Cardiovascular Diseases Introduction

Atherosclerosis and its related complications, coronary heart disease (CHD), myo-cardial infarction and stroke, have been identified as the major causes of mortality and morbidity in the Western world. Atherosclerosis is a progressive build-up of fatty streaks on the interior arterial walls that prevents adequate blood supply to the myocardium. Although many factors are involved in atherosclerosis, oxidation of low-density lipoprotein (LDL) by free radicals may initiate the lesions and lead to...

Thrifty Phenotype Hypothesis

This hypothesis has been invoked to explain why people with similar intrauterine exposures to malnutrition behave differently later, depending on the degree of catch-up growth after birth. Animal studies show that this compensatory growth shortens survival.195 The consequent rapid rates of cell division may lead to changes in genetic material and earlier cell death.196 Rapid childhood weight gain also has been shown to increase the risk of disease associated with small body size at birth and...

Energy Expenditure

Earlier studies by Krauss et al.122 and Stocker et al.123 revealed relative hypermetabolism in neonates and infants with CHD. More recently, Barton et al.124 demonstrated significant elevation of total daily expenditures of energy in underweight infants with severe cardiac failure (CCF). In their study of 14 infants with CHD and severe failure to thrive, Yahav et al.115 showed that an intake as high as 170 cal kg was necessary for significant growth. Clinical features that suggest increased...

Interpretation of Abbreviations and Computation of Parameters of LV Function

Potential energy Pressure volume area - Stroke work Percentage of potential Potential energy Pressure volume area energy End-systolic elastance of left ventricle Arterial elastance (ventricular-arterial coupling) a Cardiac cycle derived from Pmax to Pmax. function is considered as the LV ability of active isovolumic relaxation and LV compliance both affect the LV filling. The best parameters for contractility are PRSW (preload recruitable stroke work), dP dt max vs. Ved (end-diastolic volume),...

Garlic and LDL Oxidation

Oxidized LDL is an important factor in initiation and progression of atherosclerosis, promoting vascular endothelial infiltration with foam cells, and formation of fatty streaks.53-55 Oxidized LDL, having antigenic properties, behaves as a foreign substance and is recognized as such by the host immune system. The immune system responds by attracting the monocytes to intima where they differentiate into macrophages. The macrophages are stabilized in the intima, loaded with lipids, forming foam...

Current Medical Treatments For Hypertension

Hypertensive drugs are normally taken on a continuous basis.9 In diseases such as hypertension, diabetes, and asthma, a relapse following cessation of treatment is considered evidence of the effectiveness of the treatment and the need to continue monitoring the patient.32 The six main drug treatments for hypertension are diuretics, beta-blockers, calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II antagonists, and alpha-adrenergic blockers, although no reliable...

Indian Girl Ka 664266

Ageing decreases the capacity of human skin to produce vitamin D3. J Clin Invest 1985 76 1536-8. 2. Bostick RM, Kushi LH, Wu Y, Meyer KA, Sellars TA, and Folsom AR. Relation of calcium, vitamin D, and dairy food intake to ischaemic heart disease mortality among postmenopausal women. Am J Epidemiol 1999 149 151-61. 3. Koide M, Harayama H, Iio A, Obata K, Matsuda N, Ono T, Yokota M, and Tuan RS. Major risk factors for atherosclerosis are manifested in experimental...

Diet And Prevention Of Plaque Inflammation And Rupture

For several decades, the prevention of CHD (including the prevention of ischemic recurrence after prior AMI) has focused on the reduction of the traditional risk factors smoking, HBP, and hypercholesterolemia. Priority was given to the prevention (or reversion) of vascular atherosclerotic stenosis. As discussed above, it has become clear that clinical efficiency in secondary prevention primarily needs to prevent fatal complications of CHD such as SCD. This does not mean, however, that we should...

Endothelial Activation As Main Target For Antiatherogenic Properties Of Olive Oil Components

The earliest morphologically detectable cellular event in atherogenesis is the adherence of circulating blood monocytes to the arterial endothelium.37-39 This occurs because of a modification of the normal functional state of the arterial endothelium consisting of the appearance of new antigenic and functional properties, in general termed endothelial activation.40 Possible causes of endothelial activation include elevated levels of oxidized and minimally modified low density lipoproteins...

Lycopene And Cardiovascular Disease

Lycopene is a carotenoid without vitamin A activity that has gained fame as a substance in tomatoes, tomato sauces, pizza sauce, and other tomato products that prevents prostate cancer. Research has shown that lycopene containing many conjugated double bonds is a potent antioxidant and has the strongest singlet oxygen quenching capacity among the carotenoids. Antioxidant capacity of alpha-carotene, beta-carotene, and lutein follow lycopene in strength, respectively.34 Lycopene is a fat-soluble...

Homocysteine And Folate

Homocysteine is formed by the demethylation of methionine and is removed by remethylation (reconstituting methionine) or by trans-sulfuration (Figure 9.1). In most tissues, remethylation involves a derivative of dietary folate (5-methyltetrahy-drofolate, also known as 5-meTHF) as the methyl donor the process is catalyzed by methionine synthase with vitamin B12 (cobalamin) as an essential cofactor. Methionine synthase and another enzyme (methylenetetrahydrofolate reductase, also known as MTHFR)...

Leptinresponsive Neural Pathways And Cardiovascular System

Although it has been nearly 10 years since the discovery of leptin, the mechanisms by which this hormone produces its biologic actions are only beginning to be understood. As described above, hypothalamic neurons that express either POMC CART or NPY AgRP are likely candidates to serve as the initial and primary mediators of leptin, including the sympathetic and cardiovascular responses to altered CNS leptin levels. Downstream mechanisms ultimately regulating pregan-glionic autonomic neurons...

Other Treatments For Hypertension

The disappointing results of some hypertensive therapies have caused doubts about traditional approaches to management of hypertension.36 Rates of successful blood pressure control remain low among treated patients.4 Only 47 of patients with hypertension achieve optimal blood pressures below 140 90 mmHg.37 Hypertension treatments that will help patients establish healthy lifestyle changes and have fewer and less severe side effects would probably lead to more optimum results and higher rates of...

References

Zipes, D.P. and Wellens, H.J., Sudden cardiac death, Circulation, 98, 2234, 1998. 2. de Lorgeril, M., Salen, P., Defaye, P., Mabo, P, and Paillard, F., Dietary prevention of sudden cardiac death, Eur. Heart J., 23, 277, 2002. 3. Burr, M.L., Fehily, A.M., Gilbert, J.F. et al., Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction Diet and Reinfarction Trial DART , Lancet 2, 757, 1989. 4. McLennan, P.L., Abeywardena, M.Y., and Charnock, J.S., Reversal of...

Info

FIGURE 6.1 Left ventricular ejection fraction mean - SEM at the end of the doubleblind study week 1 and at the end of the open ambulatory phase week 7 . p lt 0.05, thiamine versus placebo, end of week 1. p lt 0.01, all patients, end of week 7 versus baseline. From Shimon, I. et al., Am. J. Med, 98, 485, 1995. With permission. Niacin is a generic term for nicotinic acid and nicotinamide. Nicotinamide is a component of nicotinamide adenine dinucleotide NAD , nicotinamide adenine dinu-cleotide...