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Biomedical subjects

H E Thomas

Publications and source records attributed to H E Thomas.

At least 55 records · Page 3Linked to original sources
PubMed1979

Newly acquired left bundle-branch block: the Framingham study.

The clinical implications of newly acquired left bundle-branch block (LBBB) were examined prospectively in the Framingham Study population. During 18 years of observation 55 people developed LBBB. The mean age at the onset of LBBB was 62; LBBB occurred largely in people with antecedent hypertension, cardiac enlargement, coronary heart disease, or a combination of these. Coincident with or subsequent to the onset of LBBB, 48% developed clinical coronary disease or congestive failure for the first time. Throughout the entire period of observation only 11% remained free of clinically apparent cardiovascular abnormalities. Within 10 years of the onset of LBBB, 50% had died from cardiovascular diseases. In men, the appearance of LBBB contributed independently to an increased risk of cardiovascular disease mortality. Comparison with age- and sex-matched control subjects free from LBBB confirmed that in the general adult population, newly acquired LBBB is most often a hallmark of advanced hypertensive or ischemic heart disease, or both.

Adult↗
PubMed1978

Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study.

Chronic atrial fibrillation (AF) as a precursor of stroke was assessed over 24 years of follow-up of the general population sample at Framingham, Massachusetts. Persons with chronic established AF, with or without rheumatic heart disease (RHD), are at greatly increased risk of stroke, and the stroke is probably due to embolism. Chronic AF in the absence of RHD is associated with more than a fivefold increase in stroke indicence, while AF with RHD has a 17-fold increase. Stroke occurrence increased as duration of AF increased, with no evidence of a particularly vulnerable period. Chronic idiopathic AF is an important precursor of cerebral embolism. Controlled trials of anticoagulants or antiarrhythmic agents in persons with chronic AF may demonstrate if strokes can be prevented in this highly susceptible group.

Adult↗
PubMed1971

Prevention of myocardial infarction.

The possible methods of preventing myocardial infarction have been discussed. The desirability of prevention in the total problem of myocardial infarction is stressed. The methods consist of the prevention of the underlying coronary atherosclerosis, and the secondary prevention of myocardial ischemia contributed by other factors than those presumed to relate to atherosclerosis. In the primary prevention of coronary atherosclerosis the two major risk factors are elevation of serum lipids and of blood pressure. The benefits to be achieved by reduction of elevation of both of these abnormalities are discussed. Both require a long-term approach starting as early in life as possible. The major methods of prevention or retardation of coronary ischemia irrespective of coronary artery disease involve discontinuance of cigarette-smoking and a program of increased physical activity. In addition, prevention or correction of polycythemia, anemia or hypercoagulability should be included. The use of oxygen, in higher percentage or at higher pressure than in the atmosphere, surgical intervention to improve the myocardial blood supply and pharmacologic agents to improve myocardial metabolism are also considered. Quantitation of the benefit of preventive programs is still impossible. Benefit from lowering blood lipids and blood pressure requires long-term therapy begun early in life. Discontinuance of cigarette smoking and increasing the amount of physical activity offer reasonable assurance of immediate benefit. So also does correction of hematologic abnormalities. Pharmacologic agents and surgery to improve coronary blood flow still require further evaluation.

Anemia↗