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H Gohlke

Publications and source records attributed to H Gohlke.

At least 19 recordsLinked to original sources
PubMed2006

Possible gender-dependent association of vascular endothelial growth factor (VEGF) gene and ALS.

Individuals homozygous for haplotypes -2578-A/-1154-A/-634-G or -2578-A/-1154-G/-634-G in the promoter/5'UTR of the VEGF gene have a 1.8-fold increased risk of ALS in several European populations. We did not observe any significant association with single markers, or haplotype pairs, in a German sample of 580 sporadic ALS patients and 628 controls. However, the promoter SNP-1154 (rs1570360) was associated with affection status in women (p = 0.036), suggesting that the VEGF effect may be dependent on the sex ratio of the sample.

Amyotrophic Lateral Sclerosis↗
PubMed2005

Association study between the D10S1423 microsatellite marker and Alzheimer's disease.

Several studies have reported conflicting results concerning the genetic association between Alzheimer's disease (AD) and the microsatellite marker D10S1423 on chromosome 10p12-14. In an ethnically homogeneous German population of 422 patients with AD and 254 cognitively healthy controls, the 238-bp allele of the D10S1423 marker showed a weak, but after correction for multiple testing no longer significant association with AD (p = 0.015, uncorrected; p = 0.11, corrected). These findings do not support the presence of a relevant susceptibility locus for AD on chromosome 10p12-14.

Aged↗
PubMed2005

[Possible ways of managing cardiovascular prevention: polypharmacy, additional payment or application of evidence based medicine?].

The financial balance of the health care system has changed dramatically due to a longer life expectancy and improved treatment options in elderly patients. More than 80% of cardiovascular events are lifestyle related and potentially preventable. Lifestyle modification is therefore the causal approach to decrease cardiovascular events. Improvement of nutrition and activity habits and prevention of cigarette smoking should start in the kindergarten, school and later at the workplace. A co-operation between medical societies and government institutions is necessary to achieve a population wide modification of lifestyle habits to lower the incidence of cardiovascular events in the population. Individual risk stratification is the basis for pharmacological prevention of cardiovascular events. The concept of the polypill has to be tested in controlled randomised studies.

Cardiotonic Agents↗
PubMed2005

[Total risk for cardiovascular disease. At what point is medical prophylactic medication useful?].

Despite the epidemiological importance of coronary artery disease: cardiovascular events are rare from the individual viewpoint. There is considerable uncertainty when to start medical treatment. A given risk factor modification results in a relative risk reduction independent of the global risk. Therefore the global risk determines the absolute benefit of a preventive measure. The global risk can be estimated using different scoring systems. Using the global risk and the expected relative risk reduction, the number needed to treat (NNT) to avoid one event or cardiac death can be calculated. The NNT is a measure for the usefulness of a preventive intervention. A NNT of <200 appears acceptable for primary prevention. This can be achieved with pharmacological preventive strategies if the global risk of 10 years is > or =20%. As age is one of the most important risk predictors the need for treatment at comparable risk factor constellations is age dependent. Risk stratification with estimation of the NNT is therefore important for the decision to treat or not to treat.

Cardiotonic Agents↗
PubMed2005

[Nutrition].

The favorable effect of a healthy diet on the initial development and the further progression of atherosclerosis has been demonstrated. The effect is significant even in patients with adequate pharmacological treatment. Nutrition should be calorie-adjusted high in fiber, low in total fat and in saturated fats (<10% of calories) and cholesterol (<300 mg/day). Mono-unsaturated fatty acids and omega-3 fatty acids have beneficial effects. Therefore fatty fish more than once a week, nuts, fruits and vegetables (>400 g/day) have a prognostically favorable effect, whereas the supplemental use of antioxidative vitamins is of no proven benefit. These recommendations result from the experience gained over generations in millions of people in different countries (Mediterranean and Asian) with a low rate of coronary events and a high life expectancy. These dietary habits are associated with a low rate of neoplasm and of osteoporosis. The recommendation for this type of diet is a class-I recommendation.

Coronary Artery Disease↗
PubMed2005

[Role of body weight for the prevention of coronary heart disease].

The prevalence of obesity has increased considerably in recent years; only one third of our population displays a desirable, healthy weight. Persons with increased body fat mass are in a constant pro-inflammatory and pro-thrombotic condition; in addition they are often insulin-resistant und show cardiovascular risk factors. Therefore, obesity induces the development of atherosclerosis as an independent risk factor as well as a promoter for other risk factors. In addition, congestive heart failure is more frequent in obese subjects. By reducing body weight with a decrease of predominantly visceral fat all risk factors are improved as well as endothelial function. Effects on coronary atherosclerosis and congestive heart disease are until now insufficiently investigated.

Body Fat Distribution↗
PubMed2004

[Recommendations for statin therapy in the elderly].

Elderly patients are significantly less likely to receive statins than younger patients possibly because of doubts regarding compliance or concerns regarding the increased likelihood of adverse events and drug interactions. Poor compliance can be expected especially in patients suffering from dementia or depression as well as those whose stage of cardiovascular disease exhibits few symptoms. On the other hand, the clinical significance of CHD events is high in the elderly, and 80% of coronary deaths occur in patients aged over 65 years. The average statistical life expectancy of elderly and old patients is often underestimated. The HPS and PROSPER studies showed that statins reduce mortality and morbidity even in very elderly individuals with a high global cardiovascular risk and/or CAD. Patients up to the age of 79 years should be treated according to the same guidelines as younger patients. Statin therapy should only be considered for patients aged 80 years and older who are at a very high risk for cardiovascular events.

Aged↗
PubMed2004

[The global risk for cardiovascular disease. Who is a candidate for pharmacological prevention?].

Despite the epidemiological importance of coronary artery disease, cardiovascular events are rare from the individual viewpoint. There is considerable uncertainty when to start medical treatment. A given risk factor modification results in a relative risk reduction independent of the global risk. Therefore the global risk determines the absolute benefit of a preventive measure. The global risk can be estimated using different scoring systems. Using the global risk and the expected relative risk reduction, the Number Needed to Treat (NNT) to avoid one event or cardiac death can be calculated. The NNT is a measure for the usefulness of a preventive intervention. A NNT of < 200 appears acceptable for primary prevention. This can be achieved with pharmacological preventive strategies if the global risk of 10 years is > or = 20%. As age is one of the most important risk predictors the need for treatment at comparable risk factor constellations is age dependent. Risk stratification with estimation of the NNT is therefore important for the decision to treat or not to treat.

Adult↗
PubMed2004

[Prevention of coronary disease and sudden death by nutrition].

Nutrition influences sudden cardiac death (SCD) not only by determining the development of atherosclerotic coronary disease but possibly also by more specific rhythm stabilizing abilities of some nutrients. QUANTITATIVE ASPECTS: A body mass index >30 is associated with a 2.6-fold risk of SCD, probably via the risk factors diabetes and hypertension. QUALITATIVE ASPECTS: alpha-linolenic acid (ALA) is a substrate for the production of the N-3-fatty acids eicosapentaenoic acid (EPA) und docosahexaenoic acid (DHA). The consumption of ALA correlates with decreased MI risk. Fish consumption is (in case control studies) associated with reduced MI-risk and (in prospective controlled studies) with decreased risk of SCD. Two or more fish meals/week and the estimated N-3-fatty acids (n-3-FA) ingestion of > 1.2 g/week correlate with a reduced SCD-risk. The blood level of the N-3-FA EPA and DHA correlate highly with a reduced risk for SCD. It is likely that the marine production of N-3-FA will not suffice to supply the amount needed for large scale prevention. Industrial farming of algae and genetic modification of mammal muscle cells resulting in improved ability to transform N-6-FA to corresponding N-3-FA could contribute to better availability of N-3-FA for prevention. Nutrition influences sudden cardiac death (SCD) not only by determining the development of atherosclerotic coronary disease but possibly also by more specific rhythm stabilizing abilities of some nutrients.

Animals↗
PubMed2004

[Cardiovascular risk stratification in general practice].

CONCLUSION: The ESC risk charts are helpful to identify high risk patients in general practice who are candidates for preventive treatment. The use of the ESC charts is one important step to initiate "evidence based medicine" in the daily practice of preventive cardiology.Cardiovascular diseases are the most important causes of premature disability and death in Germany. High risk patients however are frequently not recognized. A systematic risk stratification in general practice could identify high risk persons and allow a cost effective treatment approach. The goal of the CAD-scoring week was to identify high risk persons with the use of the ESC risk charts and to evaluate the treatment resulting from risk stratification. In addition the feasibility of the risk charts in daily office routine was to be evaluated. A total of 1122 of 20 000 (5.6%) contacted general physicians agreed to participate in the screening procedure. More than 27 000 patients (> 50 yrs) were evaluated using the ESC risk charts. 21.6% of women (n = 15 018) vs 22.2%* of men (n = 12 361) had markedly elevated blood pressure (> 150 mmHg), 29 vs. 24%* had a total cholesterol > 250 mg/dl (6.5 mmol/l), 25.5 vs 29.9%* smoked and 28.4 vs. 31.9%* had diabetes (*female vs male: p < 0.0003). Altogether 19.4% of women vs. 53% of men were newly identified as high risk patients (risk > 20% in 10 years). More than 40% of these high risk patients received drug treatment for prevention (ASA, lipid lowering drugs or ACE inhibitors). More than 70% of the participating physicians judged the risk charts to be helpful in patient management.

Adult↗
PubMed2004

Change in quality of life in the year following cardiac rehabilitation.

The aim of the present study was to assess change in health-related quality of life (HRQoL) after cardiac rehabilitation in the usual care setting, and to determine predictors for change. In the Post Infarction Care Study, 2441 patients were consecutively included at admission to 18 inpatient cardiac rehabilitation centres following coronary events. HRQoL was assessed with the SF-36 questionnaire at baseline as well as 6 and 12 months after discharge. HRQoL improved significantly in patients after coronary artery bypass grafting (CABG) but not in patients after myocardial infarction. Significant baseline predictors for change of the SF-36 physical component summary (PCS) score were the exercise ECG result at admission (0.59 absolute change/10-watt increase; 95% CI: 0.39, 0.79), an income > or = 1750 euros (1.64; 95% CI: 0.35, 2.93), baseline PCS score (-0.63; 95% CI: -0.69, -0.57), and CABG as indication for admission (3.65; 95% CI: 2.27, 5.04). Significant predictors for change of the mental component summary (MCS) score were age (1.28/10-year increase; 95% CI: 0.62, 1.94), East Germany as area of residence (2.62; 95% CI: 1.32, 3.91), baseline MCS score (-0.58; 95% CI: -0.63, -0.52), and CABG as indication for admission (1.68; 95% CI: 0.36, 3.01). The identification of predictors of HRQoL in the present study may aid in the further development and evaluation of cardiac rehabilitation programmes.

Aged↗
PubMed2004

Asthma is associated with single-nucleotide polymorphisms in ADAM33.

BACKGROUND: The ADAM33 gene has recently been associated with asthma and bronchial hyper-reactivity. It codes for a disintegrin and metalloproteinase that triggers intra- and extracellular signalling by protein shedding. OBJECTIVE: We examined whether polymorphisms in ADAM33 are associated with asthma and related traits in two German populations. METHODS: We genotyped 15 intragenic single-nucleotide polymorphisms (SNPs) by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry of allele-specific primer extension products. The transmission disequilibrium test was used for association analysis in the German asthma family study. Additionally, we tested for association of these SNPs in a case-control sample from the European Community Respiratory Health Study using Armitage's trend test. RESULTS: In both studies, we found SNPs that were significantly associated with asthma and related traits. In the family study, significant associations were observed for the SNPs F+1, ST+4 and ST+5 (with the lowest P-value for F+1, P=0.005). Remarkably, this association is seen even in the absence of linkage with two microsatellite markers from a previous genome scan either 3.1 million bases (Mb) up- or 5.6 Mb downstream. In the case-control study, SNP ST+7 (P=0.008) was significantly associated with asthma. Some of these SNPs overlapped with those found to be associated with elevated total IgE levels and bronchial hyper-responsiveness. CONCLUSION: This study replicates the recently published association between asthma and ADAM33 gene variants. However, most of the associated SNPs were at non-identical positions in the German, UK and US samples. As linkage disequilibrium is high among the tested SNPs, and there is no known functional polymorphism, either not-tested variants in ADAM33, unknown regulatory elements or a gene in close proximity is responsible for this association.

ADAM Proteins↗