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Prevention of Atherosclerosis with Ramipril Treatment:Clinical Trials Research Unit:"Atherosclerosis, or accumulation of fatty deposits in the walls of the blood vessels, leads to high blood pressure, which in turn is associated with vascular disease of the heart, the brain and elsewhere in the limbs and body. It was thought that, by lowering blood pressure pharmacologically in those people known to have vascular disease, a measurable improvement might be seen in the degree of atherosclerosis in the carotid arteries in the neck." http://www.ctru.auckland.ac.nz/research/part-2/ Estrogen in the Prevention of Atherosclerosis:Women's Health Information Center:"Conclusions: Overall, the average rate of progression of subclinical atherosclerosis was slower in healthy postmenopausal women taking unopposed ERT with 17-estradiol than in women taking placebo. Reduction in the progression of subclinical atherosclerosis was seen in women who did not take lipid-lowering medication but not in those who took these medications." http://www.ama-assn.org/special/womh/library/scan/vol_8/no_1/hodis.htm Phytochemicals act against cancer, but do they have some effect in the prevention of atherosclerosis?:European vegetarian Union:"Atherosclerosis has been the most frequent cause of death in industrialized countries for a quite long time and much research has been carried out to find a way out of this cul-de-sac. People are still thinking of the answer in the form of pills, surgery or, what worse, in some totally irrational approaches. It is very common for us to try to find something that, maybe, does not even exist, and, at the same time, simply ignore something right under our noses or within easy reach. This is also the case of phytochemicals, abundant in all kinds of fruit and vegetables, as well as in different sorts of spices or wild herbs. During the 1970s, great advances were made in the understanding of the role of cholesterol and, even the lay public accepts the need for reducing the increased "blood cholesterol" today. But, the cholesterol theory was not able to explain all cases of cardiovascular diseases in all circumstances. Thus, a new approach had to be used to evaluate other influences" http://www.european-vegetarian.org/evu/english/news/news964/igor.html Rosiglitazone and Prevention of Atherosclerosis :hosppract.com:"An early stage in the development of an atherosclerotic lesion is marked by massive accumulation of lipid-laden macrophages in arterial walls. Highly expressed in these "foam cells" is PPAR-gamma (peroxisome proliferator-activated receptor gamma), a nuclear receptor that regulates fat-cell development and glucose homeostasis. PPAR-gamma is the molecular target of a class of insulin-sensitizing drugs, the thiazolidinediones, now available for the management of type 2 diabetes mellitus. Theoretically, PPAR-gamma agonists might either promote or inhibit atherosclerosis, since they appear to be negative regulators of macrophage activation, an action that might be either helpful or destructive under differing circumstances. To investigate this matter, a consortium of academic and pharmaceutical researchers based in part at the University of California, San Diego, evaluated the effects of rosiglitazone (a new thiazolidinedione) and similar PPAR-gamma agonists on LDL receptor-deficient male mice. In this animal model, the usual rapid development of atherosclerosis was strongly inhibited. The inhibition correlated with improved insulin sensitivity and with decreased expression of tissue-toxic cytokines such as tumor necrosis factor-alpha." http://www.hosppract.com/cc/2001/cc0101.htm#2 Why is preventing coronary atherosclerosis important?:asiamedicinenet.com:"Coronary atherosclerosis is the major cause of heart attacks. Heart attacks are the major cause of sudden unexpected death among otherwise healthy adults in the prime of their lives. Heart attacks are also a significant cause of heart failure in this country. Heart failure considerably decreases the patient's longevity and quality of life. In dollar terms, coronary heart disease is costly. The total cost of coronary artery bypass surgery, coronary angioplasty and stenting, medications, and hospitalizations exceeds 50 billion dollars annually" http://www.asiamedicinenet.com/script/main/art.asp?li=AMN&ArticleKey=9749&page=4#tocf http://www.aapspharmaceutica.com/news/articles/2001/011501pharmreport.asp#dis:aapspharmaceutica.com:"New Target for Prevention of Atherosclerosis. Hypercholesterolemia plays a major role in the development of atherosclerosis. In mammals, cholesterol exists as a sterol or in the form of fatty acid esters (cholesterol coupled through an ester bond to any of several long chain fatty acids). Most of the cholesterol that accumulates in arterial plaques is in ester form. AcylCoA:cholesterol acyltransferase (ACAT) is responsible for intracellular cholesterol esterification and is now thought to be a target for prevention of atherosclerosis. There are two known genes encoding the ACAT enzymes, ACAT1 and ACAT2. Researchers have recently demonstrated that ACAT2, which is localized in intestine and liver in mice, monkeys, and presumably in humans, is a key cholesterol esterification enzyme for the development of hypercholesterolemia [Nature Med 2000;12:1341-47]. The investigators determined that ACAT2-deficient mice have a reduced capacity to absorb cholesterol and are resistant to diet-induced hypercholesterolemia." http://www.aapspharmaceutica.com/news/articles/2001/011501pharmreport.asp#dis Prevention and treatment of atherosclerosis:medweb.bham.ac.uk:"To help prevent atherosclerosis, a person needs to eliminate the controllable risk factors, high blood cholesterol levels, high blood pressure, cigarette smoking, obesity, and lack of exercise. So depending on a particular person's risk factors, prevention may consist of lowering cholesterol levels, lowering blood pressure, quitting smoking, losing weight, and beginning an exercise program. Fortunately, taking steps to achieve some of these goals helps achieve others. For instance, starting an exercise program helps a person lose weight, which in turn helps lower cholesterol levels and blood pressure. Quitting smoking helps lower cholesterol levels and blood pressure. In people who already have a high risk of heart disease, smoking is particularly dangerous. Cigarette smoking decreases the level of good cholesterol (high-density lipoprotein cholesterol or HDL cholesterol) and increases the level of bad cholesterol (low-density lipoprotein cholesterol or LDL cholesterol)." http://medweb.bham.ac.uk/http/depts/path/Teaching/foundat/athero/athero7.htm Therapeutic Uses of Vitamin E in Prevention of Atherosclerosis:thorne.com:"Objective: The purpose of this review is to present the evidence-based pharmacotherapeutic properties of vitamin E and provide clinical recommendations for use in the arena of atherosclerosis. Methods: A literature search was conducted from 1966 through March 1999. All usable papers were retrieved, with large, randomized, double-blinded, clinical trials and epidemiological trials receiving emphasis. Results: Vitamin E, a lipid soluble vitamin, is a potent antioxidant. Several epidemiological studies have demonstrated positive relationships between vitamin E intake and the prevention of atherosclerotic heart disease; however, only one, large randomized clinical trial (The CHAOS Trial) has been conducted using more than 400 IU per day of vitamin E. Positive outcomes included a 77-percent reduction in nonfatal myocardial infarction (MI), but no corresponding reduction in mortality. Several large clinical trials are ongoing, investigating vitamin E for the prevention of atherosclerosis. Much less work has been undertaken studying vitamin E for prevention of cerebro- and peripheral vascular disease, but there appears to be promise in these areas as well." http://www.thorne.com/altmedrev/fulltext/vite4-6.html Implications for Prevention From the Pathobiological Determinants of Atherosclerosis in Youth Study:jama:"Results Intimal lesions appeared in all the aortas and more than half of the right coronary arteries of the youngest age group (15-19 years) and increased in prevalence and extent with age through the oldest age group (30-34 years). Fatty streaks were more extensive in black subjects than in white subjects, but raised lesions did not differ between blacks and whites. Raised lesions in the aortas of women and men were similar, but raised lesions in the right coronary arteries of women were less than those of men. The prevalence of total lesions was lower in the right coronary artery than in the aorta, but the proportion of raised lesions among total lesions was higher in the right coronary artery than in the aorta." http://jama.ama-assn.org/issues/v281n8/abs/joc81013.html Heart Attack and Atherosclerosis Prevention:about-heartdisease.com:"Coronary artery disease, which involves atherosclerosis of the blood vessels leading to the heart, and the heart attacks it causes, is the leading killer in the United States. The primary risk factors for coronary artery disease are diabetes, male gender, family history of coronary disease at an early age, smoking, elevated blood pressure (hypertension), high LDL cholesterol, and low HDL cholesterol. The control of diabetes and blood pressure has resulted in a small benefit in preventing heart attacks. On the other hand, stopping smoking has resulted in a significant reduction in heart attack risk. Additionally, the treatment of elevated cholesterol, particularly with the statin class of drugs (pravastatin (Pravachol), lovastatin (Mevacor), and others), has significantly reduced the rate of death from heart disease." http://www.about-heartdisease.com/ Search Nursing Diabetics http://www.nursingdiabetics.com/A-Z_list/ ******************************************************
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