CARDIOVASCULAR JOURNAL OF AFRICA:
VOLUME 16, ISSUE 5, SEP 2005
- Title: ASCOT-BPLA signals changes to
hypertension guidelines : editorial
Authors: Rayner, Brian
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.244-245
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- Title: The contribution of diabetes
mellitus per se to the severity of coronary
artery disease : cardiovascular topic
Authors: Javidi, Daryoosh; Gharaei, Babak; Fateh, Soheil
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.246-248
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Abstract: Background : Coronary artery disease (CAD) is the most common chronic, life-threatening illness in many Western countries. The risk factors associated with diabetes mellitus and the metabolic syndrome in diabetics are generally considered more important in the evolution of CAD than the diabetic state itself.
Aim : This study was undertaken to determine the contribution of diabetes mellitus to the characteristics and severity of coronary artery disease among young patients.
Methods : Thirty diabetics (group 1) were selected from a group of young patients (≤ 45 years) with ischaemic heart disease, which was documented angiographically. For this retrospective, case-controlled study, 60 non-diabetic patients with CAD (group 2) were matched for gender, age, LDL level, hypertension, smoking, family history and obesity. These diabetic and nondiabetic groups were compared for different outcomes of coronary artery disease.
Results : Group 1 had a higher incidence of three-vessel coronary involvement (56.7 vs 20%; p < 0.05) and more hospitalisations for ischaemic episodes (4 ± 4.5 vs 2.1 ± 1.8; p < 0.05) than group 2. They also had more previous myocardial infarctions, longer intervals between their first admission and the current hospitalisation, and more common left main coronary artery disease.
Conclusion : Diabetes mellitus contributes significantly to the severity of CAD.
- Title: Correlates of serum lipids
and lipoproteins in Congolese patients with
arterial hypertension : cardiovascular topic
Authors: Lepira, F.B.; M'Buyamba-Kabangu, J.R.; Kayembe, K.P.; Nseka, M.N.
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.249-255
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Abstract: Objective : The purpose of this study was to assess the prevalence of dyslipidaemia and the correlates of serum lipids and lipoproteins among Congolese subjects with and without arterial hypertension.
Methods : One hundred hypertensive patients attending the outpatient clinics at the University of Kinshasa Hospital, and 100 age- and sex-matched controls recruited among hospital personnel or blood donors entered the case-control study. Their blood pressure (BP), heart rate (HR), body mass index (BMI), waist-to-hip ratio (WHR), serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), plasma fibrinogen (only in patients) and fasting glucose, serum uric acid, creatinine and creatinine clearance (CrCl) were compared using the Student's t-test or Chi-square test as appropriate. Associations between continuous variables were assessed with Pearson correlation coefficients, and correlates of lipids and lipoproteins were determined using multiple linear-regression analysis.
Results : Compared to healthy controls, hypertensive patients had greater BMI (p ≤ 0.05) and WHR (p ≤ 0.01), and higher levels of fasting plasma glucose (p ≤ 0.05), serum uric acid (p ≤ 0.05) and creatinine (p ≤ 0.001). The average TC (4.96 ± 1.18 mmol/l for controls vs 5.01 ± 1.49 mmol/l for hypertensives), LDL-C (3.46 ± 1.16 mmol/l vs 3.36 ± 1.32 mmol/l) and HDL-C (1.19 ± 0.39 mmol/l vs 1.27 ± 0.39 mmol/l) were similar and within the normal ranges, whereas TG in hypertensives (1.03 ± 0.66 mmol/l) were significantly higher (p ≤ 0.05) than in controls (0.85 ± 0.48 mmol/l). Dyslipidaemia was observed in 33 controls (33%) and 40 hypertensive patients (40%). Sixteen controls (16%) and 23 hypertensive patients (23%) had TC ≥ 6.20 mmol/l.
In hypertensive patients, TC (r = 0.24; p < 0.01) and LDL-C (r = 0.20; p ≤ 0.05) were positively correlated to plasma fibrinogen. A positive correlation was also observed between TC and LDL-C (r = 0.91; p < 0.001), HDL-C and CrCl (r = 0.28; p < 0.001), and TG and glucose (r = 0.24; p < 0.01), whereas TG were negatively correlated to HDL-C (r = -0.38; p < 0.001).
In multiple linear-regression analysis, LDL-C, HDL-C, TG and age accounted for 87% (R2) of variation in TC levels; plasma glucose and HDL-C for 19% (R2) of variation in TG levels; and TG and CrCl for only 17% (R2) of variation in HDL-C levels.
Conclusions : The present data indicate that dyslipidaemia affects a substantial proportion of healthy and hypertensive Congolese subjects. Furthermore, hypertension is associated with a cluster of risk factors characteristic of the metabolic syndrome, of which overweight / central obesity could be the cornerstone. Management of arterial hypertension should therefore focus both on lowering high blood pressure and correcting associated lipid disorders.
- Title: Effect of resistance training
on cardiorespiratory endurance and coronary
artery disease risk : cardiovascular topic
Authors: Shaw, B.S.; Shaw, I.
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.256-259
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Abstract: Coronary artery disease (CAD) represents a major medical problem in Western society and is a considerable cause of morbidity and mortality in South Africa. In recent years, epidemiologists have made extensive efforts to define the most common risk factors for CAD and propose preventative measures to limit the spread of the disease. Despite the increasing realisation of the importance of resistance training, the literature has focused primarily on aerobic modes of exercise and their effects on risk for CAD. The aim of this study was to determine whether resistance training could alter cardio-respiratory endurance (VO2max), and thus reduce CAD risk.
A quantitative, experimental, comparative research design incorporating a pre-test, a treatment period and a post-test was used. Twenty-eight untrained male volunteers were age matched (mean age: 28 years and seven months) and randomly assigned to either a nonexercising control group (n = 15) or a resistance-training group (n = 13). The study demonstrated no statistically significant change in VO2max for the control group from their pre-test (25.097 ml/kg/min) to their post-test (23.778 ml/kg/min) (p = 0.201). However, resistance training significantly (p ≤ 0.01) increased the VO2max from 26.674 ml/kg/min to 30.981 ml/kg/min (p = 0.004). Additionally, the difference between the pre- and post-test of the control and training group, respectively, demonstrated that the control group's mean VO2max was significantly lower than that of the resistance-training group (p = 0.001).
Although not all studies have demonstrated significant increases in VO2max following resistance training, the results of this study showed that eight weeks of resistance training were sufficient to result in a significant improvement in VO2max. This suggests that an exercise programme that includes resistance training results in a composite of physical and physiological improvements necessary to impact favourably on risk for CAD.
- Title: The William Nelson ECG quiz
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.259, 265
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- Title: Endotoxin-independent white
cell cytokine production in haemodynamically
stable patients with idiopathic dilated
cardiomyopathy : cardiovascular topic
Authors: Brooksbank, Richard; Woodiwiss, Angela J.; Sliwa, Karen; Badenhorst, Danelle; Deftereos, Dawn; Wadee, Ahmed A.; Essop, Mohammed R.; Sareli, Pinhas; Norton, Gavin R.
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.260-265
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Abstract: Introduction : In heart failure, increased circulating white cell tumour necrosis factor-α production could be attributed to elevated plasma endotoxin concentrations or an increase in white cell sensitivity to endotoxin.
Aims : To ascertain whether, in patients with IDC, circulating white cell TNF-α production is also mediated through endotoxin-independent mechanisms.
Methods : Whole blood production of TNF-α, both with and without the presence of an endotoxin stimulus, was evaluated in 89 controls and in 60 patients with IDC in New York Heart Association functional class I, II or III heart failure and without evidence of oedema, reduced peripheral perfusion or elevated plasma endotoxin concentrations. Circulating concentrations of selected proand anti-inflammatory factors were also measured.
Results : In patients compared to controls, IgG (p < 0.01) (IgG1 and IgG3), but not IgM concentrations were elevated, and plasma TNF-α and TGF-β concentrations were raised (p < 0.001, p < 0.02 respectively). In addition, endotoxin-free cultured whole blood TNF-α production (p < 0.0005) was increased. Against a role for endotoxin-mediated pre-activation of white cells in patients, the sensitivity of white cells to endotoxin, as determined from the excitatory endotoxin concentration producing 50% maximal TNF-α production was unchanged. Moreover, in favour of non-endotoxin-mediated white cell activation, the calcineurin inhibitor, cyclosporin-A, which did not alter endotoxin-induced TNF-α production, decreased TNF-α produced by unstimulated cultured cells in patients to values not significantly greater than those in controls.
Conclusions : We concluded that circulating white cell cytokine over-production can occur through both endotoxin- dependent and -independent mechanisms in IDC.
- Title: Plasminogen activator
inhibitor type 1 (PAI-1) and platelet
glycoprotein IIIa (PGIIIa) polymorphisms in
young Asian Indians with acute myocardial
infarction : cardiovascular topic
Authors: Pegoraro, R.J.; Ranjith, N.
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.266-270
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Abstract: Background : The relationship between polymorphisms in the genes for plasminogen activator inhibitor type 1(PAI-1) and platelet glycoprotein IIIa (PGIIIa), clinical and environmental features, and the risk of premature coronary heart disease (CHD) in Asian Indian subjects living in South Africa, has been investigated.
Methods : The prevalence of the PAI-1 promoter 4G/5G and the PGIIIa PIA1A2 polymorphisms was examined in 195 unrelated Asian Indian patients (≤ 45 years) who presented with myocardial infarction (MI). Results were compared with those from 107 unaffected siblings (18-45 years) and 300 healthy age- and race-matched control subjects.
Results : Overall, neither the PAI-1 4G/5G nor the PGIIIa PIA1A2 polymorphism demonstrated an independent risk for MI. No synergistic effect was observed between these two polymorphisms when analysed together. There was a marginal association between the 4G allele of the PAI-1 gene and the risk of MI in individuals who smoked compared with non-smokers (26 vs 11%; p = 0.028; OR 2.74; 95% CI 1.04-8.47). The PGIIIa PIA2 allele was, however, strongly associated with a previous history of MI (17 vs 6%; p = 0.004; OR 3.00; 95% CI 1.38-6.46, as well as the severity of disease as determined by angiography (single/double- vs triple-vessel disease: 3% vs 15%; p = 0.020; OR 0.19; 95% CI 0.02-0.92).
Conclusion : In young Asian Indians who smoke, the PAI-1 4G allele is a mild risk factor for the development of MI. The PGIIIa PIA2 allele constitutes a significant risk for individuals who have a previous history of MI, as well as serving as an indicator for the severity of CHD.
- Title: ASCOT - blood pressure arm
confirms efficacy of amlodipine / perindopril
(Norvasc® / Coversyl® regimen : drug trends in
cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.271-272, 274-275
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- Title: Trend towards prolonged
survival in bisoprolol-first (Concor® for
heart-failure trial (CIBIS III) : drug trends in
cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.276
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- Title: Comments from South African
cardiologists attending the European Society of
Cardiology Congress
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.278-279
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- Title: Focus on improving
lipid-lowering efficacy at ESC - Stockholm,
September 2005 : drug trends in cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.282-283
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- Title: Opportunities to improve risk
factor control in type 2 diabetes and reduce
cardiovascular events : drug trends in
cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.283-284
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- Title: Additional benefits of RAS
blockade in the treatment of black hypertensives
using valsartan / hydrochlorothiazide
combination : drug trends in cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.285
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- Title: PROactive study shows reduced
heart attacks and strokes in type 2 diabetics on
pioglitazone HCI (Actos®) therapy : drug trends
in cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.286-287
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- Title: Comments from South African
specialists
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.287
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- Title: Two- and three-drug therapy
with candesartan cilexetil (Atacand®) successful
in patients with severe hypertension : drug
trends in cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.288
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- Title: New agent ivabradine
(Procoralan) for treatment of chronic stable
angina : drug trends in cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.288, 290
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- Title: PREAMI : ACE inhibitor
benefits elderly MI patients with normal
ventricular function : drug trends in cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.290
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- Title: Increased integrated primary
care needed for cardiovascular disease
prevention in South Africa : drug trends in
cardiology
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.292
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- Title: Cardio news
From: Cardiovascular Journal of South Africa, Vol 16, Issue 5, Sep / Oct
Published: 2005
Pages: p.292
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