Coronary heart disease progression

Currently, more than 400 human somatic cell gene therapy protocols are being tested. Most of these involve the use of genetically modified cells to treat noninherited diseases. For example, normal copies of the p53 tumor suppressor gene are inserted into lung tumors to halt tumor progression, and genetically modified cells have been used to create new coronary vessels in patients with coronary heart disease. Success has also been achieved in the treatment of hereditary disease (most notably, the recent successful treatment of X-linked severe combined immune deficiency see Clinical Correlate). 

Deficiency can lead to cancer and immune system dysfunction Stabilizes proteins used in the immune system Promotes membrane binding that is essential for proper protein localization or biological function May hinder progression of adrenoleukodystrophy Reduces low-density lipoprotein in the blood Reduces platelet stickiness and protects against coronary heart disease... 

Heterozygous carriers of functionally relevant mutations usually present with HDL cholesterol levels that are frequently below the fifth percentile. As would be expected, apoA-I levels are also frequently below the fifth percentile (i.e., < 1.05 g/1 and < 1.1 g/1 in Caucasian men and women, respectively). In most cases, heterozygous carriers of apoA-I variants do not present with specific clinical symptoms. An important exception are some structural apoA-I variants with amino acid substitutions in the amino terminus, which have been detected in patients with familial amyloidosis of the liver, the intestine, the kidney, the heart, peripheral nerves, and in the skin. In addition, some apoA-I variants like apoA-I L178P or L159P have been associated with increased risk of premature coronary heart disease or enhanced progression of carotid intima media thickness, whereas others did not show this association, or were even claimed to have reduced cardiovascular risk and advocated as possible agents for the treatment or prevention of atherosclerosis (notably apoA-I R173CMiiano) [22,43,53]. 

Atherosclerosis (AS) is a leading cause of coronary heart disease (CHD) in most developed countries. Over the past 3 decades, significant progress has been made in reducing CHD-related mortalities through concerted efforts to modify diet and life-... 

Reductions in elevated total cholesterol and LDL cholesterol reduce coronary heast disease mortality and total mortality increasing HDL reduces coronary heart disease events as well. Aggressive treatment of hypercholesterolemia results in fewer patients progressing to myocardial infarction, angina, and stroke and reduces the need for interventions such as coronary artery bypass grafting and percutaneous transluminal coronary angioplasty. 

An abnormal lipoprotein profile increases the risk of atherosclerosis and coronary heart disease in patients with nephrotic syndrome. It is therefore prudent to treat patients with persistent nephrotic syndrome and sustained dyshpidemia, especially those with high VLDL and LDL cholesterol levels in the presence of a normal or low HDL cholesterol level (see Chaps. 21 and 43). Therapy is especially needed for those with concurrent atherosclerotic cardiovascular disease, or with additional risk factors for atherosclerosis, such as smoking and hypertension. Whether correction of hpoprotein abnormahties will slow the progression of renal disease as demonstrated in animal studies requires clinical confirmation. ... 

Chemoprevention has been defined as the use of nutrients or pharmacological agents to enhance intrinsic mechanisms that protect the organism against the development and progression of disease, e.g. malignancies and coronary heart disease. 

The management of liyperlipidacmia is an important aspect of coronary heart disease (CHD) risk factor correction. Modifying liyperlipidacmia together with the other non-lipid risk factors has been repeatedly shown to reduce the risk of developing CHD and to delay or even reverse the progression of established CHD. Risk factors for CHD (Table 1) fall into two groups those which can be corrected (such as smoking, hypertension, hyperlipidaemia and obesity) and those which cannot be inlluenced (such as age. sex and family history). 

Atherosclerosis use to slow the progression of coronary atherosclerosis. Hypercholesterolemia nse for reduction of elevated total cholesterol, LDL, apo-B, and triglyceride cholesterol levels and to increase HDL levels. Secondary prevention of coronary events used to reduce the risk of undergoing coronary revascularization procedures in patients with coronary heart disease. 

Coronary Heart Disease Several studies have linked mercury exposure to cardiovascular disease. These studies are important because consumers are advised to eat fish to protect against heart disease. Some fish species contain beneficial omega-3 fatty acids, and fish is also a low-fat source of protein. However, recent studies have raised the possibility that a moderate mercury content in fish may diminish the cardioprotective effect of fish intake in humans. Salonen et al. (2000) reported an association between moderate hair mercury content and accelerated progression of carotid arteriosclerosis in a prospective study among 1014 men aged 42-60 years in Finland. Hair mercury levels > 2 pg g showed a doubling of the risk of... 

The element mercury, also known as quicksilver (symbol Hg for hydrargyrum), and its compounds have no known normal metabolic function. Their presence in the cells of living organisms represents contamination from natural and anthropogenic sources all such contamination must be regarded as undesirable and potentially hazardous. Accumulation of mercury in tissues is reportedly associated with an excess risk of myocardial infarction, increased risk of death from coronary heart disease and cardiovascular disease, and accelerated progression of carotid atherosclerosis. 

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