Coronary vascular disease

Coronary vascular disease Atherosclerosis Hypertension Occlusion of veins... 

Hypertension, whether labile or fixed, borderline or definite, casual or basal, systolic or diastolic, at any age regardless of gender is the most common and a powerful contributor to atherosclerotic coronary vascular disease. Morbidity and mortality increase progressively with the degree of elevation of either systolic or diastolic pressure and pulse pressure, and no discernible critical value exists (see Chap. 13). Numerous trials have documented the reduction in risk associated with blood pressure lowering however, most of these studies show that mortality and morbidity reduction is a result of fewer strokes and... 

Pazderova examined Czech workers about ten years after exposure and found sustained neural and psychiatric problems and arteriosclerosis in the Czech workers, as well as glucose intolerance and increases in cholesterol (55). In a laboratory study of British workers ten years after exposure, Martin found increases in some liver enzymes as well as increased levels of cholesterol and triglycerides in exposed workers (56). Whether a health risk results from the enzyme and lipid changes is not known, but one concern is that lipid abnormalities may confer increased risk of coronary vascular disease. 

Lipids and lipoproteins are important in atherosclerosis and coronary vascular disease. Some of the lipoproteins are atherogenic such as low-density lipoprotein (LDL) while others such as high-density lipoprotein (HDL) are protective. The different fractions of lipoproteins (e.g., LDL, HDL, Lpa) have been separated by MEKC. However, the separation by CE remains difficult and thus is not common. 

Patients having high plasma renin activity (PRA) (>8 ng/(mLh)) respond best to an ACE inhibitor or a -adrenoceptor blocker those having low PRA (<1 ng/(mLh)) usually elderly and black, respond best to a calcium channel blocker or a diuretic (184). -Adrenoceptor blockers should not be used in patients who have diabetes, asthma, bradycardia, or peripheral vascular diseases. The thiazide-type diuretics (qv) should be used with caution in patients having diabetes. Likewise, -adrenoceptor blockers should not be combined with verapamil or diltiazem because these dmgs slow the atrioventricular nodal conduction in the heart. Calcium channel blockers are preferred in patients having coronary insufficiency diseases because of the cardioprotective effects of these dmgs. 

Diseases of the arteries can cause serious problems, namely coronary artery disease, cerebral vascular disease, and peripheral vascular disease Drug therapy for vascular diseases may include dragp that dilate blood vessels and thereby increase blood supply to an area... 

Prolonged exposure to elevated GH and IGP-Is can lead to serious complications in patients with acromegaly. Aggressively manage comorbid conditions such as hypertension, diabetes, arrhythmias, coronary artery disease and heart failure to prevent vascular and neuropathic complications. It is critical to monitor patients indefinitely for management of the comorbidities associated with acromegaly8 (Table 43-4). 

Inflammatory conditions of the prostate Coronary and peripheral vascular disease Neurologic disorders (e.g., Parkinson s disease and multiple sclerosis)... 

Apo E, apolipoprotein E CAD, coronary artery disease FKN, fractalkine MHC, major histocompatibility complex MCP-1, monocyte chemoattractant protein 1 MMPs, matrix metalloproteinases NK, natural killer oxLDL, oxidized LDL RANTES, regulated on activation, normal T cell expressed and secreted VSMCs, vascular smooth muscle cells. 

Wong BW, Wong D, McManus BM. Characterization of fractalkine (CX3CL1) and CX3CR1 in human coronary arteries with native atherosclerosis, diabetes mellitus, and transplant vascular disease. Cardiovasc Pathol 2002 ll(6) 332-338. 

Gartside, P. and Glueck, C., Relationship of dietary intake to hospital admission for coronary heart and vascular disease The NHANES II national probability study. Journal of the American College of Nutrition 12, 676-684, 1993. 

Hypertension, or a chronic elevation in blood pressure, is a major risk factor for coronary artery disease congestive heart failure stroke kidney failure and retinopathy. An important cause of hypertension is excessive vascular smooth muscle tone or vasoconstriction. Prazosin, an aradrenergic receptor antagonist, is very effective in management of hypertension. Because oq-receptor stimulation causes vasoconstriction, drugs that block these receptors result in vasodilation and a decrease in blood pressure. 

It is well known that high concentrations of LDL, specifically oxidized LDL, are risk factors for coronary artery disease. This fact is explained by the oxidative hypothesis of atherogenesis. According to this hypothesis, the atheroma is formed by foam cells from the vascular subendothelium that derive from macrophages that have picked up previously oxidized LDL in an uncontrolled manner. These lipoproteins are cytotoxic to the endothelium and, in addition, chemotactic to macrophages and monocytes,... 

Aspirin (acetylsalicylic acid) (Figure 29.21) is a widely applied drug for reducing ischemic cardiovascular events in patients with coronary artery disease, hypertension, or at cardiovascular risk. It is believed that the main protective function of aspirin is the inhibition of cyclooxygenase however, it has been recently proposed that aspirin may possess additional antioxidant activity [348]. It was found that long-term aspirin treatment of normotensive and hypertensive rats resulted in a decrease in vascular superoxide production by the inhibition of NADPH oxidase activity. 

Hypertension, coronary artery or other atherosclerotic vascular disease, diabetes, obesity, metabolic syndrome... 

Dopamine produces dose-dependent hemodynamic effects because of its relative affinity for cq-, /Jr, /J2-, and Dr (vascular dopaminergic) receptors. Positive inotropic effects mediated primarily by / -receptors become more prominent with doses of 2 to 5 mcg/kg/min. At doses between 5 to 10 mcg/kg/min, chronotropic and -mediated vasoconstricting effects become more prominent. Especially at higher doses, dopamine alters several parameters that increase myocardial oxygen demand and potentially decrease myocardial blood flow, worsening ischemia in some patients with coronary artery disease. 

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