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Topic: Macrovascular disease

Ads by Google      eMJA: 3: Preventing complications of diabetes Controlling hyperglycaemia and hypertension and identifying patients with peripheral neuropathy or peripheral vascular disease are the mainstays of preventing foot complications. Patients with reduced protective sensation or reduced foot pulses on examination should be assessed by a podiatrist, and all patients should be educated about daily foot care (inspection, washing and careful drying, moisturiser for dry skin and cracked heels, nail-care and use of practical footwear). They are classified as macrovascular (affecting large arteries) or microvascular (affecting capillaries and small blood vessels) (Box 1). http://www.mja.com.au/public/issues/179_09_031103/bat10488_fm.html   (4167 words)      Effect of Intensive Therapy on Early Macrovascular Disease in Young Individuals With Type 1 Diabetes The six studies were similar in quality; all scored full marks for explicit entry criteria, similarity of baseline characteristics, adequacy of follow-up, and intention-to-treat analysis; the method of randomization was unclear in three of the studies (3,4). The effect of long-term IIT on early atherosclerosis was recently examined using high-frequency ultrasound to assess endothelial function, carotid intima-media thickness, and arterial stiffness (25). Nevertheless, many of the published studies identified through our literature review were small negative studies with microvascular disease as their primary outcome. http://journal.diabetes.org/diabetescare/FullText/Supplements/DiabetesCare/Supplement299/B35.asp   (3834 words)      Postgraduate Medicine: Reducing cardiovascular risk in diabetes Coronary heart disease incidence in NIDDM patients in the Helsinki Heart Study. In a subgroup analysis of the Helsinki Heart Study (6), for example, a nonsignificant trend toward reduction of myocardial infarction and cardiovascular disease was noted with gemfibrozil therapy. Aspirin therapy (80 to 325 mg/day) should be initiated unless contraindicated by bleeding or severe retinopathy. http://www.postgradmed.com/issues/2001/04_01/spanheimer.htm   (4081 words)      NIH Guide: THE ETIOLOGY OF EXCESS CARDIOVASCULAR DISEASE IN DIABETES MELLITUS Many of the frequently cited studies are old and utilized techniques of risk factor and disease measurement that are crude by today's standards. To accelerate this understanding, this initiative will bring together basic, clinical, and population based investigators to develop a research program to address this question at the laboratory, clinical, and population levels. This initiative will also provide support for limited clinical and population studies which can either enhance understanding of the pathophysiology of cardiovascular complications of diabetes or provide information important for developing new therapeutic interventions. http://grants.nih.gov/grants/guide/rfa-files/RFA-HL-96-005.html   (5568 words)      Natural History of Macrovascular Disease and Classic Risk Factors for Atherosclerosis Although not mentioned by Dr. Stern, there are data other than those from the Pathobiological Determinants of Atherosclerosis in Youth Study (3) that indicate a relationship between relative glycemia and macrovascular disease risk in nondiabetic subjects (4,5). What remains is insufficient evidence to support other therapeutic decisions that seem obvious, e.g., reductions in glycemia, triglyceridemia, and blood pressure. Recent evidence from the Quebec Cardiovascular Study goes further in confirming such a relationship (2). http://journal.diabetes.org/diabetescare/FullText/Supplements/DiabetesCare/Supplement399/C21.htm   (3505 words)      Lipids Online Slides: ukpds, diabetes, microvascular complications There was no statistically significant reduction in the incidence of stroke or peripheral vascular disease in the intensively treated group compared with the group treated with conventional glycemic control. Lipid interventions should be equally effective in CHD equivalents as in CHD patients. ATP III: New Approaches in Identifying and Treating High-Risk Patients (Steven Haffner, MD) http://www.lipidsonline.org/slides/slide01.cfm?q=ukpds&pg=2   (1227 words)      Why High Triglycerides Spell Trouble While cholesterol levels are an important indicator of a person's risk for cardiovascular disease, they don't tell the whole story. Ask your doctor to work with you in developing a plan to keep your triglycerides low and your heart and arteries as healthy as they can be. The proper choice of drug, therefore, depends at least in part on a person's overall lipid profile. http://www.diabetes-self-mgmt.com/print.cfm?aid=488   (2564 words)      AACE This was shown clearly in a Finnish study in which the 7-year incidence of fatal/nonfatal myocardial infarction was greater in persons with diabetes who had no history of myocardial infarction than in non-diabetics who had a previous myocardial infarction (Haffner et al. “In patients with type 2 diabetes, glycemic control alone is insufficient to prevent or limit the complications associated with diabetes-related macro-vascular disease, ” said Peter Libby, MD, Mallinckrodt Professor of Medicine, Harvard Medical School, and Chief, Cardiovascular Medicine, Brigham and Women’s Hospital, Boston. According to Dr. Libby, “Optimal management also requires aggressive treatment of hypertension and dyslipidemia, making a multi-pronged approach to management essential in persons with type 2 diabetes.&; http://www.cmecorner.com/macmcm/aace/aace2004_05.htm   (2441 words)      Diabetes: Macrovascular disease is associated with increa... @ HighBeam Research Major interest has focused on lipoprotein metabolism in NIDDM, because of the increased incidence of atherosclerosis in NIDDM patients. In that study, the influence of the apoA-IV phenotype on incidence of myocardial infarction was much more pronounced in obese (BMI [greater than or equal to] 27 kg/[m.sup.2]) NIDDM patients than in lean (BMI Table 4 shows clinical and biochemical characteristics of lean (BMI http://www.highbeam.com/library/doc0.asp?DOCID=1G1:18999129&refid=holomed_1   (4100 words)      Nat' Academies Press, The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of ... There is a need for more definitive research on group versus individual formats, the number of encounters and methods needed to achieve improved clinical outcomes in weight, HgA1c levels, lipid levels, blood pressure, and patient satisfaction. LIMITATIONS OF DATA AND FUTURE RESEARCH NEEDS Although a number of studies support the usefulness of nutrition therapy in helping patients attain better control of diabetes and improving outcomes, the number of randomized, controlled trials that specifically explore this question are few. Although nutrition therapy is best carried out when a patient is first diagnosed, it appears to be effective at any time during the disease process and refresher therapy may be of value. http://www.nap.edu/openbook/0309068460/html/118.html   (5492 words)      Geneeskundeboek.nl - Boekwinkel voor medische boeken This unique manual is an ideal clinical reference for practicing veterinarians, a quick reference for students on rotations, and a supplemental or core text for related classes in the DVM program. The advent of chest CT with high-resolution techniques has changed dramatically the understanding of pulmonary diseases. Conditions previously hard to distinguish using traditional film radiography, particularly the diffuse lung diseases, can now be diagnosed rapidly and the extent of the disease process identified. http://www.geneeskundeboek.nl   (989 words)      What are MACROVASCULAR AND MICROSVASCULAR COMPLICATIONS - Diabetes Health monitor These include stroke, heart disease, leg and foot ulcers, and amputation due to gangrene. Additionally, while Health monitor frequently updates its content, medical information changes rapidly, therefore some information may be out of date. Despite this, they have very low rates of heart disease and stroke. http://www.healthmonitor.com/TEMPRES/diab030498CS1.htm   (332 words)      PROactive investigates effect of ACTOS® (pioglitazone HCl) on cardiovascular disease progression PROactive is an ongoing randomized, double-blind, placebo-controlled outcome study assessing the incidence of cardiovascular complications of diabetes, e.g., heart attack, coronary artery bypass surgery or stroke, as well as overall mortality. The study has enrolled 5,238 patients in 19 countries who have experienced one or more cardiovascular events such as a heart attack, coronary artery bypass surgery or stroke. Type 2 diabetes is associated with a two- to four-fold increase in cardiovascular disease as well as other cardiovascular risk factors such as high blood pressure and cholesterol disorders. http://www.eurekalert.org/pub_releases/2004-06/k-pie062504.php   (1015 words)      Lipids Online Slides: cabg, STENO-2, risk, macrovascular disease, diabetes In Steno-2, the intensive therapy group had a 53% reduction in macrovascular disease, relative to the conventional therapy group. Composite endpoint of death from CV causes, nonfatal MI, CABG, PCI, nonfatal stroke, amputation, or surgery for PAD: STENO-2 This 53% reduction in macrovascular disease is much higher than the percent reduction reported in single intervention trials of blood pressure, lipids, or ACE inhibitors, suggesting that multiple risk factor interventions are critical in high-risk subjects. http://www.lipidsonline.org/slides/slide01.cfm?q=cabg&dpg=15   (114 words)      eMedicine - Diabetes Mellitus, Type 2 : Article by William L Isley, MD However, the asymptomatic state does not mean that hyperglycemia is not affecting the individual. Intuitively, one would assume that therapies that normalize both preprandial and postprandial glycemia (or come close to normalization) would be optimal. Metformin reduces macrovascular risk in patients who are obese. http://www.emedicine.com/med/topic547.htm   (10373 words)      Coronary Heart Disease and Poor Blood Sugar Control - Cause or Effect? Finally, recent data we have been compiling from our own clinical experience is suggesting that coumadin may improve glycemia All of the above may lend some credence to the notion that OVER THE LONG-TERM, IT MAY BE MORE LIKELY THAT MACROVASCULAR DISEASE DRIVES HYPERGLYCEMIA [BY INCREASING VASOACTIVE CYTOKINES WHICH MAY FURTHER EXACERBATE INSULIN REISTANCE IN THE FACE OF BETA-CELL EXHAUSTION.] In a secondary prevention population of diabetics [with established coronary artery disease,] the data from the Digami Study, the Jarratt Study, and the Bezafibrate Infarction prevention Study all suggest that therapy with oral agents may be detrimental. http://www.diabetes-mellitus.org/chd.htm   (8220 words)      Macrovascular diabetes diseases, Eastern Carolina When the large blood vessels in the legs are affected (peripheral vascular disease), problems with blood circulation to the legs and feet may develop, causing changes in skin color, decreased sensation, and leg cramps. When blood vessels that supply the brain and heart are affected, a heart attack or stroke may occur. Macrovascular complications of diabetes are those that affect the large blood vessels. http://www.uhseast.com/164776.cfm   (224 words)      Diabetes India - Diabetes Macrovascular Diseases Further investigation would depend on individual circumstances and degree of clinical suspicion. Coronary and cerebrovascular disease is 2-4 times as common in a diabetic and the post-infarction mortality is higher; clinical assessment of coronary artery disease may be difficult due to the high incidence of asymptomatic cardiac ischemia in diabetics; Peripheral vascular disease is 4-6 times more commons in a diabetic associated presence of neuropathy accentuates diabetic foot problems. http://www.diabetesindia.com/diabetes/macrovascular_diseases.htm   (326 words)      DiabetesHealthOnline: Diabetes Information, Diabetic Diet & Diabetes Symptoms Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Conditions and Diseases Drugs and Medications Procedures and Tests Prevention and Wellness The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. http://diabetes.healthcentersonline.com/encyclopedia/m.cfm   (188 words)      The Prospective Pioglitazone Clinical Trial in Macrovascular Events (PROactive): Can pioglitazone reduce cardiovascular ... heart disease or had a nonfatal MI or confirmed stroke over which is a risk factor for vascular disease in patients with All patients have a history of macrovascular complications: http://care.diabetesjournals.org/cgi/content/full/27/7/1647   (4537 words)      NKF KDOQI We subscribe to the HONcode principles of the Health on the Net Foundation. New on-demand CME/CE/CEU program on cardiovascular calcification in Stage 5 CKD patients New National Kidney Foundation Guidelines Warn Cardiovascular Disease is the Leading Cause of Death Among Dialysis Patients - Sponsored by Satellite Healthcare http://www.kidney.org/professionals/doqi/kdoqi/p11_workgroup.htm   (154 words)      Diabetic Macrovascular Disease: The Glucose Paradox? -- Libby and Plutzky 106 (22): 2760 -- Circulation The expectation that strict glycemic control alone can mitigate of therapies that can improve macrovascular end points in diabetes. With some antidiabetic treatments, untoward effects may counterbalance http://circ.ahajournals.org/cgi/content/full/106/22/2760   (2137 words)      Macrovascular disease - Wikipedia, the free encyclopedia Three common macrovascular diseases are coronary disease (in the heart), cerebrovascular disease (in the brain), and peripheral vascular disease (in the limbs). Macrovascular disease is a disease of any large (macro) blood vessels in the body. This sometimes occurs when a person has had diabetes for a long time. http://en.wikipedia.org/wiki/Macrovascular_disease   (92 words)      Macrovascular disease and systemic sclerosis -- Ho et al. 59 (1): 39 -- Annals of the Rheumatic Diseases The natural history carotid arterial disease in asymptomatic patients with cervical bruits. Flow cytometric assessment of platelet function in patients with peripheral arterial occlussive disease. Thirty three (64%) patients had evidence of carotid disease http://ard.bmjjournals.com/cgi/content/full/59/1/39   (2617 words)      children with DIABETES - Diabetes Dictionary: M Three kinds of macrovascular disease are coronary disease, cerebrovascular disease, and peripheral vascular disease. A combination of health conditions that place a person at high risk for heart disease. The sickness rate; the number of people who are sick or have a disease compared with the number who are well. http://www.childrenwithdiabetes.com/dictionary/m.htm   (1045 words)      TAGS GOES HERE -->