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At least 271 records · Page 15Linked to original sources
PubMed1995

Exposure to environmental tobacco smoke and the risk of heart attack.

BACKGROUND: Environmental tobacco smoke (ETS) increases the risk of heart disease in several epidemiological studies although the methods of assessing exposure have been incomplete. We determined the prevalence of ETS from various sources, and examined the association between ETS and the risk of myocardial infarction. METHODS: A hospital-based case-control study of myocardial infarction was conducted from 1980 to 1990 by interviewing 114 case patients and 158 control subjects. RESULTS: Among controls, the sources of ETS were the workplace (56%), childhood exposure (66%), home adult exposure (48%), car exposure (20%) and from trains or other surface transportation (4%). Compared to never smokers, the odds ratio (OR) for exposure to ETS during childhood was 0.97 (95% confidence intervals [Cl]: 0.53-1.46) for men and 0.92 (95% Cl: 0.5-1.86) for women. The adjusted OR associated with adult exposure was 1.5 (95% Cl: 0.9-2.6), although no trend was observed with the number of years of exposure. Women who were exposed to ETS in automobiles had an increased but non-significant risk (OR = 2.8, 95% Cl: 0.9-8.0). CONCLUSION: Exposure to ETS comes from a variety of sources besides the spouse including parents, workplace employees and motorists. Exposure to ETS during childhood is not associated with an increased risk of heart disease. However, ETS exposure during adulthood increased the risk of myocardial infarction approximately 50% in this data although the findings were not statistically significant.

Adult↗
PubMedDate not supplied

New blood test to measure heart attack risk: C-reactive protein.

In 2003, the American Heart Association and the Centers for Disease Control and Prevention issued a scientific statement that suggested the use of high-sensitivity C-reactive protein, a recognized marker of inflammation, as an optional myocardial infarction risk factor measurement (Circulation. 2003;107:499-511). Compared with earlier guidelines, the statement suggested a more aggressive approach for identifying patients at risk of cardiovascular events. The increased interest in and the mounting evidence of the role of inflammation in the development of acute coronary syndrome was a major impetus for this. This article focuses on the use of high-sensitivity C-reactive protein as a nonlipid cardiovascular event risk marker and the implications for practice, education, and research.

Biomarkers↗
PubMed2001

Baseline characteristics of the diabetic participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

OBJECTIVE: Hypertension (HTN) is a major risk factor for cardiovascular disease (CVD) in the setting of diabetes. There is no consensus on how best to treat hypertension among those with diabetes. Here we describe the characteristics of a cohort of hypertensive adults with diabetes who are part of a large prospective blood pressure study. This study will help clarify the treatment of HTN in the setting of diabetes. RESEARCH DESIGN AND METHODS: The Antihypertensive and Lipid-Lowering high-risk hypertensive participants, ages > or = 55 years, designed to determine whether the incidence of fatal and nonfatal coronary heart disease (CHD) and combined cardiovascular events (fatal and nonfatal CHD, revascularization surgery, angina pectoris, congestive heart failure, and stroke) differs between diuretic (chlorthalidone) treatment and three alternative antihypertensive therapies: a calcium channel blocker (amlodipine), an ACE inhibitor (lisinopril), and an alpha-adrenergic blocker (doxazosin). The planned follow-up is an average of 6 years, to be completed March 2002. RESULTS: There are 15,297 diabetic individuals in the ALLHAT study (36.0% of the entire cohort). Of these individuals, 50.2% are male, 39.4% are African-American, and 17.7% are Hispanic. Demographic and laboratory characteristics of the cohort are similar to those of other studies of the U.S. elderly population with HTN. The sample size has 42 and 93% confidence, treatments for the two study outcomes. CONCLUSIONS: The diabetic cohort in ALLHAT wil be able to provide valuable information about the treatment of hypertension in older diabetic patients at risk for incident CVD.

Adrenergic alpha-Antagonists↗
PubMed1994

Dyslipidemia and metabolic factors in the genesis of heart attack and stroke.

The relationship of dyslipidemia, particularly hypercholesterolemia to coronary heart disease is now well established. Although ischemic heart disease and stroke share many of the same risk factors, the relationship of cholesterol to stroke remains controversial. The 6-year and 12-year follow-up of the MRFIT study showed that elevated cholesterol significantly increased the risk for fatal nonhemorrhagic stroke. Atkins found no evidence that lowering plasma cholesterol influenced the incidence of fatal or nonfatal stroke and regression analysis showed no statistical association between the magnitude of cholesterol reduction and the risk for fatal stroke. We cannot preclude the possibility that more effective cholesterol lowering over a longer period of time might be effective. Hypertension is the most powerful risk factor for stroke. The San Antonio Heart Study reported a clustering of cardiovascular risk factors in individuals who developed hypertension during an eight-year follow-up period (higher levels of BP, fasting TC and LDLC, TG, glucose and insulin, and BMI, less favourable fat deposition, and lower HDL). Insulin resistance may be the unifying factor that results in those phenomena, the so-called syndrome X. The important factor underlying syndrome X may be central or visceral obesity, suggesting that maintenance or attainment of ideal weight would be a powerful preventive factor against both CHD and nonhemorrhagic stroke. There is evidence from the Treatment of Mild Hypertension Study that nutritional/hygienic measures can reduce the syndrome X risk factors and hence the risk of coronary heart disease and stroke.

Cerebrovascular Disorders↗