Chronic ischemic heart disease, effects

Montero M, Schmitt C. Recording of transmembrane action potentials in chronic ischemic heart disease and dilated cardiomyopathy and the effects of the new class III antiarrhythmic agents D-sotalol and dofetilide. J Cardiovasc Pharmacol 1996 27(4) 571-7. 

Not surprisingly then, the effect of smoking cessation on the prognosis of patients with chronic ischemic heart disease is substantial. In one meta-analysis by Critchley and Capewell (113), smoking cessation in patients with established CHD resulted in a crude 36% reduction in crude relative risk of all-cause mortality. The crude risk reduction for nonfatal reinfarction was 32%. 

Perhexiline Analogs. Perhexiline is a Ca + channel blocker that is effective in the treatment of angina pectoris, the most common symptom of chronic ischemic heart disease, but is of limited use because of side effects such as hepatotoxicity, weight loss, and peripheral neuropathy. Given that these undesirable effects are related to the slow metabolism and accumulation of perhexiline, soft analogs may represent a conceivable alternative. A class of analogs with an amide moiety inserted as a possible enzymatically labile cen-... 

A cohort study of 5668 NG-exposed workers found an increased standardized mortality ratio for deaths from ischemic heart disease. The increase was more pronounced for those with 10 or more years of exposure and was statistically significant for the 40- to 49-year age group, whereas a deficit of cardiovascular mortality had been anticipated because of preplacement and annual medical examinations designed to exclude persons with cardiovascular abnormalities. These results were confirmed in a retrospective cohort mortality study that found a significant excess of ischemic heart disease mortality among workers actively exposed to NG and under the age of 45. ° (Note this study failed to detect a chronic cardiovascular effect as excess risk was only associated with workers actively exposed to NG.)... 

Most of the indications for -blockers concern the -adrenoceptor. This subtype is predominantly present in the heart, mediating all typical cardiac effects like positive inotropy, chronotropy and dro-motropy. The main indications are hypertension, ischemic heart disease, cardiac arrhythmias and some forms of congestive heart failure. The mechanism by which -blocker, when administered chronically, can reduce the blood pressure is not completely understood yet. Most probably several mechanisms. 

Adverse effects Thiazide diuretics induce hypokalemia and hyperuricemia in 70% of patients, and hyperglycemia in 10% of patients. Serum potassium levels should be monitored closely in patients who are predisposed to cardiac arrhythmias (particularly individuals with left ventricular hypertrophy, ischemic heart disease, or chronic congestive heart failure) and who are concurrently being treated with both thiazide diuretics and digitalis glycosides (see p. 160). Diuretics should be avoided in the treatment of hypertensive diabetics or patients with hyperlipidemia. 

The development of these chronic. Western-type diseases is associated with an excessive formation and function of eicosanoids derived from n-6 fatty acids. As balance can be restored to eicosanoid biosynthesis by dietary n-3 fatty acids, an effective strategy to diminish cardio-cerebrovascular mortality (in addition to several other serious disorders) may be to decrease the intake of n-6 fatty acids and replace them with n-3 fatty acids (116). Such a strategy is supported by studies that show an increased incidence of cardiovascular diseases, specifically ischemic heart disease, in Japanese whose diet has increasingly become more Westernized (113, 117). 

Treatment with bendroflumethiazide, and presumably other diuretics, augments the hjrpokalemic and electrocardiographic effects of high-dose inhaled salbutamol the dysrhythmogenic potential of this interaction can be important in patients with acute exacerbations of chronic airflow obstruction, who have concomitant hjrpoxemia and ischemic heart disease (SEDA-15,134). 

Chronic exposure has been shown to damage the liver, kidney, and other major systems and has been correlated with an increased risk of ischemic heart disease. Literature reports of the human LDlo by the oral route range from 0.14 to 14gkg. Phenol is a known mutagen however, conclusive carcinogenic data are not available. In laboratory experiments, it does show teratogenic and reproductive effects. 

Mauad T, Rivero DHRF, de Oliveira RC et al (2008) Chronic exposure to ambient levels of urban particles affects mouse lung development. Am J Respir Crit Cate Med 178 721-728 Mazzarella G, Ferraraccio F, Prati MV et al (2007) Effects of diesel exhaust particles on human lung epithelial cells An in vitro study. Respir Med 101 1155-1162 McClellan RO (2000) Particle interactions with the respiratory tract. In Gehr P, Heyder J (eds) Particle-lung interactions, 1st edn. Marcel Dekker, New York Mills NL, Ttimqvist H, Gonzalez MC et al (2007) Ischemic and thrombotic effects of dilute diesel-exhaust inhalation in men with coronary heart disease. N Engl J Med 357 1075-1082 Mills NL, Robinson SD, Fokkens PHB et al (2008) Exposure to concentrated ambient particles does not affect vascular function in patients with coronary heart disease. Environ Health Perspect 116 709-715... 

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