Multiple Risk Factors In Cardiovascular Disease: Strategies Of Prevention Of Coronary Heart Disease, Cardiac Failure, And Stroke (medical Science Symposia Series)

This volume is a collection of the most significant contributions to the 4th International Symposium on MULTIPLE RISK FACTORS IN CARDIOVASCULAR DISEASE: STRATEGIES OF PREVENTION OF CORONARY HEART DISEASE, CARDIAC F AlLURE, AND STROKE held in Washington, D. C. in April 1997. The meeting focused on the risk factors for cardiovascular disease and their interactions. The need for this symposium is based on the epidemiological, clinical, and biological evidence that individuals from industrialized countries often possess two or more risk factors which synergistically increase the global risk profile. This has become more evident in recent years with the increase in life expectancy of populations in the industrialized countries. The evidence that a combination of risk factors confers a very high risk of developing cardiovascular diseases, is of pivotal interest in the process of detection of patients who will benefit the most from pharmacological treatment. Many recent epidemiological data identifying the intrinsic and environmental factors contributing to the development of atherosclerosis are discussed. These results, in parallel with basic and clinical research, underline atherosclerosis as a complex and multifactorial process involving the influences of lipids, including lipoprotein subfractions, blood pressure rheologic forces, carbohydrate tolerance, and thrombogenic factors, including fibrinogen, tissue factor, PAl-I, and homocysteine. Furthennore, the risk associated with anyone of these risk factors varies widely depending on the level of the associated atherogenic risk factors. Hyper­ cholesterolemia and hypertriglyceridemia, for instance, are more common than would be expected by chance among hypertensive patients. Front Matter....Pages i-xvii New Insights into the Role of HDL in the Development of Cardiovascular Disease....Pages 1-7 Mechanisms of the Hypolipidemic Action of Fibrates....Pages 9-17 Lipid Lowering Drugs and the Arterial Wall....Pages 19-24 Perspectives on Lipid-Lowering Therapy: Past and Present....Pages 25-33 Role of the Fibrinolytic and the Coagulation System in the Formation and Disorders of Blood Vessels....Pages 35-44 Evolving Understanding of Coronary Thrombosis and New Insights into Therapeutic Strategies....Pages 45-59 Platelet Activation and Carotid Arterial Atherothrombosis....Pages 61-65 Tissue Factor and the Regulation of Arterial Thrombosis....Pages 67-74 Fibrinogen: Risk Factor or Risk Marker?....Pages 75-84 PAI-1 and the Risk of Cardiovascular Disease....Pages 85-92 Plasma Homocyst(e)ine [H(e)] and Arterial Occlusive Diseases: Gene-Nutrient Interactions....Pages 93-104 The Role of Social and Psychoemotional Factors in the Development of Cardiovascular Disease: The Experience in Eastern European Countries....Pages 105-107 European Action on Secondary Prevention....Pages 109-117 Cardiovascular Risk Factors in Normotensive and Hypertensive Egyptians: Preliminary Results, Egyptian National Hypertension Project (NHP)....Pages 119-129 Lipid Deposition and Oxidation in the Evolution of the Atherosclerotic Lesion: Lessons Learned from Hypercholesterolemic Animal Models....Pages 131-140 Oxidative Modification of LDL and Atherogenesis....Pages 141-147 Dietary Antioxidants and Cardiovascular Disease....Pages 149-156 Is “Antioxidant Status” a Risk Factor?....Pages 157-164 Diabetes and Atherosclerosis: Risk Factors and Clinical Trials....Pages 165-170 Insulin Resistance: What, Why, and How....Pages 171-179 Diabetes....Pages 181-190 Dyslipidemia, Diabetes, and Cell Adhesion Molecules....Pages 191-198 Novel Therapeutic Approaches to Insulin Resistance/Diabetic Dyslipidemia....Pages 199-208 Hypertension and Thrombosis, Genetic Determinants of Cardiovascular Disease....Pages 209-215 Lipoproteins and Cardiovascular Risk: From Genetics to Prevention of Coronary Heart Disease....Pages 217-228 Obesity and Diabetes....Pages 229-232 Clustering of Cardiovascular Risk Factors....Pages 233-237 Neutrophil-Endothelial Cells Cooperation in the Handling of Leukotrienes: Role in Coronary Inflammation....Pages 239-245 Integrin Expression and Macrophage Resistance to Apoptosis in Atherosclerosis....Pages 247-252 Effect of Statins Beyond Lowering Cholesterol: Where Do We Stand?....Pages 253-265 Lessons from Clinical Trials: LCAS and Other Studies....Pages 267-274 Improving the Cost Effectiveness of Lipid Lowering Therapy in Coronary Heart Disease Prevention....Pages 275-284 Diet and Cardiovascular Disease....Pages 285-296 Alcohol and Coronary Heart Disease: A Comparison of Ecologic and Non-Ecologic Studies....Pages 297-302 Preventing Cardiovascular Disease: Effective Smoking Cessation Strategies for the Busy Clinician....Pages 303-312 Risk Factors for Cardiovascular Disease and the Endothelium....Pages 313-323 Epidemiology of Risk Factor Clustering in Elevated Blood Pressure....Pages 325-333 Hypertension and Coronary Heart Disease Risk Factor Management....Pages 335-348 Global Risk Management: New Strategies for Implementation....Pages 349-355 Sudden Cardiac Death in Heart Failure....Pages 357-367 Back Matter....Pages 369-371 The issue of interaction of risk factors in cardiovascular disease is timely and of clinical relevance. This book is a collection of the scientific contributions to the 4th International Symposium on Multiple Risk Factors and Cardiovascular Disease: Strategies of Prevention of Coronary Heart Disease, Cardiac Failure, and Stroke, and addresses the role of simultaneous risk factors in patients. Because patients with two or more risk factors are at very high risk for developing cardiovascular diseases, special care should be taken in the choice of appropriate therapeutic intervention. Risk factors are also discussed from the point of view of the biochemist and the pharmacologist by addressing the mechanisms underlying the onset of hypertension, hyperlipoproteinemia, hypercoagulability, and the possibility of therapeutic intervention. This book will therefore be of value to the biochemist, pharmacologist, and clinical pharmacologist, as well as to specialists in the field of cardiovascular medicine in order to keep up-to-date with current knowledge in this fast moving field of research