[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

Outcomes of cardiac rehabilitation after angioplasty [PTCA], bypass surgery [CABG] and myocardial infarction [MI]

Cardiac rehabilitation [CR] reduces cardiovascular mortality and improves cardiovascular and mental status of cardiac patients. Evaluation of the effects of CR in different groups according to sex, age and cause of disease would help the CR program to be special and individual and reduces the cost of treatment. The aim of this study was to evaluate the outcomes of CR in patients referring to CR program with different reasons. We studied 310 cardiac patients including 150 CABG, 44 PTCA and 110 persons with any other cause like Ml, angina, etc. without revascularization. All patients were subjected to a 24 sessions of CR including aerobic exercise, education and diet therapy. Exercise capacity, ejection fraction [EF], lipid profile and body mass index [BMl] were measured before and after the CR program. The data were analyzed using Chi-square, independent pair t-test and ANOVA. Results of this study showed that lipid profile, exercise capacity, EF and BMl were improved after CR in all groups. Changes of the variables were the same in all groups and the differences were not statistically significant. all the male and female patients attending CR program equally benefited from cr. we concluded that patients under medical treatment could improve their cardiovascular status before revascularization and sometimes postpone the intensive procedures

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

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