ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Recent advances in basic science have shown that atherosclerosis should be considered as a chronic inflammatory process, and that a pivotal role of inflammation is evident from initiation through progression and complication of atherosclerosis. In the past few years many studies have examined the potential for biochemical markers of inflammation to act as predictors of coronary heart disease (CHD) risk in a variety of clinical settings. Several large, prospective epidemiological studies have shown consistently that C-reactive protein (CRP) and interleukin-6 (IL-6) plasma levels are strong independent predictors of risk of future cardiovascular events, both in patients with a history of CHD and in apparently healthy subjects. These molecules could be useful to complement traditional risk factors, as well as to identify new categories of subjects prone to atherosclerosis development. An intriguing question is whether these inflammatory molecules simply represent sensitive markers of systemic inflammation or if they actively contribute to atherosclerotic lesion formation and instability. In this paper we will review the evidence concerning the cardiovascular prognostic value and the potential direct involvement of CRP and IL-6 in atherogenesis.

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

According to thePhysicians’ Desk Reference(PDR), 36% of modern antihypertensive and antihyperlipidemic drugs produce untoward alterations in chemosensory perception. Such disturbances can adversely affect the quality of life, produce non-compliance to medication schedules, and may result in decreased food intake, loss of appetite, weight decrement, and depression. This review lists the primary antihypertensive and antihyperlipidemic drugs that adversely alter chemosensory function, provides information on better defining the nature of the dysfunction, outlines testing strategies and available tests that could be used to better define the prevalence of the dysfunction, and summarizes means for mitigating such alterations.

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundElevated blood pressure is associated with an impaired prognosis in patients with established coronary heart disease. Adequate blood pressure control is therefore of utmost importance. We report on two successive European surveys that evaluated whether the goals given in recommendations on secondary prevention are achieved.MethodsThe first European Action on Secondary Prevention through Intervention to Reduce Events (EUROASPIRE I) survey was conducted during 1995–1996 in 21 hospitals in nine European countries. The second survey (EUROASPIRE II) was conducted during 1999–2000 in 47 hospitals (including 20 hospitals that participated in EUROASPIRE I) in 15 Europeans countries. Consecutive patients (aged<71 years) were identified from hospital records after coronary artery bypass grafting, percutaneous coronary intervention, myocardial infarction, or myocardial ischaemia. Patients were invited for an interview and examination at least 6 months after hospitalization. During the interview, blood pressure was measured in a standardized fashion. Systolic blood pressure⩾140 mmHg and/or a diastolic blood pressure⩾90 mmHg were considered as elevated blood pressure. EUROASPIRE II provides a more comprehensive view on the actual management of patients with established coronary disease. Therefore, we decided to concentrate mainly on the EUROASPIRE II data, and to use EUROASPIRE I for the evaluation of time trends.ResultsIn EUROASPIRE II, 5556 patients were interviewed, and 51% were diagnosed with elevated blood pressure. Large regional variations in the prevalence of elevated blood pressure were observed, with values ranging from 37 to 64%. Twenty-five per cent (1401) of patients were on a diet to reduce blood pressure, and among these 61% had elevated blood pressure. The prevalence of elevated blood pressure among the 4827 (87%) patients taking blood pressure-lowering medication (which was not necessarily taken as an antihypertensive treatment) was 51%. Patients with elevated blood pressure were more likely to be diabetic, hypercholesterolemic, and obese than normotensive patients. The proportion of patients who reported being aware of their hypertensive status was somewhat higher in EUROASPIRE II than in EUROASPIRE I (71 versus 67%), and the use of blood pressure-lowering medication was intensified (91 versus 85%). However, these changes were not accompanied by a decrease in the prevalence of elevated blood pressure (54 versus 55% in centres that participated in both surveys).ConclusionDuring 1995–2000 the prevalence of elevated blood pressure in patients with established coronary heart disease remained at an unacceptably high level. Throughout Europe, still about half of coronary patients require more intensive blood pressure management.

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo test whether the plasma concentration of C-reactive protein (CRP), a sensitive marker of systemic inflammation, is increased in patients with newly diagnosed, never-treated hypertension and whether blood pressure and its pulsatile component, pulse pressure, are correlated with plasma CRP concentration independently of a consistent number of cardiovascular risk factors.DesignCross-sectional study in a hospital outpatient hypertension clinic.MethodsA total of 135 newly diagnosed, never-treated patients with hypertension and 40 healthy matched non-hypertensive controls underwent office and 24-h blood pressure measurement and blood sampling for determination of plasma CRP and serum lipid concentrations.ResultsPlasma CRP concentration was greater in hypertensive individuals (1.85 mg/l, interquartile range 0.74–3.64) than in control individuals (1.01 mg/l, interquartile range 0.67–1.88;P= 0.02). In the entire population, CRP had a significant direct association with office systolic blood pressure and pulse pressure, but not with diastolic blood pressure. Among hypertensive patients, plasma CRP was related to 24-h systolic blood pressure (r= 0.28,P<0.01) and pulse pressure (r= 0.32,P<0.01), but not to diastolic blood pressure (r= 0.12,P>0.2). CRP was also directly associated with body mass index (r= 0.25,P<0.01), serum low-density lipoprotein cholesterol (r= 0.21,P= 0.03) and serum triglycerides (r= 0.21,P= 0.03). In the multivariate analysis, systolic blood pressure and pulse pressure, but not diastolic blood pressure, were significant predictors of plasma CRP concentration when a consistent number of cardiovascular risk factors was controlled for simultaneously.ConclusionsSystolic blood pressure and pulse pressure, but not diastolic blood pressure, are predictors of plasma C-reactive protein concentrations in patients with newly diagnosed, never-treated hypertension, irrespective of the potential proinflammatory action of traditional cardiovascular risk factors.

ISSN:0263-6352    

出版商:OVID    

年代:2003

数据来源: OVID