Cholesterol

2009 ◽  
Author(s):  
Jie Jack Li
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cause Of Death ◽  
Heart Attack ◽  
Ldl Cholesterol ◽  
Fibrous Tissue ◽  
Heart Attacks ◽  
Total Body ◽  
The Many ◽  
The One

The story of statins starts with cholesterol because statins are a class of drugs that reduce low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol. LDL cholesterol, in turn, is a major risk factor for coronary heart disease, the leading cause of death worldwide and projected to remain so through 2025. About 1.5 million Americans suffer heart attacks each year, and heart disease has emerged as the biggest cause of death in the United States, killing 911,000 people in 2003. Before the 1940s, the average lifespan in America was 47 years, and heart disease did not contribute to mortality to a large extent because people often died of infections. Currently, an average American lives to celebrate her 77th birthday. As a consequence, heart-related disease has risen to be the number one killer. Coronary heart disease manifests in many forms: angina, arrhythmia, atrial fibrillation, congestive heart failure, hypertension, atherosclerosis, myocardial infarction (heart attack), and sudden cardiac death. Atherosclerosis, or blockage in arteries, results when a buildup of cholesterol, inflammatory cells, and fibrous tissue called plaques forms on an artery wall. If these plaques rupture, they can block blood flow to critical organs such as the heart or brain and can lead to heart attack or stroke. Despite the many different forms of cardiovascular disease, the molecule cholesterol is a common denominator for most of them. Therefore, in order to understand coronary heart disease, we first need to take a look at the cholesterol molecule. According to Roman mythology, Janus is the guardian of portals and patron of beginnings and endings. Just like the two-faced Roman god, cholesterol is a double-edged sword for the human body. On the one hand, it is an essential building block for many crucial ingredients the body needs. On the other hand, it can be lethal when it forms plaques on the surface of the arteries and subsequently causes coronary heart disease. Make no mistake, cholesterol is vital to our existence. It is most abundant in our brains—23% of total body cholesterol resides there, making up 1/10th of the solid substance of the brain.

Reflections

2009 ◽  
Author(s):  
Jie Jack Li
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Pharmaceutical Industry ◽  
Ldl Cholesterol ◽  
Bone Fractures ◽  
High Standard ◽  
Heart Attacks ◽  
Wide Range ◽  
The World ◽  
History Of

The story of statins is a success story for science (both basic and applied) and scientists (in both academia and industry). It contains one of the classic scientific and marketing battles in the history of the pharmaceutical industry. More important, it has been a great boon for the millions of patients who have benefited from statins in preventing coronary heart disease. The story of the statins is a triumph of the heart. Statins, a class of cholesterol-lowering drugs, have revolutionized the landscape of coronary heart disease treatment. Since Merck’s marketing of Mevacor in 1987, the world has benefited from statins in numerous ways. As a class of drugs, statins have set standards on numerous fronts in helping manage LDL cholesterol, one of the major risk factors for coronary heart disease. Statins set a high standard in efficacy, a high standard in safety, and a high standard in financial success for the patients, payers, and the pharmaceutical industry. Not only do statins greatly reduce cholesterol and lower mortality in people at risk for heart attacks, but some studies also suggest that they might help prevent or treat a wide range of ailments, including Alzheimer’s disease, multiple sclerosis, bone fractures, some types of cancer, macular degeneration, and glaucoma. The world has already benefited from the statins in many ways. Low is good, but lower is even better. Fifty years ago, the connection between cholesterol and coronary heart disease was still in question. Twenty years ago, the merit of lowering LDL cholesterol was not even unanimously agreed upon. Cholesterol drugs before the statins, such as resins, niacin, and fibrates, worked to some extent but were also seriously limited by their side effects. Thanks to the emergence of the statins, with Mevacor as the first on the market in 1987, all these questions on the relationship between cholesterol and coronary heart disease are answered beyond any shadow of doubt. Today, the statins have annual sales of more than $20 billion. Hundreds of millions of patients have benefited from statins by delaying and even preventing coronary heart disease.

Heart disease and gender in mass print media

2008 ◽  
Vol 14 (1) ◽  
pp. 18-20
Author(s):  
Juanne Clarke
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
Heart Attack ◽  
Print Media ◽  
Men And Women ◽  
High Achieving ◽  
And Gender ◽  
Developed World ◽  
As If ◽  
The Way

Heart disease is a major cause of death, disease and disability in the developed world for both men and women. Nevertheless, the evidence suggests that women are under-diagnosed both because they fail to visit the doctor with relevant symptoms and because doctors tend to dismiss the seriousness of women's symptoms of heart disease. This study examines the way that popular mass print media present the possible links between gender and heart disease. The findings suggest that the ‘usual candidates’ for heart disease are considered to be high achieving and active men for whom the ‘heart attack’ is sometimes seen as a ‘badge of honour’ and a symbol of their success. In contrast, women are less often seen as likely to succumb, but they are portrayed as if they are and ought to be worried about their husbands. Women's own bodies are described as so problematic as to be perhaps useless to diagnose, because they are so difficult to understand and treat.

scholarly journals Taking Every Opportunity to Reduce Cardiovascular Risk

2015 ◽  
Vol 10 (3) ◽  
Author(s):  
Mitch Levine
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Smoking Cessation ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
North America ◽  
Cause Of Death ◽  
Common Type ◽  
Men And Women ◽  
Cardiovascular Morbidity And Mortality

In North America, heart disease is the leading cause of death for both men and women; accounting for approximately 1 in every 4 deaths1,2. Coronary heart disease (CHD) is the most common type of heart disease and two of the key risk factors for CHD are hypertension and diabetes. After smoking cessation programs, the detection and management of hypertension, and of diabetes, may be the next most important interventions that physicians can offer to reduce the risk of cardiovascular morbidity and mortality.

Abstract 16508: Effect of Disclosure of Genetic Risk for Coronary Heart Disease on Information Seeking and Information Sharing in a Randomized Clinical Trial (from the MI-GENES Investigators)

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Sherry-Ann Brown ◽  
Hayan Jouni ◽  
Erin Austin ◽  
Tariq Marroush ◽  
Iftikhar Kullo ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Information Sharing ◽  
Risk Score ◽  
Information Seeking ◽  
Genetic Risk ◽  
Heart Attack ◽  
Internet Use ◽  
Risk Disclosure ◽  
Chd Risk

Background: Whether disclosing genetic risk for coronary heart disease (CHD) to individuals influences information seeking and information sharing is not known. Methods: The myocardial infarction genes (MI-GENES) trial randomized participants aged 45-65 years who were at intermediate risk for CHD based on conventional risk factors and not on statins, to receive their conventional risk score (CRS) or their CRS plus a genetic risk score (GRS) based on 28 susceptibility variants. CHD risk was disclosed by a genetic counselor and then discussed with a physician. Surveys to assess information seeking (including internet use and accessing electronic health records (EHR)) were completed before and three and six months after risk disclosure. Information sharing parameters were assessed after risk disclosure. We assessed whether these behaviors differed by GRS disclosure, or by high (≥1.1) or low (<1.1) GRS. Adjustments were made for age, sex, family history of CHD, baseline CRS and GRS, and education. Results were reported as the mean difference (and standard error) in the score for each survey response between the GRS and CRS participants, with significance determined by regression analysis. Results: GRS participants accessed their EHR to obtain information related to their CHD risk more than CRS participants (0.14 ± 0.06, p=0.03). Overall internet use (0.61 ± 0.23, p=0.01), as well as internet use to seek information about heart disease (0.14 ± 0.06, p=0.02) and how genetic factors affect risk of having a heart attack (0.23 ± 0.07, p=0.002), was significantly higher in the GRS participants. GRS participants shared information about heart attack risk with others (0.35 ± 0.13, p=0.007), particularly family members (0.1 ± 0.04, p=0.02), (V4: 0.10 ± 0.05, p=0.05), and their primary care provider (V4: 0.15 ± 0.07, p=0.03) more than CRS participants. Internet use, EHR access, and information sharing did not differ significantly between the high and low GRS groups. Conclusions: Disclosure of GRS for CHD resulted in greater information seeking (including internet use and EHR access) and information sharing by study participants. Disclosure of genetic risk for CHD may help advance patient engagement in precision medicine.

Effectiveness of Long-term Heparin-induced Extracorporeal LDL Precipitation (HELP) in Improving Coronary Calcifications

2003 ◽  
Vol 26 (3) ◽  
pp. 252-255 ◽  
Author(s):  
A. Ramunni ◽  
L.F. Morrone ◽  
G. Baldassarre ◽  
E. Montagna ◽  
A. Saracino ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Evidence ◽  
Ldl Cholesterol ◽  
Clinical Manifestations ◽  
Mean Value ◽  
Mean Values ◽  
Plasma Pool ◽  
Before And After

There is clear clinical evidence that a drastic lowering of plasma LDL- Cholesterol (LDL) concentrations significantly reduces the rate of total and coronary mortality as well as the incidence of cardiovascular events in high risk hypercholesterolemic patients. We describe the case of a 51-year-old woman with coronary heart disease (CHD) who presented with increasing angina on exertion in 1995, at the age of 45. She suffered from a heterozygous familial hypercholesterolemia and in 1985 her total cholesterol (TCHO) was 328±62 mg/dl (mean value of ten analysis). After ten years of statins her mean values (20 analysis, 2 per year) were: TCHO 259±71, LDL 209±47, HDL 35±7 mg/dl. Coronary angiography (CA) performed in 1995 disclosed three vessel coronary heart disease with significant stenoses of the distal right coronary artery, multiple calcifications of the interventricularis artery and multiple plaques with significant stenoses in the ramus circumflexus. The woman underwent coronary by-pass surgery. Thereafter the patient was treated for six years with HELP in biweekly intervals, in combination with statins. TCHO, LDL, HDL and fibrinogen (fb) levels were measured before and after each treatment. Their mean values for an amount of 120 sessions were: TCHO pre 216±23, post 111±18 LDL pre 152±16 post 67±18, HDL pre 42±5 post 35±4 fb pre 306±48 post 125±31. In 2001 a new CA was performed. Calcifications disappeared and stenoses were identical to the previous CA or reduced. There were no further clinical manifestations of CHD. We trust that the clinical benefit of the HELP procedure will be substantial for those patients who have problems in clearing LDL from their plasma pool and who are at the same time sensitive to elevated LDL levels by the development of premature coronary sclerosis.

Heart Disease Diagnosis Using Fuzzy Supervised Learning Based on Dynamic Reduced Features

2014 ◽  
Vol 5 (3) ◽  
pp. 78-101 ◽  
Author(s):  
Walid Moudani ◽  
Mohamad Hussein ◽  
Mariam abdelRazzak ◽  
Félix Mora-Camino
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Potential Risk ◽  
Heart Attack ◽  
Rough Set Theory ◽  
Disease Diagnosis ◽  
Fuzzy Classification ◽  
Classification Problems ◽  
Potential Risk Factors

The health industry collects huge amounts of health data which, unfortunately, are not mined to discover hidden information. However, there is a lack of effective analytical tools to discover hidden relationships and trends in data. Information technologies can provide alternative approaches to the diagnosis of the heart attach disease. In this study, a proficient methodology for the extraction of significant patterns from the Coronary Heart Disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to develop an innovative fuzzy classification solution approach based on dynamic reduced sets of potential risk factors using the promising Rough Set theory which is a new mathematical approach to data analysis based on classification of objects. Therefore, we propose to validate the classification using Multi-classifier decision tree to identify the risky heart disease cases. This work is based on a dataset collected from several clinical institutions based on the medical profile of patient. Moreover, the experts' knowledge in this field has been taken into consideration in order to define the disease, its risk factors, to follow up the issue results, and to establish significant knowledge relationships between medical factors related to Coronary Heart Disease. To identify cases of heart attack, experiments of several classification techniques have been performed leading to rank the suitable techniques. The reduction of potential risk factors contributes to enumerate dynamically one or more optimal subsets of the potential risk factors of high interest which implicitly leads to reduce the complexity of the classification problems while maintaining the prediction classification quality. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Association of apolipoprotein E polymorphism, low-density lipoprotein cholesterol, and coronary artery disease.

1986 ◽  
Vol 32 (5) ◽  
pp. 778-781 ◽  
Author(s):  
H J Lenzen ◽  
G Assmann ◽  
R Buchwalsky ◽  
H Schulte
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Apolipoprotein E ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Apolipoprotein E Polymorphism ◽  
Artery Disease

Abstract We determined the frequencies of genetic apolipoprotein E isoforms in 570 survivors of myocardial infarction, all with demonstrable coronary heart disease, as compared with 624 healthy persons. In controls, E-4/E-3 heterozygosity was associated with total cholesterol concentrations of 1985 (SD 364) mg/L and low-density lipoprotein (LDL)-cholesterol concentrations of 1306 (SD 332) mg/L. Significantly lower values, 1811 (SD 312) mg/L and 1121 (SD 274) mg/L, respectively, were observed for E-3/E-2 heterozygous persons. In survivors of myocardial infarction, the respective values were significantly higher than in controls, differing between E-4/E-3 and E-3/E-2 heterozygous patients by 233 and 220 mg/L, respectively. Moreover, E-4/E-3 heterozygosity was accompanied by earlier age of myocardial infarction (48.8 +/- 7.4 years) as compared with E-3/E-2 heterozygosity (53.4 +/- 6.9 years) and E-3/E-3 homozygosity (51.2 +/- 7.7 years). Evidently, apolipoprotein E polymorphism can contribute to total and LDL-cholesterol concentrations in serum, thereby affecting risk of coronary heart disease and myocardial infarction.

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