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1
Bagés, Nuri. "Psychosocial risk factors and coronary heart disease". [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 2000. http://arno.unimaas.nl/show.cgi?fid=6899.
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Ashton, Emma Louise, i emma ashton@deakin edu au. "Effects of dietary constituents on coronary heart disease risk factors". Deakin University. School of Biological and Chemical Sciences, 2000. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20061207.153511.
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Coronary Heart Disease (CHD) is a major cause of death in Western countries. Mediterranean and Asian populations have a lower risk of death from CHD compared to Westernised population, as do vegetarian versus omnivorous populations. Dietary constituents of traditional diets consumed by these populations are thought to influence both the classical risk factors for CHD, and the more recently identified risk factors, such as oxidative modification of low density lipoprotein (LDL), LDL particle size, arterial compliance and haemostatic factors. The aim of this thesis was to examine the effects of several food components, particularly soybean and monounsaturated fat (MUFA), on CHD risk factors through 3 carefully controlled dietary interventions, and a cross-sectional study.
A randomised crossover dietary intervention study was conducted in 42 healthy males to investigate the effect on CHD risk factors of replacing lean meat with tofu, a soybean product regularly consumed by Asian populations, while controlling all other dietary factors. The tofu diet resulted in significantly lower total cholesterol and triacylglycerol levels compared to the lean meat diet, and LDL particles that were more resistant to in vitro oxidative modification. However, insulin, fibrinogen, factor VII, and lipoprotein (a) were not significantly different on the 2 diets.
A postprandial study was subsequently conducted to investigate any acute effects of a tofu test meal on the oxidative modification of LDL in 16 male subjects. There was no significant difference between the susceptibility of LDL to oxidative modification before and after the tofu meal.
Twenty eight healthy subjects completed a separate randomised crossover dietary intervention comparing a high MUFA fat diet, using an Australian high oleic sunflower oil, with a low fat, high carbohydrate diet on CHD risk factors. The high MUFA oil diet significantly increased high density lipoprotein cholesterol compared to the low fat diet as well as producing LDL that were more resistant to oxidative modification. Neither the size of the LDL particle nor arterial compliance were significantly different on the 2 diets.
Twelve matched pairs of vegetations and omnivores were also studies to compare the habitual diet of a low and higher risk population group, to compare their risk factors and identify dietary constituents that may explain the differences. The vegetarians consumed less saturated fat (SFA) and dietary cholesterol while consuming more polyunsaturated fat, dietary fibre and vitamin E compared to omnivores. The vegetarians had lower total cholesterol, LDL cholesterol and triacylglycerol levels compared to the omnivores and had LDL particles that were more resistant to in vitro oxidation.
These findings contribute to our knowledge about the dietary constituents that can alter some CHD risk factors in healthy subjects, and which could reduce the risk of developing CHD. Investigations in high risk groups might reveal even more benefits.
3
Sarwar, Nadeem. "Emerging molecular and genetic risk factors for coronary heart disease". Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611549.
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Ramsay, Jean Marilyn Christina. "Psychosocial risk factors for coronary artery disease and symptom reporting". Thesis, University of East London, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.361848.
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Ashton, William David. "Coronary risk factors in women in the United Kingdom". Thesis, University of Salford, 1997. http://usir.salford.ac.uk/42977/.
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Coronary heart disease (CHD) has traditionally been regarded as a male disease and, because of this, the magnitude of the problem in women is often overlooked. Yet, cardiovascular disease (CVD) and CHD in particular, remains, next to cancer, the leading cause of morbidity and mortality in women. The longstanding emphasis on the problem of CHD in men, has resulted in a widespread tendency to minimise the incidence and severity of the disease in women. Moreover, most epidemiologic studies examining morbidity and mortality from CHD have focused largely on men, producing a significant gender gap in the research. The lack of information on CHD risk factors and prevention of heart disease in women in Britain is of particular concern, given that British women have one of the highest rates of coronary disease in the world. The Marks and Spencer Coronary Risk Factor Study (MSCRFS) is a cross-sectional and prospective study of CHD risk factors in female employees of the Marks and Spencer retail organisation. The present study is confined to an analysis of cross-sectional data from 14,077 women screened between June 1988 and July 1991. The prevalence and distribution of a variety of lipid, lipoprotein, biochemical, anthropometric and lifestyle-related CHD risk factors among women in the United Kingdom is described, together with their key interrelationships. In addition, the metabolic impact of exogenous hormones, specifically oral contraceptives and postmenopausal hormone replacement, is described. This study - the largest of its kind in the UK - provides reference ranges for a wide range of CHD risk factors in women in the UK, and gives a unique insight into the impact of a variety of lifestyle-related factors on CHD risk. There is an enormous potential for reducing the very high risk of CHD among women in the UK, which needs to be addressed. Based on these data, health strategies designed to reduce morbidity and mortality from CHD can be planned and implemented more effectively.
6
Lindberg, Gunnar. "Serum sialic acid and cardiovascular disease risk". Malmö : Dept. of Community Health Sciences, Lund University, 1992. http://books.google.com/books?id=YPxqAAAAMAAJ.
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Wilkins, Kathryn. "Socioeconomic status and risk factors for coronary heart disease, Canada, 1971-1985". Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=64061.
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Lopes, Philippe. "The relationships between respiratory sinus arrhythmia and coronary heart disease risk factors". Thesis, University of Ulster, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287137.
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Dean, Chalkley Tracey Shelly. "The effects of soy isoflavones on risk factors for coronary heart disease". Thesis, King's College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269628.
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Yasmin. "Coronary heart disease : relationships between some metabolic risk factors and anthropometric variables". Thesis, University of Cambridge, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.339727.
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Liu, Longjian, i 劉隆健. "Population based studies of fibrinogen in relation to other coronary heart disease risk factors, coronary heart disease and diabetesmellitus in Hong Kong". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31237447.
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Huang, Wen Li. "A comparative review study of risk factors and physical activities related to heart disease". Thesis, University of Macau, 2018. http://umaclib3.umac.mo/record=b3952606.
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Liu, Longjian. "Population based studies of fibrinogen in relation to other coronary heart disease risk factors, coronary heart disease and diabetes mellitus in Hong Kong /". Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19926583.
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Chan, Choi Wan, i res cand@acu edu au. "The Development and Testing of an Instrument for Measuring Awareness of Coronary Heart Disease Risk Factors Reduction in a Hong Kong Chinese Population". Australian Catholic University. School of Nursing (NSW & ACT), 2008. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp191.26022009.
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Coronary heart disease (CHD) claims millions of lives every year worldwide. In the developed countries, a clear connection has been documented between a decline in CHD mortality and modifiable risk factor reductions. While raising awareness of CHD risk factors reduction is imperative, no valid instrument backed by robust psychometric data is available to measure people‘s awareness in this regard. In addition, especially among the Chinese population, despite many studies already conducted concerning awareness of CHD-related issues, inconsistency in how people define and measure this concept remains. This study aimed to develop a valid instrument that measures Hong Kong Chinese people‘s awareness of CHD risk factors reduction. The study involved two phases. Phase I involved qualitative data collection through 18 focus group interviews (n=100). Participants in this phase included members from three groups: (1) the low risk general public, (2) people having multiple CHD risk factors either with or without CHD, and (3) people who have been diagnosed of myocardial infarction. The objective of this phase was to identify key elements and to clarify the concept inherent in awareness, from which served as a basis to generate items to form the awareness instrument. Upon completion of this phase, three main categories were generated including: CHD knowledge, perceptions of CHD, and risk control efficacy. Under these main categories, twelve subcategories emerged. Under the category of CHD knowledge, the subcategories were: pathological causes of CHD, external forces in causing CHD, modifiable and non-modifiable risk factors, CHD trends, symptoms of CHD, and knowledge of CHD prevention. Under the category of perceptions of CHD, the subcategories were: perceived seriousness of CHD and perceived risk. Under the category of risk control efficacy, the subcategories were: planning of health actions, control over risk reducing behaviour, perceived opportunities to understand CHD, and chest pain appraisal/perceptions. A total of 70 items were generated to form the Awareness of Coronary heart disease Risk Factors Reduction (ACRFR) scale. The second phase of this study focused on the evaluation of the psychometric properties of ACRFR scale. The objective of this phase was to establish the validity and reliability of the instrument. It commenced with determining the content validity by expert review, followed by identifying the factor structure, construct validity and reliability. A good content validity index (CVI) of 0.84 was achieved. The factor structure of ACRFR was identified through exploratory factor analysis (EFA) data collected from a sample (n=232) of the three groups as described in phase one. The final results revealed a seven-factor model with 43 items accounting 49.5% of the total explained variance. The seven factors were: (1) CHD knowledge, (2) planning of health actions, (3) perceived ability to monitor health-related behaviour, (4) perception of risk, (5) perceived opportunities to understand CHD, (6) perceived seriousness of CHD, and (7) chest pain appraisal/perceptions. The factor structure of ACRFR was further cross-validated by confirmatory factor analysis (CFA) in another independent sample (n=225) of the three groups. Goodness of fit statistics fell within acceptable ranges: 2 / d = 1.6, RMSEA = 0.053, NNFI = 0.92, IFI = 0.93, CFI = 0.93. The factor model was further supported by hypothesis testing and known-groups comparisons. The results of hypothesis testing demonstrated significant correlations between ACRFR and other measures. Known-groups comparisons among subjects with MI, those with CHD and without CHD provided satisfactory evidence for construct validity. Reliability of this developed instrument, as estimated by the internal consistency Cronbach‘s alphas, ranged from 0.60 to 0.90 for each sub-scale and for the total scale was 0.82, and the test-retest reliability was 0.89, suggesting good instrument reliability. While current literature reveals no objectively devised conceptual definition of ACRFR and that no published instrument was made available for healthcare professions to enhance people‘s awareness of reducing CHD, this study fills these gaps. It is envisaged that this developed instrument could assist healthcare professional in accurately estimating people‘s awareness of risk factors reduction that could provide valid and reliable data that could inform future directions in CHD prevention and cardiac health promotion.
15
Lluís, Ganella Carla 1984. "Genetic factors associated with coronary heart disease and analysis of their predictive capacity". Doctoral thesis, Universitat Pompeu Fabra, 2012. http://hdl.handle.net/10803/84185.
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The main expansion of the discovery of genetic variants associated with complex diseases has occurred during the last decade. This expansion has been accompanied, and in some sense motivated, by the desire to use this information to improve the predictive capacity of many diseases with an unidentified familial component, including coronary heart disease (CHD), with the aim of translating this genetic knowledge into clinical practice. This doctoral thesis is structured in two lines of investigation that address distinct aspects of this issue, first to evaluate the possible role of genetic variation in a candidate gene in modulating CHD risk, and second to evaluate whether genetic information can be used to improve risk assessment tools used in clinical practice.
In the first research line (described in Part I), we investigate the contribution of genetic variation in one of the most widely-studied genes in cardiovascular genetics, ESR1, which encodes the Oestrogen receptor α protein. We provide a solid meta-analysis of evidence regarding the most widely-studied variant in this gene and we further explore the role of a broad range of common and uncommon variants in this gene in CHD risk. Using these approaches, we find no evidence of association between the genetic variants studied and CHD risk. However, although we can confidently accept that common genetic polymorphisms are not associated with cardiovascular disease, we cannot discard the possibility that other types of variation in this gene (for instance epigenetic variation) could modify susceptibility to cardiovascular disease, or that other elements of this pathway are associated with an increased risk of CHD. In this research I have provided a reliable answer to this long running unanswered question in cardiovascular genetics, allowing research to re-focus on other elements of this system or other pathways.
In the second line, we explored the possible utility of genetic information obtained from genome-wide association studies (GWAS) in prediction of 10-year risk of CHD events by adding this information to cardiovascular risk functions. We have followed the recommendations proposed by the American Heart Association for evaluating the utility of novel biomarkers in clinical practice, and have demonstrated that although the magnitudes of the effects of these genetic variants on CHD risk are modest, there is a tendency towards improvement in the capacity of the risk functions to predict future CHD events. The translation of genetic information into clinical practice was one of the main motivations for the investment in genome-wide association studies, and my research represents one of the first efforts to explore this possibility.L’expansió principal pel que fa al descobriment de variants genètiques associades amb malalties complexes s’ha dut a terme durant la última dècada. Aquesta expansió ha estat acompanyada, i d’alguna forma motivada, pel desig d’usar aquesta informació per millorar la capacitat de predicció d’aquelles malalties on hi és present un cert component familiar però en les que no es coneixien les variants que conferien un major risc de patir la malaltia, entre elles la cardiopatia isquèmica (CI). La present tesis doctoral està estructurada en dues línies d’investigació que avaluen el possible rol d’un gen candidat en la susceptibilitat de la CI i també avalua la millora en la capacitat de predicció d’un esdeveniment coronari de les eines usades habitualment en la pràctica clínica mitjançant la inclusió d’informació genètica. Més concretament, la primera línea d’investigació es centra en la contribució de la variació genètica en un dels gens més estudiats en relació amb CI: el gen que codifica pel receptor d’estrogens alfa (ESR1). En aquesta línea hem proveït un sòlid meta-anàlisis entre la variant més àmpliament estudiada d’aquest gen i risc coronari i també hem explorat el paper de la majoria de les variants comunes descrites en aquest gen i risc de CI. Mitjançant cap dels anàlisis hem trobat evidència d’associació entre les variants genètiques en aquest gen i el risc de CI. No obstant això, i encara que podem acceptar que les variants genètiques comunes d’aquest gen no estan associades amb esdeveniments coronaris, no podem descartar que altres tipus de variació en aquest gen (com per exemple variació epigenètica) pugui estar modificant la susceptibilitat a patir un esdeveniment coronari, ni tampoc que altres elements de la mateixa cadena de senyalització estiguin associats amb la malaltia. En la segona línea d’investigació, hem explorat el possible paper de les variants genètiques, obtingudes mitjançant estudis d’associació global del genoma (GWAS), en la millora de la capacitat de predicció a 10 anys dels esdeveniments coronaris, mitjançant la seva addició en les funcions de risc cardiovascular clàssiques. Hem seguit les recomanacions proposades per la American Heart Association per l’avaluació en la pràctica clínica de nous biomarcadors, i hem demostrat que, tot i que la magnitud de l’associació d’aquestes variants és modesta, hi ha una tendència cap a la millora de la capacitat de predicció de les funcions de risc.
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Van, Zyl Johet Engela. "Accuracy of risk prediction tools for acute coronary syndrome : a systematic review". Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97069.
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Thesis (MCur)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Background: Coronary artery disease is a form of cardiovascular disease (CVD) which manifests itself in three ways: angina pectoris, acute coronary syndrome and cardiac death. Thirty-three people die daily of a myocardial infarction (cardiac death) and 7.5 million deaths annually are caused by CVD (51% from strokes and 45% from coronary artery disease) worldwide. Globally, the CVD death rate is a mere 4% compared to South Africa which has a 42% death rate. It is predicted that by the year 2030 there will be 25 million deaths annually from CVD, mainly in the form of strokes and heart disease. The WHO compared the death rates of high-income countries to those of low- and middle-income countries, like South Africa, and the results show that CVD deaths are declining in high-income countries but rapidly increasing in low- and middle-income countries. Although there are several risk prediction tools in use worldwide, to predict ischemic risk, South Africa does not use any of these tools. Current practice in South Africa to diagnose acute coronary syndrome is the use of a physical examination, ECG changes and positive serum cardiac maker levels. Internationally the same practice is used to diagnose acute coronary syndrome but risk assessment tools are used additionally to this practise because of limitations of the ECG and serum cardiac markers when it comes to NSTE-ACS. Objective: The aim of this study was to systematically appraise evidence on the accuracy of acute coronary syndrome risk prediction tools in adults. Methods: An extensive literature search of studies published in English was undertaken. Electronic databases searched were Cochrane Library, MEDLINE, Embase and CINAHL. Other sources were also searched, and cross-sectional studies, cohort studies and randomised controlled trials were reviewed. All articles were screened for methodological quality by two reviewers independently with the QUADAS-2 tool which is a standardised instrument. Data was extracted using an adapted Cochrane data extraction tool. Data was entered in Review Manager 5.2 software for analysis. Sensitivity and specificity was calculated for each risk score and an SROC curve was created. This curve was used to evaluate and compare the prediction accuracy of each test. Results: A total of five studies met the inclusion criteria of this review. Two HEART studies and three GRACE studies were included. In all, 9 092 patients participated in the selected studies. Estimates of sensitivity for the HEART risks score (two studies, 3268 participants) were 0,51 (95% CI 0,46 to 0,56) and 0,68 (95% CI 0,60 to 0,75); specificity for the HEART risks score was 0,90 (95% CI 0,88 to 0,91) and 0,92 (95% CI 0,90 to 0,94). Estimates of sensitivity for the GRACE risk score (three studies, 5824 participants) were 0,03 (95% CI0,01 to 0,05); 0,20 (95% CI 0,14 to 0,29) and 0,79 (95% CI 0,58 to 0,93). The specificity was 1,00 (95% CI 0,99 to 1,00); 0,97 (95% CI 0,95 to 0,98) and 0,78 (95% CI 0,73 to 0,82). On the SROC curve analysis, there was a trend for the GRACE risk score to perform better than the HEART risk score in predicting acute coronary syndrome in adults. Conclusion: Both risk scores showed that they had value in accurately predicting the presence of acute coronary syndrome in adults. The GRACE showed a positive trend towards better prediction ability than the HEART risk score.
AFRIKAANSE OPSOMMING: Agtergrond: Koronêre bloedvatsiekte is ‘n vorm van kardiovaskulêre siekte. Koronêre hartsiekte manifesteer in drie maniere: angina pectoris, akute koronêre sindroom en hartdood. Drie-en-dertig mense sterf daagliks aan ‘n miokardiale infarksie (hartdood). Daar is 7,5 miljoen sterftes jaarliks as gevolg van kardiovaskulêre siektes (51% deur beroertes en 45% as gevolg van koronêre hartsiektes) wêreldwyd. Globaal is die sterfte syfer as gevolg van koronêre vaskulêre siekte net 4% in vergelyking met Suid Afrika, wat ‘n 42% sterfte syfer het. Dit word voorspel dat teen die jaar 2030 daar 25 miljoen sterfgevalle jaarliks sal wees, meestal toegeskryf aan kardiovaskulêre siektes. Die hoof oorsaak van sterfgevalle sal toegeskryf word aan beroertes en hart siektes. Die WHO het die sterf gevalle van hoeinkoms lande vergelyk met die van lae- en middel-inkoms lande, soos Suid Afrika, en die resultate het bewys dat sterf gevalle as gevolg van kardiovaskulêre siekte is besig om te daal in hoe-inkoms lande maar dit is besig om skerp te styg in lae- en middel-inkoms lande. Daar is verskeie risiko-voorspelling instrumente wat wêreldwyd gebruik word om isgemiese risiko te voorspel, maar Suid Afrika gebruik geen van die risiko-voorspelling instrumente nie. Huidiglik word akute koronêre sindroom gediagnoseer met die gebruik van n fisiese ondersoek, EKG verandering en positiewe serum kardiale merkers. Internationaal word die selfde gebruik maar risiko-voorspelling instrumente word aditioneel by gebruik omdat daar limitasies is met EKG en serum kardiale merkers as dit by NSTE-ACS kom. Doelwit: Die doel van hierdie sisematiese literatuuroorsig was om stelselmatig die bewyse te evalueer oor die akkuraatheid van akute koronêre sindroom risiko-voorspelling instrumente vir volwassenes. Metodes: 'n Uitgebreide literatuursoektog van studies wat in Engels gepubliseer is was onderneem. Cochrane biblioteek, MEDLINE, Embase en CINAHL databases was deursoek. Ander bronne is ook deursoek. Die tiepe studies ingesluit was deurnsee-studies, kohortstudies en verewekansigde gekontroleerde studies. Alle artikels is onafhanklik vir die metodologiese kwaliteit gekeur deur twee beoordeelaars met die gebruik van die QUADAS-2 instrument, ‘n gestandaardiseerde instrument. ‘n Aangepaste Cochrane data instrument is gebruik om data te onttrek. Data is opgeneem in Review Manager 5.2 sagteware vir ontleding. Sensitiwiteit en spesifisiteit is bereken vir elke risiko instrument en ‘n SROC kurwe is geskep. Die SROC kurwe is gebruik om die akkuraatheid van voorspelling van elke instrument te evalueer en te toets. Resultate: Twee HEART studies en drie GRACE studies is ingesluit. In total was daar 9 092 patiente wat deelgeneeem het in die gekose studies. Skattings van sensitiwiteit vir die HEART risiko instrument (twee studies, 3268 deelnemers) was 0,51 (95% CI 0,47 to 0,56) en 0,68 (95% CI 0,60 to 0,75) spesifisiteit vir die HEART risiko instrument was 0,89 (95% CI 0,88 to 0,91) en 0,92 (95% CI 0,90 to 0,94). Skattings van sensitiwiteit vir die GRACE risiko instrument (drie studies, 5824 deelnemers) was 0,28 (95% CI 0,13 to 0,53); 0,20 (95% CI 0,14 to 0,29) en 0,79 (95% CI 0,58 to 0,93). Die spesifisiteit vir die GRACE risiko instrument was 0,97 (95% CI 0,95 to 0,99); 0,97 (95% CI 0,95 to 0,98) en 0,78 (95% CI 0,73 to 0,82). Met die SROC kurwe ontleding was daar ‘n tendens vir die GRACE risiko instrument om beter te vaar as die HEART risiko instrument in die voorspelling van akute koronêre sindroom in volwassenes. Gevolgtrekking: Altwee risiko instrumente toon aan dat albei instrumente van waarde is. Albei het die vermoë om die teenwoordigheid van akute koronêre sindroom in volwassenes te voorspel. Die GRACE toon ‘n positiewe tendens teenoor beter voorspelling vermoë as die HEART risiko instrument.
17
Marusic, Andrej. "Some relationships between standard and suggested psychosocial risk factors, and ishaemic heart disease". Thesis, King's College London (University of London), 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266596.
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Emberson, Jonathan Robert. "Within-person variation in coronary risk factors : implications for the aetiology and prevention of coronary heart disease". Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1444402/.
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Epidemiological studies clearly demonstrate the importance of numerous risk factors for coronary heart disease (CHD), including blood lipids, blood pressure, cigarette smoking and physical inactivity. These factors are widely believed to account for only around 50% of CHD cases. However, "within-person" variation in coronary risk factors can affect the size and even direction of estimated aetiological relationships, and though these effects have been explored for the univariate relations of blood pressure and blood cholesterol, much uncertainty remains. In this thesis, data from the British Regional Heart Study, a prospective study of cardiovascular disease in middle-aged British men, is used to investigate the extent and effects of "within-person variation" in a range of coronary risk factors. The effects on estimated relations with CHD are examined and the combined importance of the major risk factors to CHD risk assessed. The potential effectiveness of different CHD prevention strategies, and the size and cause of social inequalities in CHD are also estimated. The findings reveal a high degree of within-person variation in both established and novel coronary risk factors. Taking within-person variation into account, CHD risk-relations for blood lipids, blood pressure, cigarette smoking and physical inactivity increase in magnitude though the estimated protective effect from moderate alcohol intake is reduced. After correction for within-person variation, blood cholesterol, blood pressure and cigarette smoking together account for at least 75 80% of CHD cases in British men. Moderate population-wide improvements in these risk factors could there fore greatly reduce population levels of CHD, while "high-risk" strategies, unless applied to a large proportion of the population, are likely to have only a limited effect. Narrow ing social inequalities in CHD would also have a comparatively modest effect on CHD compared with population-wide control of the key causal coronary risk factors.
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Jenneke, Cindy A. N. "The effect of dietary patterns on risk factors for CHD : a comparative study of students residing at the Adventist International Institute of Advanced Studies in the Philippines". Thesis, Link to online version, 2006. http://hdl.handle.net/10019/554.
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Boobier, Wyndham J. "The development of a functional food to reduce selected risk factors associated with coronary heart disease". Thesis, University of South Wales, 2003. https://pure.southwales.ac.uk/en/studentthesis/the-development-of-a-functional-food-to-reduce-selected-risk-factors-associated-with-coronary-heart-disease(0c4a2022-9af5-4b7c-bc44-73f00c90d27e).html.
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Coronary heart disease (CHD) remains one of this country's leading cause of mortality. This study has concentrated on the development of a functional biscuit, which will reduce selected risk factors for heart disease, in particular elevated serum homocysteine. The developed biscuit contains vitamins Be, Bi 2, and folic acid, all of which have been shown to be important in homocysteine metabolism. There were a number of criteria that had to be met for the author to receive the full support of Burton's Foods: (1) The biscuit must remain commercially viable and be accepted by the consumer. (2) Enzymes should not be used in the preparation of the dough. (3) The jam could not be modified in any way. Without exception, these have been successfully achieved. Jammie Dodgers were selected as the control product for a number of reasons. They are one of the UK's best selling biscuits and are consumed by both children and adults. This makes the target number of consumers very large. In addition, the standard product is high in both fat and sugar, its modification into a health promoting biscuit was therefore technically challenging. The product resulting from this project is commercially viable; it is low in fat and sugar, contains the vitamins that will deliver the full RNI on consumption of just two biscuits daily, and is not significantly different to the control product. The product is also palatable. Clinical trials have demonstrated that following consumption of the product, serum homocysteine, an independent risk factor for coronary heart disease, has been significantly reduced. In addition, there appears to be a relationship with consumption of the modified biscuit and a fall in serum lipoprotein(a). It is possible to reduce selected mutable risk factors associated with heart disease, simply by the daily consumption of a product that is liked and consumed by a great number of people. As far as the author is aware, there has been no other development of this kind prior to this study, i.e. a biscuit that will reduce the risk of coronary heart disease by lowering serum homocysteine. This biscuit is therefore the first of its kind.
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Sherriffs, Natalie J. "Risk factors for coronary heart disease and mediation by socio-economic status : An analysis of the 1995 National Health Survey". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2002. https://ro.ecu.edu.au/theses/748.
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As the leading cause of death and disease in Australia, Coronary Heart Disease (CHD) places a significant burden on society. There are many lifestyle factors that are known to increase the risk of CHD. This study looks at both risk factors and protective factors of CHD. Research also shows CHD prevalence to be predicted by socio-economic status (SES) variables. This study aims to identify the extent to which risk and protective factors predict CHD prevalence in an Australian National survey and whether the association between risk factors and CHD is confounded by SES variables. This study used data from the 1995 National Health Survey (NHS/1995) to evaluate known risk factors as well as the mediating effect of SES factors. Risk factors included regular cigarette smoking, physical activity and alcohol consumption. SES variables are education, income, occupation, and an index of socio-economic disadvantage based on residence. Two dependent variables for CHO used in the analysis are the first health condition reported in medical consultation and the reported use of Heart Disease I Blood Pressure (HD/BP) medications. The results indicated that ex-smokers were more likely to report CHD than those who had never smoked and those who were current smokers. Those who engaged in regular exercise were less likely to report CHD. There were no conclusive results for alcohol consumption. While income and SEIFA index, a measure of SES of residential areas, are associated with CHD prevalence, these associations are independent of the risk and protective factor associations. There is no evidence from this study that SES variables confound the effects of known risk and protective factors. The implications of these results are discussed.
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Lee, Alison Claire. "Predictors of behavioural risk factors modification in patients recovering from acute coronary heart disease". Thesis, University of Ottawa (Canada), 1997. http://hdl.handle.net/10393/4312.
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This present investigation is a prospective study of 123 cardiac patients who attended a community-based program of education and support, following hospital admission for acute cardiovascular disease. The objective of the study was to derive a predictive model that would maximally discriminate between participants who were vs. participants who were not successful in modifying a health-risk behaviour. The four behaviours examined were following a low-fat diet, performing regular exercise, weight reduction and smoking cessation. Readiness for change was assessed prior to the commencement of the eight-week program, at post-treatment and at five-month follow-up. Participants were grouped into two outcome groups based on their stage of change as delineated by the Transtheoretical Model. Subjects who were in the action or maintenance stages of change at seven-month follow-up were classified as Progressors, and those who were in pre-action stages were classified as Non-progressors. The variables included in the predictive model were optimism, psychological distress, social intimacy and self-efficacy. Neuroticism was also included to explore its relationship with optimism. Discriminant function analysis showed that the variables that maximally separated individuals who were successful in risk-factor modification from those who were unsuccessful were social intimacy and self-efficacy. A secondary objective of this study was to compare Progressing subjects with Non-progressing subjects on psychological distress and on two Transtheoretical Model measures, decisional balance and the processes of change. Repeated measures analysis of variance indicated a slight reduction over time in scores on the measure of psychological distress for all participants as a group. However, no differences were found in psychological distress between participants who changed their health-risk behaviour and those who did not. Because more subjects than anticipated were successful in changing their target health-risk behaviour, there were insufficient data to further compare successful changers with unsuccessful changers. Thus the data did not provide for a robust test of how individuals progress through the Transtheoretical model stages of change following a coronary event. Overall this thesis emphasizes the importance of the social context of behaviour change as evidenced by the contribution of the measure of social intimacy. In addition, this thesis offers some information on the relationship between personality constructs (e.g., neuroticism) and behaviour change, although this requires further investigation.
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Soedamah-Muthu, Sabita Suvarna. "New and established risk factors for coronary heart disease in type 1 diabetic patients". Thesis, University College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.401881.
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Slunga, Lisbeth. "Serum lipoprotein(a) in relation to ischemic heart disease and associated risk factors". Doctoral thesis, Umeå universitet, Klinisk kemi, 1993. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-101298.
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Lipoprotein(a) (Lp(a)) consists of an LDL-like particle and the specific protein apo(a), which is very similar to plasminogen. Apo(a) contains repeated kringle structures and a serine protease domain, which cannot be activated by t-PA. Lp(a) is considered to be a predictor for atherosclerotic disease. It has been found incorporated in atherosclerotic plaques and inhibits in vitro fibrinolysis. Lp(a) was determined in 1527 randomly selected individuals participating in the Northern Sweden WHO-MONICA project. A weak but significant relation between Lp(a) and increasing age was found. Menopausal status was the strongest independent predictor of Lp(a) level in women. Fibrinogen was independently related to Lp(a) in both sexes. Only a minor fraction of Lp(a) variance could be explained for in a multiple regression model, which is in agreement with the contention that Lp(a) is highly genetically determined. Lp(a) was determined in 1571 patients investigated with coronary angiography because of suspected severe coronary artery disease (CAD). Patients with proven CAD at elective angiography had significantly higher Lp(a) than patients without significant CAD or healthy controls. Lp(a) was found to be an independent discriminator of CAD in both sexes. HLA-DR genotype 13 or 17 was found more frequently in 30 male patients with angiographic CAD at young age (< 50 years) than in 30 age matched controls. These genotypes were common in patients with high Lp(a) levels, which indicates that Lp(a) may be related to immunological processes. The reaction of Lp(a) was investigated in 32 patients with acute myocardial infarction (AMI). Lp(a) increased during the first week, but the response was comparatively weak. Individual Lp(a) responses were heterogeneous and no correlations to infarct size or changes in the acute phase proteins were found. In a randomized cross-over study on 36 hypercholesterolaemic patients treated with simvastatin/placebo during 12+12 weeks Lp(a) did not change significantly, but patients with high Lp(a) levels at baseline tended to develop further increased Lp(a). To conclude, Lp(a) was found to be an independent predictor of angiographic CAD in both men and women. Lp(a) levels are primarily genetically determined and only a small fraction of Lp(a) variance could be explained by other factors in this study. Lp(a) may be related to HLA DR types and immunological processes involved in atherosclerotic disease. Lp(a) increased slightly during the first week of AMI, but was not related to changes in the acute-phase proteins. The effective LDL-lowering agent simvastatin did not influence Lp(a) significantly.Diss. (sammanfattning) Umeå : Umeå universitet, 1993, härtill 5 uppsatser.
digitalisering@umu
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Vedin, Ola. "Prevalence and Prognostic Impact of Periodontal Disease and Conventional Risk Factors in Patients with Stable Coronary Heart Disease". Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-260564.
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The purpose of this thesis was to assess the prevalence and management of established cardiovascular (CV) risk factors and the prevalence and influence of self-reported markers (number of teeth and frequency of gum bleeding) of periodontal disease (PD), a less explored CV risk factor, in patients with stable chronic coronary heart disease (CHD). We studied patients from the global STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial (n=15,828), in which patients with stable chronic CHD were randomized to either darapladib or placebo. Our studies were performed using descriptive statistics and multivariable linear, logistic and Cox regression models. The use of secondary preventive medications was generally high across the whole study population. Despite this, CV risk factors were highly prevalent, including obesity, hypertension and hypercholesterolemia. Achievement of guideline-recommended treatment targets was lacking and little improvement was seen throughout the study duration. Approximately 40% of patients reported having <15 remaining teeth and 25% reported gum bleeding. More tooth loss was associated with a greater CV risk factor burden after adjustment, while the associations for gum bleeding were less evident. After multivariable adjustment for CV risk factors and socioeconomic status, more tooth loss was associated with an increased risk of major adverse CV events (a composite of CV death, myocardial infarction and stroke), CV mortality, all-cause mortality and fatal or non-fatal stroke. We found associations between a higher degree of tooth loss and elevated levels of several prognostic biomarkers known to reflect various pathophysiological mechanisms involved in CV morbidity and mortality. Most biomarkers had little attenuating effect on the relationship between tooth loss and outcomes in a multivariable model. In conclusion, we found an inadequate CV risk factor control despite a high use of evidence-based pharmacological therapies, likely to explain some of the excess risk in CHD patients. Further, we demonstrated a high prevalence of PD markers, tooth loss in particular, that were associated with a wide range of established CV risk factors, prognostic biomarkers and outcomes. Collectively, these findings indicate that tooth loss may be a significant risk factor among patients with stable chronic CHD.
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Warych, Karen. "Intra-individual variation in postprandial lipemia". Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1020153.
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Prediction for future coronary artery disease (CAD) from high-density lipoprotein (HDL) and triglyceride (TG) measurements are based off of a single measurement that has been shown to be variable. To better determine risk for CAD based on blood lipids, studies in the postprandial state are warranted. To assess the reproducibility of TG clearance, 10 men underwent three trials of a 70g oral fat loading test with blood samples collected every two hours for eight hours. These trials were all scheduled at least one week apart. Men who had fasting TG concentrations > 250 mg - dL -' were excluded from the study. Each subject presented to the laboratory having abstained from exercise for 24 hours and alcohol 72 hours prior to the upcoming trial. Each subject was also provided with a standardized frozen dinner to eat the night before at a time which allowed the subject to be 12 hours fasted for the next days' trial. To specifically assess postprandial lipemia, TG concentrations were plotted against bi-hourly collection times to form a curve. The area under this curve was then calculated to determine PPL area. Itwas found that there was no significant difference in area under the TG curve (p = 0.25) for any of the three trials (1096 ± 168, 948 ± 105, and 995 ± 127 mg - dL -' - 8 • hr-' respectively for trials one, two, and three). Pearson correlations between trials were 0.79 for trials one and two, 0.82 for trials two and three, and 0.90 for trials one and three. Also, there was no significant difference in peak TG (p = 0.34) on each of the three trial days (167 ± 27, 150 ± 16, and 151 ± 19 mg • dL -1 in peak TG for trials one, two, and three respectively). Time taken to reach peak TG concentrations (p = 0.20) or time to return to baseline TG (p = 0.27) were not significantly different across three trial days. The men in this study reached peak TG concentrations in this study in 3.2 ± 0.5, 4.0 ± 0.4, 4.0 ± 0.3 hours respectively for trials one, two, and three. Time to return to baseline was 6.8 ± 0.6, 7.4 ± 0.4, 7.8 ± 0.4 hours for trials one through three respectively. Correlations between trials and the lack of a difference between trials using repeated measures ANOVA in regards to PPL area gives some preliminary evidence that some postprandial measures such as PPL area and can be reproduced across trials. However, the intra-individual variation was 19 ± 4% which provides no additional support for reproducibility of PPL. Additionally, results from this study, as well as all others pertaining to the study of reproducibility of PPL are specific to the protocol used and the method of interpretation.School of Physical Education
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Chung, Siu-fung. "A case control study on smoking, alcohol drinking and other risk factors of coronary heart disease in Hong Kong /". Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B23569736.
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Karp, Igor. "Risk factors for coronary heat disease in systemic lupus erythematosus". Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=85922.
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Background. Systemic lupus erythematosus (SLE) is associated with considerably elevated rates of coronary heart disease (CHD). Understanding the reasons for this is crucial for developing effective CHD prevention and treatment in SLE patients.Objective. To gain insights into biological mechanisms underlying the accelerated atherosclerosis in SLE, this thesis examines (i) the longitudinal evolution of traditional coronary risk factors and global coronary risk, and (ii) the independent effects of corticosteroid use and lupus disease activity on this evolution.
Methods. First, a systematic comparison between alternative approaches to global coronary risk assessment was performed based on data from the Framingham Heart Study to determine the optimal method of representing the aggregate impact of individual risk factors. Next, data on up to 30 years of follow up of 310 lupus patients of the Montreal General Hospital Lupus Clinic and 26 years of follow-up of 4,367 control subjects from the Framingham Offspring Study were used to investigate, in separate analyses, the independent associations of lupus disease duration with the global coronary risk and each conventional risk factor. Finally, the lupus cohort was used to study the associations of recent corticosteroid use and recent lupus disease activity with a series of CHD risk factors and global CHD risk. Main analyses relied on multivariable linear mixed models for longitudinal data.
Findings. Updated risk factor values improved the predictive ability of the multivariable coronary risk score compared with prediction based on baseline values. Longer lupus disease duration was associated with increased blood glucose levels, systolic blood pressure and total cholesterol. Recent corticosteroid use and recent lupus disease activity were both positively associated with increases in the levels of conventional risk factors and the global risk.
Conclusions. Conventional coronary risk factors play an especially important role in the etiology of CHD in lupus patients. The accelerated atherosclerosis in SLE could be mediated by conventional coronary risk factors, which are affected by both lupus disease activity and corticosteroid therapy.
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Buri, Robert J. (Robert John). "The Role of Anger/Hostility on Physiological and Behavioral Risk Factors for Coronary Heart Disease". Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc278222/.
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The purpose of this study was to examine the role of anger/hostility on physiological and behavioral coronary heart disease risk factors. It was hypothesized that anger/hostility would contribute to the severity of CHD via consummatory behaviors such as smoking, poor diet, and excessive alcohol consumption. Some researchers suggest that negative consummatory behaviors play a direct causal role in CHD. The present study proposed that hostility predisposes an individual to these behaviors, and that these behaviors in turn, contribute to CHD. Further, it was proposed that some of the anger that exists in CHD patients may result from the individual being unable to participate in some of their previous consummatory behaviors after suffering a myocardial infarction. Also, it was hypothesized that the construct of anger/hostility would be differentially related to consummatory behaviors.
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Masoud, Mohamed Abdulsalam. "Validation of a recently proposed equation for the estimation of small, dense LDL particles from routine lipid measures in a population of mixed ancestry South Africans". Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2490.
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Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2016.Cardiovascular diseases (CVD) are the leading cause of global mortality, of which over 75% occurred in low- and middle-income countries such as South Africa. The lipid profile, specifically decreased levels of high density lipoprotein cholesterol (HDL-C), elevated triglyceride levels and the presence of small-dense low density lipoprotein (sdLDL) has been reported associated with CVD. An increased number of sdLDL is also common in metabolic syndrome (MetS), visceral obesity and diabetes mellitus, the last a known risk factor for CVD. The modification of low density lipoprotein (LDL) size, or number of sdLDL particles, has been reported to significantly reduce CVD risk, but not conclusively so and needs further investigation. In this regard, sdLDL particles are seldom estimated routinely for clinical use because of financial and other limitations. Currently, an alternative approach for estimating sdLDL is to use equations derived from routine lipid measures, as has been proposed by several groups. However, there is a need for extensive evaluation of this equation across different ethnic and disease groups, especially since reports showed an inadequate performance of the equation in a Korean population. The aim of this study was to assess the performance of a recently proposed equation for the estimation of sdLDL in healthy and diabetic mixed ancestry South Africans. Furthermore, we also investigated the role of sdLDL as a cardiometabolic risk factor, as measured against known risk factors such as the glycemic and lipid profiles.
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Smith, William Cairns Stewart. "An epidemiological study of coronary heart disease and its risk factors in Scotland : the Scottish Heart Health Study". Thesis, University of Dundee, 1989. https://discovery.dundee.ac.uk/en/studentTheses/63823b71-1377-4e78-bc4b-4c662c58a289.
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The Scottish Heart Health Study was conducted in response to a report by a Working Group of the Chief Scientist Organisation and followed an initial of the Cardiovascular Epidemiology Unit. The aims of the study were to establish the levels of coronary risk factors in Scotland, to determine the extent to which these risks factors explained the geographical variation in coronary heart disease, and their relative contribution to the prediction of coronary heart disease in a cohort of men and women.The Scottish Heart Health Study is a study of lifestyle and coronary heart disease risk factors in 10 359 men and women aged 40-59 years, in 22 districts of Scotland. The study was conducted in 1984-86, when Scotland had the highest national coronary mortality reported by the World Health Organisation. The study employed standardised methods emphasing quality e4 control based on a World Health Organisation protocol to allow comparisons in place and time, and therefore to provide a definitive baseline against which interventions can be assessed. The cross sectional aspect of the study has been analysed and addresses the first two study objectives. The third objective will only be achieved when sufficient prospective coronary events have occurred.Current cigarette smokers constitute 39% of men and 38% of women, higher levels than those reported in England but lower than previous Scottish reports. Considerable variation in smoking was noted across the study districts from 29% to 52% in men. Mean blood pressure levels were 134/84 mmHg for men and 131/81 mmHg in women, these levels are lower than previous studies in Britain and there was a narrow range of levels across the districts. Mean levels of blood cholesterol were 6.4 mmol/l in men and 6.6 mmol/l in women - as high as other British studies and high by international standards. There was little geographical variation in blood cholesterol noted.High levels of blood cholesterol and cigarette smoking provide a classical explanation for the excess coronary deaths in Scotland, justifying action, but other factors, such as dietary deficiencies, also merit further investigation. The geographical variation in coronary mortality can best be explained by a group of risk factors which all show a social gradient and these include cigarette smoking, physical activity, blood pressure, and the consumption of alcohol, fruit and green vegetables.
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Wong, Ka Yi Carmen. "The relationship between cortisol and stress hyperglycaemia in acute coronary syndromes". Thesis, The University of Sydney, 2011. https://hdl.handle.net/2123/28973.
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Stress hyperglycaemia refers to the transient elevation of blood glucose levels
in individuals with no known history of diabetes mellitus or impaired glucose
tolerance during acute and critical illness. It occurs as a stress response and results
from the complex interaction between the hypothalamic-pituitary-adrenal (HPA) axis
and autonomic nervous system as well as the inflammatory cytokine pathways.
There are no clear guidelines set for defining stress hyperglycaemia in the acutely
and critically ill patients. The reported prevalence of stress hyperglycaemia varied
widely as a result.
Cortisol can be seen as a marker of severity of illness as it becomes elevated
when the HPA axis is activated whilst stress i.e. acute and critical illness is
encountered. It has been shown to contribute to the development of stress
hyperglycaemia which is known to be associated with adverse outcomes and
increased mortality in patients with acute coronary syndromes. However it is unclear
if subjects who develop stress hyperglycaemia have underlying abnormal glucose
metabolism, an exaggerated hormonal response to stress, or both. Similarly, it is
unknown whether stress hyperglycaemia predicts underlying glucose intolerance.
We hypothesised that cortisol is predictive of whether stress hyperglycaemia
is due to stress, or if it is due to underlying glucose intolerance. We therefore aimed
to determine the relationship between illness severity and plasma cortisol
concentration, with the degree of hyperglycaemia in subjects experiencing acute
coronary syndromes (ACS), and their later glucose metabolic status, as well as the
prevalence of stress hyperglycaemia and underlying glucose intolerance in our initial
retrospective pilot and then the subsequent prospective studies.
We have demonstrated that:
- (1) there is a positive correlation between illness severity and admission cortisol
level in patients with acute coronary syndromes;
- (2) there is a positive correlation between illness severity and admission blood
glucose level only in those patients with normal underlying glucose tolerance status;
- (3) there is a positive correlation between cortisol and admission blood glucose
levels only in those patients with normal underlying glucose tolerance; and
- (4) admission blood glucose level is a positive whereas cortisol level is a negative
independent predictor of underlying glucose intolerance.
The findings in this thesis suggest that hyperglycaemia in patients who are
more unwell (i.e. higher cortisol) reflects the stressed state rather than underlying
glucose intolerance. Conversely, if the patient is less sick (i.e. lower cortisol),
hyperglycaemia is more likely to reflect underlying glucose intolerance. Therefore, it
can be concluded that there are two possible routes to the development of stress
hyperglycaemia in patients with ACS. These two routes reflect the different
underlying mechanisms for hyperglycaemia and the relationship between cortisol
and blood glucose levels in subjects with “true” stress hyperglycaemia.2011
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Angosta, Alona. "Coronary Heart Disease Knowledge and Risk Factors among Filipino-American's Connected to Primary Care Services". Diss., University of Hawaii at Manoa, 2010. http://hdl.handle.net/10125/22042.
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Coronary heart disease (CHD) is the leading cause of death of Filipino-Americans (FAs). Despite the growing numbers of FAs in the United States, little is known about their CHD knowledge and risk factors.
The purposes of this study were to examine the baseline knowledge and risk factors of CHD among FAs and to describe the relationships between knowledge, sociodemographic, and socioeconomic characteristic variables of FAs between the ages of 35-75 years.
The study sample consisted of 120 FAs (N = 120) who were connected to primary care services. Data were collected from three primary care clinics in Las Vegas, Nevada between the months of May and July, 2010. Participants completed the Demographics and the Heart Disease Fact Questionnaire (HDFQ) forms on CHD knowledge and CHD risk factors.
Descriptive statistics, item response frequencies, and t-tests revealed most FAs were knowledgeable about CHD. The mean CHD knowledge scores of the sample was 15.8 (SD = 4.26) out of the 21 CHD knowledge total score points. When knowledge scores were compared between men and women, women had higher CHD knowledge scores than men (t = 2.438, p = .016).
Descriptive statistics and item response frequencies also revealed FAs were at an increased risk of CHD. Many of them had CHD risk factors: Lack of exercise (65.8%), hypertension (50%), dyslipidemia (36.7%), abdominal adiposity (27.5%), Diabetes Mellitus Type 2 (25%), overweight (22.5%), and smoking (10%).
Gender, education, and income were significantly correlated with CHD knowledge, however, gender (b = .190, t = 2.21, p = .029) and education (b = .256, t = 2.85, p = .005) were the best predictors of CHD knowledge.
CHD risk factors are highly prevalent among FAs. Implications for practice should focus on primary and secondary preventions. Further research is warranted to explore the impact of health behavior, culture, sociodemographic/socioeconomic factors on CHD.
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Esslinger, Krista. "Dietary outcomes of a school-based trial to reduce risk factors for coronary heart disease". Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31227.
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The dietary outcomes of a school-based heart health promotion program in a low-income, multiethnic, inner-city neighbourhood of Montreal, Canada, were investigated. Eight intervention schools and sixteen control schools participated in the project from 1993 to 1997. Twenty-four hour recall data, as well as data on anthropometric and sociodemographic characteristics, were collected from a subsample of all students in grades 4--6 (aged 9--12 years) at baseline (n = 498), after two years (n = 491), and after four years (n = 347). There were no significant differ in nutrient intakes between 1995 and 1997, so these data were combined for analyses. Compared to students in control schools, students exposed to the program had a significantly increased mean intake of vitamin C per 1000 kcal (4184 kJ) (p = 0.0013). Compared to students in designated intervention schools at baseline, mean make of vitamin C per 1000 kcal was significantly increased (p = 0.002) and mean folate intake was significantly domed (p = 0.0058) in exposed to the program. When the intervention group was restricted to only those students who had received 16 hours or more of program exposure (n = 113), there were no significant differences in any nutrient intakes when compared to control students or students in intervention schools at baseline. This program was unsuccessful in changing nutrient intakes of school-aged children, contributing further evidence that conscious dietary change is difficult to achieve by means of a school-based program with a reasonable number of curriculum hours.
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Butt, Modaser Ahmad. "A comparative study of risk factors of coronary heart disease in South Asians and Caucasians". Thesis, University of London, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243555.
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O'Donovan, James Gary. "Exercise, cardiorespiratory fitness and coronary heart disease risk factors in men aged 30-45 years". Thesis, University of Kent, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413274.
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Al-Haifi, Ahmad. "Comparison of different methods of categorization for physical activity on coronary heart disease risk factors". Thesis, University of Southampton, 2008. https://eprints.soton.ac.uk/67618/.
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Objective: There is a general agreement that physical activity (PA) has a beneficial effect on health and those who are more active have a reduced risk of developing many chronic diseases, such as coronary heart disease (CHD). However, the amount, type and intensity of PA deemed to be sufficient to achieve good health remains unclear. Different methods have been used to categorise activity behaviour, but the level of agreement, consistency and coherence between methods and how this might influence their relationship with CHD risk factors and estimated CHD (eCHD) risk are poorly understood. This uncertainty is reflected in many different messages communicated to the public as to how active they should be to prevent chronic diseases. The primary objective of this thesis was to determine whether the methods used to categorise PA (as either inactive/active or level of PA) influence the extent to which PA is associated with CHD risk factors and eCHD risk. Methods: This thesis was divided into two parts. The first part was to conduct a secondary analysis of data on activity and CHD risk factors (blood pressure and lipid profile) obtained from the 2004 UK National Diet and Nutrition Survey (NDNS) in 1658 adults aged 19-64 years. Using the information obtained from the NDNS 7-day diary, it was possible to extend the original observations and to re-categorise individuals according to measures of PA in terms of number of days and minutes of at least moderate PA, total activity expressed as metabolic-equivalents (METs) and self-perception of PA. Each of these methods was then used to examine the proportion of the variance in CHD risk factors and the eCHD risk attributable to differences in PA using General Linear Modelling with adjustment for BMI, age and smoking. Partial eta squared a “proportion of variance due to physical activity plus error that is attributed to physical activity alone” was used. In the second part, the concurrent validity of measures of PA derived from the NDNS 7-day diary, using different systems for coding and classifying of different physical activities, was compared against those measures of PA obtained from the International Physical Activity Questionnaire (IPAQ) in a group of medical students (n = 26). Results: Taken together, this thesis revealed: 1) poor agreement across different methods of categorisation of PA level, 2) no support to justify a curvilinear dose-response relationship between PA level and CHD risk factors and eCHD risk and that a linear model was sufficient, 3) the differences in CHD risk factors or eCHD risk that could be directly attributable to differences in PA in men was modest (generally < 5%) although no associations evident in the women, 4) effect was most obviously demonstrable as improvements in lipid profile, no demonstrable effect on blood pressure, 5) a potential problem might arise when using one system and applying its results to different guidelines established by different systems. Conclusion: These findings support the view that being physically active is associated with markers of better health and lower CHD risk; a small but consistent effect that was the same irrespective of which method of categorizing PA was used and even after adjustment for differences in age, BMI and smoking. The effects were most evident in men and largely attributable to improvements in lipid metabolism.
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Du, Plessis Louwrens Andries Stephanus. "Lifestyle, body fat distribution and insulin-related coronary heart disease risk factors in hypertensive females". Thesis, University of Pretoria, 2000. http://hdl.handle.net/2263/25355.
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The full text of this thesis/dissertation is not available online. Please contact us if you need access. Read the abstract in the section 00front of this document.Thesis (DPhil (Human Movement Scinece))--University of Pretoria, 2000.
Arts, Languages and Human Movement Studies Education
unrestricted
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Chuluuntulga, Tuya. "The effect of birth weight on risk factors for coronary heart disease in adult twins". Thesis, University of Aberdeen, 2002. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU149461.
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The aim of this study was to assess whether pre-natal growth restriction due to intra-uterine factors influences risk factors for coronary heart disease in adult life. 131 pairs of same-six (60 MZ and 71 DZ) twins aged 19-50 years and 89 singleton controls matched for sex, gestational age, maternal age and parity were recruited from a local obstetric database. Measurements were made of height, weight, waist circumference, body fat and blood pressure, and a fasting blood sample was taken for measurements of cholesterol, triglycerides, apolipoproteins, fibrinogen, glucose and insulin. Smoking, diet, physical activity and medical details were obtained by questionnaire, and an ECG was recorded. The birth weight difference between twins ranged from 0-1840g, with a mean within-pair difference of 337g. The overall results suggest that twins do not have an increased risk of coronary heart disease despite their considerably smaller size at birth and substantial catch-up growth. There was no evidence of differences between MZ and DZ twins in either unpaired or paired analysis of birth weight and adult risk factors apart from total cholesterol which was significantly negatively associated with birth weight in DZ twin pairs. Birth weight was inversely associated with cardiovascular risk factors in controls, whereas the associations were inconsistent in twins. The relationship between birth weight and cardiovascular risk factors was stronger in controls than in twins, which indicates that the effect of birth weight in twins is different to that in singletons. The results of this study suggest that growth restriction in mid to late gestation, as a result of inter-uterine factors, does not lead to an increased risk of coronary heart disease in adult twins up to 50 years. This is possibly due to factors influencing birth weight in twins, which do not operate in singletons.
40
Coe, Ellen Moster. "The correlation between changes in conicity index and changes in other risk factors for coronary heart disease at baseline and after a six- month intervention program". Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/941352.
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The emphasis of the study was to determine the degree of correlation between the Conicity Index and known risk factors for heart disease. Conicity Index was shown in one study to be a useful screening tool in assessing the relationship between body composition and risk for heart disease. This study was designed to provide nutrition education and teach lifestyle modification to fourteen Veteran's Affairs patients. Change in specific risk factors including Waist-to-Hip Ratio, Body Mass Index, serum lipid levels and dietary intakes were correlated with change in Conicity Index over the six month study. Results from the present study did not suggest that the Conicity Index would serve as an effective screening tool for the present population. Mean body weight, body mass index, hip circumference, cholesterol and triglyceride levels, total caloric and fat intake all decreased significantly as a result of the program. Through nutrition education, behavior modification and group support, the risk for heart disease was successfully modified in this population.Department of Family and Consumer Sciences
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Rhodes, Philip G. "Ability of Lp-PLA2 to correctly identify women with elevated carotid IMT". CardinalScholar 1.0, 2009. http://liblink.bsu.edu/uhtbin/catkey/1505332.
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School of Physical Education, Sport, and Exercise Science
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Jokinen, V. (Vesa). "Longitudinal changes and prognostic significance of cardiovascular autonomic regulation assessed by heart rate variability and analysis of non-linear heart rate dynamics". Doctoral thesis, University of Oulu, 2003. http://urn.fi/urn:isbn:9514272005.
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Abstract
Several studies have shown that altered cardiovascular autonomic regulation is associated with hypertension, diabetes, aging, angiographic severity of coronary artery disease (CAD), and increased mortality after acute myocardial infarction (AMI). The purpose of this study was to assess the temporal changes and prognostic significance of various measures of heart rate (HR) behaviour and their possible associations to coronary risk variables, and the progression of CAD in different populations.
This study comprised five patient populations. The first consisted of 305 patients with recent coronary artery bypass graft surgery (CABG) and lipid abnormalities, the second of 109 male patients with recent CABG, the third of 53 type II diabetic patients with CAD, the fourth of 600 patients with recent AMI, and the fifth of 41 elderly subjects. HR variability and non-linear measures of HR dynamics were analysed.
Among the patients with prior CABG, a significant correlation existed between the baseline HR variability (standard deviation of N-N intervals, SDNN) and the progression of CAD (r = 0.26, p < 0.001)). In the longitudinal study of patients with prior CABG, only the fractal indexes of HR dynamics, such as the power law slope (β) and the short-term fractal exponent (α1), decreased significantly. In diabetic patients, SDNN decreased significantly (p < 0.001) during the three-year period. The reduction of SDNN was related to cholesterol, triglyceride, and glucose levels, and also to progression of CAD (r = 0.36, p < 0.01). In the longitudinal follow-up study of patients with recent AMI, reduced fractal indices (α1 and β), and reduced HR turbulence predicted cardiac death when measured at the convalescent phase after AMI. Reduced β and turbulence slope predicted cardiac death when measured at 12 months after AMI. In the elderly population, β (p < 0.001) and α1 (p < 0.01) reduced significantly. Low-frequency power spectra were the only traditional measure of HR variability that decreased significantly during the 16-year period.
HR variability is associated with many risk factors of atherosclerosis and with progression of CAD among patients with ischemic heart disease. Fractal HR dynamics are more sensitively able to detect age-related changes in cardiovascular autonomic regulation. Altered fractal HR dynamics and HR turbulence are associated with increased mortality after AMI.
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Wideman, Laurie. "Postprandial lipemia in abdominally obese and non-obese males". Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/845959.
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Recent research has shown that the combination of high triglyceride (TG) levels and low high density lipoprotein (HDL) levels, significantly increases the incidence of coronary artery disease (CAD). The incidence of CAD is also increased in abdominally obese individuals. To assess differences in postprandial TG clearance patterns between abdominally obese (AO) and controls (C), fourteen healthy, normolipidemic males (seven controls and seven abdominally obese) completed an oral fat loading test (78 grams of fat). Blood samples were collected every hour for eight hours. Abdominally obese individuals had significantly greater TG values, significantly lower total HDL and HDL2 values and significantly greater area under the TG curve (p = 0.03). Time to reach peak TG and time to reach baseline TG values did not differ between the two groups, even though fewer AO individuals reached baseline within eight hours. The data from the present investigation indicate that increased time to clear TG in AO individuals may be one pathway that increases the incidence of CAD in this group.School of Physical Education
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Räikkönen, Katri. "Type A behavior and coronary heart disease risk factors in Finnish children, adolescents and young adults". Helsinki : University of Helsinki, Dept. of Psychology, 1990. http://books.google.com/books?id=eA1sAAAAMAAJ.
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Janszky, Imre. "Non-conventional risk and prognostic factors in coronary heart disease : studies on heart rate variability, alcohol consumption, inflammation and depression /". Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-328-0/.
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Blom, May. "Psychosocial risk factors in women with coronary heart disease : stress, social support and a behavioral intervention /". Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-481-3/.
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Philippou, Elena. "Dietary carbohydrate manipulation and its effect on coronary heart disease risk factors and body weight maintenance". Thesis, Imperial College London, 2008. http://hdl.handle.net/10044/1/7272.
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Bergh, Cecilia. "Life-course influences on occurrence and outcome for stroke and coronary heart disease". Doctoral thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-54254.
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Although typical clinical onset does not occur until adulthood, cardiovascular disease (CVD) may have a long natural history with accumulation of risks beginning in early life and continuing through childhood and into adolescence and adulthood. Therefore, it is important to adopt a life-course approach to explore accumulation of risks, as well as identifying age-defined windows of susceptibility, from early life to disease onset. This thesis examines characteristics in adolescence and adulthood linked with subsequent risk of CVD. One area is concerned with physical and psychological characteristics in adolescence, which reflects inherited and acquired elements from childhood, and their association with occurrence and outcome of subsequent stroke and coronary heart disease many years later. The second area focuses on severe infections and subsequent delayed risk of CVD. Data from several Swedish registers were used to provide information on a general population-based cohort of men. Some 284 198 males, born in Sweden from 1952 to 1956 and included in the Swedish Military Conscription Register, form the basis of the study cohort for this thesis. Our results indicate that characteristics already present in adolescence may have an important role in determining long-term cardiovascular health. Stress resilience in adolescence was associated with an increased risk of stroke and CHD, working in part through other CVD factors, in particular physical fitness. Stress resilience, unhealthy BMI and elevated blood pressure in adolescence were also associated with aspects of stroke severity among survivors of a first stroke. We demonstrated an association for severe infections (hospital admission for sepsis and pneumonia) in adulthood with subsequent delayed risk of CVD, independent of risk factors from adolescence. Persistent systemic inflammatory activity which could follow infection, and that might persist long after infections resolve, represents a possible mechanism. Interventions to protect against CVD should begin by adolescence; and there may be a period of heightened susceptibility in the years following severe infection when additional monitoring and interventions for CVD may be of value.
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George, Giju. "Understanding of coronary heart disease in South Asian migrant men in the UK". Thesis, De Montfort University, 2010. http://hdl.handle.net/2086/9894.
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This research explored the understanding of coronary heart disease among the South Asian Migrant men in the UK. The objectives of this study are: • To explore migrant South Asian men's understanding of the risks involved with coronary heart disease in the UK • To relate their understanding in the context of current health care policy • To suggest ways to provide culturally sensitive health promotion programs to these groups. A phenomenological perspective using qualitative research methodology and focus group interviews were used to obtain a more precise and in-depth understanding of the risks involved with coronary heart disease. In total 83 men were recruited. 13 focus groups were conducted in three different areas across the country which had a significant South Asian population. Three themes emerged from the analysis of the interviews: Psychosocial factor, conventional risk factors & health care experiences. These themes reflected the men's understanding of the risks Involved with coronary heart disease In the UK. According to Williams et al, (2007 & 2009), information about psychosocial risk profiles in UK South Asians is limited and that there is an increased possibility that psychosocial related factors contribute to increased vulnerability to coronary heart disease in South Asian in the UK. This study concludes with the importance of recognizing that not all South Asians are the same and that health professionals should look beyond the context of religious, and ethnic background and focus on individual men.
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Brooks, Catriona. "The effects of dietary fatty acids on lipoprotein lipase activity and gene expression". Thesis, University of Surrey, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265101.
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