Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The evidence that ETS increases risk of death from heart disease is similar to that which existed in 1986 when the US Surgeon General concluded that ETS caused lung cancer in healthy nonsmokers. There are 10 epidemiological studies, conducted in a variety of locations, that reflect about a 30% increase in risk of death from ischemic heart disease or myocardial infarction among nonsmokers living with smokers. The larger studies also demonstrate a significant dose-response effect, with greater exposure to ETS associated with greater risk of death from heart disease. These epidemiological studies are complemented by a variety of physiological and biochemical data that show that ETS adversely affects platelet function and damages arterial endothelium in a way that increases the risk of heart disease. Moreover, ETS, in realistic exposures, also exerts significant adverse effects on exercise capability of both healthy people and those with heart disease by reducing the body's ability to deliver and utilize oxygen. In animal experiments, ETS also depresses cellular respiration at the level of mitochondria. The polycyclic aromatic hydrocarbons in ETS also accelerate, and may initiate, the development of atherosclerotic plaque. Of note, the cardiovascular effects of ETS appear to be different in nonsmokers and smokers. Nonsmokers appear to be more sensitive to ETS than do smokers, perhaps because some of the affected physiological systems are sensitive to low doses of the compounds in ETS, then saturate, and also perhaps because of physiological adaptions smokers undergo as a result of long-term exposure to the toxins in cigarette smoke. In any event, these findings indicate that, for cardiovascular disease, it is incorrect to compute "cigarette equivalents" for passive exposure to ETS and then to extrapolate the effects of this exposure on nonsmokers from the effects of direct smoking on smokers. These results suggest that heart disease is an important consequence of exposure to ETS. The combination of epidemiological studies with demonstration of physiological changes with exposure to ETS, together with biochemical evidence that elements of ETS have significant adverse effects on the cardiovascular system, leads to the conclusion that ETS causes heart disease. This increase in risk translates into about 10 times as many deaths from ETS-induced heart disease as lung cancer; these deaths contribute greatly to the estimated 53,000 deaths annually from passive smoking. This toll makes passive smoking the third leading preventable cause of death in the United States today, behind active smoking and alcohol.
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PMID:Passive smoking and heart disease. Epidemiology, physiology, and biochemistry. 191 25

Elevated plasma lipid and lipoprotein levels are associated with an increased risk of cardiovascular disease in middle-aged men and women. It is still not clear, however, whether lipid and lipoprotein abnormalities continue to be risk factors for cardiovascular disease in the elderly population. It is not even clear what normal lipid values are in the elderly, and whether diet or drug therapy should be advised on the basis of lipid values established in middle-aged populations. Ischemic heart disease does remain the leading cause of death in the elderly, and there is now preliminary evidence from epidemiologic studies that relative elevations of levels of lipid and lipoprotein fractions in an elderly population might be associated with an independent and increased risk of coronary heart disease, stroke, and possibly dementia. Intervention studies are about to begin that will assess various lipid-and lipoprotein-modifying therapies and their ability to reduce vascular disease risk in the elderly.
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PMID:Lipids, vascular disease, and dementia with advancing age. Epidemiologic considerations. 199 50

Cardiovascular disease is one of the major causes of death among native Americans. Ischemic heart disease has been relatively uncommon in the past, but this entity is rapidly becoming more frequent among Indians as a result of Western acculturation (Western high-fat diet, smoking, sedentary lifestyle). Hypertension remains a major problem in native American populations. Hypertension is often inadequately detected and treated in Indians. Rheumatic fever and rheumatic heart disease are moderately common and apparently in decline among native Americans. Finally, the fetal alcohol syndrome with its accompanying cardiac malformations is all too common among North American Indians. The amount of information available concerning cardiovascular disease in native Americans is rather small. Considerably more attention should be paid to this area in the future.
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PMID:Heart disease in native Americans. 202 63

Data on the hardness of drinking water were collected from 27 municipalities in Sweden where the drinking water quality had remained unchanged for more than 20 years. Analyses were made of the levels of lead, cadmium, calcium, and magnesium. These water-quality data were compared with the age-adjusted mortality rate from ischemic heart and cerebrovascular disease for the period 1969-1978. Lead and cadmium were not present in detectable amounts except in one water sample. A statistically significant inverse relationship was present between hardness and mortality from cardiovascular disease for both sexes. Mortality caused by ischemic heart disease was inversely related to the magnesium content, particularly for the men (P less than 0.01). The rather small set of data supports results from previous studies suggesting that a high magnesium level in drinking water reduces the risk for death from ischemic heart disease, especially among men, although the possible importance of confounding factors needs further evaluation.
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PMID:Magnesium and calcium in drinking water and cardiovascular mortality. 204 17

Although several previous studies have been done on the nature and prevalence of cardiovascular disease in Papua New Guinea no study has looked exclusively at a highlander population. This article reviews 154 cardiac patients who first presented to the Mt Hagen adult outpatient department over a period of one year. The study excluded non-highlanders, patients under 12 years of age, and patients with heart disease secondary to anaemia or diseases of the blood vessels. Heart disease was found to constitute a significant proportion of outpatient visits and admissions. Cor pulmonale secondary to chronic lung disease was the commonest condition seen, occurring in higher frequency than reported elsewhere, and accounting for the majority of cases of congestive heart failure. Valvular heart disease was also common, often presenting in a precocious and severe form. Congenital bicuspid aortic values were important in the generation of aortic valve disease in this population. Arrhythmias and conduction disturbances were also common. Diseases of the myocardium and pericardium occurred infrequently and were of the same nature as those reported in other studies in Papua New Guinea. Hypertension was probably underreported in this study, with renal disease being a contributing factor in the cases seen. Ischaemic heart disease represented a small number of the total cases, but was probably underreported.
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PMID:Adult heart disease in Mt Hagen: a study of 154 patients. 208 Jun 72

The authors report the case of a 18 year old man with a chronic corticosteroid-refractory nephrotic syndrome complicated by carotid artery thrombosis and myocardial infarction. Thromboembolism is one of the most serious complications of the nephrotic syndrome. Serious clotting factor disturbances are observed: changes in platelet function (hyperaggregability) increased plasma zymogens and cofactors, increased plasma fibrinogen, abnormalities of the fibrinolytic system and acquired deficiencies of coagulation inhibitors. The respective role of each of these abnormalities have not been clearly established, but it is likely that increased platelet aggregation and antithrombin III deficiency are important factors in producing a hypercoagulable state in the nephrotic syndrome. Hyperlipidemia is also a characteristic feature of the nephrotic syndrome: these is a wide spectrum of lipoprotein patterns with increased low density lipoproteins (LDL) or very low density lipoproteins (VLDL) or both; contradictory results have been reported with respect to the high density lipoproteins (HDL): decreased, normal or even increased plasma levels have been observed. In addition, changes in the distribution and composition of LDL and VLDL subclasses have been detected. Most of these changes have an atherogenic potential but controversy still surrounds the question of the prevalence of ischaemic heart disease in the nephrotic syndrome; it is unlikely that nephrotic syndromes of short duration have any influence on the incidence of coronary events, but patients with chronic heavy protein urea and long-term exposure to abnormalities of haemostasis and lipid profiles appear to have a significant risk of developing cardiovascular disease and may require long-term anticoagulant therapy.
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PMID:[Carotid artery thrombosis and myocardial infarction in nephrotic syndrome]. 210 97

The mortality due to ischemic heart disease may be assessed in the department of the Haute Garonne from a Register of cardiovascular disease. In this study the medical causes of death codified using the normal criteria of international classification of disease were compared with the causes of death classified according to the criteria of the Register determined in the same subjects after a complementary enquiry. Between July 1st 1984 and December 31st 1986, 800 consecutive cases of patients dying of cardiovascular disease aged 25 to 64 years at death were examined. A complementary enquiry into the cases of these patients was undertaken involving the treating physician and hospital establishments in order to determine the mode of death and to obtain clinical, ECG, biological and when possible autopsy results for each case. The sensitivity and specificity of the causes of death coded 410-414 according to the criteria of international classification of disease was 74 and 71 p. 100 respectively. The positive predictive value was 75 p. 100 and the value of the kappa index was 0.44. Therefore, the concordance between the causes of death codified by the usual classification and those codified after a thorough complementary enquiry was not very close. On the other hand, taken as a whole, the number of deaths due to ischemic heart disease by the international coding system (428 cases) was 2.1 p. 100 less than that observed after the complementary enquiry (437 cases). These results should, however, be interpreted with caution because of the high proportion (34%) of cases in which the cause of death could not be determined with precision even after the complementary enquiry.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of mortality caused by ischemic heart disease in Haute-Garonne]. 212 19

The possible role of oestrogens in modifying the occurrence of ischaemic heart disease and cardiovascular disease (CVD) in general in postmenopausal women has long been controversial. Analysis of the literature indicates a difference between the epidemiological studies published before 1980 and those published recently. In the former, the risk in women using oestrogen replacement therapy (ERT) was either unchanged or increased when compared with those women who did not use ERT. In the latter the trend has changed and a clear protective effect of ERT has been shown. These contradictory results might be explained by a change in prescribing habits, using lower oestrogen doses and selecting women with no risk factor for CVD as candidates for long-term ERT.
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PMID:[Estrogens and cardiovascular risk in postmenopausal women. I. Epidemiologic data]. 214 74

From 1975 to 1985 mortality from cardiovascular causes has decreased from 170.6 to 164.5 per 100,000 while its relative participation among all causes has increased from 23.0 to 27.6%. Total cardiovascular and ischemic deaths in the 35 to 74 year age range has also decreased. A lower mortality from ischemic heart disease but a higher one from cerebro vascular disease in all age groups compared to those reported in USA is shown by these data. Differences in the prevalence of risk factors such as diet, hyperlipidemia, hypertension and smoking may underlie this different mortality pattern from cardiovascular disease.
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PMID:[Has cardiovascular mortality increased in Chile?]. 215 26

Many clinical studies have shown an increased insulin response to oral glucose in patients with ischemia of the heart, lower limbs, or brain. Hyperinsulinemia also occurs in patients with angiographically proved atherosclerosis without ischemia and thus appears to be related to arterial disease and not to be a nonspecific response to tissue injury. Fasting insulin levels and insulin responses to intravenous stimuli, including glucose, tolbutamide, and arginine, are normal, suggesting a gastrointestinal factor may be involved in the increased insulin response to oral glucose. In patients with atherosclerosis, insulin sensitivity appears to be normal or enhanced with respect to both glucose and lipid metabolism. Five population studies have shown that insulin responses to glucose are higher in populations at greater risk of cardiovascular disease. Many of the hyperinsulinemic populations also had upper-body obesity, hypertriglyceridemia, lower high-density lipoprotein (HDL) levels, and hypertension. These prospective studies support an independent association between hyperinsulinemia and ischemic heart disease, although their results differ in detail. Hyperinsulinemia is associated with raised triglyceride and decreased HDL cholesterol levels. Total and low-density lipoprotein (LDL) cholesterol is less closely related to hyperinsulinemia. Upper-body adiposity is associated (in separate studies) with coronary heart disease, diabetes, hyperinsulinemia, and hypertriglyceridemia. Insulin and blood pressure are closely related in both normotensive and hypertensive people. Although obesity and diabetes are often found in hypertensive people, hyperinsulinemia also occurs in nonobese nondiabetic hypertensive people. Thus, hyperinsulinemia is closely associated with a cluster of cardiovascular risk factors, i.e., hypertriglyceridemia, low HDL levels, hypertension, hyperglycemia, and upper-body obesity. There is a possibility that insulin has a role in the sex differences in ischemic heart disease incidence and their absence in diabetes, but additional work is required for its clarification. Long-term treatment with insulin results in lipid-containing lesions and thickening of the arterial wall in experimental animals. Insulin also inhibits regression of diet-induced experimental atherosclerosis, and insulin deficiency inhibits the development of arterial lesions. Insulin stimulates lipid synthesis in arterial tissue; the effect of insulin is influenced by hemodynamic factors and may be localized to certain parts of the artery. In physiological concentrations, insulin stimulates proliferation and migration of cultured arterial smooth muscle cells but has no effort on endothelial cells cultured from large vessels. Insulin also stimulates cholesterol synthesis and LDL binding in both arterial smooth muscle cells and monocyte macrophages.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Insulin and atheroma. 20-yr perspective. 199 42


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