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Coronary heart disease therapy

A third study (85) enrolled 7825 hypertensive patients (55% males and 45% females) having diastoHc blood pressures (DBP) of 99—104 mm Hg (13—14 Pa) there were no placebo controls. Forty-six percent of the patients were assigned to SC antihypertensive dmg therapy, ie, step 1, chlorthaUdone step 2, reserpine [50-55-5] or methyldopa [555-30-6], and step 3, hydralazine [86-54-4]. Fifty-four percent of the patients were assigned to the usual care (UC) sources in the community. Significant reductions in DBP and in cardiovascular and noncardiovascular deaths were noted in both groups. In the SC group, deaths from ischemic heart disease increased 9%, and deaths from coronary heart disease (CHD) and acute myocardial infarctions were reduced 20 and 46%, respectively. [Pg.212]

NO-sensitive GC represents the most important effector enzyme for the signalling molecule NO, which is synthesised by NO synthases in a Ca2+-dependent manner. NO-sensitive GC contains a prosthetic heme group, acting as the acceptor site for NO. Formation of the NO-heme complex leads to a conformational change, resulting in an increase of up to 200-fold in catalytic activity of the enzyme [1]. The organic nitrates (see below) commonly used in the therapy of coronary heart disease exert their effects via the stimulation of this enzyme. [Pg.572]

Oster G, Epstein AM. Cost-effectiveness of antihyperlipemic therapy in the prevention of coronary heart disease. The case of cholestyramine. JAMA 1987 258 2381-7. [Pg.589]

Observational studies have suggested possible favourable effects of estrogen replacement therapy (ERT) on the risk of coronary heart disease in postmenopausal women. Since elevated plasma cholesterol has been identified as the primary risk factor for cardiovascular disease, investigations have focused on the inverse association between plasma cholesterol concentration and soy protein consumption. The cholesterol-lowering properties of soy have been demonstrated, and a good correlation has been found in... [Pg.198]

P-blocker therapy was ineffective in preventing coronary heart disease, cardiovascular mortality, and all-cause mortality when compared to diuretics for elderly patients (60 years of age or greater) treated for primary hypertension. Clearly, the effects of P-blockers on blood pressure are complex and difficult to ascribe to one or two mechanisms. Rather, the varied effects of negative chronotropic and inotropic properties along with reduced renin levels (Fig. 2-3) appear to result in an overall reduction in cardiac output and/or reduction in peripheral resistance. [Pg.23]

The NKF suggests that CKD should be classified as a coronary heart disease (CHD) risk equivalent and the goal LDL-C level should be below 100 mg/dL in all patients with CKD.22 The most frequently used agents for the treatment of dyslipidemias in patients with CKD are the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors ( statins ) and the fibric acid derivatives. However, other treatments have been studied in patients with CKD and should be considered if first-line therapies are contraindicated. [Pg.379]

Nearly two-thirds of patients with DM will die of coronary heart disease (CHD). Interventions targeting smoking cessation, glycemic control, blood pressure control, lipid management, antiplatelet therapy, and lifestyle changes, including diet and exercise, can reduce the risk of cardiovascular events. Patients with diabetes should receive at least an aspirin daily unless contraindicated. Refer to appropriate chapters in the text concerning CHD. [Pg.661]

CHD Coronary heart disease DOT Directly observed therapy... [Pg.1554]

The oral estrogen-alone arm was stopped early after a mean of 7 years of follow-up. Estrogen-only therapy had no effect on coronary heart disease risk and caused no increase in breast cancer risk. [Pg.355]

The American Heart Association recommends against postmenopausal hormone therapy for reducing the risk of coronary heart disease. [Pg.362]

The WHI trial showed an overall increase in the risk of coronary heart disease in healthy postmenopausal women aged 50 to 79 years taking estrogen-progestogen therapy compared with those taking placebo. The increased risk of coronary heart disease was most apparent at 1 year. The estrogen-alone arm of the WHI showed no effect (either increase or decrease) in the risk of coronary heart disease. Recent analysis showed that women who started hormone therapy closer to the time of menopause tended to have decreased coronary heart disease risk compared to the... [Pg.362]

FIGURE 59-1. Pharmacotherapy treatment algorithm. A select population of individuals, based on body mass index (BMI) and waist circumference (WC) together with concurrent risk factors, may benefit from medication therapy as an adjunct to a program of weight loss that includes diet, exercise, and behavioral modification. (CHD, coronary heart disease DM, diabetes mellitus, HTN, hypertension INC WC, >40 inches for males and >35 inches for females LCD, low-calorie diet.)... [Pg.679]

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). [Pg.352]

Reducing coronary heart disease risk Consider gemfibrozil therapy in those Type Mb patients who have low HDL-cholesterol levels in addition to elevated LDL-cholesterol and triglycerides and who have not responded to weight loss, dietary therapy, exercise, and other pharmacologic agents. [Pg.624]

Coronary heart disease is one of the leading causes of death in the industrialized world (Packer, 1992 Remme and Swedberg, 2001). Hypertension is a risk factor for cardiovascular disease and is associated with an increased incidence of stroke and coronary heart disease. Other risk factors for cardiovascular disease include also high cholesterol, diabetes, and obesity. Although there have been many advances in treatment over the past several decades, less than a quarter of all hypertensive patients have their blood pressure adequately controlled with available therapies. [Pg.130]

The role of the antioxidant properties of vitamins C, E, and p-carotene in the prevention of cardiovascular disease has been the focus of several recent studies. Antioxidants reduce the oxidation of low-density lipoproteins, which may play a role in the prevention of atherosclerosis. However, an inverse relationship between the intake or plasma levels of these vitamins and the incidence of coronary heart disease has been found in only a few epidemiological studies. One study showed that antioxidants lowered the level of high-density lipoprotein 2 and interfered with the effects of lipid-altering therapies given at the same time. While many groups recommend a varied diet rich in fruits and vegetables for the prevention of coronary artery disease, empirical data do not exist to recommend antioxidant supplementation for the prevention of coronary disease. [Pg.781]

Estrogen therapy may increase the risk of developing coronary heart disease, hypercalcemia, gallbladder disease, cerebrovascular disease, and breast cancer. [Pg.461]

Standard lipid screening to obtain a cholesterol profile for the risk of cardiovascular disease routinely reports total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. Cholesterol values are reported in milligrams per deciliter of blood (mg/dL). Different organizations have made recommendations for normal cholesterol levels, but these must be interpreted carefully, as they are contingent on other risk conditions. For example, the recommendations for smokers or those with a family history of heart disease will be lower for someone without these conditions. The National Center for Cholesterol Education (NCEP) endorsed by the American Heart Association believes that LDL is the primary cholesterol component to determine therapy. LDL cholesterol accounts for 60—70% of blood serum cholesterol. An LDL less than 160 mg/dL is recommended for individuals with no more than one risk factor and less than 100 mg/dL for individuals with coronary heart disease. NCEP classifies HDL, which comprises between 20% and 30% of blood cholesterol, below 40 mg/dL as low. Triglycerides are an indirect measure of VLDL cholesterol. The NCEP considers a normal triglyceride level as less than 150 mg/dL. [Pg.83]

Petitti D. Hormone replacement therapy and coronary heart disease four lessons. Int J Epidemiol 2004 33 461-3. [Pg.270]

Reconsideration of contraindications has also been proposed in a prospective study in patients with serum creatinine concentrations of 130-220 pmol/1 and coronary heart disease (n — 226), congestive heart failure (n = 94) and chronic obstructive pulmonary disease (n = 91). Half of the patients continued to take metformin and the other half stopped (39). Bodyweight and HbAic increased over 4 years in those who stopped taking metformin. Lactic acid concentrations were similar in the two groups. Deaths were similar in the two groups (62 and 64 respectively). The incidences of myocardial infarction, all cardiovascular events, and cardiovascular mortality were the same. Changes in additional therapy were only significant for insulin (30% versus 45% respectively) and diet (25% versus 0% respectively). [Pg.370]

Hence, it appears that hormone replacement can play a role in modifying certain risk factors associated with coronary heart disease in postmenopausal women, but the actual outcomes (heart attack, death) do not seem to be affected significantly by these hormonal interventions. Clearly, continued research in this area is needed to clarify if hormone replacement therapy can help decrease cardiac morbidity and mortality in certain postmenopausal women.60,121... [Pg.446]


See other pages where Coronary heart disease therapy is mentioned: [Pg.215]    [Pg.132]    [Pg.212]    [Pg.123]    [Pg.144]    [Pg.598]    [Pg.17]    [Pg.765]    [Pg.1532]    [Pg.920]    [Pg.167]    [Pg.360]    [Pg.162]    [Pg.401]    [Pg.294]    [Pg.689]    [Pg.394]    [Pg.241]    [Pg.1272]    [Pg.921]    [Pg.181]    [Pg.277]    [Pg.303]    [Pg.568]    [Pg.598]    [Pg.628]    [Pg.201]    [Pg.454]    [Pg.446]   
See also in sourсe #XX -- [ Pg.853 ]




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