heart disease. There was a striking correlation between the severity degree of coronary heart disease and the decrease of left ventricular compliance. Validity and limitations of the techniques of estimating left ventricular compliance from diastolic pressures and volumes as well as the effects of a decrease of left ventricular compliance on cardiac mechanics are discussed.
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PMID:[Coronary disease. II. Analysis of diastolic pressure-volume correlations and left ventricular elasticity in 110 patients]. 121 May 20


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