Arya Atherosclerosis
Volume:8 Issue: 1, Spring 2012

In this study, we discussed aging and common diseases associated with it which can lead to hospitalization. Hypertension was also evaluated as one of the factors affecting morbidity and mortality in elderly people. In this cross-sectional study, data was collected using checklists and extracting information from medical records in Al-Zahra Hospital (Isfahan, Iran). Data was then analyzed using descriptive statistics according to the research questions in SPSS. A total number of 11,018 people aged 60-99 years were studied. Cardiovascular diseases were the most common cause of hospitalization (2063 patients (18.7%)). In patients with cardiovascular diseases, 84 were suffering from hypertension, 76 had primary hypertension, 7 had hypertensive heart disease with or without congestive heart failure, and 1 had secondary hypertension. Among all hypertensive patients, there were 37 males (44.05%) and 47 females (55.95%). Moreover, 34 people aged 60-69, 30 aged 70-79, 18 aged 80-89 and 2 aged 90-99 years. Duration of hospitalization was less than 1 day for 12 people, 1-2 days for 27, 3-5 days for 25, 6-10 days for 14, 15-11 days for 6, and more than 15 days for 1 person. Prevention and treatment of hypertension is important in order to control this disease. Untreated or poorly/untimely controlled hypertension would thus leave permanent side effects. It may thus leave sustained side effects if remain untreated or poorly/untimely controlled. However, people with hypertension were in minority in our study. Therefore, more research in this field with larger sample size is necessary for further identification of factors affecting quality of life in elderly people.

There is still controversy about association of Helicobacter pylori (H. pylori) infection with coronary heart disease (CHD). This study designed to evaluate this association in a sample of Iranians Population. Medical and drug history as well as fasting blood samples of 112 consecutive patients who were candidate for coronary angiography were taken on catheterization day. Fasting blood samples were used to measure C-reactive protein (CRP), anti H. pylori immunoglobulin G (anti H. pylori IgG) and interlukine-6 (IL6). According to angiography reports, participants were divided into patients with (n = 62) or without CHD (n = 43). To compare the association between H. pylori infection with CHD, multivariate logistic regression tests were used by adjusting sex and age, age and sex plus history of diabetes mellitus (DM), Dyslipidemia (DLP), and/or hypertension (HTN), CRP status and IL-6 level. Sixty two patients with CHD and 43 participants without CHD were enrolled in the present study. The mean ages of patients with and without CHD were 62.4 ± 9.5 and 59.0 ± 10.5 years respectively. Multivariate logistic regression analysis after adjusting for history of DM and/or DLP and/or HTN plus CRP status and IL-6 level showed significant association of H. pylori infection with CHD (OR 3.18, 95%CI 1.08-9.40). H. pylori infection is one of the probable risk factors for CHD independent of history of DM, DLP, HTN, CRP status and IL-6 level

Stroke in young adults is a known but abnormal disease. Several recent studies have discussed the correlation between existence of coagulation factors such as V Leiden and prothrombin mutation (G20210A) as risk factors for incidence of stroke. The present study investigated the frequency of prothrombin gene mutation and its impact on incidence of ischemic stroke in Iranian youth. This was a case-control study using convenient sampling method on seventy six 18 to 50-year-old people provided that they did not have classical risk factors for stroke. Case group comprised 22 patients with ischemic stroke (15 males and 7 females). Fifty four healthy people (17 males and 37 females) were selected as the control group. Participants in both groups were recruited within 26 months (23.9.2007 to 21.11.2009) in Al-Zahra Hospital, Isfahan. Prothrombin was not found in any of the studied patients. Heterozygous mutation was observed in one of the samples of the control group (1.85%). Despite the known effect of prothrombin gene mutation on incidence of venous thrombosis, it does not seem this factor, as an independent factor, can be considered as a risk factor to create ischemic stroke in people who do not have other risk factor.

Physical activity (PA) has been associated with reduced blood pressure in observational epidemiologic studies and individual clinical trials. Since PA is considered as a key component for the prevention and treatment of hypertension in children and adolescents, the purpose of this study was to assess blood pressure changes in athletic and non-athletic students before, during and after PA. The subjects in this experimental study consisted of 60 female athletic (n = 30) and non-athletic students (n = 30) with an average age of 21-23 years. The athletes were physical education students and non-athletes were medical students. Blood pressure (BP) at the right arm was measured in sitting position at 5 minutes before, 6 minutes after starting PA and 5 minutes after the end of the exercise. Weight, height, body mass index (BMI), mean arterial pressure (MAP) and pulse pressure (PP) were measured by ordinary methods. Data was analyzed using student's t- test. Results were expressed as mean ± SD. The statistical difference was considered significant at P < 0.05. The results showed that while systolic BP (SBP) increased during and 5 minutes after the end of physical exercise in both groups, diastolic BP (DBP) decreased. However, SBP values were significantly lower in non-athletic female students compared to the athletes. On the other hand, DBP values were significantly lower in athletic female students compared to non-athletes. Moreover, heart rate values were significantly lower at rest, during and 5 minutes after the end of physical exercise in athlete female students compared to non-athletes. Our results revealed that physical activity reduced arterial BP levels in female athlete students.

Deep vein thrombosis (DVT) is a relatively prevalent disease which causes high costs due to the required diagnostic tests, specialized treatments, and hospital admission. In recent decades, implementation of thromboprophylaxis protocols has significantly reduced the incidence of thromboembolism in hospitals. The present study aimed to compare the incidence of venous thromboembolism before and after implementation of the mentioned protocol in hospital with identified risk factors and underlying diseases. In this case-control group, 385 patients at the risk of DVT, some before and some after implementation of the protocol, were studied. Therefore, the level of thromboprophylaxis and the incidence of venous thromboembolism were compared before and after the protocol. Data was entered into SPSS15 and analyzed by chi-square and t tests. Out of 385 patients, 34 patients (8.8%) had venous thromboembolism while 351 (91.2%) were not affected. The incidence of venous thromboembolism was significantly different before and after the implementation of the protocol (17.7% vs. 5.9%; P < 0.001). The incidence of venous thromboembolism in patients not receiving thromboprophylaxis was almost 5 times higher than those who received it (20.7% vs. 5.1%). The frequency distribution of thromboembolism had a significant difference in the two above mentioned groups (P < 0.001). Thromboprophylaxis protocol reduced venous thromboembolism incidence in patients with underlying diseases which increase the risk of the complication.

Childhood obesity has reached epidemic levels. Children obesity predisposes them to risk of cardiac disease in adulthood. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. Furthermore, family life style has a great influence on children obesity. This study aimed to determine the effect of family-oriented weight reduction program on the children’s anthropometric measurements. This was a non-pharmacological clinical trial study which was performed on 4-18 years old children attending outpatient clinics of Isfahan Endocrine and Metabolism. Anthropometric measurements were recorded for all the participants. Children took part in one educational session in which they were taught about ways and benefits of having a regular physical activity each day and also benefits of having healthy nutrition. All the participants took part in every 4 months one-hour educational sessions and their anthropometrics were measured. Fifty eight single-mother families participated in this study. Fourteen single-father families started the intervention but did not follow it to the end. Children’s body mass index (BMI) z-score decreased significantly after the study. Children waist circumference (WC) and hip circumference (HC) significantly increased. Mothers WC and waist to hip ratio (WHR) increased significantly. Regression test showed that mother BMI was an independent factor (B = 0.307; P < 0.021). The effect of the pattern of children’s BMI changed across a one-year period. Our study showed significant effect of repetitive family life style education on children’s BMI z-score changes. Family, as the first place for children behavior formation, must be regarded as one of the best place to tackle childhood obesity.

Hypertension is a condition normally detected in people with type II diabetes. It eventually leads to cardiovascular diseases in the patient. Visfatin is an adipocytokine which is secreted from adipose tissue and can affect the inflammatory reaction and also serum lipid levels. Additionally, omega-3 inhibits the accumulation of fat and formation of insulin resistance. The current study tried to investigate the effects of omega-3 on blood pressure compared to placebo and the relationship between serum visfatin levels and blood pressure. A total number of 71 women with type II diabetes were randomly assigned to 2 groups to receive either omega-3 capsules or placebo capsules. In the first step, a questionnaire consisting age, height, weight, waist and hip circumferences, and systolic and diastolic blood pressure was filled out for each subject. Blood samples were then collected for laboratory tests. The next step was to conduct 8 weeks of intervention. All variables, except age, were measured again after the intervention. Hip circumference was considered as the maximum circumference of the buttocks. Waist circumference was measured by placing a tape horizontally across the abdomen at the end of a normal exhalation. Laboratory tests included the assessment of visfatin, glucose, and glycated hemoglobin (HbA1c) concentrations. Lipid profile, i.e. low density lipoprotein (LDL), high density lipoprotein (HDL), triglyceride (TG), and cholesterol, was also assessed. Using SPSS18, data obtained from the study was analyzed by a variety of appropriate statistical tests. There was a significant change in mean differences of systolic and diastolic blood pressure. Blood pressure showed a significant reduction in the omega-3 group compared to the placebo group. However, no significant changes were observed in systolic and diastolic blood pressure before and after the intervention (P > 0.05). Based on the results of this study, a daily consumption of omega-3 is suggested for patients with type II diabetes.

As blood pressure is higher in menopausal women than their peers with similar Body mass index (BMI), and considering hot flashes as one of the most common symptoms of menopause, this study was conducted to examine the 24-hour changes of blood pressure in menopausal women experiencing hot flashes. This cross-sectional study was performed on 26 menopausal 47-53 year-old women divided into 2 groups of 13. None of them had a history of internal diseases, hypertension, and hormone medications. Their blood pressure and heartbeat were recorded by a blood pressure Holter for 24 hours. The data was analyzed through student t-test and analysis of variance (ANOVA) using SPSS­11.5. Systolic blood pressure of the symptomatic group was significantly higher than the asymptomatic group during waking hours (P < 0.05). However, the heartbeats and systolic blood pressure of the symptomatic group were higher than those in the other group in 24 hours. This difference was not statistically significant (P > 0.05). Similar to hot flashes, the increase in systolic blood pressure may arise from central sympathetic activity. Peripheral vasoconstriction and increased cardiac output, both caused by baroreflex dysfunction, might also have been responsible for increments in systolic blood pressure. Therefore, prospective studies are required to determine how the growing increase in blood pressure and the prevalence of hypertension differ in both groups.

Depression is among the most important barriers to proper treatment of cardiac patients. It causes failure in accepting their conditions, decreases their motivation in following the therapeutic recommendations, and thus negatively affects their functionality and quality of life. The present study aimed to investigate the effects of an educational program based on Predisposing, Reinforcing, Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model on depression level in coronary artery bypass grafting (CABG) surgery patients. This was a quasi-experimental study in which 54 post-bypass surgery patients of Isfahan Cardiovascular Research Center were investigated. The patients were randomly divided into two groups of intervention and control. The data was collected using two questionnaires. Primarily, the cardiac depression scale was used to measure the degree of depression followed by PRECEDE model-based educational questionnaire to identify the role of the educational intervention on patients. The PRECEDE model-based intervention composed of 9 educational sessions per week (60-90 minutes each). The patients were followed up for two months post-intervention. Following the educational intervention, mean scores of predisposing, enabling, and reinforcing factors, and self-helping behaviors significantly increased in the intervention group compared to the control group (P < 0.001). In addition, a significant difference in mean scores of depression was observed between the two groups following the educational intervention (P < 0.001). The findings of the current study confirmed the practicability and effectiveness of the PRECEDE model-based educational programs on preventing or decreasing depression levels in CABG patients.

Hirsutism is the condition of excessive terminal hair growth in women with a typical male pattern distribution. Hirsutism is a common disorder that affects about 5% -10% of women of reproductive age. Adipose tissue contributes up to 50% of the circulating testosterone in premenopausal women Because of excessive androgen production in fat tissue. Therefore, it seems that hirsutism must be more common in people with simple obesity but controversy exist regarding this subject. The aim of this study is to evaluate the relation between Body Mass Index and hirsutism in a representative sample of Iranian woman. This is a cross sectional case control clinical trial. The study involved 800 individuals; 400 hirsute females and 400 healthy women as control group. The mean age of the participants was 28 ± 6.2 years. Hirsutism was determined by the Ferriman-Gallwey scoring system. Height and weight were measured by a Seca scale, Body Mass Index was calculated as weight/height² (kg/m²), and collected data were analyzed by SPSS software version 18 using T-test and chi-square statistical test. There were no significant differences between the two groups regarding age and height. However, Body Mass Index and weight were significantly higher in the case group than the control group. The chi square test revealed significant differences between the case and control groups regarding Body Mass Index (P < 0.001). In the current study hirsutism was more common in patients with a higher Body Mass Index. The increased frequency of hirsutism in overweight women could be explained by increased insulin resistance and more androgen production by adipose tissue.

Fibrinolytic therapy is the standard therapeutic method for patients with acute myocardial infarction (AMI). This study endeavored to assess the delay in arrival to the emergency department and door to needle time for thrombolytic therapy. This study was conducted on 80 patients with AMI whom referred to our clinic from January 2009 to January 2010. We measured time of arrival, needle time and door to needle time for all patients. Moreover, the relations of these times to some variables such as age, gender and the referred shift of emergency department personnel were calculated. A total of 80 patients, 62 (77.5%) male and 18 (22.5%) female were evaluated for thrombolytic therapy. The arrival time of overnight shifts was 14.59 ± 1.23 minutes shorter than other shifts. The median door to needle time was 46.56 minutes and the mean time of the onset of chest pain to arrival at the emergency department was 19.44 minutes. Seventy-two patients (90%) received fibrinolytic therapy within the first 30 minutes of arrival. The needle time was significantly longer in the night shift (P < 0.05) (between 8 to 14 minutes), while the time of receiving Streptokinase therapy in the other shifts was not meaningfully different. Finally there was a statistically significant difference between the referred shifts and needle time (P < 0.05). Despite our good results for door to needle time, to improve and attain the gold standard’s limits in administering fibrinolytic therapy, improvement of policies like training the personnel to shorten this time is recommend.

Today, ischemic heart diseases (IHDs) are the most common diseases worldwide. Angiography is the best way to diagnose IHDs. Angiographic complications however can include death, myocardial infarction, nausea, spasm of the coronary arteries, chest pain, bradyarrhythmia, hypotension, or hypertension. This study aimed to determine the effects of a simultaneous injection of trinitroglycerin (TNG) with contrast agent on the early complications of angiography. This clinical trial was conducted in Chamran Hospital, Isfahan, Iran in 2005. Before the angiography, the study population were randomly assigned into two groups of intervention (n = 111) and placebo (n = 112). TNG was mixed with contrast material in the intervention group and distilled water was mixed with contrast agent in the placebo group to be used for angiography. Nausea, spasm of the coronary arteries, chest pain, bradyarrhythmia and the mean systolic and diastolic blood pressures were compared during and after the angiography in patients of both groups. The obtained data was analyzed by chi-square and t tests. The mean age in the intervention and placebo groups were 59.93 ± 9.14 and 59.37 ± 10.12 years, respectively (P > 0.05). The two groups were not significantly different in terms of gender distribution. The frequency of nausea was 4.5% and 6.2% in the intervention and placebo groups, respectively. The corresponding values were 0.9% and 5.4% for coronary artery spasm and 1.8% and 6.3% for chest pain. Bradyarrhythmia occurred in 7.1% of patients in both groups. There were no significant differences in the abovementioned complications. Mean values of the highest and lowest systolic and diastolic blood pressures of the intervention group were significantly different from the placebo group (P = 0.001). Simultaneous injection of TNG and the contrast agent in this study resulted in positive findings (except for changes in blood pressure). More studies are recommended with different doses of TNG, different times of injection and considering at-risk individuals.