Effects of a multifactorial prevention trial of coronary heart disease on the seasonal variation of the incidence of major cardiovascular events.

Under the influence of a primary prevention trial of coronary heart disease carried out for 10 years (1971-1982) in male subjects aged 40 to 60 years at entry, the curves of the seasonal variation of the incidence of myocardial infarction, sudden death and stroke were changed. The most important reductions of the incidence of these events were registered in spring and in September. In the rest of the year the effect of the action becomes variable according to the month and to the particular major events. These observations are discussed as related to their possible cause and to the necessity of a change of action methodology according to the period of investigation.

Seasonal variations of serum cholesterol detected in the Bucharest Multifactorial Prevention Trial of Coronary Heart Disease. Ten years follow-up (1971-1982).

A group of 4800 men, aged fourty to sixty at entry, subjected to a multifactorial prevention trial of coronary heart disease for a ten-year period, showed spontaneous seasonal variations of serum cholesterol, characterized by increases in winter and decreases in summer. The authors discuss the relationship between the food changes and the seasonal variation of serum cholesterol values.

Transmission filter for the compensation of the intensity falloff in the image plane by using opaque dots.

A special type of transmission filter (dotted filter) for compensating the intensity falloff in the image plane is described.A dvantages and disadvantages area lso discussed.

Ischemic heart disease in relation with the type of behavior and the emotional state.

The relationship between the cardiovascular state, on the one hand, and the type of behavior and emotional state on the other, was investigated in a professional type community of 550 subjects (280 men and 270 women) ranging in age from 20 to 64 years. The subjects were submitted to medical examination (clinical, electrocardiographic and biochemical) for the detection of ischemic heart disease and its risk factors (arterial hypertension, smoking, over weight, hypercholesterolemia) and concomitantly to a psychologic examination consisting of anxiety test as a state and as a trait, multiple affectivity test and the test of self-rating behavioral type, for the study of the emotional state and the type of behavior. The relation between the results of the two examinations showed that ischemic heart disease (irrespective of the form) and its risk factors are associated to various extents and in different manners to the psychologic factors. Thus, significantly, ischemic heart disease was proved four times more frequent in subjects with type A behavior than in those with type B; arterial hypertension was more frequent in anxious (1.6 times) and aggressive subjects (1.4 times); overweight was more often encountered in nondepressive (2 times) and adaptable subjects (1.4 times), and in subjects with type B (1.3 times); the anxious subjects were found to smoke less than the non-anxious ones (2 times).

The evolution of essential hypertension in a primary prophylactic survey. Ten-year longitudinal epidemiologic study (1971-1982).

The present work presents the evolution over a ten-year period of subjects with essential hypertension (EH) detected in a group of 5,000 men, aged 40-60 years, randomly selected in an urban environment. The prevalence of EH in the group studied was 20.5%, whereas "borderline" hypertension presented a prevalence of 21.4% reported in an earlier study. A proportion of 76.6% of the hypertensive patients were cared for in an outpatient unit; normal blood pressure values were obtained in about one third of the cases. This result is consistent in itself and, all the more so, bearing in mind ageing of the patients in the course of the study. The study had in view the annual incidence of essential hypertension and the evolution of atherogenic risk factors in hypertensive patients. The incidence of cerebrovascular accidents during the follow up period in this group was 6.85%, sudden death 1.7% and myocardial infarction 6.2%.

The evolution of atherosclerotic risk factors in a primary prophylactic survey. Ten-year longitudinal epidemiologic study (1971-1982).

The present work is a study of the evolution of atherosclerotic risk factors in the course of ten years, in a group of 5,000 male subjects, aged 40 to 60 years, from an urban district, undergoing a programme of primary prevention against ischemic heart diseases. The general intervention methodology and the results after five years follow-up were published in earlier papers. The present work describes the ten year evolution of the prevalence of the main atherogenic risk factors studied, the yearly rate of prevalences, first appearance and correction potency of the risk factors detected.

Coronary intima: the phylogenetic approach to appearance of lesions.

In the course of phylogenetic evolution the coronary artery intima undergoes changes in the composition of the ground substance (from hyaluronic acid-like substances to sulphate ones) and a relative increase of the intimal thickness. A correlation was found between these changes and the increasing propensity for coronary atherosclerotic lesions.

The Bucharest multifactorial prevention trial of coronary heart disease. General methodology and risk factor correction after five year follow-up (1971-1977).

Both the intervention and the control group included each 5000 men aged 40-60 years, randomly selected by their home address in five districts of the city of Bucharest. The intervention group underwent an "at entry" examination for risk factor detection (high serum cholesterol, high blood pressure, overweight, diabetes, minor ECG abnormalities, family history) and subsequently a five-year multifactorial intervention aimed to reduce the risk factors. Both groups were followed up in this lapse of time for major end-points: myocardial infarction, stroke, sudden death. The qualitative analysis of the results used ten evolution indices based on a quantal counting and lead to a classification of risk factors which allowed the setting up of a strategy for their correction. The quantitative analysis showed the following decreases between the first and the last examination in the intervention group: for serum cholesterol greater than or equal to 250 mg/dl -17%; for cigarettes/day greater than or equal to 15-53%; for overweight greater than or equal to 30% - 13.57%; for high blood pressure -8%; for the overall risk computed by multiple regression -33.8%.

Aortic intimal thickenings in tortoises.

The aorta and coronary arteries of two tortoise species, Testudo graeca ibera and Emys orbicularis are investigated. The elastic aorta of the first species showed minimal focal intimal thickenings while the muscular aorta of the second presented marked diffuse hyperplasia narrowing the caliber of the vessel. The author discusses this striking finding of the aortic structural differences between the two species investigated as well as the significance of such lesions for atherosclerosis development.

Spontaneous aorta and coronary lesions in mountain mammals. II. The chamois (Rupicapra rupicapra).

The study of the aorta and coronary arteries from 25 chamois shot in their mountain natural habitat allowed the observation that this animal is more exposed to liposclerotic lesions than other wild herbivorous mammals which live in the plain or at low altitudes. This observation is supported by both the frequency of the lesions (found in the coronary arteries of 14 animals and in the aorta of 10) and their morphologic and histochemical features. The author discusses the possible role of the relatively hypoxic condition, in which this animal lives at high altitudes, on the etiopathogeny of the above mentioned lesions.

Spontaneous aorta and coronary lesions in mountain mammals. I. The Carpathian deer (Cervus elaphus).

Arterial lesions were investigated in 48 adult wild Carpathian deers (Cervus elaphus). Aortas from 36 animals and fragments from the main coronary trunks of all the animals were studied histologically and histochemically. In 44.4% of the animals the specimens studied presented gross intimal lesions in the aorta consisting histologically of fibrous plaques (especially situated in the thoracic segment) and/or intimal musculo-elastic thickenings with lipid deposits or fatty streaks (especially in the abdominal segments). In only 5 of the 48 animals the coronary arteries presented slight intimal thickenings, free of lipids. The results obtained are discussed in relation with the possible effect of natural nutrition.

The peculiar structure of the dorsal aorta of carp (Cyprinus carpio L.).

The Authors describe the moniliform structure of dorsal aorta of the Cyprinus carpio L., which has successive swellings and constrictions, strictly corresponding to each vertebra. They discuss the possible physiological significance of the unusual structure of the dorsal aorta.

Coronary heart disease and its risk factors in a group of 5,000 middle aged men in urban environment.

The results obtained at entry in the subjects included in a pilot study (Institute of Internal Medicine, Bucharest) for the detection and prevention of coronary heart disease and hypertension, are presented. These data are the prevalences of the risk factors of coronary heart disease (high serum cholesterol, hypertension, smoking, overweight, diabetes, nonspecific minor ECG signs, family history), as well as the prevalences of the various forms of coronary heart disease. The study of the frequency distribution of biologic parameters likely to become risk factors showed that in middle aged subjects the upper limit of the normal should be lowered from the 95th percentile to the 76th one.

Coronary heart disease and risk factors in some special type collectivities.

Transversal epidemiologic investigations carried out in different populations from several regions of Romania : Gurghiu Valley (lumberjacks from a mountain region), Danube Delta and Razelm lagoon complex (fishermen), and Bucharest have shown that, in spite of the high caloric value of food and even of a high intake of saturated fats, mean serum cholesterol is lower in the rural areas than in Bucharest, probably owing to the strenuous physical work. However, except myocardial infarction, more frequent in the urban than in the rural regions, the other forms of coronary heart disease have a relatively higher frequency in villages, particularly atrial fibrillation and ECG signs of ischemia. These findings might be explained by a greater prevalence of hypertension in these populations. It is concluded that the risk factors, which act synergically, depend on the complex structure of the "ecologic niche".