Incidence Of Heart Disease Research Articles

Incidence of congenital heart disease in the western part of Gyeongnam Province in Korea

Purpose : The objective of this study was to ascertain the incidence of congenital heart disease in the western part of Gyeongnam Province in Korea. Methods : We enrolled 849 children (M:F=390:459) who were diagnosed with congenital heart disease (CHD) and received echocardiography during January 1997 to December 2005 in Gyeongsang National University Hospital. The subjects were limited to patients born from 1997 to 2004. The CHDs were classified into acyanotic types and cyanotic type. Further, acyanotic type CHDs were divided into shunt type and valvular types. Results : Numbers of initially diagnosed patients from 1997 to 2004 were as follows: 113, 128, 116, 104, 129, 97, 84, and 78. The median age of initially diagnosed CHD patients was 1 month in the acyanotic type and 0.5 months in cyanotic type. Also, an annual frequency among CHD types and gender ratio were no significant difference in every year. Incidences of CHD from 2000 to 2004 in the western part of Gyeongnam Province were 8.9, 12.7, 10.9, 10.0, and 9.7 per 1,000 live births, respectively. Conclusion : From 1997 to 2001, 100-130, and from 2002 to 2004, less than 100 patients were diagnosed with CHD. This showed a decrease in the numbers of CHD patients in the last three years. However, the Incidence of CHD was 0.89- 1.24% during the last five years. Therefore, the decrease in the annual frequency of CHD was due to the recent decline in birth rate in Korea.

Is alcohol consumption good for you? Results from the 2005 Canadian Community Health Survey

Data from the Statistics Canada 2005 Canadian Community Health Survey is used to test the hypothesis that classification errors of the type noted by Fillmore et al. () could invalidate the statistical results on the effects of alcohol consumption on self-rated health and the incidence of heart disease and diabetes. The results obtained in this study show that the beneficial effects of moderate alcohol use that so many studies have found, still appear even when the correct classification of alcohol use is employed. However, parameter biases and inferential errors can occur when researchers fail to distinguish between former drinkers and never drinkers within the non-drinking group.

Are Overnight Urinary Indicators Associated with Morning Blood Pressure in the Elderly?

Recent reports suggest that high blood pressure (BP) during the night is associated with hypertensive organ damage, and that increased BP in the morning is closely related to the incidence of stroke and ischemic heart disease. The aim of this study was to investigate the relationships between overnight urinary indicators and 24-hour (24-h) BP, especially in the morning and during sleep in the elderly. A total of 85 volunteers (males 43, females 42), aged between 51 and 76 years and not taking any antihypertensive medications, participated in this study. Their 24-h BP was measured by ambulatory BP monitoring every 30-minute using a TERUMO ES-H531 system. Overnight urine samples were collected using a proportional urine-sampling device, Urine mate P. Overnight sodium (UNan) and potassium (UKn) excretions were measured by an ion electrode method. Simple linear regression analyses showed that systolic blood pressure (SBP) in the morning and diastolic blood pressure (DBP) during sleep were negatively related with overnight urinary weight standardized for body weight (UWn/BW). Multiple regression analyses showed that SBP during the morning and during sleep was positively related to UNan and negatively related to UWn/BW. We also found a negative relationship between SBP during sleep and UKn. The study suggested that urine weight adjusted for BW was negatively related with 24-h BP, especially morning BP. Sodium excretion combined with a large volume of urine proportional to body weight may prevent increases in BP, especially in the morning.

Coronary heart disease and HRT in France: MISSION study prospective phase results

Objective. To determine the morbidity incidence associated with Hormone Replacement Therapy (HRTs) in postmenopausal women. This paper presents the results concerning the incidence of coronary heart disease (CHD).Design. MISSION study started on 5 January 2004, the cutoff for data collection was June 2006 (follow-up no. 1). ‘Exposed group’: postmenopausal women currently on HRT, commonly prescribed in France or stopped ≤5 years previously. ‘Unexposed group’: never received HRT or stopped >5 years previously.Results. Data were available for 4949 patients (without CHD at the beginning of the follow-up): 2693 Exposed group and 2256 Unexposed group. The incidence during follow-up no. 1 of postmenopausal CHD was not significantly different in the Exposed group (0.11%) compared with the Unexposed group (0.13%). In the Exposed group the time between start of HRT and menopause was 2.93 ± 4.46 years in those who experienced CHD and 1.53 ± 3.20 years in those who had no incidence of CHD (p = 0.3).Conclusion. In the MISSION cohort, no increased risk of CHD was found in the Exposed group compared with the Unexposed group

The Mediterranean Paradox for Susceptibility Factors in Coronary Heart Disease Extends to Genetics

The incidence of coronary heart disease (CHD) shows a North to South gradient in Europe. We tested whether that gradient could be accounted for by the distribution of putative susceptibility genotypes. We correlated the published frequencies of susceptibility genotypes for the genes most often associated with CHD (ACE, AGT, APOE, F2, F5, MTHFR, PON1, and SERPINE1) with the incidence of the disease, controlling for the effects of smoking, systolic pressure, total cholesterol, and body-mass index. In three polymorphisms a negative correlation between the incidence of CHD and the frequency of a suceptibility genotype was observed. For ACE this correlation was significantly negative even when discounting classical susceptibility factors. This suggests that some alleles described as susceptibility factors cannot account for disease incidence at the population level. A genetic component must be added to the "Mediterranean paradox": genetic variants deemed to be risk factors for CHD show a geographical pattern uncorrelated with the disease incidence. This pattern can be understood from the history of populations which has shaped the genetic diversity of the European populations in North-South clines, similar to what is observed for CHD incidence, which will tend to create spurious correlations with polymorphisms related, or not related, to the disease.

Effect of nifekalant on life-threatening ventricular arrhythmias in patients with cardiopulmonary resuscitation or during the perioperative state

Background: Nifekalant is a unique class III anti-arrhythmic agent with a strong effect on prolonging the myocardial refractoriness, but its clinical effect is still unclear. In this study, we evaluated the effect of nifekalant on life-threatening ventricular arrhythmias and compared the clinical background between the effective and non-effective patients in order to clarify the clinical factors which may have an influence on the efficacy of nifekalant. Methods: The study population consisted of 47 consecutive patients who underwent nifekalant administration for life-threatening ventricular arrhythmias (VT/VF). Their clinical characteristics and ECG parameters were retrospectively compared between patients with and without an effective result with the nifekalant administration. Results: Nifekalant was effective for refractory VT/VF in 26/47 patients. There was no significant difference in the age, gender or left ventricular ejection fraction, but the incidence of ischemic heart disease was higher in the effective group (17/26) than non-effective group (9/21, p=0.004). The incidence of in-hospital events was higher in the effective group than non-effective group (20/26 vs 10/21, p=0.037). A significant prolongation in the QTc interval was observed in all patients and the degree of QTc prolongation was greater in the effective group than in the non-effective group (0.46 ± 0.04 vs 0.43 ± 0.02 sec 1/2 , p=0.026). Conclusion: Nifekalant was effective in 55% of the patients for refractory VT/VF. It was considered that nifekalant was more effective for patients with ischemic heart disease, during the perioperative period or in those experiencing in-hospital events. The prolongation of the QTc interval might also be useful as an index for the efficacy of nifekelant administration.

Associations of von Willebrand factor, fibrin D-dimer and tissue plasminogen activator with incident coronary heart disease: British Women's Heart and Health cohort study

Associations of three markers of thrombotic tendency, von Willebrand factor, tissue plasminogen activator antigen and fibrin D-dimer, with coronary heart disease have been reported in meta-analyses. It is not known, however, whether findings are generalizable to older women. Prospective cohort of 3582 women aged 60-79 years randomly selected from 23 towns without evidence of cardiovascular disease at entry into the British Women's Heart and Health Study. Women were followed for 4.7 years for incident coronary heart disease. Cox proportional hazard models were used to compare the hazard ratio of coronary heart disease per doubling for each thrombotic factor. In models adjusting for age and town only there was no association between von Willebrand factor or D-dimer and incidence of coronary heart disease, but there was a positive association of tissue plasminogen activator: coronary heart disease hazard ratio per doubling was 1.37 (95% confidence interval: 1.08-1.75). Adjustment for potential confounders (socio-economic position, smoking, lung function, physical activity, alcohol consumption, body mass index, waist-to-hip ratio) attenuated association to 1.20 (0.92-1.58). Further adjustment for risk factors that may be part of the same pathophysiological process linking tissue plasminogen activator to coronary heart disease (high density lipoprotein cholesterol, triglycerides, blood pressure, fasting glucose, insulin, C-reactive protein, fibrinogen) attenuated the hazard ratio to 1.05 (0.79-1.40). In older women, tissue plasminogen activator was associated with incident coronary heart disease, but does not appear to be an independent risk factor for coronary heart disease as the association was attenuated by adjustment for confounding and other metabolic and vascular risk factors.

The healthy alcohol intake for the Japanese population is less than that for Caucasians

Abstract Many epidemiologic studies have shown that moderate alcohol intake, approximately 20 to 30 g/d, is associated with a decreased risk of coronary heart disease. Although alcohol intolerance is more frequently seen in Japanese, almost the same results were obtained in many studies. On the other hand, even moderate alcohol consumption increases the risks of other diseases, such as hypertension, liver cirrhosis, and chronic pancreatitis. Thus we assume that the moderate amount of alcohol intake should be examined by various indices other than the incidence of coronary heart disease. We assessed the physical characteristics, blood components, especially gamma-glutamyl transferase, a marker for excessive alcohol intake, and nutrient intake of 1802 men and 708 women in routine medical checkups. The participants were classified by alcohol intake, and linear regression analyses were conducted to investigate the relationship between this intake and the variables of each sex. Although alcohol intake had a beneficial effect on lipoproteins in both sexes, significantly increased levels of gamma-glutamyl transferase and a higher incidence of those whose levels exceeded the reference range (7-60 U/L) were seen in the 10.1 to 20 g/d male group compared with the no-intake group (26 [19-41] vs 31 [22-50] U/L, median [interquartile range], 10.0% vs 17.7%; both P

Dopamine agonists and valvular heart disease in Japanese patients with Parkinson's disease

A high incidence of valvular heart disease in Parkinson's disease (PD) patients treated with ergot-derived dopamine agonists, such as cabergoline and pergolide, has been reported. However, the frequency of valvulopathy, including “restrictive” valvulopathy, in Japanese PD patients remains unclear. We have evaluated the frequency of valvulopathy in PD patients treated with ergot-derived dopamine agonists. Patients treated with either pergolide or cabergoline were prone to higher grades of valvular regurgitation than control patients. Left-sided heart valves (aortic and mitral valves) were more affected than the tricuspid valve. However, “restrictive” valvulopathy was not observed in our patients. These results indicate that pergolide and cabergoline are risk factors for valvular regurgitation even in Japanese patients with PD.

The anti-atherogenic properties of HDL particles

Abstract High density lipoproteins (HDLs) are a class of lipoproteins characterized by small diameter and high density. Epidemiological studies have demonstrated that HDL cholesterol levels are inversely and independently related to the incidence of coronary heart disease. The mechanisms involved in HDL protection against atherosclerosis are uncertain, but the beneficial effect of HDLs might be the consequence of its properties. The best known of them is related to the “reverse cholesterol transport”, i.e. the transfer of cholesterol from non-hepatic cells to the liver. Second, HDLs exert anti-inflammatory activity by inhibiting the expression of adhesion molecules by endothelial cells and the subsequent transmigration of monocytes. Third, HDLs have antioxidant activity through the anti-oxidative properties of apoprotein A-I, and the presence of enzymes such as paraoxonase, glutathione-peroxidase, and PAF acetylhydrolase. Fourth, HDLs display an anti-thrombotic effect by inhibiting platelets aggregation, reducing von Willebrand factor levels, and enhancing the activity of activated protein C and S. Fifth, HDLs have a beneficial effect on endothelial function by activating endothelial NO synthase and enhancing NO release. Finally, high HDL-C has been associated with “longevity syndrome” while low HDL-C has been related to the “frailty syndrome”, suggesting a possible role of HDL in the phenomenon of successful aging.

Use of Dexmedetomidine in Patients with Trisomy 21 After Cardiac Surgery

Children with trisomy 21 have a high incidence of congenital heart disease that frequently requires surgical repair. These patients often require multiple and higher dosage sedatives during the postoperative period. Dexmedetomidine is an alpha(2)-adrenergic receptor agonist that has sedative, analgesic, and anxiolytic properties. We report the successful use of dexmedetomidine in patients with trisomy 21 following surgical repair of congenital heart disease.

Effect of Soy Intake on Blood Pressure and Lipids

Dietary soy is one of several factors that might explain the lower incidence of coronary heart disease in Asian countries than in Western countries. In

Serum triglyceride level in IUGR babies and its comparison with preterm AGA and term normal babies

Intrauterine growth and birth weight are probably the most important factors that affect in survival and future quality of life. Intrauterine growth retardation causes program changes in body systems specially lipid metabolism that creates various problems of which coronary heart disease is important. Higher serum triglyceride (TG) level in IUGR babies relates to increase incidence of coronary heart disease. This cross sectional study was conducted in Bhangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during July 2004 to June 2005. Serum TG levels were estimated among three groups: IUGR (n=30), preterm appropriate for gestational age (AGA) (n=30) and term normal (n=30) new born babies. Blood samples were collected from the study population in the neonatal unit and serum TG level were measured with all accuracy in a computerized automated biochemical analyzer in Biochemistry department of BSMMU. Statistical analysis were done by using student's 't' test. It was observed that serum TG level (54.4 +/- 11.2 mg/dl) in IUGR babies were significantly higher than that of term normal babies (38.7 +/- 5.8 mg/dl), p value < 0.05. This implicate future coronary heart disease in these babies as shown by others in long term prospective studies.

Mitral stenosis in a girl of five years

Mitral stenosis(MS) detected below the age of 20 years is called juvenile mitral stenosis (JMS). JMS constitute 25-40 % of all cases of isolated mitral stenosis, though overall incidence of rheumatic fever and rheumatic heart disease (RHD) within mixed population is 7.5- 7.8 per thousand. The patient was 5 years old girl hailing from Modhupur, Tangail got herself admitted into CCU Mymensingh Medical College Hospital with the complaints of low grade fever, shortness of breath and also associated with failure to thrive. She was ill looking, mildly anaemic. Precordial examination revealed apex beat was in the left 5th intercostals space, tapping in nature, palpable P(2). There was left parasternal heave. 1st heart sound loud, pulmonary component of the 2nd heart sound was accentuated, opening snap with mid diastolic murmur with pre systolic accentuation. Routine blood examination reveals leucocytosis with raised ESR. C-reactive protein (CRP) and ASO titre were significantly raised. X-ray chest P/A view showing the features of mitral stenosis. Echocardiography showing MS (moderate) with pulmonary hypertension. She was treated with antibiotics and other relevant drugs and discharge with an advice for follow up and take preparation for cardiac intervention.

Relationships Between BMI, Physical Activity and Fitness, Inflammatory Markers and Incidence of Coronary Heart Disease

Relationships Between BMI, Physical Activity and Fitness, Inflammatory Markers and Incidence of Coronary Heart Disease

Relative Value of Inflammatory, Hemostatic, and Rheological Factors for Incident Myocardial Infarction and Stroke

The aim of our present study was to compare the association of a wide range of 17 biomarkers of inflammation, hemostasis, and blood rheology with incident heart disease and stroke after accounting for an indicator of subclinical atherosclerotic disease and traditional risk factors and also to determine their incremental predictive ability. We used data from the Edinburgh Artery Study, a population cohort study started in 1987 that comprised 1592 men and women aged 55 to 74 years. Subjects were followed for a mean of 17 years, and 416 of them suffered at least 1 cardiovascular event. In analyses adjusted for cardiovascular risk factors and history of cardiovascular disease (CVD): C-reactive protein, interleukin-6, fibrinogen, fibrin D-dimer, tissue plasminogen activator (t-PA), leukocyte elastase, and lipoprotein(a) (all P<0.01), as well as von Willebrand factor and plasma viscosity (both P<0.05), had significant hazard ratios for incident CVD. Further adjustment for a measure of subclinical atherosclerosis (ankle brachial index) had little impact on these associations. The hazard ratios (95% CI) for incident CVD between top and bottom tertiles in the latter analysis were 1.78 (1.30 to 2.45) for C-reactive protein, 1.85 (1.33 to 2.58) for interleukin-6, and 1.76 (1.35 to 2.31) for fibrinogen. Single biomarkers provided little additional discrimination of incident CVD to that obtained from cardiovascular risk factors and the ankle brachial index. An incremental score of multiple markers [interleukin-6, t-PA, intercellular adhesion molecule 1, and lipoprotein(a)] provided some added discrimination. Several "novel" risk factors predicted CVD after adjustments for conventional risk factors and also for a measure of asymptomatic disease. However, their incremental predictive ability was modest and their clinical utility remains uncertain.

Incidence and Risk Factors of Coronary Artery Disease in Patients on Chronic Hemodialysis

Aim of the study was to estimate the incidence of coronary heart disease (CAD) in patients (pts) with end stage renal disease (ESRD) maintained on chronic hemodialysis (HD) and its association with the presence of predisposing factors. The study included 171 dialysis pts (107 male (M) and 64 female (F)). Mean age of pts was 67+/-13 years, mean time on dialysis 52.7+/-44 months and Body Mass Index (BMI) 25.9+/-3.7 kg/m2. Fifty pts (29.2%) were clinically diagnosed with CAD. The diagnosis was established by coronary angiography in 24 (48%) and in 26 by combined dipyridamole-exercise thallium imaging (52%). Pts' data in association with the development of CAD that were recorded included age, sex, smoking habits, hypertension, obesity, the presence of diabetes mellitus (DM), hyperlipidemia, anemia, low albumin levels, secondary hyperparathyroidism (SHP), the presence of chronic inflammation, as evidenced by the presence of elevated levels of CRP and hyperhomocysteinemia. There was a statistically significant association of increasing age and CAD (p<0.0001). Relative risk (RR) was significantly increased i) in male pts compared to female pts (RR: 8.56, p<0.001), ii) in anemic pts compared to pts with hemoglobin levels< or =11 g/dL (RR: 8.26, p<0.0001), iii) in obese pts compared to pts with BMI < or =30 (RR: 5.09, p<0.005) and iv) in pts with increased levels of homocysteine compared to pts with levels of homocysteine <15 |IM (RR: 4.14, p<0.0001). Using linear regression analysis, CAD was associated with the inadequacy of HD (r = - 0.05, p<0.0001), time on HD (r =0.04, p =0.012) and increasing age (r =0.24, p<0.001). There was no statistically significant association between CAD and the presence of the other traditional risk factors. The incidence of CAD in dialysis pts is significantly increased with age, male sex, obesity, time on dialysis, the presence of anemia, hyperhomocysteinemia and inadequacy of HD.

Pflanzen-Sterole und Stanole – Wissenschaftliche Befunde zur Wirkung und Sicherheit

Plant sterols and stanols are similar in chemical structure to cholesterol, differing in their side chain configuration. The mechanism by which they lower cholesterol is thought to involve inhibition of cholesterol absorption. A number of products containing plant sterols are now available. A limitation on the development of such products is the poor water solubility of plant sterols. The most common solution is to esterify plant stanols or sterols with fatty acids to enhance availability in food fats such as margarines and salad dressings. A number of studies have shown the efficacy of plant stanol- and sterol-enriched margarines for lowering cholesterol. However, there have been no studies demonstrating that consumption of these stanol ester-containing margarines influences the incidence of coronary heart disease.

Incidence and risk factors of coronary heart disease in elderly patients on chronic hemodialysis

To determine the incidence of coronary heart disease (CHD) in patients (pts) over 65 years (y) and its relation to common risk factors. We retrospectively studied 128 hemodialysis (HD) pts (80 M and 48 F), mean age 73+/-6.5 years, mean time on HD 44.4+/-26.4 months and BMI 25.4+/-3 kg/m2. They were evaluated for: age, sex, smoking, diabetes, hypertension, left ventricular hypertrophy, secondary hyperparathyroidism (SHP), inflammation, as evidence by elevated level of hsCRP, hyperhomocysteinemia (HOC), time on HD, fluid overload and adequacy of HD. Forty-eight pts (37%) had CAD diagnosed by coronary angiography in 22 (46%) and (201)TL-chloride dipyridamole stress test in 26 (54%). There was a statistically significant correlation between CAD and increasing age (p<0.0001). The relative risk was significantly increased concerning: (1) male over female pts (RR: 1.95, p<0.01), (2) diabetic vs. non diabetic pts (RR: 2.09, p<0.001), (3) patients with SHP over pts with iPTH values<250 pg/ml (RR: 2.16, p<0.001), (4) hypertensive vs. non hypertensive pts (RR: 2.26, p=0.002), (5) smokers vs. non smokers (RR: 1.69, p<0.05), (6) pts with HOC over pts with normal homocysteine values (RR: 2.09, p<0.05), (7) pts with increased CRP levels over pts with normal CRP levels (RR: 1.8, p<0.01), (8) pts undergoing HD for 36 vs. 12 months (RR: 1.71, p=0.03), (9) between pts with inadequate or adequate HD (RR: 1.73, p=0.02). No significant correlation existed between CAD incidence and the other risk factors. Coronary heart disease incidence in elderly HD patients increases with age, male sex, diabetes, SHP, hypertension, increased CRP levels, HOC, smoking, time on HD and inadequacy of HD.

Hormone replacement therapy in postmenopause - where we stand?

Background: The findings of most relevant randomized clinical studies such as HERS, WHI and MWS, performed in the last decade have shown that hormonal replacement therapy (HRT) users are at increased risk for the development of breast cancer, stroke and pulmonary edema. On the other hand they are at a lower risk for the development of large bowel cancer and for hip and vertebral fractures; the incidences of endometrial cancer and coronary heart disease have not been proved to be significantly affected by HRT. As for the prevention of cardiovascular diseases, the findings of these studies differed from those provided by observational studies, it became an imperative to find the causes of these discrepancies. The major criticism of randomized clinical studies was aimed at the inclusion criteria, as the mean women’s age in HERS and in WHI study was 63 years. The women of that age may no longer be healthy, and are particularly exposed to cardiovascular diseases. In all studies the same type of HRT was used, i.e. conjugated equine estrogen alone or in combination with medroxyprogesterone acetate. In Europe, this combination is rarely prescribed; we do not prescribe it in Slovenia either. The same type of HRT used in randomized clinical studies was further criticized, the basic idea of HRT being an individual approach to each woman requiring HRT. For rather sensational and often misinterpreted findings of randomized studies, the largest menopause societies worldwide, the International Menopause Society (IMS), the European Menopause and Andropause Society (EMAS) and the North American Menopause Society (NAMS), have revised the guidelines for HRT use in postmenopause. These guidelines have been adopted by the Slovene Menopause Society as well. Conclusions: The indications for HRT remain to be markedly expressed and severe climacteric symptoms, prevention and treatment of osteoporosis, urogenital syndrome and premature menopause. However, the ‘safe’ window regarding the duration of HRT use has disappeared, and so have the terms ‘short-term’ and ‘long-term’ treatment. The only criterion for the duration of HRT use is to constantly assess the benefits and risks for each individual, and to adjust the dose, type and duration of HRT use accordingly.