The study of lowering effects of blood presure in statins in Iran (Atorvastatin, Rosuvastatin, simvastatin) on mild hypertension.

Background and aims: Hypertension is the most important risk factor and a serious threat for cardiovascular diseases. This study was aimed to determine the effect of the statins drugs (included Atrovastatin, simvastatin and Rosuvastatin) in Iranian's population on mild hypertention. Methods: In a clinical trial, 120 patients with mild hypertension were selected and randomly distributed in four groups of 30 patients. The first group to third received Atrovastatin 20 mg daily and simvastatin 20 mg daily and Rosuvastatin 10 mg daily for one month and as a control group, the fourth group did not receive any statin. Four groups of patients before and 1 month after treatment were examined and their blood pressure was measured manually by sphygmomanometer in Iranian's population with mild hypertention. Finally, data were entered into SPSS software and analyzed using Chi-Square, one-way ANOVA, and paired t-test. Results: Diastolic blood pressure decreased about 15.68±3.4% in the group receiving Atrovastatin, 7±2.7% in the simvastatin group, 6.4±0.3% in the group receiving Rosuvastatin, and 6.5±3.4% in the placebo group, respectively, while the percentage reduction in systolic blood pressure were different between the four groups (P= 0.01), and the group receiving Atrovastatin showed decreaseing the highest systolic and diastolic blood pressure. Conclusion: Based on these findings, it can be concluded that the regular uses of statins may be had lowering effect on blood pressure in patients with mild hypertension

Mechanisms underlying quercetin-induced vasorelaxation in aorta of subchronic diabetic rats: an in vitro study

In this study, the mechanisms involved in vasorelaxant effect of the flavonoid quercetin was investigated in isolated aortic rings from streptozotocin (STZ)-diabetic rats. After 4 weeks, addition of quercetin (0.1 muM-1 mM) caused a significant dose-dependent relaxation of noradrenaline (NA)- and KCl-preconstricted rings in both control and diabetic groups with a significant inter-group difference of P<0.01. Furthermore, both nitro-L-arginine-methyl ester (L-NAME, 100 muM) and indomethacin (10 muM) markedly attenuated the vasorelaxant responses following quercetin application. Meanwhile, endothelium removal significantly attenuated the quercetin-induced vasorelaxation. It is concluded that the quercetin can relax the preconstricted rings of aorta in subchronic STZ-diabetic rats through nitric oxide- and prostaglandin-mediated pathways, which themselves could be considered as endothelium-dependent. (C) 2004 Elsevier Inc. All rights reserved

Can doubling the maintenance dose of clopidogrel prevent from early stent thrombosis after the primary percutaneous coronary intervention?

<p class="abstract"><strong>BACKGROUND:</strong> Treatment of significant coronary artery disease with primary percutaneous coronary intervention (PCI) seems better than angioplasty balloon; because the incidence of restenosis is lower in this method, however, a serious complication of PCI is stent thrombosis which would lead to repeated myocardial infarction (MI) and increase the mortality and morbidity. One of the frequent medications which is used to prevent from stent thrombosis is clopidogrel, but, stent thrombosis was seen in many of the patients despite given the conventional dosage of this drug. This study aimed to evaluate the effect of doubling the maintenance dose of clopidogrel to prevent from early stent thrombosis, MI and mortality rate.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This was a clinical trial study which was done in Shahid Chamran Hospital in winter 2010 in Isfahan, Iran. A total of 400 patients with PCI were prospectively followed-up for 30 days. All the patients were randomly allocated into two groups. The control group received a maintenance dose of 75 mg clopidogrel while the case group received 150 mg clopidogrel after the initial dosage of 600 mg for 30 days after the PCI.&nbsp; The incidence of primary outcome such as total mortality was recorded during the study.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> Early stent thrombosis was observed in 4 patients (1%) (One subject in the control group and 3 in the case group) during the first 30 days after PCI, but the difference was not significant between the two groups (p = 0.62). Mortality due to stent thrombosis occurred in 2 patients in the case group which showed no significant difference in this group (p = 0.5). In addition, MI occurred in 2 patients (1 in each group) which also showed no significant difference between the two groups (p = 1). Drug complication such as major bleeding had no significant difference between the two groups (p = 0.9).<strong></strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> The present study showed that doubling dose of clopidogrel could not reduce the incidence of early stent thrombosis, mortality and myocardial infarction in comparison with conventional dosage; therefore it is recommended that more studies be done in Iranian and Asian race for clinical decision-making to prevent form stent thrombosis using high dose of clopidogrel.</p><p class="abstract"><strong>Keywords:</strong> Primary coronary intervention, Early stent thrombosis, Clopidogrel, Coronary stenting.</p

Endothelium-dependent attenuating effect of Trigonella foenum-graecum on the contractile vascular reactivity of diabetic rats

The present study was undertaken to determine whether two-month treatment of streptozotocin (STZ)-diabetic rats with aqueous leaf extract of Trigonella foenum-graecum (TFG; 200 mg/kg; i.p.) could improve thoracic aortic responsiveness and to evaluate its endothelium dependency. For this purpose, vascular responses to KCl and noradrenaline (NA) were measured. Diabetic state significantly increased contractile responses to KCl and NA in aortic rings in both endothelium-intact and -denuded rings. Extract-treated diabetic rats showed a significant lower maximal contractile response to KCl only in endothelium-intact rings as compared to diabetic rings. It is concluded that intraperitoneal administration of aqueous leaf extract of TFG for two months could improve some functional indices of the vascular system in diabetic state and the integrity of the endothelium is essential for its beneficial effects

The Predictive Factors of Recurrent Deep Vein Thrombosis

<p><strong>BACKGROUND:</strong> About 2-5% of people experience deep-vein thrombosis (DVT) during their lives. Death, disease recurrence, post-thrombotic syndrome, and excessive bleeding due to coagulant medications are among the most important DVT complications. Recent research found a high incidence of DVT recurrence after the first attack. Disease recurrence has a multifactorial pathogenesis and its probability is related with the number and severity of risk factors. The present study aimed to investigate DVT recurrence and the associated risk factors.</p> <p><strong>METHODS:</strong> This retrospective cross-sectional study evaluated all DVT patients hospitalized in Alzahra Hospital, Isfahan, Iran, during April 2000 to April 2011. The risk factors were obtained from patients' records including smoking, intravenous drug abuse, having a history of surgery in last four weeks, immobility, obesity, history of cardiac disease, and cancer. <strong>&nbsp;</strong></p> <p><strong>RESULTS:</strong> A total number of 2550 DVT patients were hospitalized in Alzahra Hospital during the study period. It was only possible to extract the data from 385 patient records. A history of DVT was reported in 48 individuals (12.5%). The comparison between the risk factors in patients with a first time DVT and those experiencing a recurrent DVT revealed significant differences solely in the prevalence of blood disorders and immobility. Applying stepwise regression indicated immobility (OR: 4.57; 95% CI: 1.26-16.57; P &lt; 0.021) and coagulopathy (OR: 0.33; 95% CI: 0.13-0.81; P &lt; 0.016) with DVT recurrence.</p> <p><strong>CONCLUSION: </strong>Based on our findings, DVT patients are suggested to be mobilized as soon as possible. In addition, they should be advised to increase their activity after discharge.</p> <p>&nbsp;</p> <strong>Keywords: </strong>Deep Vein Thrombosis, Immobility, Risk Facto

The Relation Between Ankle-Brachial Index (ABI) and Coronary Artery Disease Severity and Risk Factors: An Angiographic Study

<br /><strong>BACKGROUND</strong>: The current study aims to determine the relation between ankle&ndash;brachial<br />index (ABI) and angiographic findings and major cardiovascular risk factors in patients with<br />suspected coronary artery diseases (CAD) in Isfahan.<br /><strong>METHODS</strong>: In this cross-sectional descriptive-analytic research, patients with suspected CAD<br />were studied. Characteristics of studied subjects including demographics, familial history, past<br />medical history and atherosclerotic risk factors such as diabetes mellitus, hypertension,<br />hyperlipidemia and smoking were obtained using a standard questionnaire. ABI was measured<br />in all studied patients. ABI &le; 0.9 (ABI+) was considered as peripheral vessel disease and ABI &gt;<br />0.9 (ABI-) was considered as normal. Then, all studied patients underwent coronary artery<br />angiography. The results of the questionnaire and angiographic findings were compared in ABI+<br />and ABI- groups. Data were analyzed by SPSS 15 using ANOVA, t-test, Spearman's rank<br />correlation coefficient, and discriminant analysis.<br /><strong>RESULTS</strong>: In this study, 125 patients were investigated. ABI &le; 0.9 was seen in 25 patients (20%).<br />The prevalence of ABI+ among men and women was 25.9% and 7.5%, respectively (P = 0.01). The<br />prevalence of atherosclerotic risk factors was significantly higher in ABI+ patients than in ABIones<br />(P &lt; 0.05). ABI+ patients had more significant stenosis than ABI- ones. The mean of<br />occlusion was significantly higher in ABI+ patients with left main artery (LMA), right coronary<br />artery (RCA), left anterior descending artery (LAD), diagonal artery 1 (D1) and left circumflex<br />artery (LCX) involvements (P &lt; 0.05).<br /><strong>CONCLUSION</strong>: The findings of this research indicated that ABI could be a useful method in<br />assessing both the atherosclerotic risk factors and the degree of coronary involvements in<br />suspected patients. However, in order to make more accurate decisions for using this method in<br />diagnosing and preventing CAD, we should plan further studies in large sample sizes of general<br />population.<br /><strong>Keywords</strong>: Ankle&ndash;Brachial Index, Angiography, Atherosclerotic Risk Factors

The vasorelaxant effect of simvastatin in isolated aorta from diabetic rats

BACKGROUND: The increasing incidence of diabetes mellitus (DM) is of great clinical significance. In this study, we aimed to investigate whether exposure of endothelium-intact aortic rings to simvastatin could have a vasorelaxant effect in diabetic rats. METHODS: For induction of diabetes, streptozotocin (STZ) (60&thinsp;mg/kg, i.p., single dose) was used. After 1 month, the cumulative reaction of isolated endothelium-intact aortic rings was determined to KCl and phenylephrine (PE) in the absence and presence of nitric oxide (NO) synthase inhibitor, i.e., nitro-L-arginine-methyl ester (L-NAME), and prostaglandin synthesis inhibitor, i.e., indomethacin. Meanwhile, the role of extracellular calcium was assessed in this respect. RESULTS: At the end of the study, the addition of simvastatin (at a concentration &ge; 10&minus;5 M) caused a significant concentration-dependent relaxation response of PE-precontracted aortic rings for both control and diabetic groups (at a significant difference of P &lt; 0.050), and this difference did not exist for KCl-precontracted aortic rings. Furthermore, both L-NAME (100 &micro;M) and indomethacin (10 &micro;M) significantly diminished the vasorelaxant response following simvastatin addition. Meanwhile, there was no statistically significant difference between control and diabetic groups in the absence of extracellular calcium. CONCLUSION: The results of this study suggest that simvastatin is able to relax PE-precontracted aortic rings isolated from STZ-diabetic rats via modulation of NO- and prostaglandin-dependent signaling and its effect is not via modulation of calcium mobilization from intracellular stores

The effect of chronic silymarin on serum level of some enzyme markers and tissue level of malondialdehyde in diabetic rats

Background and Aim: Diabetes mellitus causes enhanced oxidative stress due to increased production of oxygen free radicals and decreased activity of antioxidant defense system. Flavonolignan Silymarin has an antidiabetic effect. This study was conducted to evaluate the effect of its chronic administration on serum levels of aspartate and alanine aminotranferase and the heart and liver level of malondialdehyde. Materials and Methods: In this experimental study, 40 male Wistar rats were divided into 5 equal groups, i.e. control, Silymarin -treated control (100 mg/kg), diabetic, and two Silymarin- treated diabetic groups (50 and 100 mg/kg). Silymarin was daily administered (i.p.) to each of the group members ten days after streptozotocin injection for 4 weeks. Serum levels of aspartate and alanine aminotranferase were measured both before and at the end of the study. In addition, level of malondialdehyde (MDA) was measured in the liver and the heart tissues on the basis of the reaction of thiobarbituric acid. Results: Serum glucose level in high dose Silymarin-treated diabetic group was significantly lower as compared to diabetics in the sixth week (P=0.007).Moreover, diabetic rats showed a significant increase in their aspartate serum level (P=0.028) and alanine aminotranferase (P=0.008) and Silymarin treatment only significantly reduced serum level of alanine aminotranferase (P=0.034). In addition, diabetes was followed by increased level of MDA in the liver (P=0.008) and the heart (P=0.009) tissues and high-dose Silymarin treatment significantly reduced MDA level only in the liver tissues (P=0.026). Conclusion: Long-term treatment with silymarin at a dose of 100 mg/kg can attenuate serum level of alanine aminotranferase and hepatic MDA level and does not have any significant effects on serum level of aspartate aminotranferase and cardiac tissue level of MDA in the administered dose

Soybean feeding improves vascular dysfunction and atte- nuates oxidative stress in streptozotocin-diabetic rats

A B S T R A C T Background and Objective: The effect of chronic dietary soybean (Glycine max L.) on aortic reactivity of streptozotocin (STZ)-diabetic rats was studied. Materials and Methods: Male diabetic rats received soybean for 7 weeks 1 week after diabetes induction at weight ratios of 3 and 6%. Contractile responses to KCl and phenylephrine (PE) and relaxation response to acetylcholine (ACh) were obtained from aortic rings. Results: Maximum contractile response of endothelium-intact rings to PE was significantly lower in soybean6%-treated diabetic rats relative to untreated diabetics (p&lt;0.05) and endothelium removal abolished this difference. Endothelium-dependent relaxation to ACh was significantly higher in soybean6%-treated diabetic rats as compared to diabetic ones (p&lt;0.05) and pretreatment of rings with nitric oxide synthase inhibitor N(G)-nitro-l-arginine methyl ester (L-NAME) and/or indomethacin attenuated it. Two-month diabetes also resulted in an elevation of malondialdehyde (MDA) and decreased superoxide dismutase (SOD) activity and soybean treatment significantly reversed the increased MDA content and reduced activity of SOD. Conclusion: Therefore, chronic treatment of diabetic rats with soybean could dose-dependently prevent some abnormal changes in vascular reactivity in diabetic rats through nitric oxide-and prostaglandin-related pathways and via attenuation of oxidative stress in aortic tissue and endothelium integrity seems essential for this effect