Coronary Heart Disease

Source: www.ncbi.nlm.nih.gov --- 13 days ago
Related Articles Women and men with Coronary Heart Disease in three countries: are they treated differently? Womens Health Issues. 2008 May-Jun;18(3):191-8 Authors: Bönte M, von dem Knesebeck O, Siegrist J, Marceau L, Link C, Arber S, Adams A, McKinlay JB BACKGROUND: Nonmedical determinants of medical decision making were investigated in an international research project in the United States, the United Kingdom, and Germany. The key question in this paper is whether and to what extent doctors' diagnostic and therapeutic decisions in Coronary Heart Disease (CHD) are influenced by patient gender. METHODS: A factorial experiment with a videotaped patient consultation was conducted. Professional actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patient-actors of different gender, age, race, and socioeconomic status. The videotapes were presented to a randomly selected sample of 128 primary care physicians in each country. Using an interview with standardized and open-ended questions, physicians were asked how they would diagnose and treat such a patient after they had seen the video. RESULTS: Results show gender differences in the diagnostic strategies of the doctors. Women were asked different questions, CHD was mentioned more often as a possible diagnosis for men than for women, and physicians were less certain about their diagnosis with female patients. Gender ...

Source: www.ncbi.nlm.nih.gov --- 2 days ago
Coronary Heart Disease in China. Heart. 2008 Sep;94(9):1126-31 Authors: Zhang XH, Lu ZL, Liu L Coronary Heart Disease (CHD) is the second leading cause of cardiovascular death in the Chinese population. It accounts for 22% of cardiovascular deaths in urban areas and 13% in rural areas. Although mortality from CHD in China is relatively low compared with Western levels, the burden of CHD has been increasing. This is partly because of a worsening profile of risk factors, such as an increased prevalence of hypertension, hyperlipidaemia, overweight/obesity, diabetes, etc and partly because of an increase in the aged population. Large-scale, randomised controlled trials on thrombolytic, blood-pressure-lowering, antiplatelet and blood-cholesterol-lowering treatment as well as cardiac intervention have been conducted for Chinese patients with myocardial infarction. The studies provide important information for the prevention and management of chronic CHD and acute myocardial infarction in the Chinese population. PMID: 18703693 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 4 days ago
Related Articles Antioxidant status in Coronary Heart Disease (CHD) patients with type 2 diabetes mellitus. J Ayub Med Coll Abbottabad. 2007 Oct-Dec;19(4):98-101 Authors: Bansilal , Ali N, Afzal N, Khan TS, Shahjahan S BACKGROUND: The present study was carried out to see the levels of vitamin C, vitamin E and total antioxidant (AO) in Coronary Heart Disease (CHD) patients with and without Type-2 Diabetes Mellitus (T2DM). In various previous studies it has been reported that, diabetes, hypertension and smoking are risk factors for CHD and all risk factors were common in these patients. METHODS: Serum was tested from 80 CHD patients and 21 healthy controls, matched for age, height, and weight. RESULTS: No significant difference was seen between the age, height and weight of the subjects and controls. CHD patients were mostly male, smokers, over 40 year of age and belonging upper class families. The mean plasma glucose was significantly higher (p < 0.05) in CHD patients having T2DM as compare to CHD patient with out T2DM. Risk factors for CHD, like diabetes, hypertension and smoking were common in these patients. No significant difference was seen in vitamin C level of patients of CHD. Vitamin E level was significantly (p < 0.05) low among the CHD patients as compared to controls and a significant (p < 0.05) decrease in mean vitamin E level was observed among smoker CHD patients as compared to non-smoker CHD patients. But no significant d ...

Source: www.ncbi.nlm.nih.gov --- 16 days ago
Related Articles Quotations from anticipated Coronary Heart Disease mortality trends. J Am Coll Cardiol. 2008 Aug 5;52(6):498 Authors: Stang A PMID: 18672175 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 13 days ago
Related Articles Inducible ischemia and the risk of recurrent cardiovascular events in outpatients with stable Coronary Heart Disease: the Heart and soul study. Arch Intern Med. 2008 Jul 14;168(13):1423-8 Authors: Gehi AK, Ali S, Na B, Schiller NB, Whooley MA BACKGROUND: Current guidelines do not recommend routine cardiac stress testing in patients with stable Coronary Heart Disease (CHD) unless they report symptoms of angina. Our objective was to compare the prognosis of self-reported angina symptoms, inducible ischemia, or both in patients with stable CHD. METHODS: We measured self-reported angina by questionnaire and inducible ischemia using treadmill stress echocardiography in 937 outpatients with stable CHD. We used Cox proportional hazard models, adjusted for traditional cardiovascular risk factors, to evaluate the independent association of angina and inducible ischemia with CHD events (myocardial infarction or CHD death) during a mean of 3.9 years of follow-up. RESULTS: Of the study participants, 129 (14%) had angina alone, 188 (20%) had inducible ischemia alone, and 40 (4%) had both angina and ischemia. Recurrent CHD events occurred in 7% of participants without angina or inducible ischemia, 10% of those with angina alone, 21% of those with inducible ischemia alone, and 23% of those with both angina and inducible ischemia (P < .001). The presence of angina alone was not associated with recurrent CHD events (adjusted hazard rat ...

Source: www.ncbi.nlm.nih.gov --- 17 days ago
Related Articles The omega-3 index as a risk factor for Coronary Heart Disease. Am J Clin Nutr. 2008 Jun;87(6):1997S-2002S Authors: Harris WS Because blood concentrations of n-3 (or omega-3) fatty acids (FAs) (eicosapentaenoic and docosahexaenoic acids) are a strong reflection of dietary intake, it is proposed that a n-3 FA biomarker, the omega-3 index (erythrocyte eicosapentaenoic acid plus docosahexaenoic acid), be considered as a potential risk factor for Coronary Heart Disease mortality, especially sudden cardiac death. The omega-3 index fulfills many of the requirements for a risk factor including consistent epidemiologic evidence, a plausible mechanism of action, a reproducible assay, independence from classic risk factors, modifiability, and, most important, the demonstration that raising levels will reduce risk for cardiac events. Measuring membrane concentrations of n-3 FAs is a rational approach to biostatus assessment as these FAs appear to exert their beneficial metabolic effects because of their actions in membranes. They alter membrane physical characteristics and the activity of membrane-bound proteins, and, once released by intracellular phospholipases from membrane stores, they can interact with ion channels, be converted into a wide variety of bioactive eicosanoids, and serve as ligands for several nuclear transcription factors, thereby altering gene expression. The omega-3 index compares very favorably with other ris ...

Source: www.ncbi.nlm.nih.gov --- 10 days ago
Related Articles Relation of adult-onset asthma to Coronary Heart Disease and stroke. Am J Cardiol. 2008 Aug 15;102(4):508 Authors: Palaniswamy C, Selvaraj DR, Nandagopal D, Mokashi A PMID: 18678319 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 18 days ago
Related Articles Historical overview of n-3 fatty acids and Coronary Heart Disease. Am J Clin Nutr. 2008 Jun;87(6):1978S-80S Authors: Leaf A The first evidence that fish oil fatty acids might have a beneficial effect on Coronary Heart Disease came from the discovery that Greenland Eskimos, who have a diet high in n-3 fatty acids, have a lower mortality from Coronary Heart Disease than do Danes and Americans. Long-chain polyunsaturated fatty acids are essential in our diets and can be classified in 2 groups: n-6 fatty acids found in plant seeds and n-3 fatty acids found in marine vertebrates. Further evidence of n-3 benefits to human health include a 1989 study demonstrating a 29% reduction in fatal cardiac arrhythmias among subjects with a recent myocardial infarction who had been advised to consume fish oil. The GISSI-Prevenzione Trial found a significant reduction in relative reduction of death, cardiac death, nonfatal myocardial infarction, and stroke in subjects consuming n-3 fatty acids. In a recent study, subjects with implanted cardiac defibrillators (ICDs) at high risk for fatal ventricular arrhythmias were randomly assigned to four 1-g capsules of either an ethyl ester concentrate of n-3 fatty acids or olive oil daily for 12 mo. Subjects receiving n-3 who thus had significantly higher levels of eicosapentaenoic acid and docosahexaenoic acid in their red blood cell membranes showed a longer time to first ICD events and had a si ...

Source: www.moreover.com --- 15 days ago
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Source: www.ncbi.nlm.nih.gov --- 17 days ago
Related Articles Conclusions and recommendations from the symposium, Beyond Cholesterol: Prevention and Treatment of Coronary Heart Disease with n-3 Fatty Acids. Am J Clin Nutr. 2008 Jun;87(6):2010S-2S Authors: Deckelbaum RJ, Leaf A, Mozaffarian D, Jacobson TA, Harris WS, Akabas SR After the symposium "Beyond Cholesterol: Prevention and Treatment of Coronary Heart Disease with n-3 Fatty Acids," faculty who presented at the conference submitted manuscripts relating to their conference topics, and these are presented in this supplement. The content of these manuscripts was reviewed, and 2 conference calls were convened. The objective was to summarize existing evidence, gaps in evidence, and future research needed to strengthen recommendations for specific intakes of n-3 fatty acids for different conditions relating to cardiovascular Disease. The following 2 questions were the main items discussed. What are the roles of n-3 fatty acids in primary versus secondary prevention of Coronary Heart Disease? What are the roles of n-3 fatty acids in hypertriglyceridemia, in the metabolic syndrome and type 2 diabetes, and in sudden cardiac death, cardiac arrhythmias, and vulnerable plaque? Each area was summarized by using 2 general categories: 1) current knowledge for which general consensus exists, and 2) recommendations for research and policy. Additional references for these conclusions can be found in the articles included in the supplement. P ...

Source: www.ncbi.nlm.nih.gov --- 17 days ago
Related Articles Fish and n-3 fatty acids for the prevention of fatal Coronary Heart Disease and sudden cardiac death. Am J Clin Nutr. 2008 Jun;87(6):1991S-6S Authors: Mozaffarian D Large observational studies, randomized clinical trials, and experimental studies have evaluated the effects of fish and n-3 fatty acid consumption on fatal Coronary Heart Disease (CHD) and sudden cardiac death (SCD), clinically defined events that most often share the final common pathway of fatal ventricular arrhythmia. These different study designs, each having complementary strengths and limitations, provide strong concordant evidence that modest consumption of fish or fish oil (1-2 servings/wk of oily fish, or approximately 250 mg/d of EPA+DHA) substantially reduces the risk of CHD death and SCD. Pooled analysis of prospective cohort studies and randomized clinical trials demonstrates the magnitude and dose-response of this effect, with 36% lower risk of CHD death comparing 0 and 250 mg/d of EPA+DHA consumption (P < 0.001), but then little additional benefit with higher intakes. Reductions in risk are even larger in observational studies utilizing tissue biomarkers of n-3 fatty acids that more accurately measure dietary consumption. The concordance of findings from different studies also suggests that effects of fish or fish oil on CHD death and SCD do not vary depending on presence or absence of established CHD. The strength and consistency of the evi ...

Source: www.ncbi.nlm.nih.gov --- 3 days ago
Related Articles Polyvascular Disease raises Heart attack and stroke risks. Atherosclerosis in multiple locations significantly increases odds of major Coronary event, but aggressive treatment may help. Heart Advis. 2008 Jun;11(6):4 Authors: PMID: 18686308 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 15 days ago
Related Articles Effects of drug, biobehavioral and exercise therapies on Heart rate variability in Coronary artery Disease: a systematic review. Eur J Cardiovasc Prev Rehabil. 2008 Aug;15(4):386-96 Authors: Nolan RP, Jong P, Barry-Bianchi SM, Tanaka TH, Floras JS BACKGROUND: Heart rate variability (HRV) is reported as a surrogate index for clinical outcome in trials of secondary prevention strategies for Coronary artery Disease (CAD), but a standardized guide for interpreting HRV change is not established. DESIGN: We evaluated HRV change in trials with CAD patients who received conventional medications (beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors), biobehavioral treatment (psychotropics, biofeedback, relaxation) or exercise training. METHODS: Medline, Pubmed, Psycinfo, the Cochrane database, and Embase were searched until July 2007, without language restriction. We identified 33 randomized controlled trials. Two reviewers independently abstracted all trials using a standardized form. A hierarchy of frequency and time domain HRV indices defined outcome. RESULTS: A random-effects model yielded an overall pooled standardized mean difference (SMD) between treatment and control groups of moderate magnitude across treatment classes, based on a composite of time and frequency domain indices (SMD=0.40, P<0.0001), or only time or frequency indices (SMD=0.37 and 0.43, respectively, both P<0.0001). This chan ...

Source: www.moreover.com --- 36 days ago
Better treatments boost survival rates of Coronary Heart Disease patients, but the quality of those extra years may be less than ideal, according to a new study. ...

Source: www.moreover.com --- 43 days ago
A new article indicates that an increased intake in minerals such as potassium, and possibly magnesium and calcium by dietary means may reduce the risk of high blood pressure and decrease blood pressure in people with hypertension. ...

Source: www.ncbi.nlm.nih.gov --- 47 days ago
Adiponectin and Risk of Coronary Heart Disease in Older Men and Women. J Clin Endocrinol Metab. 2008 Jul 1; Authors: Kizer JR, Barzilay JI, Kuller LH, Gottdiener JS Context: Despite established insulin-sensitizing and anti-atherogenic preclinical effects, epidemiological investigations of adiponectin have yielded conflicting findings, and its relationship with Coronary Heart Disease (CHD) remains uncertain. Objective: To investigate the relationship between adiponectin and CHD in older adults. Design, Setting, and Participants: Case-control study (N=1,386) nested within the population-based Cardiovascular Health Study from 1992 to 2001. Controls were frequency-matched to cases by age, sex, race, subclinical cardiovascular Disease and center. Main Outcome Measures: Incident CHD was defined as angina pectoris, percutaneous or surgical revascularization, non-fatal myocardial infarction (MI) or CHD death. A more restrictive CHD endpoint was limited to non-fatal MI and CHD death. Results: Adiponectin exhibited significant negative correlations with baseline adiposity, insulin resistance, dyslipidemia, inflammatory markers, and leptin. After controlling for matching factors, adjustment for waist-hip ratio, hypertension, smoking, alcohol, LDL-cholesterol, creatinine, and leptin revealed a modestly increased risk of incident CHD with adiponectin concentrations at the upper end (OR= 1.37 [Quintile 5 vs. 1-4], 95% CI=1.02-1.84). This association ...

Source: www.ncbi.nlm.nih.gov --- 31 days ago
Related Articles Depression and Coronary Heart Disease: association and implications for treatment. Cleve Clin J Med. 2008 Mar;75 Suppl 2:S48-53 Authors: Blumenthal JA Growing evidence indicates that depression is an important primary and secondary risk factor for Coronary Heart Disease (CHD). Depression is quite common among patients with CHD: prevalence estimates are 14% or higher, and an additional 20% of patients have subclinical or minor depression. This review summarizes evidence that depression is a risk factor for cardiac events in patients with established CHD, suggests potential mechanisms underlying the relationship between depression and adverse cardiac outcomes, and provides evidence for the efficacy of exercise in improving both depression and clinical outcomes in depressed patients with CHD. PMID: 18540147 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 45 days ago
Evaluation of the Framingham risk score in the European Prospective Investigation of Cancer-Norfolk cohort: does adding glycated hemoglobin improve the prediction of Coronary Heart Disease events? Arch Intern Med. 2008 Jun 9;168(11):1209-16 Authors: Simmons RK, Sharp S, Boekholdt SM, Sargeant LA, Khaw KT, Wareham NJ, Griffin SJ BACKGROUND: There is a continuous relationship between glycated hemoglobin (HbA(1c)) and Coronary Heart Disease (CHD) risk, even below diagnostic thresholds for diabetes mellitus. METHODS: To evaluate the Framingham risk score in a UK population-based prospective cohort (European Prospective Investigation of Cancer [EPIC]-Norfolk) and to assess whether adding HbA(1c) improves the prediction of CHD. Participants aged 40 to 79 years were recruited from UK general practices, attended a health check, and were followed up for CHD events and death. The Framingham risk score was computed for 10,295 individuals with data on age, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, diabetes mellitus, and smoking status. We developed a Cox proportional hazards regression model with the original Framingham covariates and then added HbA(1c) to determine whether this improved the prediction of CHD. Model discrimination was compared by using area under the receiver operating characteristic curves (AUROCs), and the correctness of reclassification was determined by calculating the net reclassificatio ...

Source: www.ncbi.nlm.nih.gov --- 50 days ago
Related Articles Noninvasive Coronary Artery Imaging. Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography. A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young. Circulation. 2008 Jun 27; Authors: Bluemke DA, Achenbach S, Budoff M, Gerber TC, Gersh B, Hillis LD, Hundley WG, Manning WJ, Printz BF, Stuber M, Woodard PK PMID: 18586979 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 27 days ago
Related Articles Prevalence of moderate and severe renal insufficiency in older persons with hypertension, diabetes mellitus, Coronary artery Disease, peripheral arterial Disease, ischemic stroke, or congestive Heart failure in an academic nursing home. J Am Med Dir Assoc. 2008 May;9(4):257-9 Authors: Joseph J, Koka M, Aronow WS OBJECTIVE: To determine the prevalence of moderate and severe renal insufficiency in older persons in an academic nursing home. DESIGN: The prevalence of an estimated glomerular filtration rate (GFR) determined by the Modification of Diet in Renal Disease equation less than 60 mL/min/1.73 m(2) was investigated in older persons in an academic nursing home with either hypertension, diabetes mellitus, Coronary artery Disease (CAD), peripheral arterial Disease (PAD), ischemic stroke, or congestive Heart failure (CHF). SETTING: An academic nursing home. PARTICIPANTS: Two hundred and two persons (104 women and 98 men), mean age 73 years (range 50 to 98 years) residing in an academic nursing home. MEASUREMENTS: Prevalence of a GFR less than 60 mL/min/1.73 m(2). RESULTS: A GFR less than 60 mL/min/1.73 m(2) was present in 60 (42%) of 143 persons with hypertension, in 30 (48%) of 62 persons with diabetes mellitus, in 28 (52%) of 52 persons with CAD, in 13 (50%) of 26 persons with PAD, in 10 (44%) of 23 persons with ischemic stroke, and in 15 (63%) of 24 persons with CHF. CONCLUSION: Older persons with hypertension, diab ...