OBJECTIVE: Variations in the noncoding single-nucleotide polymorphisms (SNPs) at positions 560 and 832 in the 5' promoter region of the apolipoprotein E gene define genotypes that distinguish between high and low concentrations of plasma total and high-density lipoprotein cholesterol and triglycerides. We addressed whether these genotypes improve the prediction of ischemic heart disease (IHD) in subsamples of individuals defined by traditional risk factors and the genotypes defined by the epsilon(2), epsilon(3), and epsilon(4) alleles in exon 4 of the apolipoprotein E gene. METHODS AND RESULTS: In a sample of 3686 female and 2772 male participants of the Copenhagen City Heart Study who were free of IHD events, 576 individuals (257 women, 7.0% and 319 men, 11.5%) were diagnosed as having developed IHD in 6.5 years of follow-up. Using a stepwise Patient Rule-Induction Method modeling strategy that acknowledges the complex pathobiology of IHD, we identified a subsample of 764 elderly women (> or =65 years) with hypertriglyceridemia who had a history of smoking, a history of hypertension, or a history of both in which the A(560)T(832)/A(560)T(832) and A(560)T(832)/A(560)G(832) 5' 2-SNP genotypes had a higher cumulative incidence of IHD (172/1000) compared to the incidence of 70/1000 in the total sample of women. CONCLUSIONS: Our study validates that 5' apolipoprotein E genotypes improve the prediction of IHD and documents that the improvement is greatest in a subset defined by a particular combination of traditional risk factors in Copenhagen City Heart Study female participants. We discuss the use of these genotypes in medical risk assessment of IHD in the population represented by the Copenhagen City Heart Study.
RefSource: Circ Cardiovasc Genet. 2010 Feb 1;3(1):1-2
Coronary artery disease (CAD) is the main cause of death in renal transplant recipients. The aim of the present study was to determine the frequency and risk factors of post-transplantation CAD and its influence on the long-term results of surgery, as well as to evaluate the efficiency of myocardial revascularization in patients with severe CAD. Analysis of the observation of 479 renal recipients (332 men and 147 women) aged 38.69 +/- 11.2 was performed. The mean follow-up period was 64.56 +/- 37.44 months. Sixty-eight patients had diabetes mellitus. CAD was diagnosed in 14.8% (71 out of 479) renal recipients; in 12.7% of patients it developed de novo and was revealed 32.4 +/- 18.6 months after the surgery. Ten-year survival of renal recipients with CAD was only 39%, while in the group of non-CAD patients it was 75% (p
Studies covered incidence of coronary heart disease, its risk factors and features of constitutional types among Kouzbass coal miners suffering from anthracosilicosis and chronic dust bronchitis. Findings are reliably higher incidence of coronary heart disease among coal miners having lung diseases caused by dust. Coronary heart disease among the miners with anthracosilicosis is favored by arterial hypertension, overweight and hypersthenic constitutional type, that among those with dust bronchitis is favored only by overweight.
Sample examination of the population aged 25-64 basing on the disease history, fasting blood glucose test, glucose tolerance test, WHO criteria, diabetes mellitus was found in 6% of males and 6.9% of females. Only 2.7% of males and 3.1% of females were aware of their disease. Glucose tolerance test discovered abnormal carbohydrate tolerance in 5.6% and 13.3% of male and female examinees, respectively. Thus, a total of 12.2% of males and 20.2% of females had various disorders of carbohydrate metabolism. Diabetes mellitus patients had often hypercholesterolemia, hypertriglyceridemia, obesity, hypertension, low 10-year survival.
OBJECTIVE: To analyse agreement between patients' and GPs' perceptions of risk factors and overall risk of ischaemic heart disease (IHD). DESIGN: Cross-sectional study based on paired information from patients and GPs. SETTING: Twenty-six GPs in the County of Ringkøbing, Denmark, participating in a medical audit during 3 weeks in May 1999. SUBJECTS: 252 patients with IHD and 1239 without IHD. MAIN OUTCOME MEASURES: GPs and patients were asked about specific risk factors for IHD and their perception of overall risk. Their agreement was evaluated by Kappa statistics. RESULTS: Agreement between GPs and patients varied from 70% to 97%. Disagreement was observed most often for patients with IHD and patients listed with elderly GPs ( > 50 years). Generally, patients perceived the overall risk of IHD lower than their doctors, and for most patients with a perception of low risk the GP estimated the risk as high. CONCLUSIONS: Patients and GPs have different perceptions of the risk of [HD. This may be due to different perceptions of the importance of specific risk factors and different reference frames for risk perception. GPs have an important role in communicating the meaning of risk factors and interventions should be considered to improve risk communication in general practice.
The purpose of this paper is to determine the age-specific relationships between risk factors at age 40 through 75 years and ischemic heart disease (IHD), and to determine the effects of aging on these relationships in a cohort of 3983 Canadian males.
The Manitoba Follow-Up Study is the prospective investigation of cardiovascular disease as it develops in a cohort of 3983 young men. Over a period of 45 years, from 1948 to 1993, 1094 study members (27%) developed clinical evidence of IHD. Blood pressure, body weight, smoking, and presence of diabetes mellitus have been recorded at regular intervals throughout the follow-up period. Using measurements from examinations every 5 years between ages 40 and 75 years, age-specific Cox proportional hazard models were fit to relate these risk factors to IHD.
The adjusted relative risk of IHD for systolic blood pressure, diastolic blood pressure and smoking were found to significantly (p 0.05). After age 65 years, these risk factors were of little value for the prediction of IHD.
The relative risk and statistical significance of blood pressure and smoking, as risk factors for IHD, decline with age.
Comment In: Ann Epidemiol. 1998 Oct;8(7):411-49738686
The incidence of ischemic heart disease (IHD) and risk factors of its genesis have been studied in 380 miners of a control group non-exposed to industrial vibration. Constitution type and a number of phenotypic signs have been determined for all examined workers with hemostatic indices defined in 60 miners before and after the performance of vibrational load test. High incidence of IHD, arterial hypertension and hyperholesterolemia have been detected in the miners working with vibration instruments and hemostatic disorders predisposing to ischemic heart disease have been revealed. In the miners of vibrodangerous occupations suffering from ischemic heart disease, hypersthenic constitution type determined by Rees-Eysenc index less than 92.2 and the height below 170 cm was found to occur more frequently.
A cross-sectional study of working conditions and health of the personnel of the civil aircraft radar-tracking system has been conducted based on periodical health examinations. The personnel was divided into three occupational groups. Group I was exposed to EMF EHF, group II--to EMF HF and UHF and group III was not exposed to EMF (reference group). The groups didn't differ in any occupational and non-occupational parameters. Health status of 250 workers was examined. High prevalence rate of cardiovascular diseases (ICD-X I00-I99) was found in the exposed groups. Odds ratio (OR) was 3.78 (95% CI 1.96-7.27) in group I and 2.13 (95% CI 1.13-4.03) in group II. High prevalence rate of cardiovascular diseases is explained by arterial hypertension (ICD-X I10-I15) (OR = 1.96 95% CI 1.04-3.70 in group I and OR = 1.80 95% CI 0.93-3.50 in group II) and ischemic heart disease (ICD-X I20-I25) (OR = 7.9 95% CI 3.48-18.06 in group I; OR = 3.0 95% CI 1.23-7.33--in group II). In the exposed groups cardiovascular diseases were developed in young age. OR was 7.04 (95% CI 1.64-30.19) in group I and 4.33 (95% CI 0.96-19.65) in group II in 30-39 age sub groups. Myocardium infarction was found in 2 out of 16 persons of this age in the group exposed to EMF.
The potential predictors of ischemic heart disease mortality were studied for 931 male foundry workers in Finland who participated in a health examination in 1973. These workers were followed up to 1993 through registers and by using a questionnaire. In 1973, the systolic and diastolic blood pressures of workers exposed to carbon monoxide (CO) were slightly higher than those of unexposed workers. The prevalence of angina pectoris showed a clear dose-response relation to CO exposure. Electrocardiogram (ECG) findings indicating past myocardial infarction or suggesting coronary artery disease as a function of smoking and/or CO exposure were not evident. In the 1987 follow-up, the rate ratio for ischemic heart disease mortality was estimated as 4.4 for CO-exposed smokers compared with unexposed nonsmokers. Ischemic heart disease mortality in 1973-1993 was analyzed by using the Cox proportional hazards model. The statistically significant predictors were age, pathologic ECG findings in 1973, regular CO exposure, and abundant alcohol drinking. Of the ECG findings, changes in Q or QS and ST-J or ST waves and in ventricular extrasystoles were statistically significant. The risk of mortality from ischemic heart disease was increased by working in iron foundries, by hypertension, and by smoking.