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At least 109 records · Page 6Linked to original sources
PubMed1998

How concerned are elderly patients without coronary heart disease about hypercholesterolemia and heart disease? An UPRNet study. Upper Peninsula Research Network.

BACKGROUND: There has been much controversy in the medical literature regarding the benefit of treating elevated cholesterol levels in asymptomatic elderly people (65 years of age and older) to prevent coronary heart disease (CHD). Little has been published about the attitudes and beliefs of elderly patients regarding the importance of cholesterol levels to their health. This study seeks to describe the importance that elderly persons place on cholesterol in regard to heart disease, how worried they are about it, and what behavior changes they are making to control their own cholesterol levels. METHODS: We used a cross-sectional questionnaire to study elderly primary care patients in a rural setting with no personal history of coronary heart disease. RESULTS: Six hundred eighty patient questionnaires were analyzed. Ninety-six percent of respondents believed high cholesterol to be at least moderately important for heart disease; 67% believed it to be very important. Fifty-nine percent were at least slightly worried about their own cholesterol level. Seventy-four percent said they had had their cholesterol checked within the past 2 years, and 66% had discussed their cholesterol level with their physician within the past 2 years. Sixty-six percent were trying to keep their cholesterol level down by dieting (42%), exercising (39%), or taking prescription medicine (15%). CONCLUSIONS: Elderly patients who responded to this questionnaire are aware that hypercholesterolemia is a risk factor for CHD, and many eat a low-fat diet, exercise, or take prescription medication to lower their cholesterol. Physicians should be aware that many elderly patients without an established diagnosis of CHD are concerned about their cholesterol level. Physicians should be prepared to discuss with their elderly patients the potential advantages and disadvantages of the treatment of asymptomatic hypercholesterolemia.

Age Factors↗
PubMed2004

Depression and 24-hour urinary cortisol in medical outpatients with coronary heart disease: The Heart and Soul Study.

BACKGROUND: In patients with coronary heart disease (CHD), depression leads to worse cardiovascular outcomes. Depression has been associated with increased cortisol in medically healthy patients, suggesting that cortisol may act as a mediator in the pathway between depression and cardiovascular events. However, it is not known whether depression is associated with elevated cortisol levels in patients with CHD. METHODS: We examined the association between depression (assessed by the Computerized Diagnostic Interview Schedule) and 24-hour urinary cortisol in 693 medical outpatients with known CHD. RESULTS: Of 693 participants, 138 (20%) had current depression. Depressed participants had greater mean cortisol levels than those without depression (42 +/- 25 vs. 36 +/- 20 microg/day, p <.01). With each increasing quartile of cortisol concentration the frequency of depression increased (p <.01). Participants in the highest quartile of cortisol had a twofold increased odds of having depression, compared with those in the lowest quartile (odds ratio [OR] 2.1, 95% confidence interval [CR] 1.2-3.6, p =.01). This association remained strong after adjusting for potential confounding variables (OR 2.4, 95% CI 1.3-4.4, p <.01). In this cross-sectional analysis, elevated cortisol was not associated with worse cardiac function. CONCLUSIONS: In patients with CHD,depression is associated with elevated cortisol levels.

Aged↗
PubMedDate not supplied

Whole blood impedance platelet aggregometry and ischemic heart disease. The Caerphilly Collaborative Heart Disease Study.

The Caerphilly Collaborative Heart Disease Study is based on a large cohort of men who were ages 49 to 64 years at the time of the study. We report the results for platelet aggregation measured in whole blood from a subsample of 308 men. The index of sensitivity used was the minimum concentration of adenosine diphosphate that produced a defined degree of impedance change in the Chronolog 560 aggregometer. There was a marked association between aggregation and prevalent ischemic heart disease (IHD). The odds ratios and 95% confidence intervals (CI) for prevalent IHD in men with the most sensitive platelets compared with those with the least sensitive platelets were 3.6 (95% Cl: 1.1 to 12.2) for angina; 7.3 (95% Cl: 2.0 to 24.3) for previous myocardial infarction (MI); and 2.7 (95% Cl: 1.0 to 7.6) for electrocardiogram evidence of ischemia. The confidence limits for these odds ratios are large because of the small sample size, but the estimates of odds ratio are relatively large compared to similar relationships between the traditional risk factors of serum cholesterol, blood pressure, smoking, and prevalent IHD (1.5 to 2.5). A number of factors that might confound the relationships between platelets and IHD were examined, but the associations remained statistically significant when these were taken into account.

Adenosine Diphosphate↗
PubMed1997

Pregnancy and delivery prognostic risk score for women with congenital heart disease and acquired valvular heart disease.

Hemodynamic changes related to pregnancy in women with Congenital Heart Disease (ConHD) or Acquired Valvular Heart Disease (AVHD) require special medical care during pregnancy and especially immediately prior to, and after delivery. Following a five year retrospective study (1978-1982), the authors monitored prospectively over a period of 12 years (1983-1994), 378 pregnancies in 252 women with ConHD and AVHD. Based on the results of the initial clinical examination and monthly follow-up visits, a numerical risk score was assigned for each patient. The study showed good conformity between the predictive risk score values and the patient's condition in the course of pregnancy and delivery. Thus, this method represents a novel and potentially very useful clinical tool for management of pregnancy in patients with ConHD and AVHD.

Abortion, Spontaneous↗
PubMed1985

The carcinoid syndrome: comparison of 21 necropsy subjects with carcinoid heart disease to 15 necropsy subjects without carcinoid heart disease.

Carcinoid heart disease is a morphologically specific type of cardiac disorder that involves the mural and valvular endocardium on the right side of the heart. Twenty-one subjects (57 percent) (Group I) with carcinoid heart disease and 15 subjects (43 percent) (Group II) without carcinoid heart disease were studied at necropsy. The two groups were similar in mean age (54 years versus 55 years), duration of clinical illness (4.7 years versus 6.3 years), body weight (50 kg versus 52 kg), systemic blood pressure (117/77 mm Hg versus 128/77 mm Hg), blood hematocrit levels (37 percent versus 36 percent), total serum protein levels (6.0 g/dl), and serum albumin levels (2.2 g/dl versus 2.6 g/dl). The two groups were different in the frequency of the presence of precordial murmurs consistent with tricuspid regurgitation and/or pulmonic stenosis (95 percent versus 13 percent), cardiomegaly by chest radiography (38 percent versus 0), low voltage on electrocardiography (47 percent versus 0), and location of the primary site of the carcinoid tumor. Total electrocardiographic 12-lead QRS voltage was similar in each group (105 mm versus 132 mm) (10 mm = 1 mV). Of Group I subjects, 43 percent died of cardiac causes; none of the Group II subjects died of cardiac causes. Of the 21 subjects with carcinoid heart disease, seven had left-sided cardiac involvement, but in none was it of functional significance. Thus, although carcinoid heart disease frequently is the cause of death in patients with the carcinoid syndrome, the development of carcinoid heart disease is not related to the duration of symptoms of the carcinoid syndrome.

Adult↗