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Knud Landmark

Publications and source records attributed to Knud Landmark.

At least 19 recordsLinked to original sources
PubMed2006

[Alpha-linolenic acid, cardiovascular disease and sudden death].

BACKGROUND: Several animal experiments have documented that omega-3 fatty acid alpha-linolenic acid (ALA) (C 18:3, n-3) from vegetable oils has beneficial electrophysiological and antiarrhythmic effects. This may explain the protective effect of ALA against cardiovascular diseases and sudden death. MATERIALS AND METHODS: We have continuously and systematically collected and evaluated relevant literature (observational and secondary prophylactic studies) and here present an overview of the effects of ALA on cardiovascular diseases and sudden death. RESULTS: Several observational studies in healthy individuals and in patients with coronary heart disease have indicated that a diet rich in ALA reduces coronary death and the risk for sudden death. A cross-sectional study has shown a beneficial effect of ALA on the progression of coronary atherosclerosis. Three secondary studies have also indicated beneficial effects of ALA on several cardiovascular end-points. Diet studies do have limitations, and the secondary prophylactic studies have not given a definite answer to whether ALA possesses beneficial cardiovascular effects. INTERPRETATION: On the whole, the observational and secondary prophylactic studies indicate that ALA may have cardioprotective effects in healthy individuals and in patients with coronary heart disease. For those who seldom eat fish and only take small amounts of fish oils, a diet rich on ALA may be an alternative.

Adult↗
PubMed2006

[Could intake of vitamins C and E inhibit development of Alzheimer dementia?].

BACKGROUND: Alzheimer dementia is a neurodegenerative disease characterised by loss of memory and other cognitive functions. Oxidative stress is a possible pathogenetic factor and the anti-oxidating vitamins C and E could therefore have a beneficial effect and reduce the damage caused by beta-amyloid. MATERIALS AND METHODS: The relevant literature (several observational studies and two clinical controlled trials) describing effects of vitamin C and E in Alzheimer dementia have been evaluated. RESULTS: Several observational studies in mostly healthy, elderly individuals have indicated that vitamin C and E, mainly from food as well as the combination of high doses of the same vitamins, may have beneficial effect on the development of Alzheimer dementia. One clinical controlled trial in patients with manifest Alzheimer dementia, in which vitamin E 2000 mg/day was given as the only vitamin, has to a certain extent confirmed these results. INTERPRETATION: A causal relationship between intake of the vitamins and Alzheimer dementia has not been clarified. The correct dosages are not known, but a diet rich in these vitamin could probably reduce the risk of dementia. With a high intake of vitamin E, the addition of vitamin C is necessary.

Aged↗
PubMed2006

Treatment with statins after acute myocardial infarction in patients >or=80 years: underuse despite general acceptance of drug therapy for secondary prevention.

PURPOSE: It has not been decided to what extent the results from statin trials should be transferred to clinical practice in the very old. The aim of the study was to assess the use of cardiovascular drugs after an acute myocardial infarction (MI), with particular focus on statins, in very old patients as compared to younger patients. METHOD: A sample of 901 acute MI patients was drawn from 16 hospitals in 1999/2000; the patients were followed up for 2.5 years. Information on demographic variables and drug therapy was obtained from hospital records, and in the follow-up period by direct patient contact or questionnaire. The main indications for prescribing the various cardiovascular drugs were recorded. RESULTS: At discharge, drug use in patients >or=80 and <80 years, respectively, was as follows: ACE-inhibitors 48 versus 32%, nitrates 55 versus 32%, diuretics 64 versus 26%, aspirin 72 versus 86%, and beta-blockers 67 versus 85%. A striking difference was found for statins: 9% in the very old and 72% in younger patients. The pattern of drug use generally remained unchanged after 2.5 years. Survival rates for patients >or=80 and <80 years: at discharge 72 versus 90%, after 2.5 years 34 versus 73%. CONCLUSIONS: Drug therapy was widely accepted for the indication secondary prevention after MI in patients above 80 years of age. The various cardiovascular drugs were prescribed to about the same extent for very old and younger patients. The exception was lipid lowering drugs which, despite the physicians' recognition of the indication secondary prevention in the very old patients, were prescribed to a limited extent.

Aged↗
PubMed2005

[Do vitamins C and E protect against the development of carotid stenosis and cardiovascular disease?].

BACKGROUND: Some observational and randomized, clinical interventional studies have indicated that the antioxidative vitamins C (ascorbic acid) and E (alpha-tocopherol) can reduce intima-media thickness of the carotid arteries. It is, however, not clarified whether these vitamins may have a preventive effect against cardiovascular events. MATERIAL AND METHODS: The literature on the effects in relation to several cardiovascular endpoints of vitamins C and E, also used in combination, has been evaluated. The literature has been continuously and systematically collected over many years and supplemented by recent studies retrieved from Medline. RESULTS: Observational studies including mainly healthy individuals have shown a favourable relationship between intake of vitamins C and E, also taken in combination, and subsequent cardiovascular events. However, most randomized, clinical interventional studies including patients with manifest atherosclerotic disease have not been able to document such a relationship. INTERPRETATION: The discrepancy found between observational studies and clinical interventional studies may be due to different study populations (healthy/ill individuals) and differences regarding age, sex, diet, smoking, degree of oxidative stress and other probable confounding factors. The significance of vitamins C and E in preventing cardiovascular disease is in our opinion not yet clarified.

Antioxidants↗
PubMed2005

[ACE inhibitor or ATII receptor blocker in heart failure and myocardial infarction?].

Angiotensin converting enzyme (ACE) inhibitors are important drugs in the treatment of hypertension, heart failure and after acute myocardial infarction. The patents for most of these agents have now expired and the industry has introduced angiotensin II receptor blockers (ATII receptor blockers) with a mode of action similar to that of ACE inhibitors. All six ATII receptor blockers on the Norwegian market have the indication hypertension, while one of them also has the indication heart failure when treatment with ACE inhibitors is not appropriate. Some studies have compared ACE inhibitors with ATII receptor blockers in the treatment of heart failure and after acute myocardial infarction and found the two classes of drugs to be about equally efficacious. There is no reason to change the current practice of choosing ACE inhibitors as first line treatment for these conditions. If ACE inhibitors cannot be used, ATII receptor blockers represent an acceptable alternative.

Angiotensin II Type 1 Receptor Blockers↗
PubMed2004

[Mercury, fish, fish oil and the risk of cardiovascular disease].

BACKGROUND: Several clinical studies have documented that intake of fish may reduce mortality from coronary heart disease, and two epidemiological investigations have shown a 50% reduction in the incidence of sudden death and of "primary cardiac arrest" in subjects eating fish. However, in some studies no beneficial effects of fish intake on coronary heart disease could be found; one Finnish study even found a positive correlation between intake of freshwater fish and coronary heart disease. One possible explanation for this paradox could be a high content of mercury in fish. MATERIAL AND METHODS: We have studied the relevant literature describing beneficial, less beneficial and negative effects of fish intake on the development of coronary heart disease. Furthermore, we have studied reports that mercury may have properties that enhance the development of coronary heart disease. RESULTS AND INTERPRETATION: Several studies have shown an inverse correlation between omega-3 fatty acids from fish in serum/adipose tissue and coronary heart disease. However, a high content of mercury in hair/toe nail had a negative effect, and in one study the odds ratio for myocardial infarction in those with the highest content of mercury was 2.16. A positive correlation between mercury in hair and the progression of carotid atherosclerosis has been found. Intake of fish is a major source of exposure to mercury, and a high content of mercury probably inhibits the beneficial effects of omega-3 fatty acids on the development of coronary artery disease.

Animals↗
PubMed2003

[Nitrate therapy during and after acute myocardial infarction].

BACKGROUND: Nitrates have been an integral part of the therapy of ischaemic heart disease for more than 130 years. < MATERIAL AND METHODS: We have studied the relevant literature on the benefits of therapy with nitrates in acute myocardial infarction. RESULTS AND INTERPRETATION: During an acute myocardial infarction, intravenous nitroglycerine therapy has demonstrated favourable haemodynamic properties, and some studies have shown that nitrates reduce infarct size. Whether this could improve prognosis is uncertain. A meta-analysis from 1988 showed reduced mortality (35 %) of early intravenous nitrate therapy. Newer and larger studies have not documented a positive effect. A reason for this discrepancy may be the fact that in these studies about half of the control/placebo patients, having a low mortality, were treated with nitroglycerine. In addition, most of these patients were given thrombolytic and antiplatelet therapy. Nitroglycerine administered intravenously is, according to present knowledge, recommended during the first 24 hours after an acute myocardial infarction. In addition, patients with recurrent ischaemia, uncontrolled hypertension and heart failure should also be given nitroglycerine.

Humans↗
PubMed2003

[Secondary prevention after acute myocardial infarction: aspirin, warfarin or both?].

BACKGROUND: In patients suffering from acute myocardial infarction (AMI), new cardiovascular events can be prevented by aspirin or warfarin or a combination of both. Results from studies examining this issue have been published in recent years. We have evaluated the study results together with other factors that are decisive for implementation of the findings in clinical practice. MATERIAL AND METHODS: The following four studies were evaluated: the Coumadin Aspirin Reinfarction Study (CARS); the Combination Hemotherapy and Mortality Prevention (CHAMP) Study; the Warfarin, Aspirin Reinfarction Study (WARIS)-II; the Antithrombotics in the Secondary Prevention of Events in Coronary Thrombosis (ASPECT)-2 Study. RESULTS: The studies had somewhat different design, particularly with regard to the intensity of anticoagulation. CARS and CHAMPS did not show any benefit with combined therapy. WARIS II concluded that warfarin had better preventive effect than aspirin; so had the two drugs in combination. ASPECT-2 suggested a benefit with the combined treatment (coumadin and aspirin) but had limited study power. In all studies, bleedings occurred most frequently in groups of patients treated with anticoagulants. In clinical practice, relatively few AMI patients would be candidates for warfarin treatment, as this drug is not recommended for the oldest patients. Adverse event profile, guidance of treatment and relation to invasive treatment procedures are factors in favour of aspirin. INTERPRETATION: Aspirin should be the antithrombotic agent of choice in secondary prevention after acute myocardial infarction. Warfarin could be used when there are specific additional indications. Combining these two agents is not recommended as a routine treatment.

Anticoagulants↗
PubMed2003

Antihypertensive therapy at the onset of an acute myocardial infarction predicts in-hospital mortality.

Several studies, which have compared the efficacy of conventional antihypertensive drugs (thiazide diuretics and beta-blockers) with the newer agents [calcium blockers and angiotensin-converting enzyme (ACE) inhibitors], have shown that they are almost equally efficacious with regard to effects on blood pressure, and in preventing cardiovascular morbidity and mortality. The potential value of these drugs when hypertensive patients suffer an acute myocardial infarction (AMI) has, however, not been fully elucidated. The objective of the present observational study was to investigate whether prior use of different antihypertensive drugs could modify or influence in-hospital death in hypertensives suffering an AMI. A total of 299 hypertensive patients with the diagnosis of AMI were included. The demographic data were obtained from medical records. Variables were entered into a logistic regression model. The main predictors of death were age (adjusted odds ratio (ORa) 1.07, p = 0.002 (per each year), and the use of diuretics (ORa 2.54, p = 0.018) and calcium blockers (ORa 2.54, p = 0.010). On the other hand, the use of ACE inhibitors was associated with a marked reduction of in-hospital death (ORa 0.44, p = 0.045). The present study indicates that while the use of ACE inhibitors was associated with a reduced risk of in-hospital death in hypertensive patients suffering an AMI, the use of diuretics and calcium blockers was associated with increased risks.

Adrenergic beta-Antagonists↗