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

Ten obese men (20-40% overweight) with previously untreated arterial hypertension (WHO stages I and II) were examined before and during sodium-restricted isocaloric diets. The mean (+/- s.d.) daily sodium excretion was reduced from 199 +/- 65 to +/- 25 mmol/24 h. Intra-arterial blood pressure (BP), cardiac output (CO), plasma volume, circulating and urinary noradrenaline (NA), plasma renin activity (PRA) and urinary aldosterone were measured. Vascular reactivity was assessed with intravenous bolus injections of 50, 100 and 200 micrograms phenylephrine, and baroreflex sensitivity was assessed with the R-R interval response to pressure elevations on electrocardiogram. Significant reductions in systolic BP from 163 +/- 18 to 147 +/- 17 mmHg and in diastolic BP from 97 +/- 7 to 88 +/- 9 mmHg occurred during salt restriction. Blood pressure reductions were correlated with changes of urinary sodium excretion (r = 0.71; P less than 0.05). No significant changes in CO, heart rate (HR) or stroke volume (SV) were observed; therefore, BP reduction was secondary to the fall in total peripheral resistance (TPR) from 21.8 +/- 4.1 to 19.0 +/- 4.1 units (P = 0.05). Plasma volume, as well as total blood volume, was not affected by the moderate sodium restriction, but PRA rose from 0.71 +/- 0.1 to 0.87 +/- 0.1 micrograms angiotensin 1/ml per h (P less than 0.05). Urinary aldosterone was increased from 32 +/- 12 to 54 +/- 9 nmol/24 h. No change in venous or arterial concentrations of NA or of urinary NA was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Central haemodynamics, baroreceptor sensitivity and alpha 1-adrenoceptor-mediated vascular reactivity during weight-stable sodium restriction in obese men with hypertension. 300 1

Mortality in relation to relative weight and exercise was analyzed from data collected in the first 2 years of the American Cancer Society's Cancer Prevention Study II. It included data on 868,620 persons who had no history of cancer, heart disease, or stroke and who were not sick at the start of the study. Standardized mortality ratios (SMR) were 187 for men who were 20% or more underweight and 187 for men who were 40% or more overweight. Comparable SMR in women were 186 and 178. Current smokers had considerably higher SMR than nonsmokers for all causes of death and cancer deaths at each relative weight category. Degree of exercise reported by subjects was inversely related to mortality, independent of smoking habits. Subjects who exercised heavily and died of cancer of the lung, colon-rectum, and pancreas had 20% to 37% higher SMR than men and women who reported moderate exercise.
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PMID:Mortality by relative weight and exercise. 316 2

Cardiovascular disease mortality rates have fallen dramatically in blacks in the United States. To determine whether this may be due to a decline in cardiovascular risk factors, we compared risk factors in a 1985 urban black population, ages 35 to 69, with those obtained in blacks of the same area in 1973-74. Age-adjusted mean body mass and the prevalence of overweight increased significantly over the 12-year period in both men and women. Mean systolic blood pressures declined significantly in both sexes, diastolic blood pressure declined significantly in men, and the proportion of men and women hypertensives on medication and under control increased. The overall prevalence of cigarette smoking changed very little, but the proportion of heavy smokers decreased significantly in men. No significant changes occurred in resting heart rate. Concurrently with these risk factor trends, age-adjusted heart disease mortality rates in area blacks fell 27% between 1968-73 and 1979-84, and stroke mortality fell 58%. Changing risk factors may be contributing to declining cardiovascular mortality rates in blacks. However, overweight seems to be a worsening problem.
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PMID:Trends in cardiovascular risk factors in an urban black population, 1973-74 to 1985: the Minnesota Heart Survey. 367 87

Obesity, a well-known phenomenon in Western society, is frequently associated with cardiovascular and endocrine disease. Strokes, myocardial infarction, diabetes and hyperlipidemia are classical reasons for the high mortality and morbidity of overweight people. For this reason, intensive weight-reduction programs have been proposed: low-calorie diets, total starvation, drugs and even surgery. Total starvation and some low-calorie diets are, however, also associated with sudden death, most probably of cardiac origin. Experimental data from our laboratory show that total starvation is accompanied by a severe depletion of magnesium in myocardial tissue. Protein-sparing modified low-calorie diets, however, can protect against this mineral loss even if magnesium supplementation alone cannot obtain this goal. Applying these principles in overweight man show weight reduction without mineral loss or cardiac disturbance. Surgery with 'ileal bypass' procedures gives rise to severe hypomagnesemia and hypocalcemia with tetany and spasmophilia. New procedures, derived from experimental surgery, are 'gastric bypass' and 'gastroplasty'. These methods, only applied in very obese patients (body mass index greater than 40, normal 23-27) show no change in mineral concentrations of calcium and magnesium and no clinical symptoms suggestive for mineral loss. A good, controlled weight-reduction program under strict medical surveillance can, in this way, offer new perspectives in the treatment of one of our most frequent 'culture-induced' diseases.
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PMID:Magnesium and obesity: effects of treatment on magnesium and other parameters. 382 Nov 74

A quantitative analysis of the cardiovascular risk factors in 101 stroke patients and their reduction by dietary treatment is given. From the risk factors a risk index was calculated. It was reduced from an average 4.9 at admission to 1.4 at discharge. The most frequent risk factors at admission (high triglycerides, high blood pressure and a high LDL/HDL ratio) are probably caused by 'normal' alcohol consumption and overweight. All patients were disused from smoking and alcohol. Under a low-caloric diet all risk factors were reduced within one month. Most diabetic patients became independent of drug treatment: A treatment of type II diabetes mellitus with oral antidiabetic drugs could be avoided even in the elderly patients by a low caloric diet without alcohol. On average there was a 4.8 mg% decrease of fasting triglycerides and a 5.7 mg% decrease of total cholesterol per 1% Broca Index reduction. HDL was increased in all patients despite withdrawal of alcohol, and the HDL/LDL ratio was significantly improved by the diet. There was a significant blood pressure reduction in the whole group; in addition there was a weight-related reduction in the hypertensive patients only: the systolic blood pressure was reduced by 9.3 mm Hg for each 10% Broca Index decrease. The atherogenic and hypertensive potencies of 'normal' alcohol consumption and sulfonylurea treatment are emphasized.
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PMID:Stroke: cardiovascular risk factors and the quantitative effects of dietary treatment on them. 383 Feb 11

Estimated prevalence of diabetes mellitus in Malaysia was about 2%. Diabetes was most common in Indians especially males and least common in Chinese. There was a slight male preponderance seen in Malays and Indians. Positive family history was obtained in 14% of cases most commonly in Malays, almost 1/3 of whom had more than one family member with diabetes. Familial association was uncommon in Chinese. Over 50% of patients were overweight. Obesity was noted in nearly 70% of female Malays and Indians while the majority of Chinese were not overweight. More than 80% of patients were non insulin requiring. Youth onset diabetes was considered rare; those 10 years and below were estimated to be only 0.4% and below 20 years of age between 2%-4% of the diabetic population. Females were twice as common than males in this type of diabetes and familial association was greater. Malnutrition-related diabetes and pancreatic calcification were not well-documented but youth-onset non insulin requiring diabetics with mild symptoms but strong family history of diabetes were observed. More than half of hospital-based patients had evidence of complications, mainly amongst Malays and Indians. Hypertension was the most frequent associated disease followed by foot ulcers and ischaemic heart disease. Hypertension usually associated with chronic renal failure was most common amongst Malays while gangrenic ulcers and heart diseases were seen mainly in Indians. The major causes of death were chronic renal failure, myocardial infarction, ketoacidosis, stroke and septicaemia related to gangrene.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diabetes mellitus in peninsular Malaysia: ethnic differences in prevalence and complications. 403 85

The literature points out the meaning of risk factors causing stroke as well as their therapy or elimination as an effective prevention of cerebrovascular disease. Hypertension increases the risk of apoplexy by 4-fold, with regard to the diastolic values of blood pressure by the 5-fold up to the 10-fold. Consistent hypertension therapy decreases significantly the incidence of cerebral apoplectic attacks. Manifested diabetes mellitus and even reduced glucose tolerance raise the risk of stroke by the 3-fold, even though factors frequently associated with diabetes are taken into consideration. Hyperlipidemia, hypercholesteremia, and hypertriglyceridemia stipulate an increase of stroke incidence by the 2-fold to the 3-fold. Morbidity rate rises if these abnormalities coincide with further risk factors, up to the 6-fold. Nicotine consumption alone increases the risk of cerebral apoplectic attacks in relation to age, by the 3-fold up to the 5-fold. In combination with the use of hormonal contraceptive drugs, the risk of morbidity rate in women rises to the 7-fold. Overweight of more than 30% aggravates twice the risk of stroke. Heart diseases of different kind increase the risk of apoplectic attacks by the 2-fold, in combination with hypertension by the 5-fold. The intake of oral contraceptives (OCs) causes an increase of cerebral thromboembolic attacks by the 3-fold up to the 5-fold, whereby a relation to estrogen content and to hemorheology disturbances is proven. Blood coagulation disturbances, especially hypercoagulability with increase of blood level of fibrinogen, fibrin, and enhanced adhesiveness of thrombocytes in cerebrovascular disease are proven to be valid. By combination of various risk factors apoplexy risk is additionally increased. The possibility of surgical and neurosurgical prophylactic treatment in all stages of cerebral ischemia, caused by occlusive disease of the cartoid, vertebral, and intracranial arteries, exists in 75% of patients. With regard to the longterm results of patients with extraintracranial bypass surgery, due to stenosis or occlusion of the carotid artery in its high cervical or intracranial course, or of the middle cerebral artery, the operated group clearly was better than the nonoperated group in frequency of cerebral ischemia recurrence. The therapeutic effect of inhibitors of thrombocytic aggregates and of anticoagulants for the chemotherapeutic prevention of cerebral ischemia, is proven for acetylsalicylic acid and derivatives of coumarin. Both diminish significantly the rate of cerebral ischemia when compared with placebo-treated control groups.
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PMID:[Prevention of cerebrovascular circulatory disorders]. 404 14

In view of recent interest in the relationship of haematocrit and blood viscosity to hypertension and vascular disease, we have analysed retrospectively the relationship of haematocrit to blood pressure, vascular complications and other variables in 2,381 patients referred to the Glasgow Blood Pressure Clinic. Haematocrit correlated negatively with age and systolic pressure in men, and positively with age and systolic pressure in females. Positive correlations were found in both sexes between haematocrit and serum alanine aminotransferase (possibly due to mutual correlation with alcohol); and between haematocrit and overweight (Quetelet Index) but not obesity (Ponderal Index). Increased haematocrit was also associated with cigarette smoking; and with history of angina, myocardial infarction and intermittent claudication in females. No correlation was observed between haematocrit and history of stroke. These findings suggest that prospective studies of haematocrit in hypertensives may be of interest.
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PMID:Haematocrit in patients attending a hypertension clinic. 405 4

The occurrence of various circulatory manifestations and risk factors was evaluated in a consecutive series of 209 patients admitted for acute cerebrovascular disease (CVD) and 209 control patients admitted for acute surgical disorders. Old and recent myocardial infarction, atrial fibrillation, congestive heart failure and reduced arterial blood pressure in the big toe were all much more frequently noted in CVD patients than in their matched controls. Hypertension, diabetes mellitus, overweight, high haemoglobin values, were also overrepresented in the CVD patients. Male CVD patients had a higher alcohol consumption than their controls. These findings implicate that CVD in old age is strongly related to both hypertension and a generalized atherosclerosis. The heavy accumulation of primary risk factors, many of which are considered to be primarily associated with atherosclerosis among elderly stroke victims, may indicate their contribution to a progressive atherosclerotic process still in operation.
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PMID:Circulatory manifestations and risk factors in patients with acute cerebrovascular disease and in matched controls. 408 79

Out of 512 recipients of kidney allotransplants 36 patients exhibiting cardiovascular complications (coronary artery disease, cerebrovascular accident, aneurysm of aorta, peripheral arterial occlusions) were compared with an age and sex matched group of recipients without cardiovascular problems. The following significant differences were observed in the study group versus the controls: high systolic and diastolic blood pressure, longer duration of hypertension before renal allografting, higher serum concentrations of cholesterol, triglycerides and uric acid, and an increased incidence of left ventricular hypertrophy and preexisting cardiovascular disease. No differences were found between the two groups as regards smoking habits, overweight, hyperparathyroidism, duration of hemodialysis treatment and type of kidney disease. Diabetes mellitus, family history of cardiovascular complications and hypertonic alterations of the eye fundus were more frequent, but not to a statistically significant extent, in the study group as compared to control patients. These findings show the need for regulation of blood pressure, hyperlipemia and hyperuricemia to ensure successful longterm rehabilitation after kidney allografting.
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PMID:[Cardiovascular diseases after kidney transplantation: an analysis of predisposing factors]. 645 62


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