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Biomedical subjects

A Bingham

Publications and source records attributed to A Bingham.

At least 19 recordsLinked to original sources

Psychosocial risk factors for heart disease in France and Northern Ireland: the Prospective Epidemiological Study of Myocardial Infarction (PRIME).

BACKGROUND: France has a substantially lower level of premature mortality from cardiovascular diseases (CVD) relative to its comparators. Compared with Northern Ireland, France has one-half the rate, despite having a similar cardiovascular risk profile to Northern Ireland. In this prospective longitudinal study the psychosocial risk hypothesis for CVD was tested. METHOD: A cohort of 9758 men (7359 in France and 2399 in Northern Ireland) aged 50-59 years who were initially free of any CVD were recruited. At baseline the subjects completed a psychosocial questionnaire, measuring hostility, depression, social support, and the Type A behaviour pattern. At 5-years follow-up their clinical status was determined. RESULTS: Multivariate analysis indicated that, contrary to prediction, France had a substantially more negative psychosocial risk profile than Northern Ireland. The psychosocial risk factors were not successful at predicting at 5-years follow-up the hard clinical endpoint of definite fatal/non-fatal myocardial infarction. In the case of the softer clinical endpoint, angina pectoris/unstable angina, only depression predicted outcome with a small effect size. CONCLUSION: The findings provide little support for the psychosocial risk hypothesis. The psychosocial risk profile was more negative in France, the opposite of that predicted. The finding of a relationship between depression and angina may reflect a tendency for individuals who respond negatively on mood state to report more cardiac symptoms irrespective of physical disease state.

Depressive Disorder↗

Tumour necrosis factor alpha converting enzyme (TACE) activity in the colonic mucosa of patients with inflammatory bowel disease.

BACKGROUND: Anti-tumour necrosis factor alpha (TNF-alpha) antibodies are effective in Crohn's disease and perhaps ulcerative colitis but antigenicity and the high cost have raised interest in other strategies to block TNF-alpha. These include the TNF-alpha converting enzyme (TACE) which releases soluble TNF-alpha from transmembrane pro-TNF-alpha. AIM: To investigate whether TACE activity is present in human colonic mucosa. MATERIALS AND METHODS: Detergent extracts of cell membranes from colonic biopsies were obtained from 12 controls and 28 patients with inflammatory bowel disease. Enzyme activity was measured by hydrolysis assays using pro-TNF-alpha or oligopeptide substrates spanning the known pro-TNF-alpha cleavage site at Ala(76)-Val(77). Cleavage products were identified by western blotting, high pressure liquid chromatography, or mass spectrometry. TACE protein was localised by immunohistochemistry and identified by western blotting of detergent extracts from purified lamina propria mononuclear cells (LPMNC) or epithelial cells. RESULTS: Detergent extracts released TNF-alpha from pro-TNF-alpha and cleaved a model oligopeptide as predicted. Substrate hydrolysis was sensitive to known TACE/matrix metalloproteinase (MMP) inhibitors, but not trocade which has low activity against TACE. The median TACE level was increased in active ulcerative colitis (147 arbitrary units (AU)/mg; p<0.01) but not in Crohn's disease (81 AU/mg) compared with controls (79 AU/mg). Both the full length proform and the active form of TACE protein were expressed in LPMNC cells and epithelial cells. CONCLUSIONS: Functional TACE activity is ubiquitously expressed in the human colon and increased in ulcerative colitis, raising interest in MMP inhibitors targeting TACE.

ADAM Proteins↗

Types of alcoholic beverages and blood lipids in a French population.

STUDY OBJECTIVE: Prospective studies have shown a consistent relation between alcohol consumption and decreasing incidence of coronary artery disease. The protective effect of alcohol could be mediated through increased levels of HDL cholesterol (HDL-c). The aim of this study was to examine the relation between blood lipid levels and the consumption of different types of alcoholic beverages among 1581 men and 1535 women. DESIGN: Data from representative cross sectional surveys (1994-1997) in three different regions of France were used. The consumption of the different types of alcohol was quantified using a recall method according to a typical weekly consumption. MAIN RESULTS: The median daily alcohol intake was 24 g for men and 4 g for women. After adjustment for confounders, total alcohol showed a positive and significant association with HDL-c and triglycerides (TG) in both sexes. In multivariate analysis, wine was positively associated with HDL-c. Beer was positively associated with HDL-c in men and with triglycerides in men and women. When taking drinking patterns into account, wine drinkers had higher HDL-c levels than non-wine drinkers. Differences became non-significant after adjustment for confounders and particularly for socioeconomic parameters. CONCLUSIONS: In a French population sample, total alcohol was positively associated with HDL-c and triglycerides. The specific influence of any particular alcoholic beverage on blood lipids was not clearly demonstrated but wine preference found in a group with higher lifestyle standards was associated with a more favourable blood lipid profile.

Adult↗

Impact of sulfonylurea receptor 1 genetic variability on non-insulin-dependent diabetes mellitus prevalence and treatment: a population study.

The high affinity sulfonylurea receptor 1 (SUR1) is involved in the metabolism of glucose in pancreatic beta-cells. We investigated the impact of the SUR1 intron 16-3t-->c polymorphism on non-insulin-dependent diabetes mellitus (NIDDM) prevalence in a large representative sample of French men and women, 35-64 years old, and explored potential relationships between the SUR1 intron 16 -t-->c polymorphism and sulfonylurea therapy efficiency. This study took place in Lille (northern), Strasbourg (eastern), and Toulouse (southern France). One hundred and twenty-two subjects with NIDDM were registered. We stratified NIDDM subjects according to their medical treatment: sulfonylureas (n = 70) versus other treatments (n = 50). From the three populations, a control group was selected (n = 1,250). Subjects carrying the cc intron 16 genotype had an increased risk of NIDDM [odds ratio (OR) = 1.76, 95% confidence interval (CI) 1.10-2.80; P = 0.017]. Subjects bearing at least one -3c allele and treated with sulfonylurea agents had fasting plasma triglyceride concentrations 35% lower than subjects that were tt homozygous (P = 0.026), whereas no difference could be detected between genotypes in NIDDM subjects treated with other treatments. The SUR1 intron 16 -3t-->c polymorphism was associated with an increased susceptibility to NIDDM in this population study, and seems to modulate the sulfonylurea therapy efficiency on hypertriglyceridemia reduction. This observation may help to better target the various therapies available for treatment of NIDDM.

ATP-Binding Cassette Transporters↗

Relationships between alcoholic beverages and cardiovascular risk factor levels in middle-aged men, the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction Study.

The relationships between alcoholic beverages and cardiovascular risk factors were assessed in 6730 men living in France or Northern Ireland. In France, all alcoholic beverages were significantly correlated with body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), high density lipoprotein (HDL) parameters, PAI-1 and Factor VII, whereas only wine was negatively related with fibrinogen levels. After adjusting for center, age, BMI, educational level, smoking and marital status, wine had a lesser effect on blood pressure, triglyceride, apo B and LpE:B levels than beer. Wine was associated with lower fibrinogen levels and beer with higher PAI-1 activity levels independent of the amount of alcohol consumed. In Northern Ireland, wine was negatively correlated with BMI, triglycerides, LpE:B and fibrinogen, whereas beer was positively correlated with SBP and DBP, triglycerides, HDL, apoprotein A-I and fibrinogen. Multivariate analysis showed wine to be positively associated with HDL parameters, and negatively with fibrinogen levels. Wine was also associated with higher LpA-I levels and lower fibrinogen levels independent of the amount of alcohol consumed. We conclude that alcohol consumption is related to lipid, lipoprotein and haemostatic variables, but the magnitude of the relationships depends on the type of alcoholic beverage. Also, some effects might be related to non-alcoholic components.

Alcohol Drinking↗

Do cardiovascular risk factors in men depend on their spouses' occupational category?

OBJECTIVE: To analyse the relationships between major cardiovascular risk factors in French men and their spouses' occupational category (OC), taking their own OC into account. DESIGN: A large sample of volunteers working in the French National Electricity and Gas Company (GAZEL). As a check of the robustness, the same analysis was performed in a population-based survey (French multinational MONItoring of trends and determinants in CArdiovascular disease (MONICA) registers). SETTING: Any site of the company in France. Representative sample from the population of the three registers (Lille, Strasbourg, Toulouse). PARTICIPANTS: 9486 and 534 men respectively, in working activity, living in couple and aged 40 to 50 years. MAIN OUTCOME MEASURES: Self-reported arterial hypertension, diabetes, hypercholesterolemia, leisure time sedentary lifestyle, smoking status, body mass index (BMI) and alcohol consumption. RESULTS: In the GAZEL study, diabetes, smoking status, and alcohol consumption in men were associated with their own OC. In contrast, spouses' OC was independently associated with men's hypertension, hypercholesterolemia, sedentary lifestyle, and BMI: men whose spouses were unoccupied or workers have higher risk factors levels. In the MONICA study, the results were mostly comparable, at least for hypercholesterolemia, sedentary lifestyle, smoking status and alcohol consumption. CONCLUSION: Spouses' OC was independently associated with several cardiovascular risk factors in men. These results might indicate that socioeconomic status of the couple, and not only individual characteristics, should be taken into account for a better understanding of cardiovascular risk.

Adult↗

Possible association between CTLA4 DNA polymorphisms and early onset type 1 diabetes in a UK population.

Linkage and association has been reported between CTLA4 DNA markers and susceptibility to type 1 diabetes in some populations, but not others. We performed case-control and family-based association studies to assess if the CTLA4 A49G and intron 1 C/T polymorphisms were associated with development of early onset type 1 diabetes in the Northern Ireland population. The distribution of A49G and C/T alleles in cases (n = 144) was similar to those observed in controls (n = 307). In contrast, significant distortions in allele transmissions from informative parents to probands were observed for both the A49G (P = 0.02) and C/T (P = 0.01) polymorphisms employing 297 nuclear families. Our results suggest that the CTLA4 gene may play a minor role in the overall genetic predisposition to type 1 diabetes in this UK population.

Abatacept↗

Leisure-time physical activity and regular walking or cycling to work are associated with adiposity and 5 y weight gain in middle-aged men: the PRIME Study.

OBJECTIVE: To examine the influence of physical activity on body mass index (BMI), waist circumference (W) and body mass changes (DeltaBMI) in middle-aged men, with special regard to moderate-intensity activities. DESIGN: Longitudinal study of adults who participated in the PRIME Study. SUBJECTS: A cohort of 8865 men aged 50-59 y, free of coronary heart disease. MEASUREMENTS: BMI and W at baseline, body mass changes over a 5 y period. Detailed baseline assessment of net energy expenditure due to physical activity (PAE) in the preceding year, according to category of activity, by means of the MOSPA Questionnaire. PAE was expressed in weekly metabolic equivalent scores (MET h/week). RESULTS: After adjustment for confounders, the multiple regression analyses indicated that BMI, W and DeltaBMI were inversely associated with PAE spent in getting to work (P<10(-5), <10(-5) and 0.04, respectively) and practice of high-intensity (>or=6 MET) recreational activities (<0.01, <10(-5) and <0.01). Men who regularly spent more than 10 MET h/week in walking or cycling to work had a mean BMI, W and DeltaBMI respectively 0.3 kg/m(2), 1 cm and 0.06 kg/m(2) lower than those who did not expend energy in getting to work. In the subgroup of subjects who did not perform high-intensity activities, the level of recreational PAE was inversely associated with BMI and W but not with subsequent weight-gain. CONCLUSION: These findings indicate that, in middle-aged men, physical activities of moderate-intensity, which are probably easier to promote than more vigorous activities and, in particular, a more current daily activity, walking or cycling to work, may have a favourable effect on body fat markers and body mass gain.

Activities of Daily Living↗

Association between nutrition knowledge and nutritional intake in middle-aged men from Northern France.

OBJECTIVE: The way in which nutrition knowledge transforms into dietary behaviour and nutrient intake may vary among populations. Therefore, the goal of the study was to examine whether nutrition knowledge is associated with nutritional intake in middle-aged men who are at major risk of cardiovascular disease. DESIGN: Cross-sectional population study aimed at comparing the response to a nutrition quiz with food habits and nutrient intake determined by a 3-day food record. SETTING: Men of the Urban Community of Lille (France) examined at home. SUBJECTS: 361 men aged 45-64 y, randomly selected from the electoral rolls. RESULTS: Subjects were separated in a high-score and a low-score group according to their responses to the nutrition quiz. Subjects in the high-score group had better educational and higher income levels than those from the low-score group. Multivariate analysis, adjusting on educational and socio-economic levels and other confounding variables - such as age, body mass index, cigarette smoking, physical activity and energy intake underreporting - showed that subjects in the high-score group were more often consumers of olive oil (36 vs. 12%; ), cheese (85 vs. 76%; or cereals (27 vs. 15%; and less often consumers of sunflower oil (51 vs. 68%; or dry vegetables (12 vs. 22%; than those in the low-score group. Subjects in the high-score group had lower intakes of fat vs. and especially of monounsaturated fat of animal origin vs. than individuals in the low-score group. CONCLUSION: Nutrition quiz score is associated with specific patterns of food choices and nutrient intake suggesting that nutrition knowledge influences dietary behaviour in middle-aged men from Northern France.

Cross-Sectional Studies↗

Evaluation of outcomes in converting from intravenous ondansetron to oral granisetron: an observational study.

OBJECTIVE: To describe a systematic evaluation of the outcomes associated with revising institutional guidelines for the prevention of acute chemotherapy-induced nausea and vomiting (CINV) to promote cost-effective use of the serotonin (5-HT3) antagonists. METHODS: The 5-HT3 antagonist of choice in the antiemetic guidelines was revised from intravenous ondansetron to oral granisetron in August 1995. Patient assessments were conducted immediately prior to (Period 1) and after (Period 2) guideline revision using validated questionnaires. The effectiveness of the two 5-HT3 antagonists were compared and reported to the prescribing oncologists. Outcomes were assessed one year after guideline revision (Period 3) using identical methods. RESULTS: No difference was found in the rate of total control (no emesis, no nausea) between patients receiving oral granisetron (60%) and intravenous ondansetron (56%) (p = 0.408, Period 1 vs. 2). Nausea severity, the number of emesis episodes, and use of rescue antiemetics were also equivalent. Prescriber compliance with using the 5-HT3 antagonist of choice and dose increased from 48% to 61% following adoption of oral granisetron. By Period 3, compliance increased to 78%, and satisfactory control of acute CINV was again documented. The costs for prevention of acute CINV decreased from $107 in Period 1 (intravenous ondansetron only) to $65 in Period 3 (oral granisetron). CONCLUSIONS: Outcomes associated with use of oral granisetron and intravenous ondansetron were equivalent in this patient population. Guideline revision and outcome documentation by the oncology pharmacists resulted in increased compliance with institution guidelines and a 40% cost savings.

Administration, Oral↗

Internet-based eligibility verification lowers costs, improves payment timeliness.

Verification of claims eligibility traditionally is performed either through telephone communication between the payer's and provider's staff or through an EDI clearinghouse. These forms of verification offer inconsistent quality, often use out-of-date information, cost time and money, and may financially harm payers and providers by leading to delays in payments or claims denied after care has been rendered. Internet-based eligibility verification software reduces the number of rejected claims because it can access current information without using a clearinghouse. The software also allows earlier collection of copayments because these obligations can be identified accurately when care is rendered. By offering Internet-based eligibility verification, payers can help providers achieve financial benefits while gaining such benefits themselves.

Boston↗

Prevalence of type 2 diabetes and impaired fasting glucose in the middle-aged population of three French regions - The MONICA study 1995-97.

OBJECTIVES: The aim of this study was to determine the prevalence of type 2 diabetes and impaired fasting glucose (IFG) in a population-based sample of 3 508 subjects, aged 35-64 years, participating in the French MONICA population survey from 1995 to 1997 in three French regions: the Urban Community of Lille, the Bas-Rhin and the Haute-Garonne. MATERIAL AND METHODS: Previously diagnosed type 2 diabetes is defined by the current use of oral hypoglycaemic treatment and newly diagnosed subjects by fasting plasma glucose (FPG) > or =7.0 mmol/L according to the ADA 1997 recommendations. IFG was determined by 6.1< or =FPG< or =6.9 mmol/L. Adjusted prevalences are calculated according to the French 1990 census data. RESULTS: Type 2 diabetes adjusted prevalence is 5.1% [4.1-6.1] in women and 7.3% [6.1-8.4] in men while IFG adjusted prevalence is 5.2% [4.2-6.2] and 11.8% [10.3-13.4] respectively. Prevalences of type 2 diabetes and IFG are both significantly higher in men than in women. This trend appears in any age group for IFG, but is only observed in 55-64 year-old subjects for type 2 diabetes. The reduction of the FPG threshold to screen diabetes mellitus from 7.8 to 7.0 mmol/L according to the ADA recommendations results in a 2.2-fold increase in the number of newly diagnosed diabetic subjects, screened by one FPG measurement, in our population-based sample. CONCLUSIONS: The MONICA population survey confirms that type 2 diabetes represents a major health care problem in France and underlines the influence of gender on the prevalence of both type 2 diabetes and IFG in the French middle-aged population.

Adult↗

Influence of parental histories of cardiovascular risk factors on risk factor clusters in the offspring.

OBJECTIVES: To assess the effect of parental histories of cardiovascular risk factors on risk factor clusters (RFC) in representative samples from three French populations (MONICA centers of Lille, Strasbourg, Toulouse). MATERIAL AND METHODS: In a representative cross-sectional study, we screened 1,291 males and 1,264 females, aged 35-64 years. Subjects were defined as RFC cases when they were affected by at least 2 disorders among, hypertension (systolic or diastolic blood pressure >=140/90 mmHg and/or antihypertensive drug), diabetes (physician-diagnosed diabetes and/or glycemia >=7.0 mmol/l and/or hypoglycemic drug), and dyslipidemia (triglycerides > 2.26 mmol/l and/or HDL-cholesterol<0.9 mmol/l in men and<1.2 mmol/l in women). Nineteen percent of the subjects were RFC cases. Parental histories of cardiovascular risk factors (hypertension, diabetes, hyperlipidemia) were positive if they were under 65. About 29% of the subjects had at least one parental history of risk factor. RESULTS: After adjustment for sex, age, educational level, sedentary lifestyle, alcohol consumption, body mass index, LDL cholesterol and center, parental histories of cardiovascular risk factors were significantly associated with the RFC. One, two, or at least three parental histories were significantly associated with increased odds of being RFC cases (adjusted OR 1.39 95% CI [1.05-1.82], 2.90 95% CI [1.91-4.40], 2.93 95% CI [1.41-6.08]). Furthermore, a maternal-only history vs a paternal-only history of hypertension or diabetes was associated with strong odds of being an RFC case. CONCLUSION: At least a single cardiovascular risk factor in parents was significantly associated with RFC in offspring, independently of environmental parameters.

Adult↗

The North-East-South gradient of coronary heart disease mortality and case fatality rates in France is consistent with a similar gradient in risk factor clusters.

In France, the mortality and case fatality rates of coronary heart disease follow a decreasing North-East-South gradient. The aim of the study was to evaluate the contribution of major cardiovascular risk factors to this gradient. To this end, the results of the third population survey of the WHO-MONICA Project conducted in three French geographically contrasted regions (the Urban Community of Lille in the North, the district of Bas-Rhin in the East and the district of Haute-Garonne in the South) are presented. One thousand seven hundred seventy-eight men and 1730 women aged 35-64 years were randomly selected from the electoral rolls. Major coronary heart disease risk factors (hypertension, hypercholesterolemia, low high-density lipoprotein (HDL)-cholesterol, obesity, smoking, physical inactivity, diabetes) were studied. The results show that the distribution of major coronary heart disease risk factors is heterogeneous among geographical areas in France. However, the proportion of subjects with more than three risk factors is higher in the North than in the other regions and the number of subjects with no risk factor is higher in the South than in the other areas. This distribution of risk factors among regions supports the hypothesis that accumulation of coronary heart disease risk factors contributes to the decreasing North-East-South gradient of cardiovascular mortality rates in France.

Adult↗

Characteristics of male vitamin supplement users aged 50-59 years in France and Northern Ireland: the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction.

The prevalence and characteristics of vitamin supplement users were assessed in 7538 male subjects aged 50-59 from France and 2468 from Northern Ireland. In France, 15% of subjects used vitamin supplements; users were significantly younger, had a lower body mass index, a higher educational level, had more frequently a hard physical job, reported more frequently a personal history of disease and were less frequently retired or inactive than non-users. In Northern Ireland, 21% of subjects were vitamin supplement users; users had a lower body mass index, drank less alcohol, had a higher educational level, were more frequently non-smokers and professionally active, and reported a hard physical job and the practice of leisure sports more frequently than non-users. Finally, vitamin supplement users in Northern Ireland had a lower consumption of alcohol, smoked less, had a lower frequency of personal history of disease and were more frequently on dietary therapy for hypertension or dyslipidaemia than their French counterparts. We conclude that vitamin supplement use is associated with a healthier lifestyle and with dietary measures against hypertension and dyslipidaemia in Northern Ireland. The less favorable lifestyle observed for vitamin supplement users in France awaits further investigation.

Cross-Cultural Comparison↗

Patterns of alcohol consumption in middle-aged men from France and Northern Ireland. The PRIME study.

OBJECTIVE: To assess the patterns of alcohol consumption in France and Northern Ireland. DESIGN: Four cross-sectional studies. SETTING: Sample of 50-59 y old men living in France and Northern Ireland, consuming at least one unit of alcoholic beverage per week. SUBJECTS: 5363 subjects from France and 1367 from Northern Ireland. INTERVENTIONS: None. RESULTS: Consumption of wine was higher in France whereas consumption of beer and spirits was higher in Northern Ireland. Alcohol drinking was rather homogeneous throughout the week in France, whereas Fridays and Saturdays accounted for 60% of total alcohol consumption in Northern Ireland. In both countries, current smokers had a higher consumption of all types of alcoholic beverages than non-smokers. Similarly, obese and hypertensive subjects had a higher total alcohol consumption than non-obese or normotensive subjects, but the type of alcoholic beverages differed between countries. In Northern Ireland, subjects which reported some physical activity consumed significantly less alcoholic beverages than sedentary subjects, whereas no differences were found in France. Conversely, subjects with dyslipidemia consumed more alcoholic beverages than normolipidemic subjects in France, whereas no differences were found in Northern Ireland. In France, total alcohol, wine and beer consumption was negatively related to socioeconomic status and educational level. In Northern Ireland, total alcohol, beer and spirits consumption was negatively related whereas wine consumption was positively related to socioeconomic status and educational level. CONCLUSIONS: Alcohol drinking patterns differ between France and Northern Ireland, and also according to cardiovascular risk factors, socioeconomic and educational levels. SPONSORSHIP: Merck, Sharp & Dohme-Chibret (France), the NICHSA and the Department of Health and Social Service (Northern Ireland).

Alcohol Drinking↗

Association of hypertensive status and its drug treatment with lipid and haemostatic factors in middle-aged men: the PRIME study.

AIMS: To assess the association of hypertensive status and antihypertensive drug treatment with lipid and haemostatic levels in middle-aged men. METHODS AND RESULTS: Hypertensive status, antihypertensive drug treatment, total and high-density lipoprotein (HDL) cholesterol, triglyceride, apoproteins A-I and B, lipoparticles LpA-I, LpE:B and Lp(a), fibrinogen, plasminogen activator inhibitor-1 (PAI-1) activity and factor VII were assessed in a sample of men 50-59 years living in France (n = 7050) and Northern Ireland (n = 2374). After adjustment for age, body mass index, smoking status, educational level, country, alcohol drinking and hypolipidaemic drug treatment, untreated hypertensive subjects had higher levels of total cholesterol, triglyceride, apoproteins A-I and B and PAI-I activity than normotensive subjects. On univariate analysis, diuretics decreased total and HDL-cholesterol and apoproteins A-I and B; those differences remained after multivariate adjustment. Treatment with beta-blockers decreased total and HDL-cholesterol, apoprotein A-I and LpA-I, and this effect remained after multivariate adjustment. Calcium channel blockers decreased total cholesterol and apoproteins A-I and B; those differences remained significant after multivariate adjustment. ACE inhibitors decreased total cholesterol, triglycerides, apoprotein B and LpE:B; and this effect remained after multivariate adjustment. Analysis of the subjects on monotherapy showed beta-blockers to decrease total cholesterol and HDL parameters and angiotensin-converting enzyme (ACE) inhibitors to decrease low-density lipoprotein (LDL)-related parameters, while no effect was found for the other antihypertensive drugs. CONCLUSIONS: Hypertensive status is associated with an unfavourable lipid and haemostatic profile in middle-aged men. Antihypertensive treatment with beta-blockers decreases HDL parameters, whereas treatment with ACE inhibitors appears to decrease total cholesterol and LDL-related parameters.

Angiotensin-Converting Enzyme Inhibitors↗