Arya Atherosclerosis
Volume:1 Issue: 4, Winter 2006

This experiment was conducted to study the effects of different levels of flaxseed (0, 5, 10 and 15% of diet) and copper (in the form of cupric sulfate pentahydrate, 0 and 250 ppm of diet) on fatty acids and cholesterol in egg yolk of laying hens. A total of 128 White Leghorn layers aged 50 weeks were used in a factorialdesign and randomly assigned to 8 treatment groups. The experiment lasted 120 days. The birds were fed ad libitum on the experimental diets. Cholesterol concentration and fatty acids in plasma and egg yolk were measured monthly and bimonthly, respectively. Egg yolk cholesterol was extracted using modified Folch procedure and measured using Zak''s method. The results showed that experimental diets had no effect on plasmacholesterol. The different levels of flax had no significant effect on egg yolk cholesterol butthe presence of copper with flax at levels of 5 and 10 percent decreased cholesterol in egg yolk (mg per gram yolk) significantly (P<0.05). The egg cholesterol (mg per egg) in the group treated with 15% flax without copper also decreased significantly (P<0.05). The unsaturated fatty acids of egg yolk increased significantly in all experimental diets (P<0.05).The highest ratio of omega-3 to omega-6 fatty acids was observed in groups treated with10% and 15% flax diets. This experiment showed that feeding flaxseed to laying hens can increaseomega-3 fatty acids of egg yolk.R Ansari(1), A Azarbayejani(2), S Ansari(3), S Asgari(4), A Gheisari(5) ARYA Journal, 2006, 1(4): 242-246

Cerebrovascular accident (CVA) or stroke remains a devastatingcomplication of cardiac surgical procedures, especially coronary artery bypass graft (CABG)despite advances in perioperative monitoring and management. An individual''s risk of stroke is based in part on preoperative characteristics, but also on intra- and postoperative factors.The purpose of this study was to determine the prevalence and predictors of stroke in a large group of patients undergoing cardiac surgery. Data were collected on 1467 patients who underwent CABG at Chamran Heart Center from 1995 to 2003. Stroke was defined as "a new focal neurological deficit which appears and is still at least partially evident more than 24 hours after its onset".Logistic regression identified significant predictors of stroke. Among the preoperative and postoperative factors, significant correlates ofstroke included chronic renal insufficiency (P=0.0001), hypertension (P=0.0001), diabetes(P=0.0001), and atrial fibrillation (P=0.0001). However, stroke had no significant correlation with sex (P=0.054), age (P=0.28), severe LV failure (P=0.062), history of CVA (P=0.723) or shock state (P=0.802). Neurologic complications after cardiac surgical procedures remain arelatively common problem despite improvements in anesthetic and surgical techniques, aswell as in perioperative monitoring and management. Increased stroke risk can be predicted by preoperative and postoperative clinical factors.POST-CORONARY ARTERY BYPASS GRAFT STROKE AND ITS RELATED RISK FACTORS M Hashemi(1), A Akhavan(2), S Asgary(3), Gh A Naderi(4) F Deries(5), M Hodavy(6), V Dastgerdi(7)

Smoking is an important risk factor of coronary artery disease. Nicotinereplacement therapy (NRT) for smoking cessation should be considered, especially incoronary patients. Twenty-four healthy smokers, smoking an average of 20 cigarettes a day for15 years and with moderate cigarette dependence (according to the Fagershtrumquestionnaire score) were randomly assigned to 3 groups of 8 and followed up for 5 days.The first group consisted only of cigarette smokers. The smokers in the second group were given a piece of nicotine gum every two hours. The smokers in the third group were given a piece of non-nicotine gum (placebo) every 2 hours. The subjects'' blood pressure and heart rate were checked 12 times during four daily intervals (between 7 AM and 12 PM, 1 PM and 6 PM, 7 PM and 12 PM, 1 AM and 6 AM) and recorded in related forms. Systolic pressure was not significantly different in the three groups, but diastolicblood pressure of cigarette smokers was evidently higher than that of subjects who usednicotine and non-nicotine (placebo) gums. Heart rate in smokers was higher than in nicotine and placebo users(P<0.0001). It seems that nicotine gum does not act as a cardiovascular disease risk factor.Hence in the context of smoking cessation efforts, its prescription to smokers withcardiovascular disease is recommended.

Myocardial ischemia, cerebral ischemia and myocardial infarction arethe most important complications of hypertension and atherosclerotic disease in developing countries. Angiotensin converting enzyme (ACE) inhibitors are among the drugs used to treat hypertension and heart failure. Captopril is an ACE-inhibitor which also has antioxidant properties. This study was conducted to assess the antioxidant effects of Iranian Captopril on malondialdehyde (MDA), conjugated dienes (CD) and serum antioxidant capacity before and after treatment. This interventional prospective single-blind study was conducted on 34 mildlyhypertensive individuals and 34 patients with stage I and II heart failure. MDA, CD andserum antioxidant capacity were measured in all samples. The patients were then given50 mg Captopril tablets 2-3 times daily. The measurements were repeated 1.5 months later. Comparison of mean MDA, CD and serum antioxidant capacity in hypertensivepatients and patients with heart failure before and after drug administration revealed nosignificant difference in any of the parameters studied. Existing evidence is suggestive of the strong antioxidative properties ofCaptopril in vitro, although these effects have not been borne out by some studies. In the present study, comparison of MDA, CD and serum antioxidants before and after the period of treatment with Iranian Captopril did not reveal any statistically significant difference.

Cardiovascular diseases (CVD) and cerebrovascular diseases (CeVD)are a large and growing problem in low- and middle-income populations. Secondaryprevention, which can reduce the risk of recurrent CVD includes changes in lifestyle,pharmacological interventions and revascularization procedures. The aim of the first phaseof this project was to perform situation analysis and identify gaps in secondary prevention of major cardiovascular diseases. This study estimated the physicians'' awareness and thepatients'' knowledge and behavior towards CVD and CeVD complications. It also assessedthe efficacy of methods for decreasing recurrent events. A sample of consecutive patients was selected from the outpatient units of the health care facilities selected for the study. Stratified random sampling of primary andsecondary private and public health care facilities in cities and villages was performed toselect 449 eligible cases. A total of 257 men and 192 women were selected. The inclusioncriteria were as follows: Age above 21 years, established diagnosis of CVD and/or CeVDdefined as any of the following alone or in combination with others: previous myocardialinfarction, stable/unstable angina, percutaneous transluminal coronary angioplasty (PTCA),coronary artery bypass graft (CABG), stroke, transient ischemic attack (TIA), and/or carotid arterectomy. The patients were included if their first event had occurred more than a month, but no earlier than three years before the study. The prevalence of high systolic and diastolic blood pressure was 40.1% and 26.9% respectively in MI patients, and 70.1% and 51.2% respectively in CeVD patients. In most of the patients, fasting blood sugar and total cholesterol were within the normal range.Among MI patients, 93.9%, 68.5% and 48.2% were already taking aspirin, beta-blockers and statins, respectively. Among CeVD patients, 79.9%, 61.1% and 23.2% were taking aspirin, beta-blockers and statins, respectively. Blood pressure had been managed in 94.9% and 93.7% of MI and CeVD patients, respectively. Among MI patients, 85.8% and 83.2% had correct behavior towards blood sugar and cholesterol control and 68% had adequate knowledge of the risk of recurrent events. Secondary prevention of vascular diseases should be regarded as a keycomponent of public health strategies to reduce the rising burden of CVD and CeVD in Iran.

Hypertension is a very common cardiovascular disease with extensiveeffects on body organs. This study was conducted to compare the extent of target organdamage in hypertensive patients with and without significant nocturnal fall in blood pressure (dippers and non-dippers, respectively). One-hundred patients with recently diagnosed hypertension underwent24-hour ambulatory blood pressure monitoring and carotid Doppler ultrasonography. Theywere divided into patients with nocturnal fall in blood pressure (dippers) and withoutnocturnal fall in blood pressure (non-dippers). Sixty-five patients with nocturnal systolic blood pressure fall greater than 10%(dippers) were matched for age, sex, body mass index (BMI) and body mass area (BMA)with 35 patients with less than 10% fall in nocturnal blood pressure (non-dippers). The two groups were not different in terms of ambulatory and mean 24-hour blood pressure.Assessments showed significantly greater carotid intima-media thickening in the non-dippergroup. This study suggests that a reduced nocturnal fall in blood pressure may playa pivotal role in the development of some features of target organ damage such as carotidintima-media thickening, despite similar clinical findings and no significant difference inmean 24-hour blood pressure.

Acute Myocardial Infarction (AMI) is one of the main causes of mortalityand morbidity in developing and underdeveloped countries. The aim of the present studywas to evaluate the trend of AMI risk factors in the city of Birjand, Iran, between 1994 and 2003. This cross-sectional study was based on the medical records of patientshospitalized due to AMI from 1994 to 2003 in Birjand hospitals. The medical records of theselected patients were summarized by two trained nurses. Information was obtained on the patients'' age, sex, risk factors, medical history, cardiac enzyme levels and therapy. The data were analyzed with t-test and chi-square test at α=0.05 using SPSS. 918 patients were hospitalized for AMI between 1994 and 2003 in Birjandhospitals. In this study, 319 patients (34.7%) had no risk factors and others had at least one risk factor. The prevalence of all risk factors had increased, but the increase in theprevalence of dyslipidemia (18.2%, 30.1%, P<0.001) and smoking (18.2%, 23.5%, P=0.03) was statistically significant during ten years of the study. In light of evidence documenting the rising trend of cardiovascular riskfactors, it is essential to develop appropriate interventional programs to prevent an imminent cardiovascular disease epidemic in the region.

Hypertension is the most prevalent chronic disease encountered byphysicians. Its prevalence has been reported at 18% in Isfahan province. Hypertensioncontrol decreases the risk of stroke and coronary events by 50% and 15%, respectively.According to the World Health Organization (WHO), the rate of blood pressure controlstands at 12.5%. Effective hypertension control requires measures such as screening,diagnosis, lifestyle improvement, and drug therapy. The type of drug regimen prescribed to the hypertensive patient is of key importance in achieving optimal control. The present study was performed to determine the type of drugs used by hypertensive patients in urban and rural areas of the provincial cities of Isfahan, Najaf-Abad and Arak. This descriptive cross-sectional study was performed in the provincial cities ofIsfahan, Najaf-Abad and Arak in 2000-2001, as part of Isfahan Healthy Heart Program(IHHP). Cluster sampling method was used to select 10674 individuals from the urban andrural areas of the said provincial cities. The patients had systolic blood pressure greater than 140 mmHg, or diastolic blood pressure greater than 90 mmHg or both, or receivedantihypertensive medications. Data were entered into the EPI-5 software and analyzed with t-test using SPSS. A total of 2015 hypertensive individuals (18.9%) were identified. Awareness ofbeing hypertensive and rate of treatment and control of hypertension measured 47%, 23% and 9% respectively. Of 670 patients under treatment, 527 had been treated with one drug type, 133 with two drug types with 35 different combinations, and 30 used three drug types with 25 different combinations. Among single-drug regimens, beta-blockers were the most common choice (23%) and atenolol and methyldopa were the most frequently prescribed drugs, respectively. The frequency of diuretics use was 0.9%. Inappropriate combinations such as atenolol plus propranolol were seen among two- and three-drug regimens (nine patients). Drug regimens used by many hypertensive patients are not consistent withstandard protocols; these regimens are ineffective in blood pressure control and lead toincreased side-effects and subsequently patient noncompliance. Thus, further education of physicians and other healthcare providers on hypertension and antihypertensive treatment seems essential.