Objective: To characterize the lipid profile in Alzheimer's Disease (AD) and to determine whether it differs from the cardiac risk profile. Background: Links between hypercholesterolemia and AD development continue to grow. Presently, limited information exists about the lipid profile characteristics in AD. Methods: We examined the lipid profiles (total cholesterol (TC), high-density lipoprotein (HDL), lower-density lipoprotein (LDL), TC/HDL ratio, and triglyceride (TG) levels) of 153 subjects with probable/possible AD (mean age 77.2 ± 8.6 years, mean MMSE 19.9 ± 5.6) and 25 non-demented subjects with atherosclerotic heart disease (ASHD) (mean age 73.8 ± 7.2 years); neither on lipid lowering therapy. Results: Subjects with TC > 200 mg/dl composed 69% of AD and 72% of ASHD groups. Mean TC was 218.9 ± 38.9 mg/dl and 218.5 ± 9.2 mg/dl for AD and ASHD subjects respectively. AD subjects exhibited significantly higher HDL and lower TG and TC/HDL ratios. MMSE did not correlate with any lipid parameters in AD. Discussion: Elevated TC, LDL and TG with normal HDL and TC/HDL ratio characterize the lipid profile in AD, which somewhat overlaps with but may be distinct from the cardiac risk profile. MMSE does not correlate with lipid parameters suggesting no interaction between cholesterol and cognition in AD.

Hemodynamic effects of dopamine and intravenous nitroglycerin alone, and in combination, were studied in 27 patients with severe left ventricular failure. Dopamine alone increased cardiac index from 1.8 to 2.5 1/min/m2 but also increased wedge pressure from 24 to 30 mm Hg and heart rate from 88 to 101 beats/min. Arterial oxygen saturation fell from 92% to 87% (p < .001). Nitroglycerin alone had a lesser effect on cardiac index (1.8 to 2.2 1/min/m2) but decreased wedge pressure from 26 to 16 mm Hg and heart rate from 91 to 86 beats/min. Arterial oxygen saturation fell from 91% to 90% (NS). Combined dopamine and nitroglycerin administration resulted in optimal hemodynamics, with cardiac index of 2.9 1/min/m2, wedge pressure of 17 mm Hg, and heart rate of 96 beats/min. Arterial oxygen saturation remained low at 88% in spite of the reduction in left ventricular filling pressure, which probably reflects increased intrapulmonary right-to-left shunting coupled with increased pulmonary blood flow. These results suggest that the combination of dopamine with intravenous nitroglycerin should be considered for patients with severe left ventricular dysfunction who require temporary pharmacologic support. Circulation 68, No. 4, 813-820, 1983. TEMPORARY pharmacologic support of patients with chronic severe left ventricular dysfunction is frequently required either during episodes of deterioration or before definitive diagnostic or therapeutic procedures. Although a variety of intravenous inotropic and vasodilator drugs are available for this purpose, the selection of a specific drug or combination of drugs remains largely empiric.Dopamine, a catecholamine with significant inotropic activity, has potential advantages for use in patients with advanced low-output cardiac failure because of its selective effect on promoting blood flow to renal and splanchnic beds via stimulation of nonadrenergic vasodilator receptors in these areas.1 Although dopamine infusion may reduce an elevated left ventricular filling pressure in some patients with heart failure, other patients may show a significant increase in filling pressure associated with the development of pulmonary

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