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)

Vitamin D has been proposed as a risk factor of ischaemic heart disease. In 12 patients with acute myocardial infarction the major circulating vitamin D metabolite, 25-hydroxy-cholecalciferol (25-HCC), did not show any fluctuations during the first 4 days after onset of symptoms. The serum 25-HCC level was then measured in 128 patients consecutively admitted because of chest pain, 53 of whom had myocardial infarction and 75 had angina pectoris. The values found did not differ from those measured in 409 normal persons. The seasonal variations of serum 25-HCC were less pronounced in heart patients than in normals, probably due to less sun exposure in the summer months. The levels of serum 25-HCC did not correlate with the concentrations of serum cholesterol, glycerides, calcium or magnesium. Low serum calcium and magnesium were observed in all patients. Serum calcium was further reduced in the course of acute myocardial infarctions while serum parathyroid hormone rose significantly. We conclude that patients with ischaemic heart disease are not ingesting or producing in their skin elevated amount of vitamin D.
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PMID:Vitamin D and ischaemic heart disease. 74 75

Environmental factors are important in the aetiology of glucose intolerance, type II diabetes and IHD. The lack of vitamin D, which is necessary for adequate insulin secretion, relates demographically to increased risk of myocardial infarction. These disorders are connected, degenerative vascular disease increasing with glucose intolerance and diabetes and, with its risk factors, comprising syndrome 'X'. Evidence is presented suggesting that vitamin D deficiency may be an avoidable risk factor for syndrome 'X', adding another preventative measure to current recommendations which are aimed at reducing the worldwide epidemic of these disorders. Experimentally, vitamin D deficiency progressively reduces insulin secretion; glucose intolerance follows and becomes irreversible. Relationships between vitamin D status, glucose tolerance and 30 min insulin secretion during oral glucose tolerance tests are reported in British Asians; insulin secretion, but not glycaemia, improving with short-term supplementation. Studies showing reduction in blood pressure and in risk of heart attack and diabetes with exercise (usually outdoor), rarely consider the role of vitamin D status. Glycaemia and insulin secretion in elderly European men, however, relate to vitamin D status, independent of season or physical activity. Prolonged supplementation can improve glycaemia. Hypertension improves with vitamin D treatment with or without initial deficiency. Vitamin D status and climate are reviewed as risk factors for myocardial infarction; the risk reducing with altitude despite increasing cold. Glycaemia and fibrinogenaemia improve with insulin secretion increases in summer. Variation in vitamin D requirements could arise from genetic differences in vitamin D processing since bone density can vary with vitamin D-receptor genotype. Vitamin D receptors are present in islet beta cells and we report insulin secretion in healthy Asians differing profoundly with the Apa I genotype, being independent of vitamin D status. Those at risk of vitamin D deficiency include the elderly, those living indoors or having a covered-up style of dress, especially dark-skinned immigrants, and pregnant women, and these are groups recognized as being at increased risk of diabetes.
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PMID:Inadequate vitamin D status: does it contribute to the disorders comprising syndrome 'X'? 962 22

Vitamin D has steroid hormonal effects which can produce clinical symptoms and signs unrelated to calcium homoeostasis. Its deficiency has been implicated as a risk factor for diabetes, ischaemic heart disease, and tuberculosis in Asians. In this review, the incidence, aetiology, prevention, and treatment of symptomatic vitamin D deficiency in childhood are considered. A renewed public health campaign is required in the UK to address the continuing problem of vitamin D deficiency in Asian families.
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PMID:Vitamin D deficiency in UK Asian families: activating a new concern. 1219 54

The annual statistical survey conducted at the end of 2000 by the Japanese Society for Dialysis Therapy collected responses from 3358 (99.94%) of 3360 institutions. Japan's total dialysis patient population at the end of the year 2000, as identified by this survey, was 206,134, an increase of 8921 (4.5%) over 1999. This translates to 1624.1 patients per million population. The annual crude mortality rate was 9.4% for the period starting at the end of the year 1999 and ending at the end of the year 2000. The mean patient age at the initiation of dialysis treatment was 63.8 (+/- 13.9; +/- SD) years; the mean age of the overall dialysis patient population was 61.2 years (+/- 13.3). Both these mean ages, which had been increasing since 1983, again continued to increase. Among the primary diagnosis, the prevalence of diabetic nephropathy had continued to increase again since 1999, to 36.6%, whereas that of chronic glomerulonephritis had continued to decline, down to 32.5%, during the same one-year period since the 1999 survey. The 2000 years-end survey incorporated the following additional variables for the first time: usage of oral antihypertensives, pre- and post-dialysis systolic and diastolic blood pressures, serum HDL cholesterol level, types and dosage of oral Vitamin D analogs administered, dosage of oral calcium carbonate administered, history of intervention for peripheral vascular disease (bypass surgery, synthetic graft replacement, stenting), history of coronary artery bypass grafting (CABG), history of percutaneous transluminal coronary angioplasty (PTCA), whether stenting had been previously performed for the treatment of ischemic heart disease, number of cigarettes smoked, the type of vascular access used at the initiation of dialysis, and the year and month the vascular access was created. The survey results indicate that 60.9% of the total dialysis patient population was using oral antihypertensives. The patients' mean serum HDL cholesterol level was 47.65 +/- 18.47 mg/dL, showing positive correlation with serum albumin level and reverse correlation with body mass index. 1.6% of all dialysis patients had previously undergone amputation, and 0.7% had a history of bypass surgery for peripheral vascular disorder. 4.5% of hemodialysis patients had a history of cardiac infarction, 1.6% had previously undergone CABG, and 2.8%, PTCA. At the time the survey was conducted, 2.0% of all dialysis patients were undergoing oral Vitamin D analog pulse therapy, and 6% were undergoing intravenous Vitamin D analog pulse therapy. A history of amputation, myocardial infarction, cerebral infarction, and cerebral bleeding were identified as high-risk factors of vital prognosis. Additionally, high mortality risk was associated with the following: glutamic-pyruvic transaminase levels exceeding 20 IU/L; positive HCV antibody status; comorbid conditions such as hepatic cell carcinoma and liver cirrhosis; platelet counts below 100,000/mL or equal to or greater than 200,000/mL; C-reactive protein levels of 0.2 mg/dL and higher, leukocyte counts of less than 3000/mL or equal to or greater than 8000/mL; and body mass index of below 22 kg/m2, as well as total serum cholesterol levels of below 160 mg/dL or equal to or greater than 260 mg/dL.
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PMID:The current state of chronic dialysis treatment in Japan (as of December 31, 2000). 1292 Nov 11

Vitamin D is an important prohormone for optimal intestinal calcium absorption for mineralization of bone. Because the vitamin D receptor is present in multiple tissues, there has been interest in evaluating other potential functions of vitamin D, particularly, in cardiovascular diseases (CVD). Cross-sectional studies have reported that vitamin D deficiency is associated with increased risk of CVD, including hypertension, heart failure, and ischemic heart disease. Initial prospective studies have also demonstrated that vitamin D deficiency increases the risk of developing incident hypertension or sudden cardiac death in individuals with preexisting CVD. Very few prospective clinical studies have been conducted to examine the effect of vitamin D supplementation on cardiovascular outcomes. The mechanism for how vitamin D may improve CVD outcomes remains obscure; however, potential hypotheses include the downregulation of the renin-angiotensin-aldosterone system, direct effects on the heart, and vasculature or improvement of glycemic control. This review will examine the epidemiologic and clinical evidence for vitamin D deficiency as a cardiovascular risk factor and explore potential mechanisms for the cardioprotective effect of vitamin D.
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PMID:Vitamin D deficiency and risk for cardiovascular disease. 1959 2

Epidemiologic data indicate that about one million people worldwide suffer from and should be treated for vitamin D deficiency. The clinical impact of vitamin D deficiency is very high if we consider the pivotal role that this condition plays in determining osteoporosis, fractures, cancers, diabetes, vascular inflammation, which can severely reduce functional capacity, quality of life and may often lead to disability. Vitamin D deficiency is a widely underdiagnosed pathological condition. Although many cardiovascular diseases such as arterial hypertension, myocardial ischemia, diabetic cardiomyopathy and heart failure, may arise from a low vitamin D status, cardiologists do not routinely search for this disease in clinical practice. Vitamin D, indeed, stimulates the synthesis of various contractile proteins and activates crucial intracellular mechanisms that manage calcium metabolism and energy production. These functions can be altered once vitamin D deficiency develops. This review focuses on the relationship between vitamin D deficiency, asymptomatic changes in left ventricular geometry and function, and heart failure syndrome through a recall of the myocardial metabolic processes regulated by vitamin D. The analysis of the available data from the literature leads to raise some questions that, at present, have no answer. Future prospective studies are needed to assess the effect of treatment of vitamin D deficiency on cardiac function.
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PMID:[Vitamin D deficiency, left ventricular dysfunction and heart failure]. 2134 79

Vitamin D is essential for bone mineralisation, but a growing body of evidence points at a broader role; vitamin D deficiency has been found to be associated with mortality and several diseases ranging from cardiovascular disease to autoimmune diseases and liver diseases. The evidence is, however, inconclusive and the possible pathways remain unresolved. The aims of the thesis were to investigate the association of vitamin D status to 5-year changes in cardiovascular risk factors such as blood pressure, lipid profile, the metabolic syndrome and urine albumin creatinine ratio (UACR); the association of a known genetic determinant of vitamin D status to cardiovascular risk factors; the association of vitamin D status to the incidence of cardiovascular disease (CVD) and all-cause mortality; and the association of vitamin D status to cause-specific mortality. Data from the 3 population-based studies Monica10 (n = 2,656, 1993-94), Inter99 (n = 6,794, 1999-2001) and Health2006 (n = 3,471, 2006-2008) conducted at the Research Centre for Prevention and Health were used. The studies included questionnaires, physical examinations, and blood tests. Vitamin D status was measured at baseline. Participants were genotyped for the most frequent filaggrin mutations. Registry-based diagnoses and causes of death were obtained from The Danish National Patient Register and the Danish Registry of Causes of Death, respectively. Linear, logistic, Cox and instrumental variable regressions were used to model the associations between vitamin D status and cardiovascular risk factors, disease and mortality. With a 10 year mean follow-up time, we found a significant association between vitamin D status and all-cause mortality with a HR=0.95 (p = 0.005) per 10 nmol/l higher vitamin D level. We found no association between vitamin D status and incidence of ischaemic heart disease or stroke (HR = 1.01, p = 0.442 and HR = 1.00, p = 0.920, respectively). We found a baseline level of vitamin D that was 10 nmol/l higher to be associated with a decrease in triglycerides and very low density lipoprotein cholesterol by 0.52% (p = 0.03) and 0.66% (p = 0.005), respectively. The odds ratios per 10 nmol/l higher baseline vitamin D level were 0.95 (p < 0.05) and 0.94 (p = 0.01) for the development of the metabolic syndrome and hypercholesterolaemia, respectively. There was no association between vitamin D and blood pressure. With filaggrin genotype as an instrumental variable, we found a 23.8% (95% confidence interval, CI: 3.0, 48.6) higher HDL cholesterol level and a 30.5% (95% CI: 0.8, 51.3) lower serum level of triglycerides per doubling of vitamin D. These associations were no longer statistically significant when applying the Bonferroni-adjusted significance level. The remaining lipids showed non-significant changes in a favourable direction. A doubling of vita-min D gave a non-significantly lower odds ratio = 0.26 (95% CI: 0.06, 1.17) of the metabolic syndrome. There were no statistically significant causal effects of vitamin D status on blood pressure or anthropometrics. With a total of 832 deaths and a 10.3 year median follow-up time, we found significant associations between vitamin D status and death caused by respiratory diseases, digestive diseases, and endocrine, nutritional and metabolic diseases with hazard ratios (HRs) 0.26 (ptrend = 0.0042), 0.28 (ptrend = 0.0040), and 0.21 (ptrend = 0.035), respectively, for the fourth vitamin D quartile compared to the first. We found non-significantly lower HRs for death caused by mental and behavioural diseases and diseases of the nervous system, but no association between vitamin D status and death caused by diseases of the circulatory system or neoplasms. We found a baseline level of vitamin D that was 10 nmol/l higher was associated with a small but statistically significant decrease in UACR by 0.92% (p = 0.02), but a non-significantly lower PTH. The odds ratio for an increased UACR were 0.96 (p = 0.0006) per 10 nmol/l higher baseline vitamin D level. Our studies support the idea that vitamin D can affect lipid status in a favourable direction as well as the incidence of metabolic syndrome and increased UACR but neither blood pressure nor anthropometrics. Vitamin D status was inversely associated with mortality, but this was not explained by an association with cardiovascular disease. Rather, the association seemed to be caused by an inverse association with death caused by digestive disease, endocrine, metabolic and nutritional diseases, and respiratory disease. Further studies, e.g. RCTs or Mendelian randomisation studies, are needed to clarify whether low vitamin D status is a causal and reversible factor to prevent disease and mortality.
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PMID:The relationship of vitamin D status to risk of cardiovascular disease and mortality. 2563 11

Chronic obstructive pulmonary disease(COPD), an inflammatory disease of the lung mainly caused by cigarette smoking, is a systemic disease associated with various extra-pulmonary comorbidities such as osteoporosis, ischemic heart disease and sarcopenia. Osteoporosis is one of such complications, and the prevalence of vertebral fractures in COPD is high even in early COPD stages. Loss of bone mineral density as well as deterioration of bone quality is common in COPD patients. However, the pathophysiology of bone fragility in COPD-associated osteoporosis is still incompletely understood. COPD patients are exposed to various disease-specific risk factors such as systemic inflammation, glucocorticoid use and vitamin D insufficiency/deficiency, accumulation of which leads to development of COPD-associated osteoporosis. Vitamin D repletion and timely intervention with anti-osteoporotics would be important to protect COPD patients from fracture.
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PMID:[Secondary osteoporosis. Chronic obstructive pulmonary disease:COPD.] 3048 30

Vitamin D may have prognostic value in hypertension patients and, in addition to conventional biomarkers, could be a valuable tool for disease management. The aim of this study was to assess the association of vitamin D status in patients with essential hypertension and to evaluate its prognostic utility. Forty-eight consecutive patients (40 Caucasian and 8 Asian) aged between 30 and 80 years (mean 61.5, range 34-84 years), were enrolled in the study. The main exclusion criteria were age less than 18 years, kidney failure, onco-hematologic disease, hypo-hyperparathyroidism, osteoporosis, treatment with bisphosphonate or 25(OH) vitamin D supplementation. Of the 48 patients included in the study, hyperlipidemia was described in 28, diabetes type 2 in 8, and ischemic heart disease in 14. Serum electrolytes, calcium, sodium, and potassium concentrations were within normal range. Low 25(OH) vitamin D levels inversely correlated with essential hypertension values (p less than 0.001) were considered extremely significant. The determination of 25(OH) vitamin D levels in patients with essential hypertension could improve the research for possible underlying conditions, which should be managed meticulously according to current guidelines.
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PMID:Serum 25-hydroxy vitamin D levels in essential hypertension. 3057 72

Vitamin D in the past was thought to a play role constrained to calcium and bone metabolism, but in recent days its role beyond Calcium and bone metabolism is being speculated. Vitamin D has been blamed to be a contributory factor in number of cardiovascular diseases i.e. ischemic heart disease, hypertension, heart failure, and diabetes mellitus. Obtainable evidence in this regard is not very convincing, yet its role cannot be totally annulled. In this article we will make an endeavor to find out vitamin D's role in heart diseases.
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PMID:Vitamin D and Heart Disease. 3133 Nov 42


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