Abstracts
Alcohol (Angina)
Alcohol
With moderate consumption, alcohol exhibits many beneficial properties, including prevention of angina, myocardial infarction, and atherosclerosis. In evaluating over 22,000 healthy male physicians between 40 and 84 years of age, new-onset angina occurred in 1,368 men. In the 11-year follow-up period, 690 men experienced a first myocardial infarction. Alcohol was found to have a strong, independent, inverse association with the risk of these events. Men who reported having two or more drinks per day had a 56% lower risk for angina and a 47% lower risk for myocardial infarction than those who consumed less than one drink per week. The investigators also found that those who consumed two drinks daily had a higher risk of death from cancer than those in the lowest-intake group.
Moderate Alcohol Consumption and Cardiac Risk: Angina Pectoris Now Appears to Join the Conditions Benefiting from Two to Six Alcoholic Drinks Weekly, Emergency Medicine, November, 1997;52, 54.
Low-Fat Diet
Low-Fat Diet
This discussion focuses on angina prevention by lowering cholesterol levels through a low-fat diet. Patients in a low-fat treatment group had significant reductions in both LDL and HDL cholesterol levels. These patients had a 91% reduction in angina after 1 year, and a 72% reduction after 4 years. Cardiac positron-emission tomography showed significant improvement in myocardial perfusion in the treatment group but worsening in the control group. Lowering HDL cholesterol levels by changes in diet did not harm these patients. Other topics include the saturated fat content of olive oil (14 g total fat: 2.25 g saturated fat), and the harmful effects of high-sugar, low fat foods.
Ornish, Dean, M.D./Katan, Martijn B., Ph.D., et al: Low-Fat Diets, New England Journal of Medicine, January 8, 1998;338(2):127-129.
Alcohol (II)
Alcohol (II)
Moderate consumption of alcohol is associated with prevention of myocardial infarction and angina pectoris. This study draws primarily from one specific trial, in which 8,476 Japanese male employees between 40 and 59 years of age at baseline were followed up on the average for 8.8 years. During this time, 54 myocardial infarctions and 32 cases of angina pectoris occurred. There was an inverse association with alcohol intake that was similar for myocardial infarction and angina pectoris. Alcohol seemed to prevent the premature incidence of coronary heart disease among urban Japanese middle-aged men. However, the age-adjusted incidence rate of total cardiovascular disease was significantly higher in drinkers of 4 or more drinks per day than in those who never drank.
Kitamura, Akihiko, et al: Alcohol Intake and Premature Coronary Heart Disease in Urban Japanese Men, American Journal of Epidemiology, 1998;147(1):59-65.
Antioxidants (Angina)
Antioxidants
Tested the "antioxidant" hypothesis of coronary "heart disease" ("CHD") by comparing "blood" "antioxidants", indices of "lipid" peroxidation and classic (CHD) risk factors of 25 subjects with stable "angina pectoris" with 200 matched controls.
Angina subjects had significantly increased plasma concentrations of total "cholesterol", low density lipoproteins and "triglycerides".
It is unclear whether the increased "oxidative" "stress" in angina sufferers is a cause or consequence of the disease.
Beattie-JA et al: Duthie-GGm et al: Blood antioxidants and indices of lipid peroxidation in subjects with angina pectoris. "Nutrition". 1994 Jul-Aug; 10(4): 313-6.
Ethnicity (Hispanic)
Ethnicity (Hispanic)
There has been a long-standing interest in the relationship between cardiovascular disease ("CVD") and psychiatric morbidity, specifically "depressive" symptoms. This study suggests that functional impairment is a more important factor associated with depressive symptomatology than angina.
Portillo-CJ et al: Angina, functional impairment and physical inactivity among Mexican-American women with depressive symptoms. Prog-Cardiovasc-Nurs. 1995 Summer; 10(3): 18-25.
Lipoprotein
Lipoprotein
To clarify lipoprotein disorders in coronary artery disease. Subjects (# 64) had coronary artery disease and normal subjects (#13 ) were controls. They were divided into the groups with stable and unstable angina pectoris or acute myocardial infarction (acute coronary syndromes).
In patients with coronary artery disease, there were no significant differences from control in age, body mass index, total cholesterol, however, HDL cholesterol was significantly lower than those in the controls.
LDL cholesterol:LDL apoB ratio, which is thought to reflect the size of LDL in coronary artery disease, was significantly smaller than that in the controls; mean values were 1.2 in coronary artery disease and 1.4 in controls.
There were no significant differences in those lipoprotein disorders between the patients with stable angina and those with acute coronary syndromes. Though these lipoprotein abnormalities would not play a trigger role in acute coronary syndrome, they are characteristic of the lipid profile of patients with coronary artery disease.
Yokota C et al., Lipoprotein analyses in patients with stable angina and acute coronary syndrome. Int J Cardiol, 1996 Dec 6, 57:2, 161-6.
Mediterranean Diet (Angina)
Mediterranean Diet
Dietary habits are implicated in coronary heart disease, and the traditional Mediterranean diet is thought to be cardioprotective. However, the exact mechanisms of this protection are unknown.
To describe the various cardiovascular complications that occurred in the Lyon Diet Heart Study (a secondary prevention trial testing the protective effects of a Mediterranean type of diet), to analyze their relations with the associated drug treatments and to gain insights into the possible mechanisms underlying the beneficial effects of certain nutriments.
Major primary end points (cardiovascular death and nonfatal acute myocardial infarction), secondary end points (including unstable angina, stroke, heart failure and embolisms) and minor end points (stable angina, need for myocardial revascularization, postangioplasty restenosis and thrombophlebitis) were analyzed separately and in combination.
When major primary and secondary end points were combined, there were 59 events in control subjects and 14 events in the study patients, showing a risk reduction of 76%. When these end points were combined with the minor end points, there were 104 events in control subjects and 68 events in the study patients, giving a risk reduction of 37%. By observational analysis, only aspirin among the medications appeared to be significantly protective.
Data show a protective effect of the Mediterranean diet. However, the risk reduction varied depending on the type of end point considered. Our hypothesis is that different pathogenetic mechanisms were responsible for the development of the various complications. It is likely that certain nutriments characteristic of the Mediterranean diet (omega-3 fatty acids, oleic acid antioxidant vitamins) have specific cardioprotective effects.
De Lorgeril M et al., Effect of a mediterranean type of diet on the rate of cardiovascular complications in patients with coronary artery disease. Insights into the cardioprotective effect of certain nutriments [see comments]. J Am Coll Cardiol, 1996 Nov 1, 28:5, 1103-8.
Vitamins & Angina
Vitamins
With the changes in trends of disease pattern from infectious to chronic degenerative disease, cardiovascular disease has been considered as the major cause of death in Korea. Numerous studies have been done on the antioxidant effects of some vitamins in the prevention of chronic illness, but not many in relation to cardiovascular disease.
Therefore, this study investigated the relation between antioxidant vitamins, mainly alpha-tocopherol (alpha-T) and beta-carotene (beta-C), and coronary artery disease (CAD) such as angina pectoris and myocardial infarction.
The blood samples were obtained from the CAD patients who were angiographically diagnosed within a month (100 case group).
The concentrations of both alpha-T and beta-C were significantly lower in the CAD group than those in control group; in CAD group, mean values of alpha-T and beta-C were 11.9 +/- 7.2 (micrograms/ml), 35.8 +/- 3.1 (micrograms/dl) respectively. As for the levels of beta-C, it shows inverse relation with age, but not for the alpha-T levels.
Serum levels of both vitamins did not show any significant differences in terms of sex, but men have a tendency o higher levels of beta-C, but lower levels of alpha-T.
Kim SY et al., Serum levels of antioxidant vitamins in relation to coronary artery disease: a case control study of Koreans. Biomed Environ Sci, 1996 Sep, 9:2-3, 229-35.
Weight Loss (Angina)
Weight Loss
To investigate the effect of moderate weight loss in older overweight subjects with angina pectoris on plasma dehydroepiandosterone sulphate (DHEAS), urinary steroid metabolites, insulin and plasma lipid concentrations.
Body weight and composition by anthropometry, REE by indirect calorimetry, dietary intake by seven day inventory, plasma DHEAS, insulin and lipids.
After 12 weeks dietary supervision there were reductions in body weight (3.3 s.d. 2.3 kg, BMI 1.2 s.d., P = 0.00001) and in reported energy intake (-1179 s.d. 1393 kJ daily). No significant change was seen in plasma DHEAS or insulin but there were reductions in plasma cholesterol (-0.5 s.d. 0.6 mmol/l) HDL cholesterol (-0.1 s.d. 0.1 mmol/l) and triglyceride (-0.1 mmol/l s.d. 0.5).
Weight loss of 4% body weight by conventional dietary means over 12 weeks does not alter plasma DHEAS, urinary steroid metabolites or insulin concentrations, but does reduce plasma cholesterol in older moderately overweight subjects with angina.
Hankey CR et al., Plasma lipids, dehydroepiandosterone sulphate and insulin concentrations in elderly overweight angina patients, and effect of weight loss. Int J Obes Relat Metab Disord, 1997 Jan, 21:1, 72-7.
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