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Prevention of atheroschlerosis in hyperuricemia and in gout
Thursday June 29, 2000: Read by litle Abstracts T:W31 Prevention of CVD
316
ThT14:W31 I Correlations between risk factors in coronary heart i
disease
G. Krstacic l, M. Martihis 2, J. Crnugelj 2. llnstituteforprevention cardiovascular diseases, management and rehabilitation; 2Institute Rudjer Boskovic, Zagreb, Croatia
Objective: To study correlation between coronary risk factors and the occurrence of the ST segment abnormalities. Methods: The data describe occurrence of ST segment abnormalities in 300 patients with CHD who were divided into five groups according to symptoms and objective diagnostic cardiovascular parametars. The data describe patients who entered our Institute during the period of a few months. The descriptor set used includes anamnestic data (10 items), laboratory test results (6), the resting ECG data (5), the exercise test ECG data (6), ecbocardiography results (2), vectorcardiography results (2) and long term continuous ECG recording data (3). It makes all together 34 data items. The clasiffication of patients was performed by the cardiologist using generally accepted medical knowledge. Results: Complex statistical analysis of the data set (1020 items) shows that some of the descriptors are more significant than the others (like body mass index, diabetes mellitus, arterial hypertension in anamnestic data set, or high density lipoproteins, acid uric and fibrinogen in laboratory tests). Analysis is performed by calculating the pair and higher order correlation functions between different descriptors. Conclusion: The performed analysis generally verifies the existing medical practice in non-invasive diagnosis of CHD and has been used for development of an useful machine learning algorithm. 3
ThT15:W31 ] The MEDPED-FH p r o g r a m in Australia I.R. Hamilton-Craig, M. Platts. For the MEDPED-FH (Australia) Steering Committee; Adelaide, South Australia
Objective: To present the current status of the MEDPED-FH (Make Early Diagnosis, Prevent Early Deaths in Familial Hypercholesterolemia) program in Australia as part of the international program to improve the management of patients with FH. Methods: Patients with FH were registered with the Adelaide coordinating centre after notification by participating physicians. Patients and physicians completed questionnaires based on the Utah international coordinating centre. Follow-up of relatives was performed through telephone and mall contact. Results: Clinical criteria only were used to diagnose FH, as LDL receptor DNA analyses were not available at the time of data collection. Since the program began in 1993, 572 patients have been registered, and 1233 of their relatives contacted to inform them of the need for lipid testing and further family studies if indicated. At present 38 specialist physicians and general practitioners participate in the program. This compares with an estimated FH population of about 35,000 for a total population of 17 million, with about 17000 general practitioners. At present a multinational multicentre trial of a new statin is being conducted in some patients registered in the MEDPED-FH program. Condusious: Only a small proportion of FH patients has been registered in the MEDPED-FH program, through the participation of a small proportion of participating physicians, in spite of several years of continued effort. Current research collaboration is encouraging. In order to achieve its goals of greater public awareness of FH, the MEDPED program needs to be oriented to the general population rather than to medical practitioners, and requires greater funding to achieve success.
1 ThT16:W31 ] Estrogen replacement therapy (ERT): Prevalence in a cardiology ambulatory A.A. Faludi. t, M.C. Bertolami 1, A.T. Paes I , J.M. Aldrighi 2 . llnstituto Dante Pazzanese de Cardiologia; 2Facaldade de Sadde Ptlblica da Universidade de Sto Paulo, S~o Paulo, Brazil
Objective: To determine the prevalence of ERT among postmenopansal women who searched a cardiology ambulatory for primary prevention of coronary heart disease (CHD) by controlling risk factors (RF). Methods: An observational study where all postmenopausal women more than 50 years old, that were present for a consultation in a cardiology ambulatory during 1999, answered a questionnaire about the use of ERT, physical activity and smoking and were submitted to an investigation of hypertension, diabetes mellitus, hyperlipidemia and obesity. Results: Five hundred seventy six women were included, ages varying from 50 to 92 years old (average = 64.5 4- 8.73). From the total of women, 70.8%
were hypertensive, 21.7% diabetics, 84.2% hypedipidemic and 29.3% obese. ERT was being used by 18.1% of the participants. Among the remaining group, the causes of not using ERT were: no gynecological consultation (29%), no indication by the gynecologist (24.1%), adverse effects (10.5%), suspension by the gynecologist (5.4%), no interest in the use (4.9%), belief of prejudicial effects (4.2%) and contra-indication by the gynecologist (3.8%). ERT was used by only 15.9% of the hypertensive women (p = 0.052), 5.6% of diabetics (p < 0.001), 15.9% of hyperlipidemic (p = 0.003) and 8.9% of obese (p < 0.001). Conclusion: The prevalence of ERT in the studied population was low. It was significantly lower among women who presented diabetes, hyperlipidemia or obesity, with a tendency to lesser use by hypertensive women. I
I ThT17:W31 I Risk factors for coronary heart disease in children: A study in Lodz, Poland A. Sierakowska-Fiia3ek, M. Wosik-Erenbek. Dep. of Pediatrics MiL Med. Academy, Lodz, Poland Coronary heart disease becomes a major cause of mortality and morbidity in Poland. It is mainly adults disease but atherosclerosis begins in childhood and preventive program should be started in childhood. The aim of our study was to estimate the risk factors in children. Our studies demonstrate that the most frequent risk factors are obesity, hypertension arterialis, smoking habits, low physical activity, family history of coronary heart disease and lipid disorders. The study comprised 496 children aged 7-15 from primary school. Among of them we have selected 55 children with risk factors. Results: We have shown that the most frequent risk factors of atherosclerosis were lipid disorders and obesity. Most investigated children had more then one risk factor (60%). Among lipid disorders our studies demonstrate that the most frequent are: increase level of cholesterol and triglicerydes, decrease of HDL-cholesterol. We determined the total plasma lipid enzymatic methods. Conclusion: High frequency of risk factors of atherosclerosis in investigated group demonstrates the necessity of using such investigations as a common activity in public health.
IThT18:W31] Prevention of atheroschlerosis in hyperuricemia and in i
gout
J. Figueirinhas l, Luis Lima Faleiro 2, J. Vaz Patto 1, M -a. Carmo Martins 3, M a. Odete Rodrigues3 . 1Reumatologia; 2Cardiologia-lnstituto Portugu~s de Reumatologia; 31nstituto Nacional de Satide. Lisboa, Portugal
Objective: Most common causes of the death in the industrialized countries, is the cardio and cerebrovascular disease. The precocious detection of risk factores in the populations should be imposed. At this time, we are doing the approach of the prevention of the atherosclerosis in the rheumatic chronic diseases, just comming the refering results of gout and hyperuricemia, both situations very frequent in Portugal. Patients and Methods: We observed 166 patients with mean age 59.4 years, being 161 male (97.0%). The laboratory methods for lipid parameters were: CHOD-PAP goes total cholesterol and HDL-cholesterol after precipitation of LDL + VLDL with magnesium and tungstate ions, the totally enzymatic method was used goes triglyceride determinations and the LDL cholesterol quantified using the friedwall it formulates. It goes glycemia and uric acid were used enzymatic methods. Results and Discussion: The hypemricemia was present in 162 patients (97.6%), the hypercholesterolemia, in 81 (48.8%) the hypertriglyceridemia in 101 (60.8%), the hyperlipoproteinemia type IV in 81 (48.8%) and the reduction of the HDL cholesterolemia in 23 (13.9%). Other risk factors are the obesity verified in 88 (53.0%), diabetes in 47 (28.3%) and the hypertension in 104 (62.7%). There are frequently associated with tabagic and alcoholic habits and in the family history it appears the gout in 44 (26.5%), the obesity in 66 (39.1%), the diabets in 39 (23.5%) and the arterial hypertension in about 50%. Conclusion: The results suggest the need of the atherosclerosis prevention in this chronic rheumatic disease, in order to prevent the modifiable risk factors.
Xllth International Symposium on Atherosclerosis, Stockholm, Sweden, June 25-29, 2000
316
ThT14:W31 I Correlations between risk factors in coronary heart i
disease
G. Krstacic l, M. Martihis 2, J. Crnugelj 2. llnstituteforprevention cardiovascular diseases, management and rehabilitation; 2Institute Rudjer Boskovic, Zagreb, Croatia
Objective: To study correlation between coronary risk factors and the occurrence of the ST segment abnormalities. Methods: The data describe occurrence of ST segment abnormalities in 300 patients with CHD who were divided into five groups according to symptoms and objective diagnostic cardiovascular parametars. The data describe patients who entered our Institute during the period of a few months. The descriptor set used includes anamnestic data (10 items), laboratory test results (6), the resting ECG data (5), the exercise test ECG data (6), ecbocardiography results (2), vectorcardiography results (2) and long term continuous ECG recording data (3). It makes all together 34 data items. The clasiffication of patients was performed by the cardiologist using generally accepted medical knowledge. Results: Complex statistical analysis of the data set (1020 items) shows that some of the descriptors are more significant than the others (like body mass index, diabetes mellitus, arterial hypertension in anamnestic data set, or high density lipoproteins, acid uric and fibrinogen in laboratory tests). Analysis is performed by calculating the pair and higher order correlation functions between different descriptors. Conclusion: The performed analysis generally verifies the existing medical practice in non-invasive diagnosis of CHD and has been used for development of an useful machine learning algorithm. 3
ThT15:W31 ] The MEDPED-FH p r o g r a m in Australia I.R. Hamilton-Craig, M. Platts. For the MEDPED-FH (Australia) Steering Committee; Adelaide, South Australia
Objective: To present the current status of the MEDPED-FH (Make Early Diagnosis, Prevent Early Deaths in Familial Hypercholesterolemia) program in Australia as part of the international program to improve the management of patients with FH. Methods: Patients with FH were registered with the Adelaide coordinating centre after notification by participating physicians. Patients and physicians completed questionnaires based on the Utah international coordinating centre. Follow-up of relatives was performed through telephone and mall contact. Results: Clinical criteria only were used to diagnose FH, as LDL receptor DNA analyses were not available at the time of data collection. Since the program began in 1993, 572 patients have been registered, and 1233 of their relatives contacted to inform them of the need for lipid testing and further family studies if indicated. At present 38 specialist physicians and general practitioners participate in the program. This compares with an estimated FH population of about 35,000 for a total population of 17 million, with about 17000 general practitioners. At present a multinational multicentre trial of a new statin is being conducted in some patients registered in the MEDPED-FH program. Condusious: Only a small proportion of FH patients has been registered in the MEDPED-FH program, through the participation of a small proportion of participating physicians, in spite of several years of continued effort. Current research collaboration is encouraging. In order to achieve its goals of greater public awareness of FH, the MEDPED program needs to be oriented to the general population rather than to medical practitioners, and requires greater funding to achieve success.
1 ThT16:W31 ] Estrogen replacement therapy (ERT): Prevalence in a cardiology ambulatory A.A. Faludi. t, M.C. Bertolami 1, A.T. Paes I , J.M. Aldrighi 2 . llnstituto Dante Pazzanese de Cardiologia; 2Facaldade de Sadde Ptlblica da Universidade de Sto Paulo, S~o Paulo, Brazil
Objective: To determine the prevalence of ERT among postmenopansal women who searched a cardiology ambulatory for primary prevention of coronary heart disease (CHD) by controlling risk factors (RF). Methods: An observational study where all postmenopausal women more than 50 years old, that were present for a consultation in a cardiology ambulatory during 1999, answered a questionnaire about the use of ERT, physical activity and smoking and were submitted to an investigation of hypertension, diabetes mellitus, hyperlipidemia and obesity. Results: Five hundred seventy six women were included, ages varying from 50 to 92 years old (average = 64.5 4- 8.73). From the total of women, 70.8%
were hypertensive, 21.7% diabetics, 84.2% hypedipidemic and 29.3% obese. ERT was being used by 18.1% of the participants. Among the remaining group, the causes of not using ERT were: no gynecological consultation (29%), no indication by the gynecologist (24.1%), adverse effects (10.5%), suspension by the gynecologist (5.4%), no interest in the use (4.9%), belief of prejudicial effects (4.2%) and contra-indication by the gynecologist (3.8%). ERT was used by only 15.9% of the hypertensive women (p = 0.052), 5.6% of diabetics (p < 0.001), 15.9% of hyperlipidemic (p = 0.003) and 8.9% of obese (p < 0.001). Conclusion: The prevalence of ERT in the studied population was low. It was significantly lower among women who presented diabetes, hyperlipidemia or obesity, with a tendency to lesser use by hypertensive women. I
I ThT17:W31 I Risk factors for coronary heart disease in children: A study in Lodz, Poland A. Sierakowska-Fiia3ek, M. Wosik-Erenbek. Dep. of Pediatrics MiL Med. Academy, Lodz, Poland Coronary heart disease becomes a major cause of mortality and morbidity in Poland. It is mainly adults disease but atherosclerosis begins in childhood and preventive program should be started in childhood. The aim of our study was to estimate the risk factors in children. Our studies demonstrate that the most frequent risk factors are obesity, hypertension arterialis, smoking habits, low physical activity, family history of coronary heart disease and lipid disorders. The study comprised 496 children aged 7-15 from primary school. Among of them we have selected 55 children with risk factors. Results: We have shown that the most frequent risk factors of atherosclerosis were lipid disorders and obesity. Most investigated children had more then one risk factor (60%). Among lipid disorders our studies demonstrate that the most frequent are: increase level of cholesterol and triglicerydes, decrease of HDL-cholesterol. We determined the total plasma lipid enzymatic methods. Conclusion: High frequency of risk factors of atherosclerosis in investigated group demonstrates the necessity of using such investigations as a common activity in public health.
IThT18:W31] Prevention of atheroschlerosis in hyperuricemia and in i
gout
J. Figueirinhas l, Luis Lima Faleiro 2, J. Vaz Patto 1, M -a. Carmo Martins 3, M a. Odete Rodrigues3 . 1Reumatologia; 2Cardiologia-lnstituto Portugu~s de Reumatologia; 31nstituto Nacional de Satide. Lisboa, Portugal
Objective: Most common causes of the death in the industrialized countries, is the cardio and cerebrovascular disease. The precocious detection of risk factores in the populations should be imposed. At this time, we are doing the approach of the prevention of the atherosclerosis in the rheumatic chronic diseases, just comming the refering results of gout and hyperuricemia, both situations very frequent in Portugal. Patients and Methods: We observed 166 patients with mean age 59.4 years, being 161 male (97.0%). The laboratory methods for lipid parameters were: CHOD-PAP goes total cholesterol and HDL-cholesterol after precipitation of LDL + VLDL with magnesium and tungstate ions, the totally enzymatic method was used goes triglyceride determinations and the LDL cholesterol quantified using the friedwall it formulates. It goes glycemia and uric acid were used enzymatic methods. Results and Discussion: The hypemricemia was present in 162 patients (97.6%), the hypercholesterolemia, in 81 (48.8%) the hypertriglyceridemia in 101 (60.8%), the hyperlipoproteinemia type IV in 81 (48.8%) and the reduction of the HDL cholesterolemia in 23 (13.9%). Other risk factors are the obesity verified in 88 (53.0%), diabetes in 47 (28.3%) and the hypertension in 104 (62.7%). There are frequently associated with tabagic and alcoholic habits and in the family history it appears the gout in 44 (26.5%), the obesity in 66 (39.1%), the diabets in 39 (23.5%) and the arterial hypertension in about 50%. Conclusion: The results suggest the need of the atherosclerosis prevention in this chronic rheumatic disease, in order to prevent the modifiable risk factors.
Xllth International Symposium on Atherosclerosis, Stockholm, Sweden, June 25-29, 2000