Journal of cardiovascular risk最新文献

{"title":"Hyperlipidaemia and primary prevention of coronary heart disease: are the right patients being treated?","authors":"S Ramachandran,&nbsp;M H Labib","doi":"10.1177/204748730000700401","DOIUrl":"https://doi.org/10.1177/204748730000700401","url":null,"abstract":"<p><strong>Background: </strong>In 1997, the Standing Medical Advisory Committee report suggested that patients with a coronary heart disease risk of 3% per year or greater should be considered appropriate for lipid-lowering medication. The report stated that cholesterol concentration alone is a poor predictor of absolute risk of coronary heart disease and recommended the Sheffield table as a method of estimating the coronary heart disease risk.</p><p><strong>Objective: </strong>To assess the impact of the Standing Medical Advisory Committee report on the management of patients with hyperlipidaemia in the primary prevention of coronary heart disease in primary care.</p><p><strong>Method: </strong>A survey questionnaire giving the clinical details of 20 patients with various coronary heart disease risk factors was sent to 200 general practitioners in the West Midlands, UK.</p><p><strong>Results: </strong>Forty-eight percent of the respondents used clinical assessment/perception as the sole means of risk assessment and 26% used the Sheffield table. In patients who did not require treatment, 40.1% of the decisions were inappropriate and, in patients who required treatment, 35.1% of the decisions were inappropriate. Overall, inappropriate decisions were made in 37.9% of the responses. Despite the clear advice in the Standing Medical Advisory Committee report on the importance of incorporating multiple risk factors in estimating absolute coronary heart disease risk, only total cholesterol and triglycerides were significant in influencing treatment decisions.</p><p><strong>Conclusions: </strong>The Standing Medical Advisory Committee recommendations on the management of hyperlipidaemia in primary prevention of coronary heart disease are not widely used. Large savings could be made by correctly identifying and treating individuals at high risk. We recommend use of the full Framingham risk score in assessment of coronary heart disease risk in primary care.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 4","pages":"245-9"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21839441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliography. Current world literature.","authors":"","doi":"10.1177/204748730000700408","DOIUrl":"https://doi.org/10.1177/204748730000700408","url":null,"abstract":"Liu J.E.,Hahn R.T., Stein K.M., Markowitz S,M., Okin P.M.,Devereux R.B., Lerman B.B.: Left ventricular geometry and function preceding neurally mediated syncope. Circulation 2000, 101:777-783. Lisowski L.A., Verheijen P.M., Benatar A.A., Soyeur OJ.G., Stoutenbeek P., Brenner J.J., Kleinman C.S., et a/: Atrial flutter In the perinatal age group: Diagnosis, management'and outcome. J Am Coli Cardiol 2000, 35:771-777. Ikeda T., Sakata T., Takami M., Kondo N., Tezuka N., Nakae T., Noro M., et a/: Combined assessment of T·wave alternans and late potentials used to predict arrhythmic events after myocardial Infarction· A prospective stUdy. J Am Coli Cardio/2000, 35:722-730. Hobbs WJ.C., Fynn S., Todd D.M., Wolfson P., Galloway M., Garratt CJ.: Reversal of atrial electrical remodeling after cardloverslon of persistent atrial fibrillation In humans. Circulation 2000, 101 :1145-1151.","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 4","pages":"293-300"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21839448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Work stress and coronary heart disease.","authors":"C Tennant","doi":"10.1177/204748730000700405","DOIUrl":"https://doi.org/10.1177/204748730000700405","url":null,"abstract":"<p><strong>Background: </strong>Coronary heart disease (CHD) has been often regarded as a psychosomatic illness; one of the psychosocial variables influencing the onset or course of disease is stress. Work stress in particular may therefore be a significant factor influencing CHD.</p><p><strong>Method: </strong>This descriptive review derives from those predictive studies of work stress and CHD published from 1990-2000 based on structured literature searches.</p><p><strong>Results: </strong>There is reasonably robust and consistent empirical evidence indicating some causal relationship between work stress and CHD risk.</p><p><strong>Conclusions: </strong>Work stress has clear implications for the health and welfare of employees and medico legal implications for employers.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 4","pages":"273-6"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21839445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliography. Current world literature.","authors":"","doi":"10.1177/204748730000700310","DOIUrl":"https://doi.org/10.1177/204748730000700310","url":null,"abstract":"Acta Cardiologica (Acta Cardiol) American Heart Journal (Am Heart J) . American Journal of Cardiology (Am J Cardiel) American Journal of Hypertension (Am J Hypertens) American Journal of Preventive Medicine (Am J Prev Med) Annals of Internal Medicine (Ann Intern Med) Annals of Medicine (Ann Med) Annals of Thoracic Surgery (Ann Thorac Surg) Annual Review of Medicine (Annu Rev Med) Annual Review of Public Health (Annu Rev Public Health) . Arteriosclerosis Thrombosis and Vascular Biology (Arterioscler Thromb Vasc Biol) Atherosclerosis (Atherosclerosis) British Joumal of Hospital Medicine (Br J Hosp Med) British Medical Journal (BMJ) Cardiology (Cardiology) . Cardiovascular Research (Cardiovasc Res). Cerebrovascular Diseases (Cerebrovasc DIs) Circulation (Circulation) Circulation Research (Circ Res) Clinical Cardiology (Clin Cardiol) . Clinical and Experimental Hypertension (Clin Exp Hypertens) , Coronary Artery Disease (Coron Artery DIs) , Current Problems in Cardiology (Curr Probl Oardiol) Diabetes Research and Clinical Practice (Diabetes Res Clin Pract) Diabetic Medicine (Diabet Med) European Heart Journal (Eur Heart J) Heart (Heart) Heart and Lung (Heart Lung) Hypertension (Hypertens.ion) , .. International Journal of Epidemiology (lnt J Epldemlo!) International Journal of Obesity and Related . Metabolic Disorders (lnt JObes Relat Metab Disordl JAMA Journal of the American Medical Association (JAMA) Japanese Heart Journal (Jpn Heart J) . , . Journal of Clinical Epidemiology (J Clin Epidemiol] Journal of Clinical Pharmacy and Therapeutics (J Clin Pharm Ther) Journal of Human Hypertension (J Hum Hypertens) Journal of Hypertension (J Hypertens) Journal of Internal Medicine (J Intern Med) Journal of Thoracic and Cardiovascular Surgery (J Thoracic Cardiovasc Surg) , Journal of the American College of Cardiology (J Am Coli Cardiol) Lancet (Lancet) New England Journal of Medicine (N Engl J Med) PACE Pacing and Clinical Electrophysiology (PACE Pacing Clin Electrophyslol) Pediatric Cardiology (Pediatr Cardiol) Pediatric Clinics of North America (Pediatr Clin North Am) Postgraduate Medical Journal (Postgrad Med J) Postgraduate Medicine (Postgrad Med) Preventive Medicine (Prev Med) Progress in Cardiovascular Diseases (Prog Cardiovasc Dis) Public Health (Public Health) Scandinavian Cardiovascular Journal (Scand Cardiovasc J) . Seminars in Thrombosis and Hemostasia (Semin Thromb Hemost) Stroke (Stroke) Thoracic and Cardiovascular Surgeon (Thorac Cardiovasc Surg)","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 3","pages":"231-43"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21840822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wall stress and hypertension.","authors":"M A James,&nbsp;A M Saadeh,&nbsp;J V Jones","doi":"10.1177/204748730000700304","DOIUrl":"https://doi.org/10.1177/204748730000700304","url":null,"abstract":"<p><p>The precise role that abnormal wall stress may play in the pathophysiology of hypertensive heart disease is not known. Hypertension is almost unique in that it ultimately affects all parts of the law of Laplace equation, i.e. intraventricular pressure changes and with the advent of left ventricular hypertrophy both internal radius and wall thickness alter. If heart failure supervenes the components of the equation change once more. This article will discuss the implications of abnormal wall stress at these various stages in hypertensive heart disease.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 3","pages":"187-90"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21840816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined seropositivity for H. pylori and C. pneumoniae is associated with age, obesity and social factors.","authors":"R Ekesbo,&nbsp;P M Nilsson,&nbsp;L H Lindholm,&nbsp;K Persson,&nbsp;T Wadström","doi":"10.1177/204748730000700305","DOIUrl":"https://doi.org/10.1177/204748730000700305","url":null,"abstract":"<p><strong>Background: </strong>Manifestations of cardiovascular disease (CVD) have been associated with chronic infection by Helicobacter pylori and Chlamydia pneumoniae both in cross-sectional and in prospective follow-up cohort studies. This association may be partly due to an increase in metabolic risk factors for CVD, secondary to low-grade inflammation caused by infections.</p><p><strong>Objective: </strong>To investigate for subjects classified according to serology titres for infection with C. pneumoniae and H. pylori associations between seropositivity and the degree of obesity and fasting insulin levels, as well as social factors.</p><p><strong>Methods: </strong>Using methods based on those in earlier investigations of hypertensive patients in the Dalby primary-health-care district, southern Sweden, we investigated frozen samples from serum of 310 middle-aged treated hypertensives and 288 age-matched and sex-matched normotensive controls from a defined population. The baseline examination included the measurement of weight, height and blood pressure as a mean of two office readings with the subject supine. The body mass index (BMI) was calculated as kg/m2. Fasting blood samples were drawn for measurements of levels of serum lipids, blood glucose, plasma insulin and serum lipids, including total cholesterol and triglycerides. The serology titres for H. pylori were determined by an enzyme-linked immunosorbent assay. The titres for C. pneumoniae were determined by a micro-immunofluorescence method. Self-reported factors concerning social and lifestyle backgrounds were recorded.</p><p><strong>Results: </strong>The group (n = 245) of subjects with combined positive serology for H. pylori and C. pneumoniae differed from the group without any positive serology (n = 57) in age (61.6 versus 57.4 years, P < 0.05) and BMI (27.3 versus 25.8 kg/m2, P < 0.05). The seropositive group also differed in terms of fasting levels of insulin (12.7 versus 11.6 pmol/l, P < 0.05), but this difference did not remain significant after adjustment for age and BMI. We detected no intergroup difference in blood pressure and levels of glucose and lipids. Members of the group with combined seropositivity reported having a lower social-class position (educational level) than that of members of the seronegative group.</p><p><strong>Conclusion: </strong>Subjects with combined positive serology for H. pylori and C. pneumoniae are characterized by greater age, lower social class and higher BMI, as well as higher fasting levels of insulin than those of seronegative subjects. Obesity might be a marker not only for lower social class but also for greater than normal susceptibility to such infections.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 3","pages":"191-5"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21840817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High prevalence of seropositivity for antibodies to Chlamydia-specific lipopolysaccharide in patients with acute coronary syndrome.","authors":"K Shimada,&nbsp;H Mokuno,&nbsp;Y Watanabe,&nbsp;M Sawano,&nbsp;H Daida,&nbsp;H Yamaguchi","doi":"10.1177/204748730000700308","DOIUrl":"https://doi.org/10.1177/204748730000700308","url":null,"abstract":"<p><strong>Background: </strong>Results of recent studies have demonstrated that there is an association between infection with Chlamydia pneumoniae and coronary artery disease (CAD). Inflammatory response caused by chlamydial infection has been considered to contribute to the development of atherosclerosis in coronary arteries.</p><p><strong>Objective: </strong>The aim of this study was to investigate the specific relations between chlamydial infection and coronary events in patients with CAD.</p><p><strong>Methods: </strong>We measured serum levels of immunoglobulin A and G antibodies against Chlamydia spp.-specific lipopolysaccharide in 155 patients with CAD and 60 age-matched and sex-matched healthy controls by enzyme-linked immunosorbent assay. CAD patients were divided into groups of the patients with acute coronary syndrome [(ACS), n = 35], old myocardial infarction [(OMI), n = 60] and chronic coronary heart disease [(CCHD), n = 60].</p><p><strong>Results: </strong>Prevalence of both seropositive antibodies in the control group and CCHD group were not different. In contrast, in ACS group there were significantly higher prevalences of seropositive immunoglobulin A (46 versus 12%, P = 0.0001) and G (74 versus 45%, P = 0.005) antibodies and in OMI group there was a significantly higher prevalence of seropositive immunoglobulin A antibodies (28 versus 12%, P = 0.02). Furthermore, compared with CCHD group, in ACS group there were significantly higher prevalences of seropositive immunoglobulin A (P = 0.00006) and G (P = 0.002) antibodies and in OMI group there was a higher prevalence of seropositive immunoglobulin A (P = 0.01). Adjustment for confounding factors did not change these findings.</p><p><strong>Conclusions: </strong>Infection with Chlamydia is significantly associated with ACS and OMI, but not with CCHD. These findings suggest that chronic and reactive infection with Chlamydia can lead to disruption of vulnerable plaque in patients with ACS.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 3","pages":"209-13"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21840820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for atherosclerosis in young individuals.","authors":"A Misra","doi":"10.1177/204748730000700309","DOIUrl":"https://doi.org/10.1177/204748730000700309","url":null,"abstract":"<p><p>Atherosclerosis starts in childhood, and is accelerated in some individuals. A cluster of clinical and biochemical factors constitute the risk profile for many of them, perhaps most important being metabolic insulin resistance syndrome. Insulin resistance and its components for children and adolescents, especially obesity and dyslipidemia, are generators of hypertension, glucose intolerance and complications of atherosclerosis in adulthood. Some individuals are genetically predisposed, particularly those with the family history of such disorders. For many subjects, there is 'tracking' of metabolic and lifestyle factors from early age to adulthood. Several new risk factors of atherosclerosis (e.g. level of lipoprotein (a), procoagulant state, hyperhomocysteinemia, low birth weight and adverse in-utero environment, and possibly inflammatory markers) are current and potentially future areas of research concerning children and young individuals. Definition of and research on new and hitherto not investigated factors and formulation of strategies to neutralize the known factors are of paramount importance for primary prevention of atherosclerosis. Simple and effective measures for prevention include increasing awareness of the diseases, maintenance of ideal body weight, regular physical exercise, avoidance of smoking and chewing of tobacco, eating a balanced diet, and early periodic monitoring of blood pressure and metabolic status. These measures, starting from childhood, should be applied to all and in particular to the susceptible offspring, predisposed individuals, and populations.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 3","pages":"215-29"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21840821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A common polymorphism in methionine synthase reductase increases risk of premature coronary artery disease.","authors":"C A Brown,&nbsp;K Q McKinney,&nbsp;J S Kaufman,&nbsp;R A Gravel,&nbsp;R Rozen","doi":"10.1177/204748730000700306","DOIUrl":"https://doi.org/10.1177/204748730000700306","url":null,"abstract":"<p><strong>Background: </strong>Methionine synthase reductase (MTRR) catalyzes the regeneration of methylcobalamin, a cofactor of methionine synthase, an enzyme essential for maintaining adequate intracellular pools of methionine and tetrahydrofolate, as well as for maintaining homocysteine concentrations at nontoxic levels. We recently identified a common A-->G polymorphism at position 66 of the cDNA sequence of MTRR; this variant was associated with a greater than normal risk for spina bifida in the presence of low levels of cobalamin.</p><p><strong>Objective: </strong>To investigate whether the polymorphism was associated with alterations in levels of homocysteine, folate, and vitamin B12, and with risk of developing premature coronary artery disease (CAD), in a population of individuals presenting for cardiac catheterization procedures.</p><p><strong>Methods: </strong>We screened 180 individuals aged < 58 years with angiographically documented coronary-artery occlusions or occlusion-free major arteries for the presence of the 66A-->G MTRR polymorphism using a polymerase-chain-reaction-based assay.</p><p><strong>Results: </strong>We identified a trend in risk of premature CAD across the genotype groups (P = 0.03) with a sex-adjusted relative risk of premature CAD equal to 1.49 (95% confidence interval 1.10-2.03) for the GG versus AA genotype groups. There was no difference in fasting levels of plasma total homocysteine, serum folate, and vitamin B12 among the three MTRR genotypes.</p><p><strong>Conclusions: </strong>Our findings suggest that the GG genotype of MTRR is a significant risk factor for the development of premature CAD, by a mechanism independent of the detrimental vascular effects of hyperhomocysteinemia. This association needs to be confirmed in other studies.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 3","pages":"197-200"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21840818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wall stress and the heart.","authors":"J V Jones,&nbsp;A S Serafi,&nbsp;M A James","doi":"10.1177/204748730000700301","DOIUrl":"https://doi.org/10.1177/204748730000700301","url":null,"abstract":"","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"7 3","pages":"159-61"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/204748730000700301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21840813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}