Arya Atherosclerosis
Volume:2 Issue: 2, Summer 2006

It is well documented that low birth weight may increase the risk of chronic diseases, notably atherosclerotic cardiovascular disease, later in life. However, the mechanisms of maternal and fetal weight regulation during pregnancy are not clearly defined, and leptin might play a role in this process. To compare the serum leptin levels in normal and intrauterine growth retarded (IUGR) term neonates. In addition, we aimed to determine the relationships of maternal and neonatal leptin concentrations with birth weight. From April 2005 to December 2005, serum leptin concentration were measured in umbilical cord and maternal venous blood samples of 32 mother-infant pairs with IUGR full term neonates and 34 mother-infant pairs with normal full-term neonates. Independent sample t-test was used for the comparisons. The correlation analysis was performed by Pearson correlation coefficient. The mean leptin concentration in newborns with IUGR and in their mothers (2.82±1.95 and 3.16±2 µg/L, respectively) was lower than in infants with normal growth and their mothers (3.04±1.74 and 3.18±1.97 µg/L, respectively) but these differences were not significant. Cord blood leptin concentrations did not correlate with birth weights (r=0.02), BMI of neonates (r=0.033) and leptin concentrations of their mothers (r=0.17). When data of all newborn infants were analyzed together, cord blood leptin concentration in the IUGR group correlated with BMI of neonates (r=0.36, P=0.03) but not with birth weight (r=0.22, P=0.20). There was no significant difference in terms of gender. Cord blood leptin levels appear to correlate with BMI, as an indicator of fat mass, but not the birth weight of IUGR neonates. In addition, maternal leptin concentration cannot be considered as an accurate indicator of fetal growth.

It is thought that lacunae occur in patients with hypertension or diabetes mellitus as small-vessel involvement. The frequency of other stroke mechanisms in patients with lacune was evaluated in this study. Consecutive stroke patients admitted to Valie-Asr Hospital, Khorasan in 2006 were enrolled in a prospective study. Diagnosis of stroke and its risk factors was made by a stroke neurologist. All of the stroke patients underwent a standard battery of diagnostic investigations. Brain infarction was categorized as lacunae and large-vessel territory infarction (LVTI). Chi-square test and odds ratios were used for statistical analysis. Ninety-six patients with lacune and 252 patients with LVTI were studied.The frequency of diabetes and hypercholesterolemia was significantly higher in patients with lacunar stroke than in those with LVTI (P=0.034, P<0.001 respectively). The frequency of hypertension, smoking, TIA and ipsilateral carotid stenosis was not significantly different between the two groups (P=0.94, P=0.59, P=0.37, P=0.13, respectively). Atrial fibrillation was significantly more frequent in patients with LVTI (P<0.001). The frequency of various etiologic mechanisms was not significantly different in lacunar and LVTI patients (df=4, P=0.164). Hypertension in patients with lacune is not more frequent than other stroke patients. Cardioembolism and artery to artery embolism are important but less common mechanisms of lacunae.

Cardiovascular diseases and coronary artery disease (CAD) in particular are the main cause of morbidity and mortality in Iran. This study was designed to determine the prevalence of CAD in Central Iran using the Rose Questionnaire and Electrocardiography. 6498 people aged above 35 years were studied in this cross-sectional study. Multi-stage cluster sampling was conducted in the cities of Isfahan, Najaf-Abad and Arak. A questionnaire was used to collect demographic and job data. The Rose chest pain questionnaire containing five questions was filled out by trained physicians. ECG and Minnesota coding were performed. Data was analyzed with chi-square test using SPSS 11. 3338 women and 3160 men participated in the study. The prevalence of CAD based on the Rose questionnaire and Minnesota coding was 37.5% in women and 22.2% in men. The prevalence of CAD increased with age in both sexes. The prevalence of definite and possible MI based on ECG was higher in men; however, a higher prevalence of possible and definite ischemia was found in women. The prevalence of CAD based on the Rose questionnaire was higher in women of all age groups. The high prevalence of CAD in the Iranian community warrants a comprehensive primary and secondary prevention program.

T ► this is the news (1385/11/23) The link between occupational factors and coronary artery diseases (CAD) has been studied and confirmed in many countries. Conditions associated with driving such as stress, and factors such as long working hours and the environment can increase the risk of CAD. In this study, we measured potential CAD risk factors in bus and taxi drivers and compared them with a control group. 135 taxi drivers, 194 bus drivers and 121 non-drivers (control group) were evaluated for CAD risk factors, i.e. age, body mass index (BMI>24), cigarette smoking, hypertension, high-density and low-density lipoprotein cholesterol (HDL, LDL), triglyceride >200, blood sugar >126 and familiar history of CAD. Univariate and multivariate logistic regression tests were used to distinguish major risk factors. Taxi drivers have an increased risk of hypertension compared with the control group (odds ratio: crude=5.94, adjusted=9.09; P<0001). Cigarette smoking in taxi and bus drivers was 1.4 (P<0.3) and 3.24 (P<0001) times greater than the control group, respectively. The risk of increased LDL and decreased HDL in bus drivers was 4.38 and 5.28 (P<0001) times greater than the control group, respectively. The risk of obesity, high blood sugar and high triglyceride was not significantly different among the groups. Driving is an independent risk factor for hypertension. Known CAD risk factors are also higher in drivers.

Due to a worldwide increase in the incidence of type II diabetes, it will likely continue to be a major cause of morbidity and mortality in the future. Given that usually a mean of 4-7 years has passed from the initial onset of type II diabetes until the time of diagnosis, a great number of patients have already been affected by one or more diabetic complications by the time of diagnosis. Our objective in this study was to evaluate the prevalence of diabetic complications and risk factors in recently diagnosed type II diabetic patients in Mashhad, Northeast Iran. This cross-sectional prevalence study was performed between March, 2002 and September, 2002, in Mashhad, Iran. The study group included 200 type II diabetics whose disease had been diagnosed within one year prior to the start of our study. The collected data included medical history, physical examination and clinical tests, including urinalysis (for evaluation of macroproteinuria), blood sampling (for evaluation of serum glucose and lipid levels), and electrocardiography (EKG). Several common indicators of diabetic complications were analyzed. Of the 200 patients studied, 66 were male and 134 were female. The mean age of the patients was 52.2 years for men and 46.8 for women at the time of diagnosis. Overall, 74.2% of the patients were shown to have been affected by one or more diabetic complications prior to diagnosis with type II diabetes. Formulating a new screening program may help us to diagnose type II diabetes earlier and control it more effectively. This may lead to a reduction in morbidity and mortality in type II diabetes patients.

The purpose of this study was to determine the effect of cognitive-behavioral therapy on anxiety reduction and improvement of quality of life in patients with cardiovascular disease. The statistical population comprised patients with coronary artery disease (CAD) in Isfahan in 2006. Fifty-six CAD patients referring to Chamran Heart Center and Isfahan Cardiovascular Research Center were randomly selected and assigned to control and case groups. The case group underwent cognitive-behavioral therapy (CBT) in 8 two-hour structural sessions. Patients in both case and control groups completed Cattel anxiety questionnaire and Macnew life quality questionnaire, which are specific for patients with cardiac disease before, and 2 weeks after therapy. The control group only completed the questionnaires without therapy. Both groups completed another questionnaire, which obtained demographic information. Based on the results, cognitive-behavioral therapy in the case group led to reduced anxiety and improved quality of life (P<0.000). Our findings showed the effectiveness of cognitive-behavioral therapy in reducing hidden and manifest anxiety (P<0.000) and improving the quality of life, as well as emotional, physical, and social function (P<0.000) in patients with cardiovascular disease. We recommend that methods for anxiety reduction and improvement of quality of life be taught to CAD patients via cognitive-behavioral therapy programs.

Dyslipidemia is one of the major risk factors of cardiovascular disease. Nutrition can significantly affect blood lipids. Egg is a common food for many people and is rich in nutrients and vitamins. It is also rich in cholesterol. Considering the different recommendations and controversies surrounding the healthiness or otherwise of egg consumption, we added two eggs to the usual daily dietary regimen of healthy normolipidemic young volunteers. This clinical trial was done on 60 volunteers living in the university campus. They regularly ate food served in the university restaurant. Their diet was monitored from 2 weeks before the start of the new diet with additional eggs. Fasting blood samples were taken at the beginning of the study. Two well-cooked moderately sized eggs (all from the same supplier) were added to the subjects'' breakfast for one month. Blood lipids were measured again at the end of this period. Mean levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C) and triglyceride had increased significantly, however, they were still within normal limits at the end of the study (P=0.001, 0.000 and 0.01, respectively) and high-density lipoprotein cholesterol (HDL-C) had deceased (P=0.000). Adding 14 eggs a week to the usual diet of normolipidemic healthy individuals can unfavorably affect blood lipids and may have adverse long-term cardiovascular consequences. In other words, eating less than two eggs a day may be a healthier practice.

Childhood obesity is a cultural and medical problem and is usually refractory to treatment. The objective of this study was to assess the effects of parental therapy behavior and relaxation methods on children in controlling childhood obesity. In this randomized controlled clinical trial, 90 obese children aged 10-17 years were randomly divided into three groups of equal number. All there groups received similar diet and exercise recommendations. The first group of children attended 15 relaxation sessions. Parents of the second group participated in 15 behavior therapy sessions. The third group was considered as control. Data were analyzed by SPSS 13. Mean changes of weight, BMI and WC were calculated. Mean BMI decreased in all three groups after the intervention. This decrease was more remarkable, but not significant in the first group. Mean weight decreased in the first group but increased in the second group. Mean WC decreased in all three groups. This decrease was more obvious, but not significant in the first group. Stress leads to sympathetic system arousal which it associated with many pathologic conditions. Elicitation of relaxation response can help individuals embrace healthy lifestyle choices. Relaxation and parent behavior therapy can be considered as useful methods of controlling childhood obesity.

Adult cardiovascular disease has its root in childhood. Cardiovascular disease aggregates in families, so determination of high-risk families and early screening and control of cardiovascular risk factors in offspring will help in efforts to prevent cardiovascular disease. This study was performed to determine the relationship between cardiovascular risk factors in parents with a positive history of premature myocardial infarction and their offspring. This cross-sectional study was conducted in 2004 on 91 parents and their offspring (91children). The parents were randomly selected from among patients hospitalized in the critical care unit of Vali-e-Asr hospital with premature myocardial infarction. Important indicators such as systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured in both groups. There was no significant relation of systolic and diastolic blood pressure between parents and their offspring. Thirty-three percent of the parents had hypertension. No cases of hypertension were found in children. Mean systolic and diastolic blood pressure were significantly higher in the children of hypertensive parents. Significant relations were seen between BMI and obesity in parents and their children. There was no significant relation between serum lipids, high TC, high LDL-C and low HDL-C levels in parents and their children. The commonest lipid disorder in parents and their offspring was low HDL-C. The results of this study show a significant relation between hypertension, obesity and blood lipid disorders between parents with positive history of premature myocardial infraction and their children. Hence, screening programs in these children for detection of cardiovascular risk factors are recommended.