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At least 793 records · Page 44Linked to original sources
PubMed1994

High factor-VII activity in the elderly is related to vascular disease through activation of the coagulation system.

BACKGROUND: High factor-VII activity has recently been recognized as an independent risk factor for coronary artery disease. The aim of the present study was to determine whether high levels of factor-VII activity in elderly patients are caused by endothelial cell injury and are related to vascular disease through activation of the coagulation system. METHODS: We studies 27 asymptomatic healthy elderly men with high factor-VII activity (155-206%) and 22 healthy elderly men with low factor-VII activity (96-122%) selected from 246 men over 60 years of age attending annual health examinations. We also studied 36 patients with vascular disease (22 with coronary artery disease and 14 with chronic cerebral infarction). RESULTS: The levels of endothelium-derived markers (thrombomodulin, tissue plasminogen activator-plasminogen activator inhibitor-1 complex, active plasminogen activator inhibitor 1 and tissue factor pathway inhibitor) did not differ between the subjects with high and those with low factor-VII activity. We therefore conclude that high factor-VII activity is not primarily caused by endothelial cell injury. The high-factor-VII group had higher levels of coagulation inhibitors (protein C, antithrombin III and heparin cofactor II), coagulation activation markers (prothrombin fragment 1 + 2, D-dimer and plasmin-alpha2- plasmin-inhibitor complex), lipoprotein (a) and total cholesterol than the low-factor-VII group. The coagulation and lipid profiles of the group with vascular disease were closer to those of the high-factor-VII group than to those of the low-factor-VII group; the same was true of elevated active plasminogen activator inhibitor-1 levels. CONCLUSION: High factor-VII activity in the elderly is accompanied by hyperlipidaemia, including increased levels of lipoprotein (a), and leads to coagulation activation in vivo. Thus, elderly people with high factor-VII activity are predisposed to vascular disease.

Aged↗
PubMed1999

Lower limb deep venous flow in patients with peripheral vascular disease.

PURPOSE: A prospective controlled study was undertaken to determine how peripheral vascular disease (PVD) influences flow in the deep veins of the leg. METHODS: Eighty-nine patients with peripheral vascular disease and 35 age-matched control subjects were studied. The popliteal vein diameter and flow velocity were measured at rest by means of color duplex ultrasound scanning, and these measurements were compared with the ankle-brachial pressure index. For 23 subjects, measurements were also performed during reactive hyperemia and then repeated after venous return from the foot was prevented by an ankle cuff. RESULTS: There was a significant correlation between the ankle-brachial pressure index and the popliteal vein diameter (r = 0.35, P <.001) but a negative correlation between the ankle-brachial pressure index and venous flow velocity among patients with PVD (r = -0.24, P =.002). In PVD patients the diameter decreased further in reactive hyperemia, whereas it increased in control subjects ( P <.001). Preventing venous return from the foot in PVD patients led to diameter increase at rest and abolished the reduction in diameter caused by reactive hyperemia. Despite the reduction in diameter during reactive hyperemia, flow velocity increased less in patients with PVD than it did in control subjects (P =.01). CONCLUSION: Chronic tissue ischemia results in constriction of the popliteal vein. This appears to be an active process related to the washout of humoral factors from ischemic tissues distally, which leads to an increase in flow velocity. The latter may confer some protection against the deep vein thrombosis that would otherwise tend to occur with low venous flow rates.

Adult↗
PubMed1981

The relationship of serum hexuronic acid and monosaccharide levels to urinary free cortisol and cortisone excretion in healthy subjects and in patients with diabetes mellitus and atherosclerotic peripheral vascular disease.

The relationship of hexuronic acid and monosaccharide concentrations in serum to the excretion of urinary free cortisol and cortisone was studied in 14 healthy subjects, in 16 patients with diabetes mellitus, and in 14 patients with atherosclerotic peripheral vascular disease. In both groups of patients increased values of hexuronic acids, reducing monosaccharides and keto-sugars were registered. In diabetics the relative proportion of monosaccharides was increased, the proportion of hexuronic acids was lowered. In atherosclerotic peripheral vascular disease a significant preponderance of hexuronic acid and keto-sugar amounts in the composition of total sugar components was observed in comparison with healthy subjects. In healthy subjects there is a close correlation of urinary free cortisol and cortisone with reducing monosaccharides in blood, measured on the same day. In diabetes not any correlation of the increased values of free corticoids with the sugar components was registered. In atherosclerotic peripheral vascular disease a highly significant correlation between urinary free cortisol and cortisone and the hexuronic acid content in serum was observed. In patients with atherosclerotic peripheral vascular disease the results suggest an altered metabolism of glucose, which is shunted into insulin-insensitive glucuronate pathway in conditions of endogenous hypercortisolism.

Adult↗
PubMed2005

Peripheral vascular disease and depression.

The occurrence of peripheral vascular disease (PVD) in our aging population is of great proportion affecting approximately 20% of the population, which extrapolates to 8 to 12 million Americans. PVD is a progressive disease that almost always includes one or more comorbidities that impact greatly on severity and management of the disease. The age of disease onset can vary but most commonly presents at age 65 years and older. Depressive symptoms in the same age group occur in 30% to 60% of individuals with PVD. When a disabling disease such as PVD is combined with the already deteriorating effects of the aging process, the risk of these patients developing depression is greatly increased. The depressive symptoms in this population of patients are often unrecognized by their primary physician. This article reviews the potential mechanisms of depression, the effects of the combination of depression and a chronic illness such as PVD, the importance of recognizing depressive symptoms, and the available treatment options. The characteristics of PVD, including the effects on physical and mental health, the signs and symptoms of major depressive disorder, and the available screening tools used to evaluate a patient who may have depression, will also be discussed.

Age Distribution↗
PubMed1992

Plasma homocysteine in vascular disease and in nonvascular dementia of depressed elderly people.

Depression among elderly people with reversible cognitive loss often manifests with concomitant vascular disease and can also precede the development of nonvascular degenerative dementia. Little is known about etiological factors for reversible or irreversible dementias in older depressed people. The amino acid homocysteine (HC), which is both a vascular disease risk factor and a precursor of the excitotoxic amino acids cysteine and homocysteic acid, could play a role in the pathophysiology of such individuals. Twenty-seven depressed elderly acute inpatients by DSM-III-R criteria had significantly higher plasma homocysteine levels and lower cognitive screening test scores than did 15 depressed young adult inpatients. HC was highest in the older patients who had concomitant vascular diseases (n = 14). HC was lowest in the older depressives who had neither vascular illnesses nor dementia (n = 8), comparable to the young adult depressives. Higher HC correlated significantly with poorer cognition only in the nonvascular geriatric patients (rs = -0.53). The findings extend earlier work showing higher HC in vascular patients from general medical populations, and also suggest a possible metabolic factor in certain dementias associated with late-life depression.

Adult↗
PubMed1983

Fatal coccidioidomycosis in collagen vascular diseases.

Ten patients who died from coccidioidomycosis in Arizona from 1968 to 1975 had underlying collagen vascular diseases: 4 with rheumatoid arthritis, 4 with systemic lupus erythematosus, and 2 with dermatomyositis. All 10 patients had been treated with corticosteroids; 2 were taking cytotoxic drugs. Collagen vascular diseases and the use of corticosteroids and cytotoxic drugs may be associated with the depression of cell-mediated immunity. The potential for opportunistic coccidioidomycosis should be noted when corticosteroids and cytotoxic drugs are used for treating collagen vascular disease in patients residing in or coming from areas where coccidioidomycosis is endemic.

Adrenal Cortex Hormones↗
PubMed1993

Prognostic value of noninvasive cardiac tests in the assessment of patients with peripheral vascular disease.

Two hundred thirty-six patients with peripheral vascular disease were prospectively studied to assess whether noninvasive cardiac investigations could predict prognosis better than simple clinical assessment. Clinical history, examination and resting electrocardiography were considered in all patients; exercise electrocardiography, Holter monitoring, radionuclide ventriculography and dipyridamole thallium imaging were performed in a subgroup of 168 patients. Follow-up for 6 to 30 months revealed major cardiac events in 21 patients. Cox survival analysis showed that clinical evidence of prior coronary artery disease was the best variable from clinical assessment that predicted cardiac events, with no other clinical variable adding to the statistical model. When variables from noninvasive cardiac assessment were added to the model, which included clinical evidence of coronary artery disease, dipyridamole thallium heart:lung ratio and left ventricular ejection fraction added significantly and incrementally to the prediction of cardiac events. Results of exercise electrocardiography or Holter monitoring did not add significantly. It is concluded that high lung uptake of thallium during dipyridamole stress, and impaired left ventricular ejection fraction help to identify patients with peripheral vascular disease who are at high cardiac risk, and should therefore be used for selecting subsequent cardiovascular medical, surgical and anesthetic management.

Aged↗
PubMed1985

The relationship between parental history of vascular disease and cardiovascular disease risk factors in children: the Bogalusa Heart Study.

The relationship between parental history of vascular disease (heart attack, stroke, diabetes mellitus, and hypertension) and risk factor variables for cardiovascular disease was assessed in 3,312 offspring aged 5-17 years during the 1981-1982 school year in the biracial community of Bogalusa, Louisiana. Risk factors studied included systolic blood pressure, diastolic blood pressure, serum total cholesterol, triglycerides, and individual lipoprotein cholesterol (beta-, low density lipoprotein (LDL) cholesterol; pre-beta, very low density lipoprotein (VLDL) cholesterol; and alpha-, high density lipoprotein (HDL) cholesterol). Risk factors were adjusted for age, race, sex, and height (blood pressure only) prior to testing parental history effects. Univariate comparisons between risk factors in children and vascular disease in parents resulted in statistically significant increases in systolic and diastolic pressures associated with the presence of maternal or paternal hypertension (p less than 0.001). Paternal heart attack was also associated with elevations in diastolic pressure (p less than 0.01) of children. Maternal diabetes mellitus was associated with an increase in serum total cholesterol (p less than 0.05). Paternal diabetes mellitus and maternal heart attack (for female progeny only) were associated with increases in mean triglyceride levels of children. VLDL cholesterol results were similar to those for triglycerides. For HDL cholesterol, paternal diabetes mellitus was associated with a small decrease in mean levels (p less than 0.05). Dramatic increases to the highest decile of risk were found in association with the following parental disease combinations: paternal heart attack-paternal diabetes for serum total cholesterol (p less than 0.0001), maternal heart attack-paternal diabetes (p less than 0.001) and paternal stroke-maternal diabetes (p less than 0.0001) for LDL cholesterol. Multivariate analysis detected no significant effects of single parental vascular disease. However, paternal heart attack in combination with either diabetes mellitus or hypertension was statistically significant in their relationship to the risk factors overall.

Adolescent↗
PubMed1987

Aging and diabetes mellitus as risk factors for vascular disease.

During this century, cardiovascular diseases have become the major cause of death for elderly and diabetic patients. Although risk factors for vascular diseases have been identified, the interactions of aging and diabetes on the prevalence and incidence of vascular disease have not been systematically studied. A spectrum of such interactions appears to exist. Future research efforts are likely to permit accurate weighting of the influence that diabetes and aging have on vascular disease.

Adult↗
PubMed2004

Vascular disease risk factors as determinants of incident depressive symptoms: a prospective community-based study.

BACKGROUND: The potential association between vascular disease and depression have been the focus for much clinical psychiatric research, although few epidemiological prospective studies have looked into this association. AIMS: This study explores the a priori hypothesis of a prospective association between cardiovascular disease or its risk factors and incident depressive symptoms. METHOD: A prospective primary care based study derived from a multi-centre randomized controlled trial of moderate hypertension. 2584 moderately-hypertensive volunteers were followed-up for 54 months when five assessments of depressive symptoms, vascular disease and its risk factors were made. RESULTS: We found an association between the dependent variable (incident depressive symptoms measured with the Self-CARE-D) and baseline smoker status, low serum cholesterol levels, poorer cognitive function (particularly executive dysfunction), female gender and increasing age. These associations were independent of all other cardiovascular risk factors (ECG evidence of ischaemia or arrhythmia, systolic or diastolic blood pressure, blood pressure decline along the trial and body mass index). CONCLUSIONS: Our results do not support the hypothesis of a specific association between vascular disease or its risk factors and incident depressive symptoms.

Age Factors↗
PubMed1992

Peripheral vascular disease in patients with systemic lupus erythematosus.

Patients with systemic lupus erythematosus may develop premature atherosclerosis, notably coronary artery disease. A group of 10 patients with peripheral vascular disease presenting with intermittent claudication or gangrene were studied from a group of 563 patients followed prospectively at the Wellesley Hospital Lupus Clinic. These 10 patients were compared with the next lupus clinic patient matched for age and sex, with respect to demographic characteristics and risk factors. The patients and controls did not differ significantly in lupus activity criteria count, partial thromboplastin time, the number with antibody to cardiolipin, number receiving steroids or mean steroid dose, family history of atherosclerosis, hyperlipidaemia, smoking, hypertension or use of oral contraceptives. The risk factors for developing peripheral vascular disease were a longer duration of systemic lupus erythematosus and a longer duration of use of steroids. Eight of the 10 patients had coexistent coronary artery disease or transient ischaemic attack.

Adult↗
PubMed1986

Hematocrit as a risk factor for vascular disease.

Besides the classical risk factors for vascular diseases, markedly elevated or reduced hematocrit values may also affect the course of circulatory disturbances. To find out an appropriate hematocrit for sufficient oxygen perfusion of the tissues, several studies have been conducted. Most of the surveys indicate that a hematocrit between 35% and 40% is the best solution. To achieve this aim by iso- and hypervolumetric hemodilution, a clinical double-blind trial with three substances, dextran 40, middle-molecular hydroxyethyl starch and isotonic saline solution was carried out. With regard to clinical results and the possible side effects of dextran middle molecular hydroxyethyl starch seems to be the best choice for hemodilution.

Animals↗