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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The SU.VI.MAX study is a double blind, randomized, placebo-controlled trial testing, for 7,5 years, the effect of a combination of antioxidant vitamins and minerals, at doses considered to be nutritional (120 mg vitamin C, 30 mg vitamin E, 6 mg beta-carotene, 100 microg selenium and 20 mg zinc) in reducing cancer and ischemic vascular disease incidence in a general population (12.741 middle-aged). After 7.5 years, low-dose antioxidant supplementation had no effect on vascular disease incidence. This dose lowered, however, total cancer incidence in men, but not in women. With regard to contradictory results of observational and interventional studies published for the last decades, we can consider that the effect of antioxidants on cancer may depend on the doses (nutritional versus pharmacological), baseline antioxidant status (different between gender and/or nutritional status) and health status of subjects (healthy versus cancer high-risk subjects). Antioxidant supplementation may have a beneficial effect on cancer incidence only in healthy subjects who are not exposed to cancer risk, and with a particularly low baseline status. Finally, antioxidants as well as free radicals appear to be ambiguous nutrients with a wide range of benefits and toxicity. High doses of antioxidant supplements may be deleterious in high-risk subjects without any clinical symptoms in whom the initial phase of cancer development has already started.
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PMID:[The SU.VI.MAX study, a randomized, placebo-controlled trial on the effects of antioxidant vitamins and minerals on health]. 1711 69

Acclimatization to intermittent hypoxia (IH) improves exercise performance by enhancing oxygen delivery and utilization, but the effect of IH on hemodynamic control remains unclear. This study investigates how two intensities of IH influence hemodynamic control to develop an IH regimen that improves aerobic fitness and minimizes risk of peripheral vascular disorder. Thirty healthy sedentary men were randomly divided into severe (SIH) and moderate (MIH) IH and control (C) groups. The subjects were exposed to 12% (SIH), 15% (MIH), or 21% (C) O2 for 1 h/day, 5 days/week for 4 weeks in a normobaric hypoxia chamber. The results demonstrate that (1) improved pulmonary ventilation and oxygen uptake by SIH and MIH; (2) SIH elevated blood pressure during exercise and increased plasma malondialdehyde and nitric oxide (NO) metabolite levels, accompanied by reduced hyperaemic arterial response, venous compliance, endothelium-dependent vasodilatation, and decreased plasma total antioxidant and vitamin E levels; (3) while such effects were not seen following MIH; and (4) there were no significant differences in endothelium-independent vasodilatation during all experimental periods among the three groups. We conclude that both SIH and MIH regimens improve pulmonary ventilation. However, SIH but not MIH decreases anti-oxidative capacity and increases lipid peroxidation in circulation, leading to suppression of vascular endothelial function, causing impairment of vascular haemodynamics.
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PMID:Effects of moderate and severe intermittent hypoxia on vascular endothelial function and haemodynamic control in sedentary men. 1729 25

Mild cognitive impairment (MCI) refers to persons who are slightly cognitively impaired for age but do not meet the criteria for dementia. MCI has been related to a pre-dementia stage of Alzheimer's disease (AD). However, other possible diagnoses such as cerebro-vascular disease, frontotemporal dementia or normal aging have been considered. Diagnosis, etiology and conversion to dementia are a source of ambiguity in MCI. The aim was to evaluate the opinion of experts on dementia and of general practitioners concerning MCI. A total of 24 experts from Argentina and Brazil (16 neurologists and 8 psychiatrists) and 30 general practitioners agreed to reply to a questionnaire on MCI (adapted from Dubois inventory, 2003). Of these, 92% of experts considered MCI as an ambiguous entity, not necessarily as a "pre-dementia" stage; 63% confirmed a tendency to worsen over the time and 83% of experts decided to initiate treatment using cholinesterase inhibitors, memantine and vitamin E. The opinion on MCI was that a priori it is not only an Alzheimer disease pre-dementia stage, but most of them consider the treatment against AD. MCI is a heterogeneous entity that should be classified as an open category and making it necessary to standardize definitions and design diagnosis guides to better understand Alzheimer disease pre-dementia stage.
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PMID:[Mild cognitive impairment. Survey of attitudes of specialists and general physicians. mild]. 1740 16

Oxidative damage by free radicals has been implicated in the pathogenesis of vascular disease in diabetes and hypertension. In the present study, the total antioxidant status in diabetic and hypertensive rats before and after treatment with garlic (Allium sativum) was determined. The total serum antioxidants were measured by a modified method reported earlier by Miller and coworkers. The reproducibility of the assay was confirmed by determining standard curves for the known antioxidants: trolox (a stable analog of vitamin E), glutathione and vitamin C with interassay correlation coefficients (R(2), n = 10 in triplicate) of 0.9984, 0.9768 and 0.987, respectively, confirming the reliability and reproducibility of the assay. This assay was then used to determine total serum antioxidant levels of streptozotocin-induced diabetic rats and two-kidney one-clip hypertensive rats both before and after 3 weeks of treatment with an aqueous extract of garlic (500 mg/kg IP daily). The serum antioxidant levels of rats after 3 weeks of treatment were significantly higher (P < .001) than the pretreatment levels in both diabetic and hypertensive rats. The increased serum antioxidant levels were paralleled by a decrease in serum glucose in the garlic-treated diabetic rats and lowered systolic blood pressure in the garlic-treated hypertensive rats. We conclude from our study that (i) total antioxidants can be measured by a simple, reproducible, reliable assay and (ii) the total antioxidant status can be significantly improved by treatment with garlic.
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PMID:Garlic increases antioxidant levels in diabetic and hypertensive rats determined by a modified peroxidase method. 1923 77

Many therapeutic agents that are used in patients with diabetes mitigate oxidative stress. These agents are of particular interest because oxidative stress is elevated in diabetes and is thought to contribute to vascular dysfunction. Agents that merely quench already formed reactive oxygen species have demonstrated limited success in improving cardiovascular outcomes. Thus, although vitamin E, C, and alpha lipoic acid appeared promising in animal models and initial human studies, subsequent larger trials have failed to demonstrate improvement in cardiovascular outcomes. Drugs that limit the production of oxidative stress are more successful in improving vascular outcomes in patients with diabetes. Thus, although statins, ACE inhibitors, ARBs and thiazolinediones are used for varied clinical purposes, their increased efficacy in improving cardiovascular outcomes is likely related to their success in reducing the production of reactive oxygen species at an earlier part of the cascade, thereby more effectively decreasing the oxidative stress burden. In particular, statins and ACE inhibitors/ ARBs appear the most successful at reducing oxidative stress and vascular disease and have potential for synergistic effects.
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PMID:Therapeutic interventions and oxidative stress in diabetes. 1927 63

There is evidence that reactive oxygen species (ROS) are related to the development of cardiovascular disease (CVD). Results from many studies support the hypothesis that ROS released from various sources or dysfunctional mitochondrial respiratory chain play a role in the development of atherosclerosis and its complications. This phenomenon is due to ROS-mediated signalling pathways that are involved in the modulation of several vascular mechanisms. Various animal models have demonstrated that ROS have a causal role in atherothrombosis and other vascular diseases. Oxidative stress is being proposed as the unifying mechanism for many CVD risk factors. In particular, ROS may be responsible for plaque rupture and subsequent thrombosis which lead to myocardial infarction and stroke. Many drugs or agents have been tested to prevent or block oxidation underlying atherothrombotic processes, often with discordant outcomes. We observed that pre-treatment with some antioxidants, such as pyrrolidine dithiocarbamate (PDTC) or N-acetylcysteine, as well as some vitamins with recognized antioxidant properties, namely ascorbic acid (vitamin C), all-trans Retinoic Acid (atRA) and alpha-tocopherol (vitamin E) can suppress oxidative stress (OS)-induced Tissue Factor (TF) expression in human coronary artery endothelial cells. The present review, starting from our experimental observations, focuses on the influence of redox balance on atherothrombotic processes and on the effects of antioxidant treatment. A better understanding of the complex regulation of cellular redox balance could facilitate the development of newer antioxidants aimed at specific cellular targets. Research could also help assess the role of combination pharmacological intervention for the treatment and prevention of vascular disease.
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PMID:Reactive oxygen species and antioxidants in the pathophysiology of cardiovascular disease: does the actual knowledge justify a clinical approach? 1975 11

Cardiovascular disease represents an unparalleled proportion of the global burden of disease and will remain the main cause of mortality for the near future. Fortunately, most premature cardiovascular deaths are preventable. Therefore, prevention becomes vital and diet has shown beneficial effects to protect from CVD (CVD). Fruits and vegetables are dietary sources of natural antioxidants and it is generally accepted that antioxidants in these foods are key in explaining the inverse association between fruits and vegetables intake and the risk of developing a cardiovascular event or having elevated levels of cardiovascular risk factors. Available evidence supports the central role of oxidative stress in the atherosclerosis process and the correlation between increased oxidative stress and vascular disease. Theoretically, antioxidants in fruits and vegetables are important in inhibiting oxidative mechanisms that lead to various degenerative diseases including CVD. However, results from many interventional trials using antioxidants given as supplements have not been concordant with previous positive findings from observational epidemiologic cohort studies. The present manuscript gives a brief overview of the relationship between natural antioxidants (specially vitamin C, vitamin E and beta-carotene) intake and the risk of CVD.
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PMID:Antioxidant vitamins and cardiovascular disease. 2150 30

Lifestyle and nutrition have been increasingly recognized as central factors influencing vascular nitric oxide (NO) production and erectile function. This review underscores the importance of NO as the principal mediator influencing cardiovascular health and erectile function. Erectile dysfunction (ED) is associated with smoking, excessive alcohol intake, physical inactivity, abdominal obesity, diabetes, hypertension, and decreased antioxidant defenses, all of which reduce NO production. Better lifestyle choices; physical exercise; improved nutrition and weight control; adequate intake of or supplementation with omega-3 fatty acids, antioxidants, calcium, and folic acid; and replacement of any testosterone deficiency will all improve vascular and erectile function and the response to phosphodiesterase-5 inhibitors, which also increase vascular NO production. More frequent penile-specific exercise improves local endothelial NO production. Excessive intake of vitamin E, calcium, l-arginine, or l-citrulline may impart significant cardiovascular risks. Interventions discussed also lower blood pressure or prevent hypertension. Certain angiotensin II receptor blockers improve erectile function and reduce oxidative stress. In men aged <60 years and in men with diabetes or hypertension, erectile dysfunction can be a critical warning sign for existing or impending cardiovascular disease and risk for death. The antiarrhythmic effect of omega-3 fatty acids may be particularly crucial for these men at greatest risk for sudden death. In conclusion, by better understanding the complex factors influencing erectile and overall vascular health, physicians can help their patients prevent vascular disease and improve erectile function, which provides more immediate motivation for men to improve their lifestyle habits and cardiovascular health.
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PMID:The link between erectile and cardiovascular health: the canary in the coal mine. 2162 50

The 1996 Bethesda Conference acknowledged the following conditions as possible new cardiac risk factors: left ventricular hypertrophy, homocysteine, lipoprotein(a), hypertriglyceridemia, oxidative stress, and fibrinogen. Left ventricular hypertrophy is an independent risk factor for vascular disease, the improvement or progression of which influences subsequent cardiovascular complications. Clinical trials are currently underway to assess potential benefit from lowering homocysteine levels. The role of lipoprotein(a) excess in vascular disease is controversial; its atherogenic potential seems to be neutralized by effective lowering of LDL-cholesterol. Increasing evidence supports the independent role of hypertriglyceridemia in cardiovascular disease and possible clinical benefit from lowering triglyceride levels. Among antioxidant micronutrients, supplementation with vitamin E has been shown to be beneficial in some but not all primary and secondary prevention studies, but data to support use of other antioxidants are much weaker. Preliminary evidence suggests that the reduction of fibrinogen levels in patients with high baseline levels and coronary disease may be beneficial.Despite the potential relation between new risk factors and cardiovascular disease, routine clinical application of these conditions as cardiovascular risk factors would be premature. We first need evidence that these conditions extend prognostic ability beyond conventional risk factors and that modification of these conditions can decrease the risk of cardiovascular events.
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PMID:New paradigms in preventive cardiology: unconventional coronary risk factors. 2176 98

The technique of single needle dialysis (SN) was invented in the 1960s and enjoyed great success during the 1970s and '80s in northern Europe, particularly in Belgium. In recent years, the double needle mode has awakened new interest in this technique, as it may represent a good alternative to the use of a central venous catheter at the beginning of dialysis, while waiting for the growth of the arteriovenous fistula. For today's dialysis patients, mostly elderly with ever greater numbers of co-morbid conditions, in particular vascular disease, treatments have become ever more flexible and individually tailored. A single needle approach can be also used in the case of native fistula dislocation. The single needle technique requires careful control of dialysis dose, keeping recirculation into account. If the technique is used for long periods of time, there is the risk of inadequate dialysis dose and it is necessary to pay particular attention to the sampling of post dialysis urea for the KT/V calculation (always 20 minutes after the end of dialysis). Modern dialysis machines have greatly reduced the risk of hemolysis (which can be evaluated with the control of LDH pre and post dialysis) and of back-filtration which no longer represents a problem thanks to ultrapure dialysate. The probability of of blood circuit coagulation has also been greatly reduced thanks to citrate dialysis baths and membranes treated with heparin or vitamin E, and systems often do not require an increase of anticoagulants. The technique is, therefore, particularly reliable and easy to use thanks to its simplicity.
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PMID:[News on single needle dialysis: technique, indications, precautions and limits]. 2383 68


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