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Biomedical subjects

M R García-Palmieri

Publications and source records attributed to M R García-Palmieri.

At least 19 recordsLinked to original sources

[Coronary disease in women].

Coronary heart disease is the leading cause of death among women, with a high prevalence in the older women. Women have a less favorable outcome after myocardial infarction and after myocardial revascularization procedures. We have revised the most up to date published information about risk factors for coronary heart disease in women. The most salient features concerning lipids, hypertension, diabetes, cigarette smoking, physical activity and obesity are summarized. The differences on clinical manifestations of coronary heart disease among men and women are also presented. The salient data about estrogen replacement therapy effect on coronary heart disease on postmenopausal women is also summarized.

Adult↗

Chuichi Kawai.

Explore the source record for details and available documents.

Cardiology↗

The treatment of stable angina pectoris.

A review of the available therapeutic measures for the management of stable angina pectoris is presented. The subject is critically examined by focusing on 5 main categories: general measures, drug therapy, coronary artery by-pass surgery, percutaneous transluminal coronary angioplasty and the handling of associated illnesses or disorders. General measures provide attention to the control or removal of aggravating conditions and to the institution of alterations in habits and life-style that will benefit the patient. Drug therapy depends upon the use of nitrates, beta adrenergic blockers and calcium entry blockers either alone or in combination. The mechanism of action of different drugs, its indications, as well as the dosage and frequency of use are reviewed. The indications for coronary artery by-pass surgery are presented as well as those for percutaneous transluminal angioplasty. An orientation in the selection of specific drugs when important concomitant diseases, such as hypertension and diabetes, coexist with stable angina pectoris is offered. The rationale behind the different alternatives is presented.

Adrenergic beta-Antagonists↗

Educational status and coronary heart disease in Puerto Rico: the Puerto Rico Heart Health Program.

The Puerto Rico Heart Health Program is an observational epidemiological study of coronary heart disease (CHD) among 9824 Puerto Rican men conducted from 1965 to 1980. Increased level of education was associated with decreased total mortality and increased CHD incidence among the urban participants. Urban men with more education, age 45-64, also showed higher levels of blood pressure and serum cholesterol, more obesity, less physical activity and more atherogenic diets. The increased level of risk factors among those with high education could statistically account for the elevations in CHD incidence. Among rural participants there was an increase in total mortality among those at the highest and lowest levels of education.

Cohort Studies↗

Left ventricular hypertrophy among dark- and light-skinned Puerto Rican men: the Puerto Rico Heart Health Program.

Racial groups were assessed by determinations of skin color in 3366 urban men in the Puerto Rico Heart Health Program, an epidemiologic study of coronary heart disease in Puerto Rico. These men participated in a comprehensive cardiovascular examination that included assessment of blood pressure, relative weight, physical activity, cigarette smoking, left ventricular hypertrophy (LVH) as determined by ECG, and measurements of skinfold thickness. They were followed for mortality over the next 6 years. Dark-skinned Puerto Rican men had a higher prevalence of both definite and possible LVH-ECG after stratifying by levels of hypertension, relative weight, physical activity, number of cigarettes smoked, and subscapular skinfold thickness. After multivariate adjustment of these factors, the dark-skinned men had approximately twice the prevalence of both definite and possible LVH-ECG as the lighter skinned men. Definite LVH-ECG carries a high mortality risk over the next 6 years as compared to men without definite LVH (fivefold increased risk in lighter skinned and sevenfold increased risk in darker skinned Puerto Rican men).

Adult↗

Factors related to diabetes mellitus in Puerto Rican men.

Urban-rural comparisons of the prevalence of diabetes were made in a cohort of 2567 rural and 6190 urban participants aged 45 to 64, in the Puerto Rico Heart Health Program. The prevalence of diabetes in the urban population was more than double that in the rural. Consistent with this, blood glucose concentrations were significantly higher in urban than in rural populations. The prevalence of diabetes increased with age and relative weight. It was associated with elevations of serum cholesterol, blood pressure, and fasting serum triglycerides. A positive family history was found more commonly in diabetics than in nondiabetics. If there was a history in both a sibling and a parent, there was at least a threefold increased prevalence over those with no family history. The reason for the higher prevalence of diabetes in the urban than in the rural area is elusive. In obese men, the urban and rural prevalence rates are the same, but, among relatively lean men, the prevalence in the urban area is twice that of the rural men.

Age Factors↗

Urban-rural differences in coronary heart disease in a low incidence area. The Puerto Rico heart study.

This report explores coronary heart disease (CHD) risk factors and the incidence of new CHD events developing over a two and one-half year period in 8793 urban and rural Puerto Rican men aged 45--64 years. Rural men had a lower average blood pressure, serum cholesterol, blood sugar, heart rate and relative weight than urban men. They were more active physically and although more of them smoked, they smoked fewer cigarettes than urban dwellers. The age-adjusted CHD incidence rate for urban men was 1.5 times that of rural men. Among rural areas the most rural had the lowest incidence. Among urban areas there was a suggestive trend of increasing incidence with degree of urbanization. Differences in conventional risk factors, while substantial, do not entirely explain the modest differences in incidence. There also appeared to be a relation with geographic mobility. Urban men who had always lived in the same area had an incidence rate as low as that for rural men whereas recent rural migrants to urban areas had the highest rates of all.

Adult↗