Arya Atherosclerosis
Volume:5 Issue: 4, Winter 2010

Cardiac rehabilitation is a well-established treatment for patients with coronary artery disease and it is beneficial for cardiac patients. It improves functional capacity and modifies risk factors of coronary artery disease such as hypertension, arrhythmia and others. The aim of this study was to investigate the effects of cardiac rehabilitation on functional capacity of patients after cardiac surgery by using the six-minute walking test which is simple and well tolerated test for cardiac patients compared with other stress test. Thirty two patients were selected for this study. All patients had cardiac surgery two months before admission. These samples allocated to two groups. Interventional group (n = 17, age: 62 ± 12 years) entered and completed cardiac rehabilitation programs for two months; but reference group (n = 15, age: 58.5 ± 12.5 years) didn''t have any physical activity during this period. At the beginning of entrance functional capacity of patients was evaluated by exercise test and six-minute walking test. After two months of cardiac rehabilitation, functional capacity was evaluated for second time in each group. Cardiac rehabilitation consisted of exercise, nutritional and psychological consultation and risk factor management. Data were analyzed with SPSS software version 15. For comparing the mean of outcomes in repeating measures the repeated ANOVA model was used. A Significant improvement was observed in the interventional group compared to reference group in walking distance (472.62 ± 19.29 m, vs. 412.24 ± 20.54 m,respectively P = 0.04). Cardiac rehabilitation significantly improves functional capacity and this evolution was shown by 6MWT which is easy and safe and low cost test compared to other stress test.

Obesity is increasing worldwide, but the debate about the most valid index associated with its health hazards remains unresolved. This study aims to compare four main anthropometric indices by gender, to determine the best index in predicting cardiometabolic risk factors and to find their cutoff This Cross-sectional community-based study was performed on a representative sample of 12,514 adults (aged ≥19 years) selected via 2-stage random cluster sampling from 3 cities in Iran. Partial correlation and ROC curve analyzes were used to determine the best anthropometric index and their cutoff values. The study population comprised 6123 males and 6391 females. In both genders, waist circumference (WC) had the highest correlation to cardiometabolic risk factors (6 of 8 risk factors in men and 7 of 8 risk factors in women).ROC analyses showed that in males, the largest area under curve (AUC) was obtained for waist-to-stature ration (WSR) in most risk factors (6 of the 10) followed by body mass index (BMI) and waist-to-height ratio (WHR) with largest AUC (3 of the 10). The corresponding figure for females was obtained for WSR (9 of the 10) followed by BMI and WHR (1 of 10). Optimal cutoff values computed for combination of 3 major risk factors (including diabetes mellitus, hypertension and dyslipidemia) revealed that in males and females, respectively, the cutoff values were 21.9 and 23.5kg/m2 for BMI, 80.70 and 84.70 cm for WC, 0.85 and 0.86 for WHR and 0.47 and 0.53 for WSR. WSR could be a valid anthropometric index for predicting cardiometabolic risk factors, it has less variation than other indices among populations with ethnic differences in body size and fat distribution.

With reference to the importance of physical activity during childhood and adolescence in their health promotion and prevention of chronic diseases during adulthood, it is necessary to have a reliable and valid method for evaluating physical activity level in this age group. Physical activity questionnaire child (PAQ-C) and adolescents (PAQ-A) have been designed for this purpose. This study aimed to validate these questionnaires PAQ in a representative sample of Iranian children and adolescents. After translating the PAQ-C and PAQ-A to Persian, the face- and content validities of these questionnaires were assessed by an expert committee consisting of experts of different specialties including specialists in Pediatrics, Community Medicine, Social specialist and Sport Medicine. After minor modification of some items of the questionnaires according to available types of physical activity and the socio-cultural conditions, the final questionnaires were prepared. Thereafter, 82 children and adolescents with 8 to 18 years of age completed the questionnaires. To assess this questionnaire reliability in Iranian students, it was modified and got the validity accreditation from a committee consisting of specialists. An alpha Cronbach of 0.894 was produced at the end of the analysis showing it has been reliable for this population. According to the results found in this survey, this questionnaire can be used as a reliable and valid method for next studies; so health planning due to Iranian students’ physical activity will be possible in future.

The role of L-arginine, the precursor of nitric oxide, on the oxidative stress and atherosclerosis has been previously studied; it has had inconsistent beneficial effects. The aim of this study was to investigate whether administration of L-arginine reduces oxidative stress and the progression of atherosclerosis in cholesterol fed rabbits. Eighteen white male rabbits were randomized to three experimental groups. All of them received 1% high cholesterol diet for the first four weeks and normal diet for second four weeks of the experiment. The early treatment (ET) group received L-arginine (3% in drinking water) in the first four weeks (ET) and late treatment (LT) group received L-arginine for the second four weeks of the experiment. Control (C) group received no L-arginine. The plasma levels of lipids, 8-isoprostaglandin F2α, CRP and oxLDL were measured before, and at 4th and 8th weeks of the experiment. Aorta fatty streak formation was measured at the end of the experiment. The plasma levels of lipids were increased significantly during the first 4 weeks and decreased significantly during the second 4 weeks with no significant differences between the groups. The plasma concentration of 8-isoprostaglandin F2α was significantly decreased in the ET group rather than the C group at the end of the experiment. The fatty streak formation in the ET group was significantly lower than the C group at the end of the experiment. The plasma concentration of CRP significantly increased after 4 weeks administration of hypercholesterolemic diet in all groups. Also its amount was significantly smaller in ET group in comparison with other groups. The plasma concentration of oxLDL decreased significantly in the ET group rather than LT group at the end of the experiment. However the plasma concentration of oxLDL increased in the C group and in the LT group at the end of the experiment. L-arginine therapy from the very beginning of hypercholesterolemia reduced oxidative stress and the consequential irreversible vascular damage, and may be useful for primary prevention.

Leptin, the product of the ob gene, could have a role in the pathogenesis of obesity and non-insulin-dependent diabetes mellitus (NIDDM). The aim of this study was to investigate relationships between serum leptin concentration and insulin, glucose, HbA1c levels and insulin resistance in diabetic women.

We studied 45 diabetic women and 45 healthy women (controls) who aged 45-60 years and had BMI of 25-30 kg/m2. Serum leptin, insulin, HbA1c, fasting blood sugar and insulin resistance were determined in the two groups.

There was a significant positive correlation between leptin and insulin (r = 0.295, P = 0.049) and insulin resistance (r = 0.329, P = 0.027) in controls but non significant correlation between leptin and HbA1c and fasting blood sugar were observed in two groups.

This study did not document any significant relationship between serum leptin and insulin, glucose, HbA1c and insulin resistance in diabetic women.

Cigarette smoking is an important risk factor of various chronic diseases. Smokers also seem to make a lifestyle which is different from those of non-smokers. This study was conducted to compare dietary habits of smoker and non-smoker individuals. This cross sectional study was conducted in 2000-2001 in Isfahan and Najaf-Abad counties. Sample size was 6300 individuals aged ≥ 19 years old. The individuals'' food habits were assessed by using a food frequency questionnaire. Smokers'' consumption of some foods, including whole diary products, was higher than that of non-smokers (P = 0.001). Also the frequency consumption of hydrogenated oil and liquid oil in smoker men and non-smoker ones was 6.9 ± 4.2, 6.5 ± 4.3, 2.2 ± 2.6 and 2.7 ± 2.4, respectively (P = 0.001). Mean consumption of fast food in smoker men was higher than non-smokers (1 ± 1.4 vs. 0.8 ± 1.5, respectively, P = 0.01). Non-smoking men''s mean intake of fruit and vegetables was higher than that of smokers (11.7 ± 6 vs. 11± 6, respectively, P = 0.01). The result shows that smokers have an unhealthier dietary pattern than non-smokers so, this is reflected in their unhealthy food choices, e.g. greater consumption of food products with high levels of saturated fat and cholesterol. Smoking and unhealthy dietary behavior have synergistic effects on incidence of non communicable diseases. Broad interventions are required in the community towards tobacco consumption control and lifestyle modification in smokers.

Treatment of hypertension (HTN) as an important risk factor of cardiovascular disease (CVD) is for prevention of its mortality. The aim of the present study was to investigate risk factor distribution, prevalence and severity of CAD among hypertensive and normotensive patients undergoing elective coronary angiography in Tabriz Madani Heart Center. In a descriptive cross-sectional study, 976 out of 3000 patients who underwent coronary angiography (CAG) between February 1, 2005 and February 1, 2006 were randomly selected to enter the study. Demographic and angiographic data were collected. Data entry and analysis was done by SPSS software version 11.5 and EPI software version 6.4. Prevalence of hypertension in patients who underwent CAG was 60.5%. Prevalence of CAD was 84% and 87% in hypertensive and normotensive patients respectively (p = 0.2). Prevalence of diabetes mellitus and hyperlipidemia were more frequent in hypertensive patients (p = 0.001). Although the prevalence of three vessel disease was higher in hypertensive patients (32% vs. 28%) the difference was not significant statistically. The difference in prevalence of CAD among hypertensive and normotensive men was not statistically significant (91% and 92% respectively); but this difference among women was statistically meaningful (78% vs. 63%; p = 0.01). Three vessel disease in hypertensive women was more frequent than normotensive women (37% vs. 18%, p = 0.02). With regard to high prevalence of cardiac risk factors and severe CAD in hypertensive patients, prompt health measures are needed for control of HTN in general population especially in the hypertensive women.

Carotid Endarterectomy (CEA) is recommended in patients with symptomatic and some times asymptomatic carotid stenosis in vascular surgery centers with low perioperative complication rate. A retrospecticve study was carried out in patients underwent CEA in 3 vascular surgery centers in Tehran and 2 centers in Mashhad. Patients selection criteria, methods of detection of carotid stenosis, method of anesthesia, surgical techniques and perioperative complications were evaluated. Overall, 388 CEA in 345 patients (65% males) with mean age of 66.8 years old (ranged 46-84 years) were evaluated. Detection of carotid stenosis was made by one carotid duplex ultrasound in 90% of CEA candidates. The whole perioperative stroke and death rate in reported Iranian vascular surgery centers is 6.4%. Perioperative stroke and death rate in Emam Reza, Razavi, Shohada Tajrish, Taleghani and Iranmehr hospitals was 2.4%, 0%, 4.8%, 10.2% and 10.2%, respectively. In Iran, CEA is recommended only in patients with symptomatic ≥ 70% ICA stenosis and preferably in patients with symptomatic ≥ 90% ICA stenosis. Method of detection of carotid stenosis in Iranian vascular surgery centers should be corrected.