[Association of waist circumference and blood pressure]

Obesity is a risk factor for the incidence of hypertension. Waist circumferences [WC] reflect abdominal fat distribution and provides a simple yet effective measure of truncal obesity, WC being correlated to blood pressure. In this study the relation between blood pressure and WC has been evaluated. The study is part of the Isfahan Healthy Heart Program [IHHP] and included 7806 persons; demographic data were collected by questionnaires and body weight, height, systolic blood pressure, diastolic blood pressure and WC were measured. Statistical analysis was performed using correlation, logistic regression and general linear regression. In all groups, systolic and diastolic blood pressure were correlated to WC. In younger patients, WC was correlated more with systolic blood pressure [r=0/119 for male and 0.248 for female] [P<0.001]; in older people [over 55 years], WC was correlated more to diastolic blood pressure [P<0.001]. This effect was independent of BMI, sex, age and daily energy intake. WC which is related to total body fat especially abdominal distribution of fat, is correlated positively to systolic and diastolic blood pressure; any increase of WC, even in persons with normal BMI could predict development of hypertension

relationship between different occupations and risk factors of heart diseases

Cardiovascular diseases have been known as the first cause of morbidity and mortality in Iran and many other countries. The noise of workplace and the shift work are among the risk factors of these diseases. This study was conducted to assess the relationship between different occupations and risk factors of heart diseases. This study was done on 4872 men and women, ageed over 19, in Isfahan. For each subject a questionnaire was filled in order to collect necessary information about the anthropometric characteristics and some cardiovascular risk factors and clinical tests were done in order to determine the status of participants blood factors. Men were divided according to the noise of workplace and the shift work non -shift work, and women were divided based on whether they were housekeepers or not. Results of this study showed that in men with high-noise workplace, the prevalence of hypertriglyceridemia [p=0.02] and hypertension [p=0.01] was more than others but there was not any significant difference in other risk factors. Also in subjects with shift work, the prevalence of hypertriglyceridemia [p=0.03] and obesity [p=0.001] was high whereas there was not any significant difference in other risk factors. In housekeeping women mean value of waist circumference [p=0.001], body mass index BMl [p=0.000] serum triglyceride [p=0.000], cholesterol [p=0.0001], LDL cholesterol [p=0.001], 2hpp [p=0.001], diastole blood pressure [p=0.001], systole blood pressure [p=0.01] and also the prevalence of obesity [p=0.0001], high LDL cholesterol [p=0.001], hypertriglyceridemia [p=0.001], hypercholesterolemia [p=0.0001] and hypertension [p=0.003] were significantly higher than those in employed women. Considering the result of this study, the noise of workplace causes increase in the prevalence of hypertriglyceridemia and hypertension and the prevalence of hypertriglyceridemia and obesity increased because of the shift work. It seems that two factors of noise and shift work cause these changes by inducing stress. Housekeepers had a high level of most of the CVD risk factors in comparison with employed women. It seems that two factors of noise and shift work by producing stress and reduction of physical activity in housekeepers can prone the subject to CVD

Mean duration of EKg changes in patients with unstable angina

Chest pain in unstable angina is associated with EKG changes in T-wave and ST-segment, which may help diagnose the disease. Based on certain references EKG changes prolonged for more than 12 hours may be suggestive of non-Q myocardial infarction. This study was conducted to assess the mean duration of EKG changes in patients with unstable angina. This cross-sectional study was conducted on 34 patients in 2001. The subjects were randomly selected among patients hospitalized in the critical care unit of Isfahan Nour Hospital. New ST-segment T-wave changes and ruling out of acute myocardial infarction by enzymatic tests [Total CPK, CPK-MB, LDH] constituted criteria of inclusion in the study. Subjects with Wolf-Parkinson-White syndrome [WFW], salivary diseases, those taking anti-arrhythmic, anti-angina, or digital medications, patients with left bundle branch block, and those who had recently undergone surgery [all of which may cause T-wave and ST-segment changes] were excluded from the study. The patients were followed up for three months after discharges. EKG changes persisted for 28.65 +/- 7 days. Changes of ST-segment and T-wave lasted for 14.7 +/- 24 and 30.1 +/- 38 days, respectively. The minimum and maximum durations of EKG changes in patients were 1 day and 90 days, respectively. Eight patients underwent angiography; seven displayed abnormal findings. Statistical analysis did not show a significant relationship between the duration of EKG changes and severity of coronary involvement or incidence of future complications. EKG changes in patients with unstable angina who have recently developed these changes may persist for an average duration of one month and may complicate diagnosis. Hence greater importance should be attached to clinical symptoms and further laboratory diagnostic methods should be used

relationship between serum vitamin D level, coronary artery diseases and the associated risk factors in female carpet weavers

Regarding some evidences, the mortality of coronary artery diseases may be related to vitamin D [VD] deficiency. This kind of deficiency is more common among female carpet weavers. To determine the relationship between serum vitamin D level, coronary artery diseases [CAD] and the associated risk factors in female carpet weavers. This case-control study was conducted on 460 postmenopausal carpet-weavers and noncarpet- weavers in the villages of Isfahan with similar socio-economic conditions. The participants initially underwent the clinical examinations and electrocardiography and if necessary, ecocardiography and exercise tests. Blood pressure, blood lipids and both serum and dietary vitamin D were measured and a questionnaire was completed for every participant. The presence of CAD was determined based on the Rose questionnaire and/or Minnesota electrocardiography coding system. The frequency of CAD and the mean values of other factors were insignificant between two groups [p>0.05]. There was no statistical association between the serum vitamin D level and some of the CAD risk factors among carpet and non-carpet weavers and persons with or without CAD [p>0.05]. There was only a direct relationship between abdominal obesity and serum vitamin D level [OR=0.69, p= 0.03]. Regarding our data, no relationship was found between CAD and serum vitamin D. However, more investigations including the determination of serum and dietary calcium, serum phosphorus and PTH are needed. Also a research, analyzing the vitamin D receptor [VDR] gene polymorphisms is proposed

mean duration of electrocardiographic changes in unstable angina

According to some references, the duration of these changes for more than 12 hours after pain relief in unstable angina may be indicative of non-Q-Wave myocardial infarction [MI]. To obtain the mean duration of ECG changes in patients with unstable angina. The present work was a cross-sectional study in which 34 patients, who were admitted to the coronary care unit [CCU] for unstable angina, were investigated. The selection of subjects was based on the presence of ST-segment and T-wave changes in ECG of patients with anginal pain but without MI, confirmed by laboratory measurements of enzymes such as LDH, CPK-MB and total CPK. The patients with other causes of ST-segment and T-wave changes [WPW syndrome, salivary diseases, using anti-arrhythmic and anti-angina drugs, left bundle branch block, digital administration and currently experienced surgery] were excluded from the study. The subjects were followed up for 3 months after discharge. The mean duration of ECG changes in study group was 28.65 +/- 7 days. The mean duration of ST-segment and T-wave changes were 14.7 +/- 24 days and 30.1 +/- 38 days, respectively. The minimum duration of ECG changes was one day and the maximum was 90 days. The results showed that in hospitalized patients with unstable angina, the ECG changes can be prolonged for an average of one month which must be considered for further diagnostic and treatment decisions

[ situation of new risk factors of cardiovascular disease in urban population of Isfahan]

During recent years, many epidemiological studies on risk factors of cardiovascular disease [CVD] have been performed among which are fibrinogen, activity of factor VII, lipoprotein [a], and homocysteine as new CVD risk factors. Through completed studies, it is found that in urban population of Isfahan more than one risk factor [hypertension, smoking, hypercholesterolemia, diabetes and obesity are seen in 32% of men and a descriptive cross-sectional study was performed in 1998-99 and 409 subjects [175 men, 234 women] were randomly sample. Then each subject underwent a blood test, electrocardiography, medical examination and daily physical activity assessment. Nutrient intakes were obtained through assessment of food consumption as 3-day recall. Personal information and anthropometric measurements were also recorded. Fast blood sugar and serum lipids were measured by auto analyzer Elan 2000; lipoprotein [a] by ELISA; hemocystein by HPLC; fibrinogen by turbidimetry and factor VII by calculating coagulation time compared to standard time. Statistical analyses were done by t-tests. The results showed that mean fibrinogen, factor VII, lipoprotein [a], and hemocystein were 244.9+/-7 mg/dl, 118.3+/-58 per cent. 13.3+/-13 mg/dl and 11.5+/-3 micro mol/lit respectively in studied population. By comparing these new CVD risk factors over the world, it was determined that their- levels were in the normal range in urban population of Isfahan. The level of fibrinogen and hemocystein are higher and lower in women than those in men, respectively that is compatible with many other studies

relation between creatine kinase, magnesium and fibrinogen in patients with acute myocardial infarction

One of the most important mechanism of myocardial infarction is coronary thrombosis. One of the diagnostic procedures for myocardial infarction [MI] is serological tests to determine the levels of creatine kinase enzyme [CK] and, more effectively, creatine kinase MB isoenzyme [CK-MB]. On the other hand, high serum fibrinogen concentration can be considered as a risk factor for MI or the occurrence of complications after MI. The present study was conducted to find any possible relationship between the serum CK and CK-MB levels with serum magnesium and fibrinogen concentrations in acute MI [AMI], as well as any association between each of the factors mentioned with post-MI complications. The study included 100 MI affected patients [60 men and 40 women, between 30-60 years] hospitalized in the coronary care units [CCUs] of Isfahan hospitals in 1995. A questionnaire was completed for each subject to obtain information on personal characteristics, previous history of cardiovascular disease risk factors, MI type and location, radiological symptoms, prescribed medicines, and., in addition daily electrocardiography was performed for all patients. Also, blood samples were taken from each patient on admission, 6, 24 and 48 hours after MI for serum CK and CKMB measurements; the serum magnesium and fibrinogen concentrations were measured on the first and the second days, respectively. The results show that the peak value for CK enzyme and isoenzyme occurs 24 hours after MI. As regards the correlation between the serum magnesium and fibrinogen levels with the CK enzyme and CK-MB isoenzyme concentrations at different time points after MI, a significant correlation was observed only after 24 hours. The serum fibrinogen concentration was higher in men [366'103.7] than in women [311'105.2] [p=0.05]. On the other hand, the mean value of CK-MB isoenzyme was significantly higher in the Q-wave MI patients than in the non-Q-wave ones 6 and 24 hours after MI. In addition, there was a significant correlation between the CK enzyme and CKMB isoenzyme levels with post-MI complications after 24 hours. No correlation was found between serum magnesium and enzyme or the occurrence of MI complications were observed. It is concluded that only serum fibrinogen concentration can be used as a diagnostic serum marker for complicated MI

Lipid profiles in the Isfahan population: an Isfahan cardiovascular disease risk factor survey, 1994

A population-based study was conducted in 1994 in Isfahan to define the prevalence of various types of hyperlipidaemia and the mean concentrations of serum total cholesterol, triglycerides, low-density lipoprotein cholesterol and high-density lipoprotein [HDL] cholesterol. In all, 2200 people were randomly chosen and classified into five age groups [20-70 years]. The data were obtained by questionnaires and anthropometric measurements and serum lipids and fasting blood sugar were measured. The prevalence of hyperlipidaemia was higher in women than men. Multiple linear regression showed only HDL cholesterol and triglycerides to be associated with body mass index. The most prevalent lipid abnormality was HDL cholesterol. Diet modification and physical activity should be encouraged to reduce hyperlipidaemia

Prevalence of hypertension and associated risk factors in Isfahan, Islamic Republic of Iran

A population-based cross-sectional survey was conducted to determine the mean levels of blood pressure and prevalence rates of hypertension and to identify differences in the prevalence of other risk factors in hypertensive and nonhypertensive people. A total of 8624 men and women > or = 19 years were randomly selected. Overall, 18.0% [16.8% males and 19.4% females] had systemic hypertension. The mean levels of systolic and diastolic blood pressure and the prevalence of hypertension increased with age, but no significant differences were found between the sexes when adjusted for body mass index. There was a high prevalence of obesity, hyperlipidaemia and diabetes mellitus among hypertensive people compared with nonhypertensive. Our study suggests that the prevalence of hypertension in Isfahan is greater than supposed