Sexual problems in men with cardiac conditions
Clive Handler, Gerry Coghlan, Nick Brown in Management of Cardiac Problems in Primary Care, 2018
The willingness of men to discuss their sexual problems depends on their age, culture, religion, upbringing, marital status, the impact the problem has on their life and also their understanding of the problem and its causes. It is important that general practitioners offer patients and their partners the opportunity to discuss erectile dysfunction in the same way as one might ask routinely about angina or breathlessness. Erectile dysfunction is more common in individuals who smoke, or who have hypertension, diabetes or hyperlipidaemia. Sexual dysfunction and cardiovascular disease are commonly associated with each other. Erectile dysfunction is understandably common in men during and after any illness or hospitalisation. Sexual activity is generally safe and is encouraged as part of a normal healthy lifestyle in male and female patients with heart disease. Sexual matters for patients, particularly for those with cardiac conditions, are as important as other lifestyle issues and should be given equal consideration and care.
The Coronary Arteries: Atherosclerosis and Ischaemic Heart Disease
Mary N. Sheppard in Practical Cardiovascular Pathology, 2022
The great majority of ischaemic damage to the myocardium is the result of coronary atherosclerosis. Atherosclerosis is a focal intimal disease of medium to large arteries, including the aorta, carotid, coronary and cerebral arteries. Atherosclerosis is a biphasic disease. Virtually all individuals in the countries of the developed world will have some plaques, but only a minority will, at some point in their life, enter the second phase of atherosclerosis and develop clinical symptoms. Examination of the intimal surface of the human aorta opened longitudinally at autopsy shows plaques with considerable variation in their macroscopic appearances. Lipid is an essential component of the atherosclerotic disease process; atherosclerosis can be produced in animal models only by inducing hyperlipidaemia. Currently, there are five types of clinical myocardial infarction (MI) with distinct differences in aetiological background, pathogenetic mechanisms, and also evolving treatment strategies.
Health care in societal context
Joachim P Sturmberg, Carmel M Martin in The Foundations of Primary Care, 2018
The medical system itself shapes the social context and its associated expectations of medical care. In addition the political framework of government as well as medico-political groupings modifies expectations towards the delivery of health care. These differences are particularly obvious comparing the financial models underpinning the healthcare system in the US and the UK. The differences in intervention rates and expenditure on health care though have not achieved better population health; in fact within the Organization for Economic Cooperation and Development (OECD), America ranks at the bottom of most health indicators whereas the UK ranks in the top third. In market-driven healthcare environments, self-interest is at work on several levels. The substantial withdrawal of public funding into health research has made the pharmaceutical industry one of the biggest resource providers of medical research, directing most of their interest into the high-prevalence diseases of Western societies – hypertension, hyperlipidaemia and diabetes.
Nanoparticulate carrier system: a novel treatment approach for hyperlipidemia
Published in Drug Delivery, 2016
Kritika Sharma, Kulyash Kumar, Neeraj Mishra
Hyperlipidemia is a prevailing risk factor that leads to development and progression of atherosclerosis and consequently cardiovascular diseases. Several antihyperlipidemic drugs are having various disadvantages such as low water solubility and poor bioavailabilty due to presystemic gastrointestinal clearance. Thus, there is a considerable need for the development of efficient delivery methods and carriers. This review focuses on the importance and role of various nanoparticulate systems as carrier for antihyperlipidemic drugs in the treatment of hyperlipidemia. Some nanoparticle technology-based products are approved by FDA for effective treatment of hyperlipidemia, namely Tricor® by Abbott Laboratories (Chicago, IL, USA) and Triglide® by Skye Pharma (London, UK). Efforts to address each of these issues are going on, and should remain the focus on the future studies and look forward to many more clinical products in the future.
Metabonomic profiling of diet-induced hyperlipidaemia in a rat model
Published in Biomarkers, 2010
Qi Zhang, Guangji Wang, Jiye A, Bo Ma, Yu Dua, Lingling Zhu, Di Wu
This study describes the metabolic profiles of the development of hyperlipidaemia in a rat model, utilizing metabonomics by gas chromatography–mass spectrometry (GC-MS) determination coupled with multivariate statistical analysis. Rat plasma samples were collected before and during a high-lipid diet at days 0, 7, 14, 21 and 28, and were analysed for lipid levels using kit assays or metabonomics using GC-MS. Forty-one endogenous metabolites were separated, identified and quantified using GC-MS. The data matrix was processed by principal component analysis or partial least squares discriminant analysis. Dynamic modification of the rat metabonome can be clearly identified and tracked at different stages of hyperlipidaemia in the rat model. Potential biomarkers, including β-hydroxybutyrate, tyrosine and creatinine, were identified. The current work suggests that metabonomics is able to provide an overview of biochemical profiles of disease progress in animal models. Using a metabonomic approach to identify physiopathological states promises to establish a new methodology for the early diagnosis of human diseases.
Postprandial hyperlipidemia as a risk factor in patients with type 2 diabetes
Published in Expert Review of Endocrinology & Metabolism, 2020
Brian Tomlinson, Paul Chan, Christopher Wai Kei Lam
Introduction: Postprandial hyperlipidemia is a common feature of the atherogenic dyslipidemia in patients with type 2 diabetes. Quantification of this with oral fat tolerance tests is not used routinely in clinical practice and abnormal postprandial lipids are usually inferred from non-fasting plasma triglyceride levels. Identifying excessive postprandial hyperlipidemia may help to refine cardiovascular risk assessment but there are no treatments currently available which selectively target postprandial lipids and no large cardiovascular outcome trials using this as the entry criterion. Areas covered: In this review of relevant published material, we summarize the findings from the most important publications in this area. Expert opinion: Postprandial hyperlipidemia appears to contribute to the cardiovascular risk in patients with diabetes. Non-fasting triglyceride levels provide a surrogate marker of postprandial hyperlipidemia but more specific markers such as apoB48 levels may prove to be more reliable. Omega-3 fatty acids, fibrates and ezetimibe can reduce postprandial lipids but may not correct them completely. Several novel treatments have been developed to target hypertriglyceridemia and some of these may be particularly effective in improving postprandial levels. Further clinical trials are needed to establish the role of postprandial lipids in assessment of cardiovascular risk and to identify the most effective treatments.
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