The International Pandemic of Chronic Cardiovascular Disease

McDermott, Mary McGrae

doi:10.1001/jama.297.11.1253

Cited by 40 publications

(27 citation statements)

References 43 publications

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“…The strong correlation found between HHcy and cardiovascular morbidity and mortality has been recognized since 1969 [30] and repeatedly confirmed by other investigations carried out in developed countries [31,32,41,81,155,156]. This situation constitutes a public health problem of growing importance in western ageing societies as HHcy incidence discloses exponential rise with increasing age [157]. The amplitude of the problem is less well substantiated in developing countries although preliminary surveys mainly performed in Asian countries [37,[97][98][99] may be regarded as alarm signals predicting the occurrence of similar harmful disorders which remain to be causally identified in the light of overall subclinical PEM affecting vegan and low income population groups.…”

Section: Concluding Perspectivesmentioning

confidence: 52%

Hyperhomocysteinemia is a Biomarker of Sulfur-Deficiency in Human Morbidities~!2009-10-03~!2009-11-18~!2009-12-22~!

Ingenbleek¹

2010

TOCCHEMJ

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Methionine (Met) is crucially involved in the synthesis of S-compounds endowed with molecular, structural and functional properties of survival value. Dietary Met may undergo transmethylation processes to release homocysteine (Hcy) which may either be regenerated to Met following remethylation (RM) pathways or catabolized along the transsulfuration (TS) cascade. The activity of enzymes governing RM and TS pathways is depending on pyridoxine, folate and cobalamin bioavailability. Dietary restriction in any of these watersoluble B-vitamins may lead to hyperhomocysteinemia (HHcy) causing a panoply of cardiovascular disorders. Taken together, the vitamin triad only affords partial account of Hcy variance, prompting the search for additional causal factor(s). Body composition studies demonstrate that nitrogen (N) and sulfur (S) maintain tightly correlated concentrations in tissues of both healthy subjects and diseased patients. Any morbid condition characterized by insufficient N intake or assimilation, as seen in protein malnutrition or intestinal malabsorption, reduces body S accretion rates. Excessive urinary N-losses, as reported in acute or chronic inflammatory disorders, entail proportionate obligatory S-losses. As a result, lean body mass (LBM) undergoes downsizing and concomitant depletion of N and S body stores which depresses the activity of cystathionine--synthase, thereby promoting upstream accumulation of Hcy and overstimulation of RM processes. HHcy thus appears as the dark side of efforts developed by S-deprived patients to safeguard Met homeostasis. Irrespective of vitamin-B status, Hcy values are negatively correlated with LBM shrinkage well identified by the serial measurement of plasma transthyretin (TTR). The Sdeprivation theory fulfills the gap and allows full causal coverage of the metabolic anomaly, hence providing together with vitamin-deficiencies an unifying overview of the main nutritional determinants implicated in HHcy epidemiology.

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Section: Concluding Perspectivesmentioning

confidence: 52%

Hyperhomocysteinemia is a Biomarker of Sulfur-Deficiency in Human Morbidities~!2009-10-03~!2009-11-18~!2009-12-22~!

Ingenbleek¹

2010

TOCCHEMJ

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“…Although some of the risk factors were relatively prevalence to certain ethnic, this finding was generally quite consistent and similar to the national and global trend to indicate that this issues were already a pandemic problem. 14,15 It appeared that behavior or lifestyle factor has dominated most of CVR markers of CVD. It affected more than half of the respondent.…”

Section: Discussionmentioning

confidence: 99%

Lifestyle dominates cardiovascular risks in Malaysia

Latiff

Yusof

2008

Med J Indones

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“…10-year risk may not be sufficient enough to manifest such effects. It is a known fact that the incidence of coronary artery disease increases exponentially with age (McDermott, 2007;Petersen et al, 2005). Thus, if one decides to go by 10-year prediction algorithms alone, a significant number of patients with coronary artery disease would be classified as low risk.…”

Section: Assessment Of Atherosclerosis and Cardiovascular Riskmentioning

confidence: 99%