Left ventricular dysfunction secondary to ischemia in women with angina and normal coronary angiograms.

Background: Microvascular disease is proposed as a cause of segmental myocardial blood flow abnormalities and heterogeneous myocardial perfusion in cardiac syndrome X.

Objective: To assess if myocardial ischemia can be evidenced through both perfusion abnormalities and poststress left ventricular ejection fraction (LVEF) reduction by gated single photon emission tomography (SPECT) myocardial scintigraphy in women with syndrome X in a similar way to those with epicardial coronary lesions.

Methods: Three groups of postmenopausal women were studied: group I, 20 women with angina, perfusion defects, and normal coronary angiography; group II, 20 women with epicardial coronary lesions (> or =50% of coronary lumen reduction); group III, 15 volunteers without signs or symptoms of ischemia (control group).

Influence of Hispanic ethnicity on blood pressure control and cardiovascular outcomes in women with CAD and hypertension: findings from INVEST.

Background: Prospective data regarding blood pressure (BP) control and cardiovascular (CV) outcomes in Hispanic women are lacking.

Methods: We analyzed 5017 Hispanic and 4710 non-Hispanic white hypertensive women with coronary artery disease (CAD) in the INternational VErapamil SR/Trandolapril STudy (INVEST) to determine the impact of baseline characteristics and BP control on CV outcomes.

Results: At baseline, Hispanic women were younger and a had lower prevalence of most established CV risk factors than non-Hispanic white women.

Ischemia in women with angina and normal coronary angiograms.

Background: Coronary artery disease is frequent in postmenopausal women. Myocardial ischemia has been induced with stress testing, and a relationship between endothelial dysfunction and perfusion defects has been reported.

Objective: To evaluate whether myocardial ischemia can be evidenced both by perfusion and function abnormalities using gated single-photon emission computed-tomography myocardial scintigraphy with technetium-labeled compounds in women with typical angina, normal coronary angiography, and endothelial dysfunction.

Mental stress-induced myocardial ischemia in women with angina and normal coronary angiograms.

Background: Coronary artery disease is frequent in postmenopausal women. Silent myocardial ischemia has been induced with mental stress testing.

Methods And Results: To evaluate whether mental stress can induce ischemia in women with typical angina and normal coronary angiography, postmenopausal patients (n = 16) were studied.

Blood pressure control and cardiovascular outcomes in high-risk Hispanic patients--findings from the International Verapamil SR/Trandolapril Study (INVEST).

Background: People of Hispanic origin are the fastest growing ethnic minority in the United States and often have hypertension and other comorbidities which increase the risk associated with coronary artery disease (CAD).

Methods And Results: An analysis of the 8045 Hispanic patients enrolled in INVEST was conducted, and comparisons were made to the 14,531 non-Hispanic patients. INVEST was a prospective, randomized, open, blinded end point study in CAD patients with hypertension.

Characteristics of contemporary patients with hypertension and coronary artery disease.

Background: Despite a high prevalence of hypertension in the population with CAD, there are limited data describing the clinical characteristics and treatments, as well as their interrelations in these patients. This is particularly true for black and Hispanic patients who have been underrepresented in randomized CAD trials.

Hypothesis: There exist racial and ethnic differences that define the characteristics of patients with both coronary artery disease (CAD) and hypertension.

Estrogen does not prevent endothelial dysfunction caused by cigarette smoking.

Background: Estrogen favors endothelial function while acute tobacco use provokes dysfunction. Previous studies have not examined the effect of smoking one cigarette at different stages of the menstrual cycle.

Hypothesis: Favorable actions of estrogen on endothelial function are transitorily abolished by smoking one cigarette.

A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial.

Context: Despite evidence of efficacy of antihypertensive agents in treating hypertensive patients, safety and efficacy of antihypertensive agents for coronary artery disease (CAD) have been discerned only from subgroup analyses in large trials.

Objective: To compare mortality and morbidity outcomes in patients with hypertension and CAD treated with a calcium antagonist strategy (CAS) or a non-calcium antagonist strategy (NCAS).

Design, Setting, And Participants: Randomized, open label, blinded end point study of 22 576 hypertensive CAD patients aged 50 years or older, which was conducted September 1997 to February 2003 at 862 sites in 14 countries.

[Endothelial dysfunction in cardiologists after 24 hours on call].

The objective was to determine if the stress caused by 24 hours on call in a cardiology emergency room alters endothelial function assessed by high-resolution ultrasonography in the brachial artery. Fifteen young physicians were studied in a crossover design: a) after a normal night of sleep at home, and b) after 24 hours on call without sleeping in an emergency room. Both studies were made at rest, 5 minutes after forearm occlusion and 3 minutes after administration of sublingual nitroglycerin.