Efficacy of drug intervention for lipids in the prevention of coronary artery disease.

Meta-analysis of the benefit of drug intervention in hypercholesterolaemia has produced conflicting conclusions, dependent upon which studies were included or which outcomes were considered. We have approached this question by considering coronary artery disease (CAD) outcomes, fatal and non-fatal, in studies considered to be pivotal--those of sufficient size and duration and those achieving sufficient cholesterol reduction to be likely to have a statistically significant outcome. In parallel, we have reviewed all the published angiographic trials of adequate design (randomised and controlled).

FH-Sydney 1 and 2: two novel frameshift mutations in exon 10 of the low-density lipoprotein receptor gene detected by heteroduplex formation.

We report two novel frameshift mutations in exon 10 of the low-density lipoprotein receptor gene that lead to familial hypercholesterolemia in separate lineages. The lesions, FH-Sydney 1 and FH-Sydney 2, were detected by a modified heteroduplex analysis of exon-specific polymerase chain reaction (PCR) amplified DNA, and characterized at the molecular level by sequencing. Restriction enzyme digestion of PCR amplified DNA confirmed the presence of the mutant alleles in affected family members and their absence in nonaffected family members in both lineages.

The vanadium chloroperoxidase from the fungus, Curvularia inaequalis. Evidence for the involvement of a histidine residue in the binding of vanadate.

The binding of vanadate to the novel vanadium chloroperoxidase from C. inaequalis was investigated. Reconstitution experiments of apo-chloroperoxidase by vanadate at different pH values showed that in the pH 6-7 range an acid/base group is present which affects the binding of the vanadate.

The low-density lipoprotein receptor and cholesterol synthesis are affected differently by dietary cholesterol in the rat.

In the hamster and the rabbit, the low-density lipoprotein (LDL) receptor and cholesterol synthesis are coordinately downregulated by dietary cholesterol. In the rat, cholesterol synthesis is downregulated but LDL kinetic studies suggest that the LDL receptor is not. The aim of this study was to determine the effect of dietary cholesterol on the expression of the hepatic LDL receptor in the rat.

Non-steroidal anti-inflammatory drugs and hypertension in the elderly: a community-based cross-sectional study.

1. Whether non-steroidal anti-inflammatory drug (NSAID) usage in the elderly elevates blood pressure or antagonises the blood pressure-lowering effect of antihypertensive medication is presently unknown. The primary aims of this study were to estimate the prevalence of NSAID usage, to evaluate the prescription of NSAIDs for arthritis and to determine whether NSAID usage was an independent predictor of hypertension in a large elderly community.

Simvastatin in severe primary hypercholesterolemia: efficacy, safety, and tolerability in 595 patients over 18 weeks. The Principal Investigators.

We report the results of an open multicenter study which evaluated the efficacy, safety, and tolerability of simvastatin in a large cohort of patients with primary hypercholesterolemia. Against a background of standard dietary advice, the study enrolled 595 patients with total cholesterol > or = 6.5 mmol/l and triglycerides < 6.

Lipoprotein(a) is not associated with coronary heart disease in the elderly: cross-sectional data from the Dubbo study.

Lipoprotein(a) (Lp(a)) may be an independent risk factor for cardiovascular disease. We have examined Lp(a) concentration in 1202 males and 1512 females, aged 60 years and older, who were participants in an ongoing prospective study of cardiovascular disease in the elderly. This report relates to cross-sectional data at study entry.

Triglyceride levels and the risk of coronary artery disease: a view from Australia.

A prospective study of cardiovascular disease in elderly Australians commenced in 1988 in Dubbo, New South Wales. The study population comprised 1,237 men and 1,568 women aged > or = 60 years. The prevalence rates of coronary artery disease (CAD) and putative risk factors were examined cross-sectionally in the baseline data.

Treatment of primary hypercholesterolaemia with pravastatin: efficacy and safety over three years.

Objective: To assess the efficacy, safety and tolerability of pravastatin over three years of treatment.

Design: An open, multicentre randomised study.

Setting: Subjects receiving tertiary care at three hospital lipid clinics.

Successful management of primary hypercholesterolaemia with simvastatin and low-dose colestipol.

Objective: To examine whether a small dose of bile acid sequestrant used in combination with a hydroxymethylglutaryl coenzyme A reductase inhibitor is more effective in reducing serum and low-density lipoprotein (LDL) cholesterol levels than inhibitor used alone.

Design: A randomised, double-blind study.

Setting: Subjects receiving tertiary care at a hospital lipid clinic.

Multiple medication use in the elderly. Use of prescription and non-prescription drugs in an Australian community setting.

Objective: To document the extent of polypharmacy or multiple medication use in the elderly.

Design: Cross-sectional examination of an age cohort of a community.

Setting: Community-based study in Dubbo, NSW, in 1988-1989.

Health status and lifestyle in elderly Hawaii Japanese and Australian men. Exploring known differences in longevity.

Objective: To contrast health status and lifestyle in two elderly populations with differing longevity.

Design: Comparison of two cross-sectional data sets.

Setting: Non-institutionalised subjects.

Lipoprotein(a) concentration in diabetes: relationship to proteinuria and diabetes control.

Diabetic patients are at increased risk of cardiovascular disease, particularly when proteinuria is present. Lipoprotein(a)[Lp(a)] levels were assessed in 37 patients with insulin dependent (IDDM) and in 75 patients with non-insulin dependent (NIDDM) diabetes who showed varying degrees of proteinuria and glycaemic control. Median Lp(a) in 112 diabetic patients was significantly greater than in 116 healthy controls (113 vs 48 mg/L; p less than 0.

Lipoprotein(a) levels in chronic renal disease states, dialysis and transplantation.

Lipoprotein(a) is an independent risk factor for cardiovascular disease. Lipoprotein(a) levels were measured in 196 patients (103 Male [M]: 93 Female [F]) with chronic renal diseases and in 116 controls. Median levels of Lipoprotein(a) [Lp(a)] were found to be significantly elevated in patients with untreated chronic renal disease (285,285 mg/L; M,F; range 30-1675 mg/L) and in those treated with continuous ambulatory peritoneal dialysis (320, 603; M,F; range 50-1450) compared with controls (70,51; M,F; range 1-750; p less than 0.

A rapid method for diagnosis of the Lebanese allele in the low-density lipoprotein receptor gene.

The Lebanese allele in the low-density lipoprotein receptor gene is one of the alleles which results in the disease familial hypercholesterolemia. We describe a rapid method for detection of the Lebanese allele, using the polymerase chain reaction to amplify part of exon 13, intron 14 and all of exon 14. The amplified DNA is then digested with HinfI which distinguishes between the normal and Lebanese alleles.

Characterization of the antigenic and adhesive properties of FaeG, the major subunit of K88 fimbriae.

The two K88 serotypes, K88ab and K88ac, differ in terms of antigenic and adhesive properties. The structural determinants of the serotype-specific epitopes and the identify of the amino acid residues involved in fimbriae-receptor interaction were studied by the construction and analysis of K88 hybrid proteins in which various parts of the K88ab and K88ac fimbrial subunit FaeG were exchanged, and by in vitro mutagenesis of non-conserved amino acid residues. Using a set of monoclonal antibodies, several regions or amino acid residues involved in the formation of serotype-specific antigenic determinants were located.

Dubbo Study of the elderly: hypertension and lipid levels.

Untreated hypertension in age groups below 60 years has been shown to be associated with significant elevations in serum cholesterol and triglyceride levels. Drug therapy of hypertension has also been shown to have adverse effects on lipoproteins. We have investigated lipid and lipoprotein levels in a community-based sample of men and women 60 years and older belonging to one of the following groupings: (a) normal blood pressure (n = 1075); (b) untreated hypertension (n = 329); (c) drug-treated hypertension (n = 880).

Localization and function of FanH and FanG, minor components of K99 fimbriae of enterotoxigenic Escherichia coli.

Specific antisera against FanG and against FanH were prepared by immunization with hybrid Cro-LacZ-FanG and Cro-LacZ-FanH proteins, respectively. Immunoblotting with these antisera revealed the presence of FanG and FanH as minor components in purified K99 fimbriae. Mutations were constructed in fanG and fanH and cells defective in FanG or FanH were characterized by ELISA, immunoblotting, adhesion assays and electron microscopy.

Dubbo study of the elderly: sociological and cardiovascular risk factors at entry.

A prospective study of elderly Australians commenced in 1988 in Dubbo, NSW. Its goals are to identify predictors of mortality, hospitalisation and placement in long-term care, with special focus on risk factors for cardiovascular disease. The study population were non-institutionalised subjects, comprising 1237 males and 1568 females 60 years and over.

The Dubbo study of the health of elderly: correlates of coronary heart disease at study entry.

A prospective study of the health of elderly Australians recently commenced in Dubbo, NSW, the study population comprising 1,237 males and 1,568 females 60 years and older. The prevalence rates of coronary heart disease (CHD) and its associated risk factors have been examined in the baseline data. The age-standardized rate of CHD was 23.