Assessment of the relationship between red cell distribution width and cardiac syndrome X.

BACKGROUND: Cardiac syndrome X (CSX) is characterised by angina-like chest pain, a positive stress test, and normal coronary arteries. Increased red cell distribution width (RDW) level may be indicative of an underlying inflammatory state. AIM: To investigate RDW level in patients with CSX and compare patients having coronary artery disease (CAD) and normal subjects. METHODS: 245 subjects (79 patients with CSX, 81 patients with CAD, and 85 controls) were enrolled in the study. The CSX group consisted of patients with anginal chest pain, ischaemia on noninvasive stress test and a normal coronary angiogram.CAD was defined as ≥ 50% stenosis in at least one coronary artery. The control group was selected from the patients with anginal symptoms but a normal stress test and a normal coronary angiogram. RDW measurements among the three groups were compared. RESULTS: Baseline clinical and biochemical characteristics were not different among the three groups. There were no statistically significant differences in RDW levels between the CSX and CAD groups (p = 0.17). RDW measurements in both the CSX and CAD groups were found to be significantly higher than the control group (p < 0.01). CONCLUSIONS: We discovered that patients with CSX and CAD have significantly higher RDW measurements compared to controls. The relationship between CSX and higher RDW level suggests that endothelial dysfunction may also contribute to the etiopathogenesis of the CSX phenomenon as it does with CAD.

Noninvasive assessment of impaired endothelial function in psoriasis.

The objectives of this study are noninvasive assessment of endothelial dysfunction (ED) and diagnosing the possible early vascular development of atherosclerosis in psoriasis disease (PD). Twenty-eight PD patients (study group) without any obstructive vascular involvement were compared with 28 healthy controls (control group) in terms of ED utilizing endothelium-dependent dilation as well as endothelium-independent dilation, which was assessed by measuring changes in brachial artery diameter following sublingual glyceryl trinitrate (400 microg Nitrolingual spray). All patients underwent a complete transthoracic echocardiographic and tissue Doppler study. A standard form was utilized for the documentation of the presence or absence of the known risk factors for atherosclerotic vascular disease. Statistical analysis was performed by utilizing SPSS version 11. There was no difference between patients and controls in terms of echocardiographic and tissue Doppler parameters as well as baseline brachial artery diameters. Flow-mediated dilation showed 37% impairment in study group compared with control (p < 0.05). Endothelium-independent NTG dilatation did not differ in both groups. Noninvasive methods such as ultrasonography, saving time and cost-effective, can be utilized for following outpatient PD patients for the risk of ED, which may preclude to atherosclerosis.

The assessment of adherence of hypertensive individuals to treatment and lifestyle change recommendations.

OBJECTIVE: Most of studies about adherence in hypertension highlight the adherence to the medical treatment but do not include the adherence to the other recommendations, such as lifestyle modifications. The factors effective on adherence to each type of recommendation may differ. Accordingly, we aimed in this study to show that nonadherence to each recommendation should be assessed individually. METHODS: The study, which was designed as cross-sectional and descriptive, included 150 patients who were followed by the outpatient clinics for at least one year. A data collecting form with 44 questions was prepared by the investigators, and the patient adherence was assessed in five categories: medicine-related adherence, diet-related adherence, exercise-related adherence, measurement-related adherence and smoking related adherence. The face-to-face interview method was used to collect data. Statistical analysis was accomplished by Chi-square test and logistic regression analysis. RESULTS: Of 150 subjects included in the study, 94 (63%) were female and mean age was 56+/- 12 (20-81) years. Mean duration of drug use was 6.5+/- 6.5 years and the mean number of drugs used was 1.6+/- 0.8. The adherence to recommendations of medication, diet, exercise, home-blood measurement and smoking were 72%, 65%, 31% , 63% and 83%, respectively. Each patient was adherent to at least one recommendation, while 11% of patients were adherent to one recommendation, 23% - to two, 29% - to three, 24% - to four and 13% - to five. According to the regression analysis, factors effective on each type of adherence were found to be different from others. The presence of three or more types of adherence was related to income level (OR= 0.297; 95%CI - 0.132-0.666; <0.001) and presence of any other chronic disease (OR=2.329; 95% CI - 1.114-4.859; p=0.002). CONCLUSION: The rates of adherence to medicine and life-style changes were generally found to be low in hypertension. The cause of nonadherence is different according to the type of adherence. Each recommendation should be assessed individually in terms of adherence.