Correlation between fasting blood sugar and resting blood pressure in teachers residing in Shiraz, Iran 2009

Coronary Artery Disease [CAD] is the major cause of morbidity and mortality. The knowledge about correlation between the different risk factors of CAD provides valuable information for prediction and prevention of the disease in a specific population.The aim of this study was to evaluate the correlation between fasting blood sugar [FBS] and resting blood pressure in teachers residing in Shiraz, Iran. A total of 3115 teachers from different educational centers of Shiraz, Iran were interviewed in this cross sectional study. The data obtained comprised demographic information including age, sex, and history of hypertension [HTN], diabetes mellitus [DM], and current use of medications. Other parameters measured were height, weight, fasting blood sugar [FBS] and resting blood pressure [BP] as well as calculating the body mass index [BMI]. Out of all the cases studied, undiagnosed and/or untreated cases of diabetes and hypertension were 1.5% and 15.2% respectively. FBS was higher in the elderly and in cases with higher BMI, but without any significant difference in relation to sex. The prevalence of HTN was higher in males, in older cases and in those with higher BMI. A significant relationship was observed between FBS and resting BP in hypertensive and prehypertensive groups [P < 0.001] as compared to normotensive subjects. There was a significant correlation between FBS and resting BP in hypertensive and prehypertensive teachers residing in Shiraz,Iran. But this correlation was not present in the vast majority of the population with normal resting blood pressure. The prevalence of neglected DM and HTN in this population was high enough to warrant regular screening

Systolic and diastolic blood pressure among three groups of occupation

It is believed that occupation influences cardiovascular risk factors. To assess blood pressure [BP] and other cardiovascular risk factors in three occupation groups-teachers, military personnel and female housekeepers residing in Shiraz, southern Iran. We studied 2783 teachers, 366 military personnel, and 1896 female housekeepers who attended various medical education centers in Shiraz. BP, anthropometric parameters as well as fasted lipid profile and blood glucose level were measured determined for each participant. The mean values of all analyzed cardiovascular risk factors were higher among female housekeepers compared to female teachers. The mean systolic and diastolic BP was significantly [<0.001, and P=0.047, respectively] higher in female housekeepers than female teachers. Neither systolic nor diastolic BP had association with the type of occupation in men [military personnel vs. male teachers]. Housekeeping compared to teaching, may increase both systolic and diastolic BP in women

Correlation between cigarette smoking and blood pressure and pulse pressure among teachers residing in Shiraz, southern Iran

Hypertension [HTN] affects nearly 26% of the adult population worldwide. Assessment of factors which influence blood pressure is a major topic for public health. One of these preventable risk factors is smoking. This cross-sectional study was conducted on 3115 [1842 [59.1%] females] teachers from Shiraz. The participants aged between 21 and 73 years. A questionnaire was used to collect data on several cardiovascular disease risk factors including smoking and blood pressure. The prevalence of smoking in our study group was 5.85%; 1.52% of the studied participants were ex-smokers. The prevalence of pre-HTN and HTN [JNC VII] was 42.6% and 18.2%, respectively. HTN was more prevalent among men and elderly people. Pre-HTN was more prevalent in smokers but HTN was more frequent in non-smokers. The mean rang of systolic and diastolic HTN, and pulse pressure was greater in heavy smokers than those who smoked <20 packs year, although the difference was not statically significant. The relation between the smoking status and blood pressure is not yet obvious. However, it seems that cessation or at least reduction in the amount of smoking would significantly decrease blood pressure

Predictive value of cardiovascular risk factors for risk assessment in cohort of Shiraz Heart Study

Risk assessment for fast growing burden of cardiovascular diseases is very important and difficult. As a response to this challenge, in particular, genetic risk factors which potentially modify risk, we conducted a survey of primary data registry of Shiraz Heart Study on integration and application of family history data in prevention of cardiovascular disorders. This study is a longitudinal cohort project to be extended from subpopulations of different job groups to the community. Parental family history of MI, diabetes mellitus [DM], hyperlipidemia [HPL], hypertension [HTN] was reported more frequently among females than males. Histories of MI, DM, HPL, and HTN in both parents were respectively positive in 2.6%, 2%, 4.6%, and 7.9% of the participants. Odd ratios [OR] for risk of MI from family history of MI were 2.7; risk of DM from family history of DM 4.5; risk of HPL from family history of HPL 2.04; and risk of HTN from family history HTN 4.7. Also, family history of MI modifies risk of HPL [OR=1.7, P<0.0001]; and family history of DM modifies risk of HPL [OR=2.04, P<0.0001]. Our primary result shows potent application of family history data in risk assessment of cardiovascular outcome. In particular, HTN appears as a silent and leading risk modifier. In regard to the course of continuing Shiraz Heart Study integration of family history of risk factors crucial in public health we suggest to adopt a network of electronic health records from the [Health House] to the [Heart House]

Prevalence of cardiovascular risk factors among military personnel in southern Iran

The incidence of cardiovascular disease [CVD] is rapidly increasing at an alarming rate worldwide and is currently considered as the leading cause of death in both developing and developed countries. The aim of the present study is to determine the prevalence and clear analysis of cardiovascular risk factors among army population and provide a guideline for improving the health status of army personnel. This is a cross-sectional study on the prevalence of cardiovascular risk factors among 341 male subjects from a military population in southern Iran. Each eligible participant was evaluated in the military clinic in Shiraz, Southern Iran. Information regarding demographic and life style were obtained from each subject. Arterial blood pressure, weight, height, body mass index [BMI], waist circumference [WC] and hip circumference [HC], fasting blood glucose, lipid profile consisting of total cholesterol, LDL, HDL and triglyceride were measured by standard methods. Mean age of the population under study was 35.1 +/- 7.5 years. Twenty-nine [8.8%] individuals were hypertensive whereas 108 [32.9%] had blood pressure in the range of pre-hypertension. According to laboratory investigations, 29 [8.5%] participants had glucose intolerance while 6 [1.8%] of them had diabetes mellitus. On the other hand, prevalence of hypertriglyceridemia and hypercholesterolemia were 104 [30.5%] and 114 [33.4%] respectively. Twenty-eight [8.2%] subjects had criteria for metabolic syndrome. Clinical and Para-clinical data indicated that army population in southern Iran had a low level of CVD risk factors that may be related to their life styles

Prevalence of coronary artery disease risk factors in teachers residing in Shiraz-Iran 2009

Coronary artery diseases [CAD] are the leading cause of mortality, morbidity and disability with high health care cost in any countries including Iran. The prevalence of all CAD risk factors including hypertension, diabetes, lipid profile abnormalities and obesity is rising in the population of Iran. Knowing the population at risk would lead to proper education to decrease these risk factors and ultimately would reduce CAD. This descriptive cross- sectional study was conducted in February to December 2009 and comprised a total of 3115 Shiraz educational staff, aged 21- 73 years. Questionnaires were applied to collect information including; demographic data, physical activity, history of CAD, hypertension, dyslipidemia, and smoking. In addition, waist circumference, height, weight, body mass index [BMI], and hip circumference [HC] were measured and serum biochemistry profiles were determined on venous blood samples. Such data helped identify the prevalence of diabetes, hypercholesterolemia, hypertriglyceridemia, hypertension, overweight and obesity, central obesity, and smoking. The mean age of 3115 participant was 42.7 and 41.5 years for men and women respectively. The prevalence of pre-diabetes, diabetes hypertension, hypercholesterolemia and hypertriglyceridemia were%10.2,%4,%18.2,%38.30 and%33.2 respectively. Diabetes, hypertension and dyslipidemia were more prevalent among males and older subjects. The prevalence of central obesity was%75.05 [IDF criteria] and%40.64 [ATP- III criteria]. The frequency of obesity, current smoking, ex-smoking and passive smoking were%12.1,%5.85,%1.52 ,%7.9 respectively which were below the reported prevalence in Iran in previous studies, but physical inactivity was%73.3 which is very high in this study group. Although CAD risk factors seem to be very common in the study population, clinical and paraclinical data indicated that teachers residing in Shiraz have a lower rate of CAD risk factors in comparison with previous studies done in general population of Iran. This may be related to high level of education, awareness and better lifestyle in the study group. But still further educating in regard to lifestyle modifications as well as dietary surveillance is needed in general population including those dealing with educating children and on a larger scale, the community as a whole

relationship between body mass index and pre-diabetes in teachers residing in Shiraz-Iran 2009

Diabetes and cardiovascular diseases often go hand in hand and conversely, many patients with established coronary heart disease suffer from diabetes or its pre-states. Thus, it is high time that diabetologists and cardiologists join their forces to improve the quality management in diagnosis and care for the millions of patients who have both cardiovascular and metabolic diseases in common. The cardio-diabetological approach not only is of utmost importance for the sake of those patients, but also instrumental for further progress in the fields of cardiology and diabetology and prevention. This descriptive cross- sectional study was conducted February to December 2009. A total of 3115 teachers residing in Shiraz aged 21- 73 years, were enrolled. Questionnaires were applied to collect information including demographic data, physical activity, history of CAD, hypertension, dyslipidemia,and smoking. In addition, waist circumference, height, weight, body mass index [BMI], and hip circumference [HC] were measured and serum biochemistry profiles were determined on venous blood samples. The prevalence of diabetes, hypercholesterolemia,hypertriglyceridemia, hypertension, overweight, obesity, central obesity, and smoking were identified based on the above mentioned data. Total prevalence of impaired fasting glucose and diabetes were 47.2% and 6.2% and the prevalence of impaired fasting glucose and diabetes were 44.3% and 5.3% among men and 49.2% and 6.6% among women respectively. Thus the association of sex with prevalent impaired fasting glucose and diabetes was signi?cant and greater among women. Diabetes and prediabetes are more prevalent in men and women who are considered as obese in regard to waist circumference and waist/hip ratio scales. This study showed a relationship between higher range of BMI and prevalence of diabetes and prediabetes. Obesity is a preventable risk factor for diabetes mellitus and preventive measures taken to control obesity are effective means of reducing the risk of diabetes mellitus and also cardiovascular disease

Relationship between periodontal disease and acute myocardial infarction

Conventional risk factors for coronary artery disease and myocardial infarction do not explain all of the clinical and epidemiological features of the disease. Periodontal disease is a common bacterial and destructive disorder of oral tissues. Many studies demonstrate close association between chronic periodontitis and development of generalized inflammation, vascular endothelial injury, and atherosclesis. Periodontal disease has been convincingly emerging as an important independent risk factor for ischemic heart disease. A case - control study was carried out to assess the prevalence of periodontitis in patients with Acute myocardial Infarction [AMI] and evaluate the possible relationship between AMI and chronic periodontitis. A number of 160 patients, aged 35 to 70 years old, enrolled in the study. Eighty patients [43 men, 37 women] were examined four days after hospitalization due to AMI. Control group consisted of 80 persons [38 men, 42 women] with normal coronary angiography. The following periodontal parameters were examined: Plaque index [PI], gingiral index [GI], bleeding on probing [BOP], probing depth [PD], clinical attachment loss [CAL] and number of sites with CAL. The case, compared to control showed significantly worse results for some periodontal variables studied: The mean of PD and PD > 3 mm, CAL, and number of sites with CAL, had worse results compared to control despite similar oral hygiene and frequency of brushing. The confounding factors for the present study were found to be hypertension and diabetes. The association between periodontitis and acute myocardial infarction was significant after adjusting for conventional risk factors for AMI

incidence of late stent thrombosis after successful cypher stent implantation

Stent thrombosis is a rare but devastating complication of coronary stent implantation. Coronary stent deployment is associated with a low incidence of acute and sub-acute thrombosis. However, late stent thrombosis has been recognized clinically. The aim of this prospective study was to evaluate the incidence of late stent thrombosis in patients receiving sirolimus-eluting stents. One hundred patients [132 lesions] who underwent implantation of sirolimus eluting stents were selected. All patients were pre-medicated with 325 mg of aspirin, which was continued indefinitely. Anti-thrombotic regimens, including intravenous heparin and a loading dose of clopidogrel [300 mg] were given in the catheterization laboratory and clopidogrel 75 mg/day was continued for at least 6 months. In patients allergic to clopidogrel, ticlopidine at a dose of 250 mg twice daily was prescribed as a substitute. Late stent thrombosis was defined as myocardial infarction characterized by anginal symptoms with ST-elevation on the electrocardiogram and creatine kinase-MB elevation > 3 times the upper limit of normal with angiographic documentation of partial or total stent occlusion more than 30 days after sirolimus eluting stent implantation [while the stented segment was the culprit lesion]. Complete 2 year follow-up was available for all patients. Between 30 days to 2 years after sirolimus-eluting stent implantation, 2 patients [2%] experienced late stent thrombosis at a mean time of 420 days [range 360 to 480]. This study reports a very late stent thrombosis after 20 months of sirolimus eluting stent implantation and 15 months after cessation of clopidogrel treatment, despite continued aspirin administration. This study also implies the possible need for long term antiplatelet therapy among patients receiving sirolimus eluting stents

Nandrolone- induced myocardial infarction in a professional soccer player

Androgenic Anabolic Steroids [AAS] are often used by athletes for enhancing athletic performance but are strongly associated with detrimental cardiovascular effects including sudden cardiac death1. Herein, we present a 24 year-old professional soccer player who suffered acute myocardial infarction after nandrolone consumption

Pacemaker twiddler's syndrome

A 76-yr-old man with unipolar ventricular pacemaker, previously implanted in the right ventricular apex, presented with syncopal attack and twitching of the right pectoralis muscle. He finally was diagnosed as having Twiddler's syndrome. The patient had a pulse rate of 36/min and cannon waves in the neck veins. Chest radiography showed a dislodged pacing lead completely wrapped around the pulse generator. After uncoiling the lead it was positioned in the right ventricular apex and the pulse generator implanted and sewed tightly in a smaller pocket. After six months follow-up there was no further twiddling or pacemaker dysfunction

Prolonged atrio - ventricular block following scorpion bite: a case report

This report describes a 55-year-old woman in whom yellow scorpion sting resulted in the development of Mobitz type 1 and transient complete heart blocks unresponsive to atropine administration. It might be concluded that although autonomic involvement including parasympathetic overactivity is present in such cases, other factors such as toxic damage to the cardiac conduction system may play a role in the development of some of the cardiovascular manifestations of scorpion toxin

Mitral stenosis complicated by renal artery embolism

Six patients with mitral stenosis complicated by renal artery embolism studied prospectively are presented. In five patients there was unilateral and in one patient bilateral renal artery involvement. The diagnosis was confirmed by intravenous pyelography, retrograde pyelography, renal angiography, renal scan or a combination of these. All had atrial fibrillation, proteinuria and elevated LDH levels. Two had developed hypertension at the initial presentation. All patients were treated with anticoagulants and other supportive measures. One developed reversible acute renal failure and the others had an uneventful hospital course. Subsequent I.V.P. and scans revealed nonfunctioning shrunken kidney in just one patient with complete obstruction of the main renal artery. We conclude that anticoagulation is an adequate substitute to embolectomy. The main role of surgery is in occasional patients who remain anuric despite medical therapy and in those whose angiography reveals complete occlusion of the main renal artery