Din cele relatate în studiul nostru s-au observat proprietăţile antiaterogene ale Nebivololului, eficacitatea cărora se măreşte o dată cu durata tratamentului.
Studiul efectuat a relatat prezenţa dislipidemiei în mare măsură la pacienţii grupului cu SM. În studiul EGIR s-a observat prevalenţa trigliceridemiei la pacienţii cu insulinorezistenţă .
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În studiul PROCAM a fost demonstrată ipoteza că, pacienţii care au un profil lipoproteic favorabil aterogenezei au un risc crescut de boală cardiovasculară, riscul căreia sporeşte o dată cu creşterea nivelului trigliceridemiei. Administrarea de durată a Nebivololului în studiul actual a redus semnificativ nivelul trigliceridelor şi LDL - colesterolului.
Acest moment poate fi explicat prin proprietăţile antiaterogene ale Nebivololului, eficacitatea cărora se măreşte o dată cu durata tratamentului.
Date similare au relatat şi alţi autori. Astfel Ciazov I. Unele studii relatează lipsa modificărilor spectrului lipidic în rezultatul tratamentului de durată, altele indică reducerea valorilor trigliceridelor . Concluzii 1. Rezultatele studiului au demonstrat că tratamentul de durată nu a influienţat negativ starea spectrului lipidic la pacienţii cu hipertensiune arterială şi obezitate. Nebivololul fiind un ß-adrenoblocant selectiv de generaţia a III ar putea fi un preparat de elecţie în tratamentul hipertensiunii arteriale la pacienţii cu sindrom metabolic şi multipli factori de risc cardiovascular.
Alberti K. În: Circulation,nr. Alexander C. Diabetes ; Wei Zheng, M. McLerran, M. N Engl Pansels pe picior cu tratament venelor varicoase Med ; February 24, Baker A. Multivariate association analysis of the components of metabolic syndrome from the Framingham Heart Study. În: BMC Proc,nr. High-normal blood pressure is associated with a cluster of cardiovascular and metabolic risk factors: a population-based study.
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În: J Hypertens. Effects of nebivolol in obese African Americans varicoza este un handicap hypertension NOAAH : markers of inflammation and obesity in response to exercise-induced stress.
Journal of Human Hypertension 25, —; doi Ärnlöv J. Circulation, Jan ; - Study of impaired glucose tolerance, dyslipidemia, metabolic syndrome, and cardiovascular risk in a south Indian population.
Journal of postgaduate medicinevol Issue:1, p. Prakash D. Hypertension, Dyslipidemia, and Insulin Resistance in Patients with diabetes mellitus or the cardiometabolic syndrome: benefits of vasodilating ß-Blokers. The Journal of clinical hypertensionvol. Many studies have demonstrated that moderate alcohol consumption promotes health.
Metabolic syndrome, a constellation of central obesity, impaired glucose metabolism, dyslipidemia, and hypertension, is associated with subsequent development of type 2 diabetes and cardiovascular diseases.
A protective effect of moderate alcohol consumption on the cardiovascular system has consistently been reported, but limited evidence has been produced on the association of alcohol with metabolic factors.
The aim of this review was to ask to the question: should alcohol intake be recommended in patient with metabolic syndrome and if so, when and in what amounts.
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Rezumat Alcoholul şi sindromul metabolic — risk sau beneficiu, oare contează? Influenţa alcoolului asupra sănătăţii este o discuţie ce durează mai multe secole. Multe studii au demonstrat că consumul moderat de alcool promovează sănătatea. Sindromul metabolic reprezintă o constelaţie de simptome, incluzând obezitatea centrală, dereglarea metabolismul glucidic, dislipidemia, hipertensiune arterială şi este asociat cu dezvoltarea ulterioara a diabetului zaharat de tip 2 şi a patologiei cardiovasculare.
În mod constant a fost raportat un efect protector al consumului moderat de alcool asupra sistemului cardiovascular, dar există dovezi limitate privind influenţa alcoolului asupra factorilor metabolici. Scopul acestei lucrări a fost răspunderea la întrebare: dacă este necesar de recomandat consumul de alcool la pacienţi cu sindrom metabolic şi, dacă da, atunci când şi în ce cantităţi.
Introduction Health aspects of alcohol have been debated for centuries. In ancient and medieval times, wine and beer were parts of everyday diet, because many places on earth lacked reliable sources of drinking water. Nowadays, they are mostly regarded as regular staples of modern day living and their consumption parallels the increase in welfare. During the last two decades the popularity of alcoholic drinks, especially wine, has received an extra pansels pe picior cu tratament venelor varicoase because of an assumed beneficial effect on the cardiovascular system.
Metabolic syndrome, a constellation of central obesity, impaired glucose metabolism, dyslipidemia, and hypertension, is associated with subsequent development of type 2 diabetes and cardiovascular diseases CVD 1. In recent decades, the association between alcohol intake and cardiovascular disease has received considerable attention. For example, alcohol consumption of a certain amount and frequency prevents the development of diabetes mellitus 3reduces the risk of coronary heart disease 4 and elevates high-density lipoprotein cholesterol and adiponectin levels 5.
These pansels pe picior cu tratament venelor varicoase contributions of alcohol consumption appear equivalent to a reduction in the risk of developing metabolic syndrome. Improved insulin sensitivity by alcohol consumption 6may be responsible for ameliorating metabolic syndrome, since insulin resistance is a key component of metabolic syndrome 7.
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But alcohol consumption has also proven to be associated with liver disease, cardiomyopathy, trauma and injuries, the Wernicke-Korsakov syndrome and some forms of cancer. Heavy alcohol consumption and irregular binge drinking are associated with several adverse effects: fetal alcohol syndrome, liver cirrhosis, certain cancers, hypertriglyceridemia, hypertension, hemorrhagic stroke, obesity, alcohol intoxication and dependence 8.
Should alcohol intake be recommended in patient with metabolic syndrome, and if so, when and in what amounts?
Alcohol consumption and cardiovascular protection Moderate alcohol consumption has been shown to be protective against cardiovascular disease and reduced incidence of morbidity and mortality from coronary heart disease in comparison with abstainers 9.
This was first observed in observational studies comparing countries with regard to wine consumption and cardiac mortality Despite a high intake of saturated fats, a significant lower mortality rate of coronary heart disease was observed in France compared with other Northern European countries, a phenomenon which became known as the French paradox This paradox was initially explained by ingredients of the Mediterranean diet, which resulted in much attention to the potential favorable effect of wine.
Most physicians and medical organizations, however, stayed critical and reserved gollen varicose the promotion of wine drinking, being aware of the other and darker side of the Janus head. Furthermore, later analyses and studies threw doubt on the superiority of red wine over other alcoholic drinks. Mechanisms of action of alcohol as a protective factor against CVD Alcohol consumption correlates with modification of several vascular and biochemical factors that have potential cardio protective benefits.
Mechanisms by which alcohol may increase cardiovascular risk Heavier alcohol consumption is associated with increased risk of myocardial infarction, arrhythmias and sudden death and binge drinking increases the risk of both hemorrhagic and ischemic stroke, possibly due to variable effects on blood pressure, bleeding tendency and dehydration.
The hypertensive effect of regular alcohol drinking has been demonstrated in a number of randomized controlled trials 2.
Alcohol is a well-documented cause of cardiomyopathy with a direct toxic effect on myocardial as well as skeletal muscle fibers, even in the absence of hypertension or thiamine deficiency. However, again recent population studies suggest that the incidence of heart failure is less frequent in regular drinkers 4,5. Nevertheless, both positive and negative reported mechanisms have often been deduced from epidemiologic data, and are not real mechanisms.
The actual relevance of inhibition of some enzymes and varicoza în sochi oxidation is indirect and often questioned. Further basic studies, able to define plausible mechanisms of action are warranted. The role of the pattern of drinking The pattern of drinking defined as regular drinking versus binge plays a role in pansels pe picior cu tratament venelor varicoase relationship between alcohol intake and cardiovascular risk.
Experimental studies 12 suggest that drinking wine at meals provides maximal health effect, by prevention of the development of atheromatous lesions, while a binge pattern of drinking has been associated with higher risk of CVD Phenols from the wine have great antioxidant effect, but need to remember about different toxic substances which used for conservation of wine in modern time.
A regular small intake of alcohol, several days per week or even daily, is associated with more favorable outcomes than only occasional or once or twice weekly drinking The subjects who mainly consumed wine had the lowest systolic pressure levels, those who mainly drank beer had the lowest diastolic pressures and those who preferred hard liquor had the highest systolic and diastolic pressures.
Light regular drinking, possibly during meals appears as the ideal behavior, while binge drinking is to be absolutely avoided. Non-alcoholic fatty liver disease and alcohol Non-alcoholic fatty liver disease NAFLD is also a feature of metabolic syndrome in the liver Recent studies have suggested pansels pe picior cu tratament venelor varicoase inverse association between light alcohol consumption and the likelihood of NAFLD.
An analysis of a limited number of morbidly obese subjects suggested that light alcohol consumption reduced the likelihood of non-alcoholic steatohepatitis Other studies performed on a large, general population have also revealed an inverse association between alcohol 18 or wine 19 consumption and unexplained hypertransaminasemia.
Furthermore, a cross sectional study on a general population revealed an inverse association of light alcohol consumption with ultrasonographically determined fatty liver Dunn et al. The liver protective effects of modest wine drinking are supported by other studies 21, Degrace et al. Alcoholic beverages certainly seem to have a beneficial effect on the liver, and the current observations suggest that frequent drinking enhances the effect.
Further studies are required to elucidate the underlying mechanism s of the association between fatty liver and alcohol consumption, particularly in terms of frequent intake.
On the other hand, excessive alcohol consumption causes alcoholic liver injury, 24 and the molecular mechanisms of alcoholic fatty liver have been indicated Liver cirrhosis and hepatitis may be very sensible for administration even a little amount of alcohol.
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The paradox to these acute alcohol studies is a large body of epidemiological evidence which in cross sectional studies suggests that long-term exposure to alcohol is associated with an improvement in insulin sensitivity. Further, a substantial number of prospective studies point to a protective role for light to moderate chronic alcohol intake against the development of diabetes as well as a protective effect of regular mild to moderate drinking against coronary artery disease in type 2 diabetic subject.
Patterns of drinking alcohol were linked to beneficial and detrimental effects on coronary heart disease morbidity and mortality. It is, however, clear that there is no compelling evidence at this time for health care professionals to recommend that nondrinkers begin consuming alcohol for medical reasons. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA ; Alcohol and coronary heart disease: a meta-analysis.
Addiction ; — A prospective study of drinking patterns in relation to risk of type 2 diabetes among men. Diabetes ; —5.