Coronary heart disease: risk factors as guides to preventive action.
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Biomedical subjects
Publications and source records attributed to F H Epstein.
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Current views on the usefulness of pre-clinical markers to detect susceptibility toward coronary heart disease have been presented, including the role of the hyperlipidemias, hypertension, hyperglycemia, obesity, family history and several other personal attributes. In addition, various clinical, electrocardiographic and other indices of early clinical disease serve as premonitory warning signals toward myocardial infarction and sudden death. Individuals harboring one or more of these risk factors should be detected and protected by means of preventive measures.
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The activity of sodium-potassium-activated adenosine triphosphatase (Na-K-ATPase) is considerably higher in homogenates of outer medulla than in the cortex or papilla of the kidney. The enzyme has similar kinetic characteristics in both cortex and medulla, and binds ouabain in the same proportion. The discrepancy in enzymatic activity is not paralleled by similar change in the activity of adenyl cyclase, 5'nucleotidase, glucose-6-phosphatase, or succinic dehydrogenase. Na-K-ATPase is also higher in distal convoluted tubules (ventral slices) than in the proximal tubules (dorsal slices) of the kidney of Amphiuma. The high concentration of Na-K-ATPase in the red medulla of the kidney is probably related to the presence here of the thick ascending limb of the loop of Henle, and this has important implications with regard to the mechanism of sodium reabsorption by different portions of the nephron.
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