High density lipoprotein composition versus heredity for acute myocardial infarction in middle-aged males

Variation of serum lipoproteins in postmyocardial infarction patients treated with verapamil or placebo

The effect of verapamil on plasma lipids and lipoproteins was studied in 64 patients taking part in a double blind controlled trial of verapamil versus placebo in post myocardial infarction. During a six month treatment period no significant difference was seen in plasma cholesterol, triglycerides, high density lipoproteins or low density lipoproteins.

A prospective study of parental history of myocardial infarction and coronary artery disease in men

The relation between parental history of myocardial infarction (MI) and risk of coronary artery disease (CAD) was prospectively examined among 45,317 U.S. male health professionals who were free of diagnosed CAD, 40 to 75 years of age in 1986 and followed for 2 years. These men provided details of parental history of MI, including their parents' age at the first event, their personal history of hypertension, hypercholesterolemia and diabetes mellitus, and a detailed dietary assessment completed at baseline. During 72,454 person-years of follow-up, 181 non-fatal MIs were documented, 49 men died from MI or sudden death, and 140 underwent coronary artery surgery or angioplasty. Compared with men without any history of parental MI, those whose mothers or fathers had had an MI at less than 70 years of age had a substantially elevated risk of MI (relative risk = 2.2, 95% confidence interval, 1.2 to 3.8 for maternal history; relative risk = 1.7, 95% confidence interval 1.2 to 2.3 for paternal history). Risk of MI increased with decreasing age at parental MI. Paternal but not maternal history of MI was related to increased risk of coronary artery surgery. These associations were not appreciably altered by controlling for diet or established risk factors, either individually or in multivariate models. These prospective data indicate that a history of MI in either parent is associated with an increased risk of CAD among men.

Influence of dietary cod liver oil on fatty acid composition of plasma lipids in human male subjects after myocardial infarction

A randomized crossover study was carried out to investigate the fatty acid profile and concentrations of plasma lipids in male patients with myocardial infarction (MI) who supplemented their diet with 20 ml cod liver oil daily for 6 weeks. Subjects were divided into two groups, A and B. Group A received cod liver oil daily for 6 weeks after hospital discharge, but none for the subsequent 6 weeks. Group B did not start taking cod liver oil until 6 weeks after hospital discharge, and they then took cod liver oil for 6 weeks. Diet, medication or smoking habits were kept as constant as possible during the study. During the period of cod liver oil intake, eicosapentaenoic acid (20:5 (n-3), EPA) and docosahexaenoic acid (22:6 (n-3), DHA) increased significantly in phospholipids (PL), triglycerides (TG) and cholesterol esters (CE), whereas linoleic acid (18:2 (n-6), LA), dihomo-gamma-linolenic acid (20:3 (n-6), DHGLA) and arachidonic acid (20:4 (n-6), AA) were significantly decreased in phospholipids. The plasma level of TG was significantly decreased during the cod liver oil intake. Total cholesterol, high density lipoprotein (HDL) cholesterol, and levels of apolipoproteins A1 and B were not affected by cod liver oil in these MI patients.

Low serum apolipoprotein A-I in acute myocardial infarction survivors with normal HDL cholesterol

High density lipoprotein (HDL) cholesterol, apolipoprotein A-I (apo A-I), gamma-glutamyl-transferase, testosterone and oestradiol were determined in plasma in non-diabetic males who had survived an acute myocardial infarction (AMI) before the age of 60. They also had serum levels of cholesterol below 7.0 mmol/l 1 year after the AMI. On the basis of diastolic blood pressure they were subdivided into 2 groups with diastolic blood pressures below 90 mm Hg (n = 39), and with or above 95 mm Hg (n = 21) and then compared with an age-matched male non-diabetic reference group (n = 32). There were no significant differences in the levels of HDL cholesterol, gamma-glutamyl-transferase, and sex hormones between the AMI groups and the reference group. Reduced plasma levels of apo A-I were found in the AMI groups.

Beta-blocker induced changes in the cholesterol: high-density lipoprotein cholesterol ratio and risk of coronary heart disease

The lowering of blood pressure with beta-blocking drugs has had a low impact on coronary heart disease (CHD) mortality and the question has been raised whether adverse changes in plasma lipoproteins offset the benefits of blood pressure reduction. Comparison of plasma lipoprotein concentrations in hypertensive patients treated with commonly used beta-blockers with lipoprotein concentrations in patients with coronary heart disease shows that these drugs cause clinically important shifts in the cholesterol ratio [total cholesterol (TC): high-density lipoprotein cholesterol (HDLC)] and reductions in the atheroprotective lipoprotein HDLC. The magnitude of these changes is sufficient to increase the risk of heart attack two- to four-fold depending on the initial cholesterol ratio and the duration of treatment. Only beta-blockers with marked intrinsic sympathomimetic agonist activity (pindolol) or combined alpha-beta-blocking properties (Labetalol) appear free of adverse effects on plasma lipoproteins and triglycerides. Chronic treatment with other beta-blockers should be accompanied by cholesterol and HDLC measurements at the beginning of therapy. Plasma lipoprotein measurements at 3-6 month intervals seem mandatory in patients with cholesterol values greater than 6 mmol/1 (230 mg/dl) and (TC):HDLC ratios above 5 at the start of treatment. The risk of a coronary event must be regarded as unacceptable when the cholesterol ratio exceeds a critical value of about 6. Further controlled studies are needed to evaluate the effects of beta-blockers in hypertension when administered for periods of up to a year or more. More information is required on the behaviour of lipoprotein subspecies and apoproteins.(ABSTRACT TRUNCATED AT 250 WORDS)