ARYA Atherosclerosis
Year:2006 | Volume:1 | Issue:3|Papers Count:12

Historically, infectious diseases and undernutrition have been the focus of global health care initiatives by international organizations. However, there has been a move in recent years towards the prevention and management of chronic non-communicable diseases (NCD) such as cardiovascular disease (CVD), osteoporosis, diabetes mellitus and cancer. NCDs have spread rapidly and are no longer restricted to highly industrialized countries. For the first time, in 1997 the World Health organization (WHO) reported that NCDs constitute a more significant contribution to ill health throughout the world than do infectious diseases. In contrast to the situation in industrialized countries, it has been shown that in some developing economies, obesity begins much earlier in life and reaches a peak by the early forties. According to WHO estimates, by the year 2020, NCDs will account for approximately three-quarters of all deaths in the developing world. In these societies, rapid modernization is associated with a cluster of NCD and unhealthy lifestyle including smoking, physical inactivity and rapid increase in junk food consumption. This has been described as the "Lifestyle Syndrome" or the "New World Syndrome", which is responsible for the very high rates of mortality in developing nations, and is likely to create an enormous socioeconomic and public health burden for poorer nations in the near future.      

INTRODUCTION: Liposuction is a surgical procedure effective in reducing body fat, with growing application in conjunction with diet and exercise therapy in the treatment of obesity. In view of the positive effect of weight reduction on cardiovascular disease (CVD) risk factors, such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), systolic and diastolic pressure, lipid profile, fasting blood sugar, insulin resistance, inflammatory markers (e.g. chronic reactive protein: CRP), antioxidant capacity, fibrinogen and lipoprotein A (Lpa), this study was conducted to assess the effect of liposuction as a therapeutic procedure in the treatment of obesity. METHODS: A total of 24 non-diabetic obese women (BMI>30) with a mean age of 48.7±7.3 years were studied. Before liposuction, the subjects filled out questionnaires obtaining demographic information. Complete physical examination, measurement of waist and hip circumference, height, weight and calculation of WHR and BMI were performed. Fasting blood samples were taken to measure fasting blood glucose, total cholesterol, highdensity lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), fibrinogen, antioxidant capacity, CRP, lipoprotein A, serum insulin, and insulin resistance. All measurements and physical examinations were repeated 12-14 weeks after liposuction. Data were analyzed with SPSS11 software using paired t-test and repeated measure ANOVA. RESULTS: WHR, BMI and LDL decreased significantly following liposuction (P<0.05). Other parameters, however, did not change significantly, although there were signs of positive changes. DISCUSSION: Liposuction decreases BMI, WHR and LDL within 12-14 weeks of liposuction. Providing these reductions are maintained, liposuction may prove valuable in reducing CVD risk factors, besides offering a means for obesity control.      

INTRODUCTION: Coronary artery disease (CAD) is the main cause of mortality in industrial and developing countries. New risk factors including infections are under investigation as potential factors. One of these infectious agents is Helicobacter pylori, which has been investigated in numerous studies. This study was designed in view of the controversies surrounding the impact of Helicobacter pylori on the prognosis of patients with acute coronary syndrome (ACS). METHODS: All patients with ACS including unstable angina and myocardial infarction who were referred to Fatemieh Hospital between 20 February 2003 and 19 February 2004 and were admitted to the CCU ward were enrolled in this cohort study. A total of 411 patients with ACS were evaluated for Helicobacter pylori serologically, and the occurrence of cardiac events needing angioplasty or coronary surgery was assessed. RESULTS: Mean age of patients was 59.97±38.12 years and 56% of them were male. The serology test for Helicobacter pylori infection was positive in 45.6±12.38%, negative in 43.8%, and borderline in 10.6% of patients. 191 patients had unstable angina and 220 patients had myocardial infarction. In a one-month follow-up, 10% of the patients developed cardiac events and PCI or CABG was performed in 6.1% (16.1% totally). One-month occurrence of cardiac events in the group with Helicobacter pylori infection was 11.9% vs. 19.3% in the group without infection (χ2 =3.078, P=0.079). DISCUSSION: This prospective study showed that Helicobacter pylori infection has no effect on short term prognosis of patients with ACS.      

INTRODUCTION: Anxiety is associated with a higher risk of cardiovascular disease. The present study aims to assess the extent of carotid artery atherosclerosis in patients with and without anxiety disorder. METHODS: In a cross-sectional study, two groups of participants with and without anxiety disorder (40 and 80 subjects, respectively) according to DSM-IV were selected from the Psychiatry Clinic of Noor Hospital and Mental Health Unit of Isfahan Cardiovascular Research Center by simple sampling method. Evaluation of major risk factors was performed after recording demographic characteristics. Zung questionnaire was used to assess severity of anxiety. Carotid ultrasonography was performed in three portions of carotid arteries, bilaterally, and Intima-Media Thickness (IMT) ≥8 mm was considered as atherosclerosis. Statistical analysis included t-test, χ2 and logistic regression. RESULTS: Mean age of participants with and without anxiety disorder was 49.07±12.08 and 48.68±11.02 years, respectively. Major atherosclerosis risk factors did not differ significantly between the two groups. IMT values in all portions were significantly higher in the anxiety group. The presence of anxiety was positively associated with the presence of atherosclerosis in all branches, except for the left common carotid artery. DISCUSSION: Anxiety increases the risk of cardiovascular disease, hence measures must be adopted to control anxiety with pharmacologic and nonpharmacologic interventions to reduce atherosclerosis.      

INTRODUCTION: Doppler echocardiography is used to evaluate global myocardial performance. An index of myocardial performance (Tei Index) can be of great prognostic value in heart failure. This study was performed to assess the correlation between Tei Index (TI) and left ventricular end diastolic pressure (LVEDP). METHODS: The study group consisted of 38 patients. Each patient underwent ventriculographic evaluation (all had EF≤45). Eighteen patients had LVEDP<15 (14 males, 4 females, 57±6 years old) and 20 subjects (15 males, 5 females, 56±7 years old) had LVEDP≥15. Using Doppler echocardiography, TI was determined for all patients and compared. RESULTS: Mean TI value was significantly different between subjects with LVEDP<15 and those with LVEDP<15 (0.55±0.18 vs. 0.76±0.19, P<0.001, T=4.1). DISCUSSION: In patients with systolic heart failure (EF≤45), TI was significantly lower in subjects with LVEDP<15 compared to those with LVEDP≥15. Thus, TI may be useful for noninvasive assessment of LVEDP in heart failure.      

INTRODUCTION: Hypertension is one of the most prevalent chronic diseases worldwide. Because of its chronicity, hypertension requires life-long therapy. Many patients tend to discontinue therapy and seek alternative treatments. In this study, we evaluated the efficacy of two behavioral therapeutic techniques, namely relaxation and biofeedback-assisted relaxation in reducing blood pressure. METHODS: Fifty-six mildly hypertensive men (aged between 30 and 60 years) who did not use any pharmacological treatment, took part in this study. The participants were randomly divided into three groups, relaxation (group one), biofeedback-assisted relaxation (group two) and control (group three). The treatment course consisted of ten sessions (every other day). Relaxation was performed in groups one and two for 15 minutes during each session. In group 2, for another 15 minutes at the end of each relaxation session, blood pressure was measured at 2- to 3-minute intervals and declared to the patient. Heart rate and blood pressure were measured and recorded before and after each session. In the control group, only blood pressure was measured at each session. Stress was measured using Malekpoor questionnaire with 67% validity. Anxiety was measured by Ketel's questionnaire. The patients filled stress and anxiety questionnaires before and after the study period (20 days). RESULTS: Mean systolic and diastolic blood pressures decreased after the study period in groups one and two. There was a significant difference between groups one and three (P<0.05) and between groups two and three (P<0.05). DISCUSSION: Relaxation and biofeedback-assisted relaxation techniques can reduce systolic and diastolic blood pressure, hence their benefits in the treatment of hypertension can be used in appropriate settings.    

INTRODUCTION: Adequate intake of fruits and vegetables as part of the daily diet could help prevent major non-communicable diseases including osteoporosis. Some nutrients abundant in fruits and vegetables have been shown to affect bone health. In the present study we evaluated fruit and vegetable intake in postmenopausal women with osteopenia who had referred to bone mineral densitometry center of Shariati hospital in Tehran. METHODS: The present cross-sectional study was carried out on 51 healthy postmenopausal women aged 45-60 years. Bone mineral density was measured by Dual Energy X-ray Absorptiometry at lumbar spine and total hip. All women were osteopenic according to WHO criteria. Food groups’ intake was assessed by 2 days 24 hour recall. Bone resorption was calculated by measuring carboxy-terminal telopeptide of type Ι collagen (crosslaps) and bone formation by measuring serum osteocalcin. RESULTS: No significant correlation was found for current food groups’ intake and bone mineral density at either lumbar spine or total hip. Fruit and vegetable intake was significantly negatively correlated with osteocalcin level (r = -0.4, P< 0.001). Serum osteocalcin level in those who consumed more than 400 grams of fruit and vegetable daily was significantly lower than in the others (18±6.5 compared with 30±13.7, P<0.05). DISCUSSION: Increasing fruit and vegetable intake up to WHO recommendations for prevention of many chronic diseases can also be effective in prevention of osteoporosis and reducing fracture risk in postmenopausal osteopenic women. Intake of at least 400 grams  of fruits and vegetables daily can complement what is currently recommended for osteoporosis prevention.    

INTRODUCTION: The clustering of several cardiovascular disease risk factors such as abdominal obesity, hypertension, dyslipidemia and disturbances in glucose metabolism has been termed the Metabolic Syndrome (MS). The MS has been shown to predict cardiovascular disease (CVD) and diabetes. Epidemiological studies have demonstrated that CVD is the main cause of worldwide mortality; they have also linked diabetes to an increased risk of mortality due to CVD. METHODS: According to the ATP III (Adult Treatment Panel) reports, individuals having three or more of the following criteria are defined as having the MS: abdominal obesity (waist circumference > 102 cm in men and >88 cm in woman), hypertriglyceridemia (triglyceride ≥ 150 mg/dl), low high-density lipoprotein (HDL) cholesterol (HDL<40 mg/dl in men and <50 mg/dl in women), high fasting blood sugar (FBS) (FBS≥110 mg/dl) and high blood pressure (BP) (BP≥130/85 mmHg). The SPSS package (SPSS Chicago IL) was used and the significance level was set at P<0.05. RESULTS: Overall, the age-adjusted prevalence of the MS was 25.4% and 21.7% in the urban and rural areas of Isfahan, respectively. It was the highest among 50-59-year-old rural Isfahani women (68.9%) and the lowest among rural Araki men (5.6%). DISCUSSION: We found approximately 21.9% of Iranian adults living in Central Iran to have the MS. In summary, this study showed an increasing risk of the MS among middleaged woman in urban areas owing to their physical quality of life. The results indicate that primary prevention should not only consider biological risk factors, but also take account of sociodemographic variables to identify individuals at high risk for diabetes and cardiovascular disease.    

INTRODUCTION: Adequate intake of fruits and vegetables (at least five servings a day) is recommended as a nutritional behavior of great importance in prevention of chronic diseases. This study aimed to compare the intake of fruits and vegetables in adult males and females of Isfahan and to assess its association with personal and demographic factors, as well as seasons. METHODS: This cross-sectional study was performed on 123 healthy adults (64 males and 59 females) during the cold season (fall and winter) and warm seasons (spring and summer). Study samples were aged 30 to 60 years and were residents of Isfahan. Fruit and vegetable consumption was assessed using a 110-item semi-quantitative food frequency questionnaire on fruits and vegetables. Validity of the questionnaire was evaluated in a pilot study through comparison with two 24-hour food recalls and four food diaries. Mean consumption of fruits and vegetables was analyzed in males and females, as well as in age and educational groups. The relationship between the amount of fruit and vegetable consumption and different factors including age, sex, level of education and occupation was determined through stepwise linear regression. RESULTS: Mean fruit consumption in men and women in cold seasons was 275.3±100.8 and 234.5±116.5 grams per day, respectively (P<0.05), and in warm seasons 217.6±95.5 and 185.3±77.1 grams per day, respectively (P<0.05). Vegetable consumption in men and women in cold seasons was 291.5±93.5 and 245.7±76.6 grams per day, respectively (P<0.05) and in warm season 197±76.3 and 166.4±60.7 grams per day, respectively (P<0.05). The proportion of men who consumed more than 5 servings of fruits and vegetables in a day was significantly greater than women (P<0.05). Fruit and vegetable intake in men educated below junior school and high school was significantly higher than in their female counterparts (P<0.05). Fruit and vegetable intake in single men was significantly lower than in their female counterparts (P<0.05). DISCUSSION: The findings show the effectiveness of social and cultural factors on the pattern of fruit and vegetable intake.      

INTRODUCTION: Prevalence of cardiovascular diseases (CVD) is 19.4% in Iran and diabetes mellitus is an important CVD risk factor in this country. Non-insulin-dependent diabetes mellitus (type II DM) is associated with increased morbidity and mortality due to atherosclerosis. With cardiac rehabilitation (CR) we can modify CVD risk factors such as type II DM and play an important role in decreasing its mortality and morbidity. We investigated the effects of CR on cardiac patients with and without type II DM. METHODS: In this retrospective before-and-after study we analyzed data from 496 cardiac patients (419 with type II DM and 77 without type II DM). All of the subjects completed demographic data questionnaires and underwent weight and height measurement, exercise test to assess exercise capacity (EC), echocardiography, and blood test to assess lipid profile and fasting blood glucose. The subjects then participated in a 24-session CR program. Each session consisted of 10 minutes warm-up, 40 minutes aerobic exercise, 10 minutes cool-down and 20 minutes relaxation. They also took part in 8 educational sessions on life style modification, diet therapy and stress management supervised by CR team (a cardiologist, a physician, a physiotherapist, a nurse, a nutritionist and a psychiatrist). At the end of the program, all measurements, exams and tests were repeated. Data were analyzed with SPSS11.5 using independent t-test at level of P<0.05. RESULTS: We studied 419 non-diabetics (mean age: 55.61±9.41 years) and 77 diabetics (mean age: 58.59±7.76 years). Mean EC increased significantly after CR in both groups. In the diabetic group, EC increased significantly compared to the non-diabetic group (62.21±133.40 vs. 33.68±31/42, P=0.02). Mean levels of triglyceride, cholesterol, LDL cholesterol, as well as body mass index and heart rate decreased significantly after CR in both groups. However, no significant difference was seen between the two groups in respect of these variables. DISCUSSION: CR is an effective intervention in diabetics as well as non-diabetics especially given its remarkable effects in improving EC as a critical indicator of mortality and morbidity of diabetic patients. Hence we suggest these patients undergo CR programs.      

INTRODUCTION: Lifelong behavior and risk factors of chronic diseases extend from early life to adulthood. It seems that dietary habits and unhealthy food consumption, as well as passive smoking play an important role in the development of such diseases. Multiple studies have shown that healthy lifestyle education in preschool children improves their knowledge, attitude and practice about healthy lifestyle. This study was conducted to evaluate the effect of lifestyle education with educational posters in daycare centers on preschool children. METHODS: In an interventional study, 250 preschool children were selected via 2-stage random cluster sampling and taught tips on healthy lifestyle via educational posters. Their knowledge on healthy lifestyle was assessed before and after (1 week and 3 months) education via a picture-questionnaire, and their practice and behavior were assessed before and after education via their favorite choice of snack in daycare centers. Collected data were analyzed using SPSS13 by paired t-test and Man Whitney test. RESULTS: The knowledge and practice scores of the studied subjects improved significantly one week after intervention compared with baseline, and persisted until the third month after education. DISCUSSION: Healthy lifestyle education via poster for preschool children can significantly improve their knowledge and practice towards healthy lifestyle.    

INTRODUCTION: Loud noise is more than a hazard to hearing. Noise can hinder communication, isolate workers, and impact on production and in some cases cause physiological health problems. It can also cause an array of health problems and create a dangerous workplace. Hence it is important for workers to reduce their exposure to noise. Noise is defined as sounds that are unwanted, unpredictable and uncontrollable. If noise levels are not reduced, their impact (physiological impact in particular) on health will be grave. This study measured and evaluated sound levels and assessed their adverse health impacts on textile industries workers. METHODS: Time-weighted average sound level was measured with B & KEJ 2231 sound level meter. Sound levels were measured at all locations in textile factories. Two groups of workers were selected according to location (group A: major, group B: minor). Group A comprised workers exposed to more than 85 dB (A). Their age range was 20-50 years with a working history of 5-30 years. Noise-related physiological parameters were evaluated using questionnaires. The questionnaires obtained information on blood pressure, gastrointestinal and cardiovascular condition, bowl disorders, dizziness, sleep problems, and fatigue. RESULTS: Mean systolic and diastolic blood pressure was 117.5 mmHg and 74 mmHg respectively in group A, and 118 mmHg and 77.8 mmHg respectively in group B. DISCUSSION: There is no evidence to support the relationship between noise levels above 85 db (A) and high blood pressure, loss of sleep and gastrointestinal problems, however, there is significant evidence supporting the relationship between noise levels above 85 Db and adverse physiological effects.