Effects of Coronary Heart Disease Risk Factors on Atherosclerosis of Selected Regions of the Aorta and Right Coronary Artery

McGill, Henry C.; McMahan, C. Alex; Herderick, Edward E.; Tracy, Richard E.; Malcom, Gray T.; Zieske, Arthur W.; Strong, Jack P.

doi:10.1161/01.atv.20.3.836

Cited by 265 publications

(193 citation statements)

References 31 publications

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“…A study of Ͼ3,000 men and women participating in the third examination cycle of the Framingham Offspring study demonstrated that non-HDL-C levels were significantly associated with CAD (25). More recent work has also shown significant associations between high levels of non-HDL-C and the presence of extensive fatty streaks in both abdominal aortas, right coronary arteries, and left anterior descending arteries (26,27).…”

Section: Lipid Concentration Trendsmentioning

confidence: 93%

Trends in Lipid Management Among Patients With Coronary Artery Disease

et al. 2003

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OBJECTIVE -To examine lipid management trends for coronary artery disease (CAD) patients with and without diabetes in order to determine whether those with diabetes are beginning to receive aggressive lipid management consistent with their elevated risk.RESEARCH DESIGN AND METHODS -We used outpatient medical record data from 47,813 CAD patients seen at 295 medical practices participating in the Quality Assurance Program II between 1996 and 1998. Lipid testing rates, lipid treatment rates, and serum lipid concentrations are described for CAD patients with and without diabetes within strata of office visit date.RESULTS -Lipid testing and treatment rates increased and mean lipid levels decreased markedly over time. Those with diabetes were 26% less likely to have a lipid profile and 17% less likely to receive a lipid-lowering medication than their nondiabetic counterparts, and this disparity did not diminish over time. Among treated patients, mean non-HDL cholesterol (non-HDL-C) and LDL cholesterol (LDL-C) declined less rapidly over time for patients with than without diabetes.CONCLUSIONS -Although impressive progress was made in the outpatient lipid management of CAD patients, lipid management for CAD patients with diabetes improved no more rapidly, and in some cases less rapidly, than for nondiabetic patients. Given their higher risk, more effort is needed to ensure that CAD patients with diabetes receive aggressive lipid management. Diabetes Care 26:991-997, 2003T he increased risk of cardiovascular events associated with diabetes is well established (1-6). In a recent report from a Finnish cohort, Haffner et al. (2) demonstrate that diabetic patients without a prior myocardial infarction (MI) had approximately the same 7-year incidence of MI (ϳ20%) as nondiabetic patients with a prior MI (2). This finding is consistent with a recent report of patients hospitalized with unstable angina or non-Q-wave MI showing that the 2-year event rate for diabetic patients without prior coronary artery disease (CAD) was similar to that of nondiabetic patients with prior CAD (3). Another important finding from both studies, and one especially relevant for this report, is that the incidence of new MI among diabetic patients with a prior MI is more than twice that of patients with either prior MI or diabetes alone. Others have demonstrated that CAD patients with diabetes are more likely to die following an MI than their nondiabetic counterparts (4 -6).Thus, a multitude of clinical and epidemiological evidence indicates that individuals with both CAD and diabetes are at an exceptionally high risk for new cardiovascular events and mortality compared with those with either CAD or diabetes alone (1-10). Patients with combined CAD and diabetes represent one of the highest risk populations commonly seen by physicians in the outpatient setting.Although at high risk for future cardiovascular events, individuals with CAD and diabetes are as likely as those without diabetes to benefit from 3-hydroxy-3-methylglutaryl coenzyme A reductase in...

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Section: Lipid Concentration Trendsmentioning

confidence: 93%

Trends in Lipid Management Among Patients With Coronary Artery Disease

et al. 2003

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“…50 It seems plausible that the introduction of healthy lifestyle habits (diet low in fat and cholesterol, physical activity, balanced energy intake with expenditure, no smoking) in childhood could not only stop the progression but also promote the regression of lesions. 46,48 -50…”

Section: Stein and Stein Arrest Of Progression Or Regression Of Athermentioning

confidence: 99%

Does Therapeutic Intervention Achieve Slowing of Progression or Bona Fide Regression of Atherosclerotic Lesions?

Stein

2001

ATVB

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Abstract-This review focuses on the regression of atherosclerosis in humans and experimental animals. It highlights the difficulties to determine unequivocally whether with a given therapeutic intervention, such as diet, drugs, or apheresis, the progression of lesions was curtailed or bona fide regression of atherosclerotic lesions was achieved. It seems appropriate to mention that 2 very different ways to measure regression were used in experimental animals and in humans. Regression in animals was determined mainly in the aorta or coronary arteries isolated at post mortem, and the criteria used were degree of sudanophilia and/or aortic wall thickness and cellular composition or cholesterol content. In humans, the evaluation of regression relied mainly on quantitative coronary angiography. The literature of the past decade is reviewed selectively but not exhaustively, and in some instances, a brief historical overview is given.

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“…47,48 This study provides that our military community was not immune against the consequences of today's way of life that promotes for technology comfort, little fiber and fast food consumption. The prevalence of pre-HTN/HTN and some associated risks, most of which are modifiable, such as obesity, smoking, and dyslipidemia is rather challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Apparently, both young-and old-age populations in this area of the world are growing hypertensive. 4,9 Elsewhere, too, there is a growing concern that young adults have a relatively comparable risk of developing cardiovascular events 46,47,48 In the 2008 study to identify the prevalence of pre-HTN/HTN, their risks among recruits in Taif 26 , the recruits' age ranged between 18 and 50y, and more than 70% of them were younger than 40. While 80.3% of this study's cohort had high BP, HTN only involved 19.1% of the 2008-study recruits (17.3% pre-HTN: 1.7% HTN=10.2:1).…”

Section: Discussionmentioning

confidence: 99%