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Biomedical subjects

P Marques-Vidal

Publications and source records attributed to P Marques-Vidal.

At least 19 recordsLinked to original sources

Transformation of high density lipoprotein 2 particles by hepatic lipase and phospholipid transfer protein.

High density lipoprotein 2 (HDL2) was incubated with phospholipid transfer protein (PLTP) or with hepatic lipase (H-TGL), and the incubation products were separated into a d < 1.22 g/ml and a d > 1.22 g/ml fractions. The d < 1.22 g/ml fraction produced by PLTP was larger, had lower apolipoprotein A-I and higher lipid and apolipoprotein A-II content than native HDL2. The d > 1.22 g/ml fraction represented 30% of the initial HDL2 protein and consisted of small, apolipoprotein A-I and phospholipid-rich particles, with a high sphingomyelin:phosphatidylcholine ratio. Incubation with H-TGL led to a d < 1.22 g/ml fraction which was comparable to native HDL2 regarding size and chemical composition. The d > 1.22 g/ml particles represented only 5% of the initial HDL2 protein and had slightly higher diameter and sphingomyelin:phosphatidylcholine ratio than those produced by PLTP. Enrichment of HDL2 with triglyceride prior to incubation increased the amount of protein released into the d > 1.22 g/ml fraction (20%) but had no effect on size and chemical composition of the particles. We conclude that PLTP and H-TGL promote the formation of small, pre-beta-like HDL particles from HDL2.

Ca(2+) Mg(2+)-ATPase

Hypertension awareness, treatment and control in the community: is the 'rule of halves' still valid?

One of the cornerstones of the primary prevention of cardiovascular disease has been screening and early antihypertensive drug treatment of patients with high blood pressure (BP). Nevertheless, recent population studies have shown that awareness and management of high BP levels are far from optimal. In this study, we performed a search for publications providing frequencies of hypertension awareness, treatment and control in different populations. In men, the frequencies of awareness, antihypertensive drug treatment and BP control among all hypertensive patients varied between 23% and 93%, 5% and 89% and 5% and 87%, respectively. In women, the frequencies ranged between 28% and 97%, 6% and 97%, and 0% and 97%, respectively. The percentage of aware hypertensives who were under antihypertensive drug treatment varied between 47% and 95% in men and between 50% and 100% in women. The percentage of hypertensives who were under antihypertensive drug treatment varied between 47% and 95% in men and between 50% and 100% in women. The percentage of treated hypertensives achieving an adequate BP control varied between 29% and 95% in men and between 0% and 100% in women. Overall, women had a better awareness, treatment and control status for hypertension than men, and worse in developing countries than in industrialised countries. Hypertension awareness, treatment and control improved with time, together with the proportion of diagnosed hypertensive patients under treatment and the proportion of well controlled among treated hypertensive patients. We conclude that although the 'rule of halves' no longer applies for screening and treatment of hypertension in industrialised countries, it might still be valid for developing countries and for the effectiveness of antihypertensive drug treatment in all countries.

Adolescent

Trends in coronary heart disease morbidity and mortality and acute coronary care and case fatality from 1985-1989 in southern Germany and south-western France.

BACKGROUND: Although it has been shown that coronary heart disease mortality rates are decreasing in industrialized countries, little is known about time trends in coronary heart disease incidence. Further, although a number of randomized clinical trials have shown that percutaneous transluminal coronary angioplasty and thrombolysis improve survival of acute myocardial infarction patients, it is not known if widespread use of these therapeutic procedures has contributed to a decrease in in-hospital case fatality on a population basis. METHODS: The change over time of coronary heart disease attack, incidence and mortality rates was assessed in men and women (35 to 64 years) using data collected between 1985 and 1989 by the Augsburg (Germany) and Toulouse (France) MONICA Centres. Acute coronary care and 28-day case fatality for hospitalized 24-h survivors were also assessed. RESULTS: Men and women from Augsburg had higher age-standarized attack, incidence and mortality rates than their Toulouse counterparts. In both centres, attack, incidence and mortality rates declined in men, but increased in women. Patients in Toulouse received more percutaneous transluminal coronary angioplasty and thrombolysis and had lower 28-day case fatality than patients in Augsburg. The therapeutic procedures, percutaneous transluminal coronary angioplasty and thrombolysis increased in both centres; however, only in Toulouse was this increase associated with a decrease (non significant) in 28-day hospital case fatality. CONCLUSION: The increase in morbidity and mortality rates of coronary heart disease in women stresses the need for preventive measures in this group. The absence of a favourable effect of acute coronary care on 28-day fatality for hospitalized 24-h survivors in the Augsburg centre will be further investigated.

Adult

Awareness and control of hypertension and hypercholesterolaemia in France and Northern Ireland.

We assessed awareness and control of hypertension and hypercholesterolaemia in a cross-sectional study of 586 men from France and 189 from Northern Ireland, aged 35-55, without known coronary artery disease. Prevalence of hypertension was 28% in France and 31% in Northern Ireland (p < 0.42). In France, 70% of hypertensive subjects were aware of their status, vs. 58% in Northern Ireland (p < 0.10). Overall, 40% of subjects with a history of hypertension were untreated, and only 32% of the French and 12% of the Northern Irish subjects treated for hypertension (diet with/without drugs) were normotensive. The prevalence of hypercholesterolaemia was 46% in France and 48% in Northern Ireland (p < 0.62). In France, 59% of hypercholesterolaemic subjects were aware of their status, vs. only 17% in Northern Ireland (p < 0.0001). In both countries, half of those with a history of hypercholesterolaemia were untreated, and only 47% of the French and 43% of the Northern Irish patients treated for hypercholesterolaemia (diet with/without drugs) were controlled. While awareness of hypertension is comparable in France and Northern Ireland, awareness of hypercholesterolaemia is much lower in the latter. Control of hypertension and hypercholesterolaemia in both countries is poor and should be improved.

Adult

Sex differences in awareness and control of hypertension in France.

OBJECTIVE: To assess the prevalence, awareness, treatment and control of hypertension for men and women living in three French regions. DESIGN: A cross-sectional population survey. SETTING: Subjects in the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease population surveys of Bas-Rhin, the urban community of Lille and Haute-Garonne, France. SUBJECTS: We studied 1924 men and 1874 women aged 35-64 years. MAIN OUTCOME MEASURES: Hypertension was defined as a systolic blood pressure > or = 160 mmHg, a diastolic blood pressure > or = 95 mmHg, being administered antihypertensive drug treatment or any combination of the foregoing. Treated hypertensive subjects were considered controlled if their systolic blood pressure was < 160 mmHg and their diastolic blood pressure was < 95 mmHg. RESULTS: The prevalence of hypertension was 40.2, 43.8 and 27.7% among men in Lille, Bas-Rhin and Haute-Garonne, respectively. For women, the corresponding values were 31.5, 33.8 and 18.9%. Among hypertensive men, 51.8% were aware of their condition, 30.0% were being administered drug treatment and 9.2% were controlled; the respective values for hypertensive women were 69.8, 51.2 and 25.3% (P < 0.001). Awareness of hypertension was associated with antihypertensive treatment more commonly in Haute-Garonne (81.0% for men and 84.7% for women). The percentages of treated subjects in whom adequate control of the blood pressure had been achieved were only 30.7% for men and 49.4% for women. CONCLUSION: Women have a better awareness of hypertension than do men and their hypertension is controlled better but the low rate of control for both sexes calls for further improvements.

Adult

The Leu33/Pro polymorphism (PlA1/PlA2) of the glycoprotein IIIa (GPIIIa) receptor is not related to myocardial infarction in the ECTIM Study. Etude Cas-Temoins de l'Infarctus du Myocarde.

The GPIIb/IIIa receptor complex may contribute to acute coronary syndromes by mediating platelet aggregation. The Leu33/Pro polymorphism (PlA1/PlA2) of the GPIIIa has recently been shown to be associated with CHD in a small case-control study. We have investigated this polymorphism in a large multicenter study of patients with myocardial infarction and controls and found no difference in the distribution of allele and genotype frequencies between cases and controls.

Adult

The Gln/Arg polymorphism of human paraoxonase (PON 192) is not related to myocardial infarction in the ECTIM Study.

Paraoxonase is a high-density-lipoprotein associated enzyme capable of hydrolyzing lipid peroxides, which has been suggested to contribute to atherosclerosis and coronary heart disease (CHD). We studied the Gln/Arg polymorphism affecting codon 192 of human paraoxonase (PON 192) to determine whether this polymorphism, which is associated with serum paraoxonase (PON) activity, represents a risk factor for myocardial infarction (MI). The PON 192 polymorphism was analysed in 642 male patients with myocardial infarction and 701 age-matched controls participating in the ECTIM Study (Etude Cas-Témoins de l'Infarctus du Myocarde). The frequency of the Gln allele was 0.69 in cases and 0.70 in controls (ns). The frequency of the PON 192/Arg allele in 405 MI patients who underwent coronary angiography was 0.295, 0.323 and 0.331, respectively in those with 1, 2 or 3 stenosed arteries (stenosis > 50%) (ns). The mean levels of several plasma lipids, lipoproteins and apolipoproteins were compared between the 3 PON genotypes and no difference was observed. The PON 192 polymorphism was unrelated to MI, the severity of coronary atherosclerosis and to plasma levels of several lipid variables.

Adult

Alcohol consumption and myocardial infarction: a case-control study in France and Northern Ireland.

The effect of alcohol consumption was assessed in 561 men with myocardial infarction and 643 healthy controls recruited from France and Northern Ireland between 1988 and 1991 in the ECTIM Study (Enquête Cas-Témoins de I'Infarctus du Myocarde). In total, patients consumed less wine than did controls, while non-wine-derived alcohol consumption did not differ significantly. After adjustment for cardiovascular risk factors and country of recruitment by logistic regression, alcohol consumption displayed a protective effect against myocardial infarction, the magnitude of which was comparable in both countries. This effect, which was essentially due to wine consumption in France and to nonwine consumption in Northern Ireland, was largely attenuated by the introduction of high density lipoprotein cholesterol into the model. Thus, both wine and nonwine consumption appear to exert a protective effect against myocardial infarction which is partly mediated through an increase in high density lipoprotein cholesterol.

Adult

Association between the LPL-D9N mutation in the lipoprotein lipase gene and plasma lipid traits in myocardial infarction survivors from the ECTIM Study.

Using polymerase chain reaction (PCR) based techniques, we have identified individuals in the ECTIM study of myocardial infarction survivors (cases) and healthy matched controls who are carriers for a mutation of the gene for lipoprotein lipase (LPL) which alters amino acid 9 from aspartic acid to asparagine (LPL-D9N). The frequency of carriers in the cases from Belfast and France (3 separate centres) was 2.5 and 3.7%, respectively (mean 3.3%, 95% CI 1.9-4.7) and in the controls 2.0 and 2.9%, respectively (mean 2.7%, 95% CI 1.6-3.8%), but this difference was not statistically significant. In the cases, carriers of the allele for LPL-N9 had higher levels of several plasma lipid traits including total triglycerides (TG) (30%), very low density lipoprotein (VLDL) cholesterol (19%), apo E (24%), apo C-III (17%), lipoprotein particles (Lp) containing both apo E and apo B (LpE:B) (32%), and particles containing both apo C-III and apo B (LpCIII:B) (39%), and this effect was consistent in cases both from Belfast and from the French centres combined. By contrast, in the controls there were no differences in any lipid trait between carriers and non-carriers of the mutation that was consistent between the French centres and Belfast. There were no significant differences in the levels of any measured factor between cases and controls that could explain the different effect on plasma lipid traits associated with the mutation. However, compared to the non-carriers, in both cases and controls who carried the mutation, plasma TG concentrations were higher in those whose body mass index (BMI) was above the mean of the sample (26.0 kg/m2), with statistically significant interaction seen between BMI and genotype and levels of apo C-III, and lipoprotein particles containing both apo C-III and apo B (P < 0.02). The data suggest that carriers for the LPL-N9 mutation have a mild genetic predisposition to developing hyperlipidaemia and an atherogenic lipid profile, but that this requires the presence of other genetic or environmental factors for full expression, one of which appears to be increasing obesity.

Adult

[Long-term effects of prescription drugs in 174 patients treated for myocardial infarction, followed up from 4 to 5 years (the DEVENIR study)].

The aim of this study was to document changes in drug prescription after myocardial infarction. One hundred and seventy four men with typical myocardial infarction recensed by the Toulouse MONICA centre between 1989 and 1990 were followed up for 4.5 years. A copy of their drug prescription was obtained during the acute phase of infarction, at the time of discharge from hospital or clinic, after 6 months, and finally, after 4.5 years after infarction. During the acute phase, the majority of patients received nitrate derivatives, platelet antiaggregants, calcium antagonists, betablockers and antiarrhythmics. Between hospital discharge and the sixth month, the prescription of lipid lowering drugs quadrupled (from 8 to 33%; p < 0.00001) and those of platelet anti-aggregants decreased (from 82 to 70%; p < 0.01). The prescriptions of other drugs remained relatively stable. Between the 6th month and the 4th year of follow-up the only prescription to increase significantly was that of ACE inhibitors (from 14 to 23%; p < 0.03). The other prescriptions were maintained: platelet anti-aggregants (70% at 6 months vs 75% at 4.5 years), nitrate derivatives (59 vs 51%), betablockers (51 vs 52%), calcium antagonists (51 vs 48%), lipid lowering drugs (33 vs 42%), diuretics (3 vs 6%) and inotropic agents (2 vs 2%). Overall analysis showed an increase in the prescriptions of lipid-lowering agents (p < 0.00001) and ACE inhibitors (p < 0.002). On the other hand, the prescriptions of calcium antagonists and nitrate derivatives tended to decrease. These results show that the treatment of patients with coronary artery disease is based on drugs of proven efficacy, reflecting the impact of large scale therapeutic trials on everyday medical practice.

Adult

Relationships between blood pressure components, lipids and lipoproteins in normotensive men.

The aim of this study is to assess the relationships between pulse pressure (PP) mean arterial pressure (MAP), clinical and lipid parameters in normotensive men. One hundred and twenty-seven normotensive men aged 35-64 years from the French department of Haute-Garonne were analysed. Blood pressure (BP) was measured using a random zero device. Correlation analysis was performed using Pearson's coefficient. Variables significantly related to PP and MAP were then introduced in a stepwise multiple regression analysis. On univariate analysis, PP was significantly and positively related to total cholesterol, triglycerides, VLDL and LDL-cholesterol and apo B. MAP was positively related to age, body mass index (BMI), triglycerides and VLDL-cholesterol. Stepwise multiple regression analysis showed only apo B to be independently related to PP after adjustment for MAP. Also, after adjustment for PP, only BMI and VLDL-cholesterol were related to MAP. Hence, MAP is related to BMI and VLDL-cholesterol, which are a common feature of hyperinsulinism. PP is linked to apo B, an important proatherogenic factor. These biological parameters appear specific of steady and pulsatile components of BP. The relationship between PP and apo B suggests a possible link between lipids and arterial stiffness, and may partly explain the prognostic value of PP in myocardial infarction.

Adult

[Trends in the screening and management of hyertension and hypercholesterolemia in men in Haute-Garonne].

The evolution of awareness and management of hypertension and hypercholesteroloemia in the department of Haute-Garonne, France, was studied using 1265 male subjects aged 35-64 years who participated in the WHO-MONICA population surveys conducted in 1985-87 (675 subjects) and 1989-91 (590 subjects). After correcting for measurement bias in the second survey, there were 186 and 175 hypertensive subjects in the first and in the second survey, respectively, of which 47% and 59% were aware of their condition (p < 0.02), of which 76% and 90% were treated (p < 0.008), of which 42% and 32% were controlled (p < 0.20). There were 213 and 188 hypercholesteroloemic subjects in the first and the second survey, respectively (p < 0.91), of which 33% and 62% were aware of their condition (p < 0.0001), of which 56% and 43% were treated (p < 0.10), of which 59% and 64% were controlled (p < 0.63). In conclusion, although awareness of hypertension and hypercholesteroloemia in men has recently increased in Haute-Garonne, their management still needs to be improved.

Bias

Do hydroxy-carotenoids prevent coronary heart disease? A comparison between Belfast and Toulouse.

High intakes of antioxidants in fruit, vegetables and wine are thought to protect against coronary heart disease (CHD). Because people in Toulouse have a much lower incidence of CHD compared with Belfast, the plasma concentrations of antioxidant vitamins and carotenoids in the two populations have been compared. The major difference was in some of the plasma carotenoids. Hydroxy-carotenoids were twice as high in Toulouse in both sexes, notably lutein which occurs principally in dark green vegetables and beta-cryptoxanthin which occurs chiefly in citrus fruits. In addition, alpha-carotene was 50% higher in Toulouse, gamma-tocopherol was 50% higher in Belfast. Other plasma vitamins and carotenoids were not significantly different. If antioxidants play a role in preventing CHD, then the hydroxy-carotenoids are major candidates for further investigation.

Aged

[Cardiovascular risk factors trends in men from Haute-Garonne, 1985-87 and 1989-91. Results from the MONICA project].

Cardiovascular risk factors were assessed in two population surveys conducted in 1985-87 and 1989-91, in Haute-Garonne, among 675 and 590 middle-aged men, respectively. Relative to the first survey, the frequency of reported diabetes increased (9.7 vs 5.5%, p < 0.02), the frequency of hypertension decreased (27.6 vs 21.9%, p < 0.001), body mass index increased (26.3 vs 25.6 kg.m-2, p < 0.001), while the lipid levels did not change (total cholesterol: 2.25 vs 2.29 g/l; HDL-cholesterol: 0.51 +/- 0.13 vs 0.53 +/- 0.14 g/l). Although the frequency of smokers decreased slightly (42.0 vs 34.7%, p < 0.01), the cigarette consumption among smokers did not change (16.0 +/- 13.9 vs 15.7 +/- 12.1 cigarettes/day). These results show that cardiovascular risk factor levels did not improve significantly in Haute-Garonne.

Adult

Distribution, fatty acid composition and apolipoprotein A-I immunoreactivity of high density lipoprotein subfractions in myocardial infarction.

The lipoprotein profile, the HDL subfractions and the apolipoprotein (apo) A-I conformation of HDL were determined in 119 patients with myocardial infarction and 119 controls, paired for age. Apo A-I conformation was assessed by its immunoreactivity towards two monoclonal antibodies, 5F6 and 3G10. HDL phospholipid levels and fatty acid composition were also determined. HDL and HDL3 cholesterol, apo A-I, LpA-I and LpA-I:A-II levels were significantly lower in patients than in controls, whereas the levels of total and LDL-cholesterol and of apo B were not different. Apo A-I immunoreactivity against MAb 5F6 was significantly better in patients than in controls, while the immunoreactivity against 3G10 was similar. Paired stepwise logistic regression showed only apo A-I, HDL3 cholesterol and 5F6 immunoreactivity to be significantly related to myocardial infarction. After adjustment for HDL cholesterol, lower levels of HDL phospholipids and polyunsaturated fatty acids (PUFA) were found in patients compared with controls. Hence, of all HDL markers, apo A-I and HDL3 cholesterol appear to be the most informative. Also, lower HDL phospholipid and PUFA content may explain a different apo A-I conformation in patients with myocardial infarction.

Adult

Cardiovascular risk factors and alcohol consumption in France and Northern Ireland.

The levels of different lipid, lipoprotein and haemostatic variables were assessed in 615 control subjects of the ECTIM Study, defined by five groups of alcohol consumption: non-drinkers, 0 < or = 15 g/day, 15 < . < or = 36 g/day, 36 < . < or = 66 g/day and > 66 g/day. After adjustment for age, body mass index, cigarette consumption and country, alcohol consumption was associated with an increase in HDL-cholesterol (0.47 +/- 0.02 to 0.59 +/- 0.01 g/l in non-drinkers and > 66 g/day consumers, mean +/- S.E.M., P < 0.0001), apolipoproteins A-I and A-II (1.37 +/- 0.03 to 1.60 +/- 0.03 g/l and 0.32 +/- 0.01 to 0.41 +/- 0.01 g/l, respectively, P < 0.0001), LpA-I, LpA-I:A-II (0.46 +/- 0.01 to 0.50 +/- 0.01 g/l and 0.75 +/- 0.02 to 0.91 +/- 0.02 g/l, respectively, P < 0.001) and PAi-1 activity (134 +/- 11 to 177 +/- 11 U/ml, P < 0.001). Conversely, no increases were found for total and LDL-cholesterol, triglycerides, apolipoproteins B and C-III, LpE:B, LpC-III:B, fibrinogen and factor VII. Hence, among the lipid and haemostatic variables studied, only HDL parameters and PAi-1 activity were increased by alcohol consumption.

Adult