Cardiac and cardiovascular diseases

Cardiac and Cardiovascular Diseases and Occurrences of Clinical Concern... 

While there are multiple cardiac and cardiovascular diseases, this section presents brief reviews of a relatively small subset that are of relevance to discussions later in the book. 

Associations have also been made between areca and cardiovascular disease, diabetes, and asthma (Winstock et al. in press). Areca may affect cardiovascular disease by increasing homocysteine concentrations and/or through areca copper concentrations and interaction with the lysyl oxidase enzyme (Trivedy et al. 1999). Areca chewing has been associated with cardiac dysrhythmias in a few cases and a case of myocardial infarction was temporally associated with areca use (Hung and Deng 1998 Chiang etal. 1998). 

The respiratory and cardiovascular adverse effects of topical therapy with timolol or betaxolol have been studied in a randomized, controlled trial in 40 elderly patients with glaucoma (83). Five of the 20 allocated to timolol discontinued treatment for respiratory reasons, compared with three of the 20 patients allocated to betaxolol There were no significant differences in mean values of spirometry, pulse, or blood pressure between the groups. This study confirms that beta-blockers administered as eye-drops can reach the systemic circulation and that serious adverse respiratory events can occur in elderly people, even if they are screened before treatment for cardiac and respiratory disease. These events can occur using either the selective betaxolol agent or the non-selective timolol. 

Both hyoscine and antihistamines should be avoided in patients suffering from glaucoma or prostatic hypertrophy, are not recommended for use by pregnant or breastfeeding women, and should be used with caution in the elderly and patients with epilepsy or cardiac or cardiovascular disease. 

Patrignani, P., Capone, M. L., Tacconelli, S. (2008 Apr). NSAIDs and cardiovascular disease. Heart (British Cardiac Society), 94(4), 395-397. 

In the world of published journal articles, can we demonstrate both that associations are stronger when subject exposure is well characterized, and that there may be transference of associations from the poorly measured to the better measured emissions Grahame (2009) addressed this question for heart rate variability (HRV), an easily measured cardiac health endpoint. Perhaps because of the non-invasive nature of this measure, there appear to be more human panel studies of this endpoint than of other cardiac and cardiovascular endpoints. HRV changes appear not only to have medical relevance in their own right for those with a history of heart disease, but also to cause and be a marker for oxidative stress, e.g. in the heart, a chronic risk factor for cardiovascular disease (Rhoden et al. 2005 Chahine et al. 2007). 

When adrninistered long-term for the treatment of hypertension, diuretics fulfill the goals of preventing cardiovascular disease and increasing longevity. However, diuretic therapy may produce both side and toxic effects that are significant in certain patient subgroups, eg, diabetics and cardiac patients. 

Mast cells are present in the normal human heart and even more abundant in diseased hearts [ 16-18,25,47]. Within heart tissue, mast cells he between myocytes and are in close contact with blood vessels. They are also found in the coronary adventitia and in the shoulder regions of coronary atheroma [20, 21], The density of cardiac mast cells is higher in patients with dilated and ischemic cardiomyopathy than in accident victims without cardiovascular diseases [25], Importantly, in some of these conditions there is in situ evidence of mast cell activation [16,34],... 

Cardiovascular Effects. Chronic cardiovascular disease has not been reported in workers occupationally exposed to low levels of trichloroethylene (El Ghawabi et al. 1973), although deaths following acute high-level inhalation exposures to trichloroethylene have been attributed to cardiac arrhythmias. Case studies have described cardiac arrhythmias that in some instances led to death after occupational exposure (Bell 1951 Kleinfeld and Tabershaw 1954 Smith 1966), poisoning (Dhuner et al. 1957 Gutch et al. 1965), or... 

Elevated homocysteine concentrations have been associated with an increased risk for cardiovascular disease in both epidemiologic and clinical studies.43 Several studies have evaluated the benefit of lowering homocysteine levels with folic acid supplementation. One study reported a reduction in major cardiac events with the combination of folic acid, vitamin B12, and vitamin B6 following PCI.44 However, a more recent study found an increased risk of instent restenosis and the need for target-vessel revascularization with folate supplementation following coronary stent placement.45 The role of folate in the management of IHD is currently unclear. 

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