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Biomedical subjects

H Kesteloot

Publications and source records attributed to H Kesteloot.

At least 19 recordsLinked to original sources
PubMed1992

Serum lipoprotein(a) levels in racially different populations.

Lipoprotein(a) is an atherogenic lipoprotein which has been studied predominantly in white populations. Serum lipoprotein(a), serum lipids, and apolipoproteins A-I and B were quantified in 1991 in a total of 300 sex-matched samples derived from five different ethnic groups. Three population samples of Asian origin (Tibet, Korea, and China), one population sample of West African origin (Nigeria), and one Western population sample (Belgium) were included. All serum samples had been collected in the past (3-11 years previously) and had been stored at -80 degrees C since then. Thirty serum samples from males and 30 serum samples from females were analyzed from each ethnic group. Overall median lipoprotein(a) levels in Koreans, Chinese, Tibetans, Nigerians, and Belgians were 99, 89, 49, 134, and 80 mg/liter, respectively. Lipoprotein(a) frequency distributions were highly skewed to the right in all populations, with the Nigerian distribution showing less skewness than the Asian and Western plots. All distributions became nearly gaussian after logarithmic transformation. No statistical difference was found between the mean log lipoprotein(a) values of the sexes (4.43 +/- 1.01 mg/liter (standard deviation) in men; 4.44 +/- 1.08 mg/liter in women). Pearson correlation analysis of both sexes combined revealed no statistically significant correlation (at the p less than 0.01 level) of log lipoprotein(a) with age, height, weight, body mass index, cholesterol, high density lipoprotein cholesterol, apolipoprotein A-I, or apolipoprotein B within any of the population groups studied or after pooling of all population groups.

Apolipoproteins↗
PubMed1992

Value of Food and Agriculture Organization data on food-balance sheets as a data source for dietary fat intake in epidemiologic studies.

The relationships between the per person supply (expressed as percent of total energy supply) of saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) obtained from 1979-1981 Food and Agriculture Organization (FAO) data, and the per person intake obtained from 52 individual dietary surveys performed in 19 countries, were examined. In particular, the ratio of PUFAs to SFAs (P:S) and the ratio of unsaturated fatty acids (MUFAs and PUFAs) to SFAs (U:S) obtained from both data sources were examined. Significant correlations (P less than 0.001) were found between the two data sources for the P:S, U:S, SFAs, and MUFAs and PUFAs (P less than 0.02) in 19 countries. It is concluded that the data on fat intake from the FAO are valid for use in epidemiologic studies. In view of the variability of the data, it is recommended to use them either expressed as percentage of energy or as ratios of the different components.

Diet Surveys↗
PubMed1992

Nutrition and health.

Important differences in all-causes mortality and in cardiovascular mortality exist between populations and they cannot be explained by differences in the level of medical care. During the last 20 years important changes have occurred in the level of cardiovascular mortality with an increase in Hungary and a decrease in Japan. These rapid changes in mortality cannot be explained by genetic factors. The epidemiological evidence strongly points towards nutrition and especially to the intake of saturated fat and salt as the major determinant of the existing differences in mortality. Saturated fat also appears to be related to total cancer mortality. A major effort should be directed towards a decrease in the dietary intake of saturated fat by Western populations.

Cardiovascular Diseases↗
PubMed1992

Relation between 25-hydroxyvitamin D3, apolipoprotein A-I, and high density lipoprotein cholesterol.

In a survey of cardiovascular risk factors in 185 men and 173 women of a Belgian population group, an independent and highly significant positive correlation was found between the serum concentrations of 25-hydroxyvitamin D3 and apolipoprotein A-I (p less than 0.001 in both sexes). 25-Hydroxyvitamin D3 also showed a positive correlation with high density lipoprotein cholesterol levels (p less than 0.05 in men and p less than 0.005 in women). This relation was independent of a possible effect of 25-hydroxyvitamin D3 on serum calcium. Taking the biological variation of 25-hydroxyvitamin D3 levels (+/- 2 SD = 25 ng/ml) into account, these findings could explain variations in the levels of apolipoprotein A-I of 15 mg/100 ml and of high density lipoprotein cholesterol of 4 mg/100 ml.

Adult↗
PubMed1992

Time course of serum lipid and lipoprotein levels after coronary bypass surgery: modification by pravastatin.

The time course of the changes in serum lipid and lipoprotein levels have been studied in 100 patients undergoing coronary artery bypass surgery. Marked decreases occur in the levels of cholesterol (-45%), HDL-cholesterol (-35%), LDL-cholesterol (-53%), Apo A1 (-43%) and Apo B (-43%) on the third day after the operation. In the control group the values gradually returned to preoperative levels which are reached after three months. Three months after the intervention, in the pravastatin-treated group (20 mg/day) the values of total cholesterol (-20%), LDL-cholesterol (-28%) and Apo B (-22%), remained significantly lower than in the control group (p 0.0001) and were lower over the whole duration of the study. The postoperative time course of HDL-cholesterol and Apo A1, however, was not significantly influenced by the administration of pravastatin.

Aged↗
PubMed1992

Time course of serum Lp(a) in men after coronary artery bypass grafting.

The serum Lp(a) time course was studied in 100 male patients who underwent coronary artery bypass grafting (CABG). The patients were randomized in a placebo (N = 50) and pravastatin treated (N = 50) group. The pravastatin regimen was 10 mg daily from the third postoperative day on and 20 mg daily after 1 week during 11 weeks. Lp(a) levels and serum lipids were analyzed at baseline, at 3 and 10 days, and at 4 and 12 weeks post-CABG. A decrease of serum Lp(a) levels at the third postoperative day was seen which parallels the changes noted with the other serum lipids when using extracorporeal circulation. In contrast with the other serum lipids, a slight but significant Lp(a) overshooting was noticed at day 10 followed by a decrease of the serum Lp(a) levels to preoperative levels 1 month after the acute event. The study clearly depicts that there is a significant time-dependent effect on the serum Lp(a) levels post-CABG and that there is no effect of treatment (pravastatin). The data also reveal that reliable postoperative Lp(a) measurements can be made at earliest 1 month post-CABG.

Adult↗
PubMed1992

Clinical and electrophysiologic studies of R61748 (transcainide): a new class Ic antiarrhythmic drug.

The electrophysiology and antiarrhythmic efficacy of R61748, a 4-OH metabolite of R54718 (transcainide), have been studied in patients and animal experiments. The results indicated that R61748 (1 mg/l) decreased the rate of rise of the transmembrane action potential (Vmax) by 40% and shortened the action potential duration (APD) by 10% in guinea-pig right ventricular papillary muscle. ERP/APD increased by 10%. The effect was dose-dependent. Clinical electrophysiologic studies (EPS) in 6 patients with ventricular premature beats showed that R61748 (0.1 mg/kg) prolonged PA duration by 30%, AH interval by 13% and HV duration by 24%. ECG revealed prolonged P duration by 16%, P-R interval by 16% and QRS duration by 17%. R61748 has also been used in 14 patients with idiopathic premature ventricular contraction (PVCs). PVCs were abolished in 6 patients and decreased more than 93% in 2 patients. The average reduction of PVCs was 80%. R61748 (0.075 mg/kg) abolished an episode of repetitive ventricular tachycardia in 1 patient. It is concluded that R61748 is a potent new class Ic antiarrhythmic agent with slow kinetics. R61748 is the 4-OH metabolite of R54718 (transcainide) (Stroobandt et al., 1987) which is a new class Ic antiarrhythmic agent. Up to now no reports have been published about R61748. This paper presents the initial studies of cellular and clinical electrophysiologic effects and the evaluation of antiarrhythmic efficacy of R61748.

Action Potentials↗
PubMed1992

The relationship between urinary cations obtained from the INTERSALT study and cerebrovascular mortality.

An epidemiological study on the relationship between 24 hour urinary sodium, potassium, calcium, magnesium and creatinine (Creat), as obtained from the INTERSALT study, and cerebrovascular disease (CVA) mortality in the age-standardised group 45-74 years, was conducted using data from 25 countries worldwide. A significant positive relationship was observed by multivariate analysis between cerebrovascular disease mortality and 24 hour urinary Na excretion in men, with Na/K ratio in women and with Na/Creat ratio in all groups. A significant negative correlation was found between the 24 hour urinary magnesium excretion and CVA mortality in men and in men and women averaged, while 24 hour urinary potassium excretion correlated significantly and negatively with CVA mortality in women. No significant relationship between systolic and diastolic blood pressure, 24 hour urinary calcium excretion and BMI with CVA mortality could be established. A log10 transformation revealed a significant positive relationship between Ca/Mg ratio with CVA mortality in men as well as in the group of men and women averaged. A significant negative correlation between CVA mortality and 24 hour creatinine excretion was found. This relationship was stronger in men and could point to a protective effect of protein intake. The findings also point to a direct relationship between dietary cation intake and CVA mortality.

Aged↗
PubMed1991

The relationship between animal fat intake, cigarette smoking, and lung cancer.

An international ecologic study on the relationship between fat intake, cigarette consumption, and age-specific lung cancer mortality rates was conducted using data obtained from 29 countries. The 1969-71 and 1984-86 mortality rates for lung cancer were related to smoking habits and to levels of animal fat intake. Highly significant independent positive correlations for lung cancer with both cigarette smoking and animal fat consumption were seen. No significant independent relationship was found between lung cancer mortality and vegetable fat consumption. In a multiple regression analysis linking lung cancer mortality to dietary intake of animal fat, cigarette smoking, and the interaction term between cigarette smoking and animal fat intake, only the latter term was significant (P less than 0.001) pointing towards a role for animal fat as a promoter of lung cancer.

Aged↗
PubMed1991

Trends in systolic blood pressure, 24-hour sodium excretion, and stroke mortality in the elderly in Belgium.

Data from six surveys of systolic blood pressure conducted in Belgium between 1967 and 1986 were analyzed. The mean ages of the six groups of 3,328 subjects ranged from 70 to 81 years. The prevalence of systolic blood pressure levels above 159 mm Hg decreased between 1967 and 1986 from 51% to 21% in men and 66% to 22% in women; severe hypertension (systolic blood pressure greater than 220 mm Hg) nearly disappeared. During the same period, body mass index increased 1.1 kg/m2 in men and was unchanged in women; mean systolic blood pressure decreased from 159 to 142 mm Hg in men and from 171 to 147 mm Hg in women; the proportion of subjects receiving treatment for hypertension increased from 10% to 36% in men and from 18% to 41% in women; and the mean standardized 24-hour sodium excretion decreased from 265 to 188 mmol in men and from 208 to 160 mmol in women. Systolic blood pressure levels were significantly and independently related to sodium excretion in the 1967 and 1972 studies. The decrease in systolic blood pressure in Belgium was influenced by the combined effects of more and better treatment for hypertension and a decrease in sodium intake.

Adult↗
PubMed1991

Dairy fat, saturated animal fat, and cancer risk.

The relationship between the per person supply of fat from dairy products and lard and cause-specific cancer mortality was examined using 1979-1981 FAO data from 36 countries. Significant correlations (P less than 0.01) were found between dairy and lard fat intake and total, breast, prostate, rectal, colon, and lung cancer. Significant relationships between site-specific cancer mortality and ischemic heart disease mortality could also be established. Hormone-dependent cancers significantly correlate with both hormone-dependent and non-hormone-dependent cancers of the opposite sex, pointing toward other than sex-linked factors as an explanation. The level of saturated fat intake provides the most plausible link for the relationship between the cancers considered and ischemic heart disease mortality. Our findings support the concept of the important role saturated fat plays in cancer promotion.

Aged↗
PubMed1991

Relationship between dietary cations and blood pressure.

The relationship between dietary cations and blood pressure is complex. Epidemiological evidence points to a significant independent positive relationship between dietary sodium and blood pressure. The same evidence favours the existence of a significant negative relationship between dietary potassium and blood pressure. On a molar basis 1 mmol of potassium is about 2.5 times more effective in lowering blood pressure than sodium is in raising it. The evidence concerning the effect of dietary calcium on blood pressure remains controversial. Intervention studies favour a blood-pressure-lowering effect, but serum and urinary calcium correlate positively with blood pressure. Dietary magnesium has probably a slight blood-pressure-lowering effect, but more data are needed in order to evaluate its importance. At the population level blood pressure is significantly related to the dietary intake of cations.

Belgium↗
PubMed1991

Findings of the International Cooperative INTERSALT Study.

INTERSALT, an international cooperative study on electrolytes and other factors related to blood pressure, found, in within-population analyses involving 10,079 persons, a significant positive association between 24-hour urinary sodium excretion and systolic blood pressure and between the sodium/potassium ratio and systolic blood pressure. These significant findings were derived from analyses for individuals from all 52 centers and from the 48 centers remaining when persons from four low sodium centers were excluded. Potassium excretion of individuals was significantly and independently related inversely to their systolic blood pressure. For men and women, both separate and combined, the relation between sodium and systolic blood pressure was stronger for older than younger adults, perhaps reflecting the result of longer exposure with age or diminished capacity to handle a sodium load. Relations between electrolyte excretion and diastolic blood pressure in individuals were weaker than for systolic blood pressure. Body mass index and heavy alcohol consumption of individuals were strongly and independently related to blood pressure. In cross-population analyses with n = 52 or n = 48, sample median sodium excretion was significantly and independently related to the slope of systolic blood pressure and diastolic blood pressure with age. Other ecological analyses yielded inconsistent results. Four isolated populations showed low sodium excretion, low sodium/potassium excretion, low body mass index, and low alcohol consumption; sample median blood pressures were low, there was little or no upward slope of blood pressure with age, and high blood pressure was rare or nonexistent.

Adult↗
PubMed1991

Silent ischaemia: an update on current concepts.

Angina pectoris is the cardinal symptom of coronary heart disease and is a symptom with which physicians are very familiar. The clinical diagnosis of ischaemic heart disease is often based largely on a history of typical chest or arm pain, and the major therapeutic endeavour in such patients is directed towards abolition or amelioration of angina. Indeed physicians have, at least up until recently, been confident in assuming that angina is a reliable marker of ongoing ischaemia and that success of medical or surgical treatment of coronary heart disease can be accurately gauged according to improvement or disappearance of anginal symptoms (Cohn & Braunwald, 1988). However, the results of a number of important clinical studies, reported over that last 10 to 15 years, appear to challenge these traditional medical assumptions. In many patients with coronary heart disease, acute episodes of myocardial ischaemia are frequently unaccompanied by angina, often referred to as "silent myocardial ischaemia" (Epstein et al., 1988; Fox, 1988; Cohn, 1985; Maseri, 1985). It has to be pointed out that not all painless ischaemic episodes are truly silent. Instead of experiencing pain during some episodes of acute myocardial ischaemia, patients may, on occasion, instead report symptoms such as dyspnoea or palpitations (these symptoms being known as "anginal equivalents") (Cohn & Braunwald, 1988). Nevertheless, the great majority of painless ischaemic episodes are, truly silent and not accompanied by "anginal equivalents", which has led to the trend in the recent literature to regard the terms "silent" and "painless" myocardial ischaemia as synonymous.

Coronary Disease↗
PubMed1990

Serum lipid and apolipoprotein levels in a Tibetan population sample.

Serum lipid and apolipoprotein levels were measured in a Tibetan population sample. In both men and women serum cholesterol levels were markedly lower than in Western populations. In men HDL-cholesterol levels were higher compared to both Oriental and Western populations while in women the values were markedly higher than in other Oriental populations and similar to Western populations. Highly significant positive relationships were found between serum lipid levels and corresponding apolipoprotein levels. In men but not in women serum cholesterol was markedly higher in office workers than in factory workers.

Adult↗