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BACKGROUND: Recent studies examining the association between sleep duration and cardiovascular disease (CVD) showed inconsistent results. The aim of our study was to evaluate the association between self-reported night sleep duration and ischemic changes in electrocardiography (ECG).METHODS: We conducted this cross-sectional study on 3513 participants from Iranian middle-aged population as a part of Isfahan Healthy Heart Program (IHHP), Isfahan, Iran. Sleep duration was obtained by questioning participants. The frequency of electrocardiographic ischemic changes was calculated using ECG Minnesota coding system.RESULTS: Short sleep duration was associated with increased frequency of electrocardiographic ischemic changes. In a fully adjusted multiple logistic regression analysis, the odds ratio (OR) for short sleep duration less than 5 hours per night was 1.501 [95% confidence interval (CI) for OR: 1.085-2.076] compared to 8 hours of sleep. After stratifying the study population into sex groups, the association remained significant only in women. The OR for short sleep less than 5 hours per night was 1.565 (95% CI for OR: 1.052-2.329) and 1.455 (95% CI for OR: 0.833-2.539) in women and men, respectively. There was no association between long sleep duration and electrocardiographic ischemic changes in men and women.CONCLUSION: We concluded that there is a positive association between short sleep duration and frequency of electrocardiographic ischemic changes in middle-aged women. This association suggests that short sleep duration may increase the risk of ischemic heart disease (IHD) in women, and this need to be evaluated in further studies.

BACKGROUND: Obesity is a common health problem in both developed and developing countries. There are many unconventional therapies, including herbal medicine, to treat this condition. Some people believe that herbal medicines are safe. This case and review is about adverse complication of treating obesity with some herbal medicine. CASE REPORT: A 19 year old male with sever obesity (120 kg) used green tea (15 cups of green tea per day) and an intensive dietary regimen to lose weight. He lost 30 kg after 2 months. At that time, one day after usual exercise he suddenly lost consciousness due to left ventricular fibrillation. CONCLUSION: Use of herbal medicine for weight reduction is not always safe. Moreover, for some herbal medicine the risk is sufficient to shift the risk–benefit balance against the use that medicine. Keywords: Herbal Medicine, Sudden Death, Complication, Obesity

BACKGROUND: Atherosclerosis is one of the leading causes of mortality all around the world. Obesity is an independent risk factor for atherosclerosis and cardiovascular diseases (CVD). In this respect, we decided to examine the effect of the subgroups of weight on cardiovascular risk factors. METHODS: This cross-sectional study was done in 2006 using the data obtained by the Iranian Healthy Heart Program (IHHP) and based on classification of obesity by the World Health Organization (WHO). In this study, the samples were tested based on the Framingham risk score, Metabolic Measuring Score (MMS) and classification of obesity. Chi-square and ANOVA were used for statistical analysis. RESULTS: 12514 people with a mean age of 38 participated in this study. 6.8% of women and 14% of men had university degrees (higher than diploma). Obesity was seen in women more than men: 56.4% of women and 40% of men had a Body Mass Index of (BMI) ≥ 25 Kg/m2. 13% of the subjects had FBS > 110 and13.9% of them were using hypertensive drugs. In this study, we found that all risk factors, except HDL cholesterol in men, increased with an increase in weight. This finding is also confirmed by the Framingham flowchart for men and women. CONCLUSION: One of every two Americans, of any age and sex, has a Body Mass Index of (BMI) ≥ 25 Kg/m2. Obesity associated CVD and other serious diseases. Many studies have been done in different countries to find the relationship between obesity and CVD risk factors. For example, in the U.S.A and Canada they found that emteropiotic parameters, blood presser and lipids increased by age(of both sexes). Moreover, another study done in China, which is a country in Asia like Iran, shows that BMI has an indirect effect on HDL cholesterol, LDL cholesterol and triglyceride. This data is consistent with the results of the current study. However, In China they found that this relationship in men is stronger than women, but our study reveals the opposite. Keywords: Body Mass Index (BMI), Overweight, Cardiovascular Risk Factors, Framingham Risk Score, Metabolic Syndrome.

Introduction:Anxiety and stress are known to increase blood pressure. Psychological methods and behavioral therapy are appropriate and low-cost methods in hypertensive patients. This study aimed to assess the effect of biofeedback and biofeedback-assisted relaxation on stress and anxiety in patients with mild hypertension.Material and Methods:10 sessions were held every other day for the intervention groups. The subjects received 15 minutes of relaxation every session. Blood pressure was recorded every session before and after relaxation. The control groups referred for 10 sessions every other day and blood pressure was recorded twice 15 minutes apart. Kettle anxiety questionnaire and Malekpour stress questionnaire were used to assess stress and anxiety, respectively.Results:Stress and anxiety scores showed significant differences in relaxation and relaxation-biofeedback method relative to the control group (p

Background: Pharmacological therapy is a critical step in the management of individuals with Metabolic Syndrome (MetS) when lifestyle modifications can not to achieve the therapeutic goals. However, it is well-documented that other than weight loss, there is no single best therapy, and the treatment should consist of treatment of individual components of the MetS. The objective of this study was to investigate treatment of individual components of the MetS among a population–based sample of individuals with the clustering of those components of the MetS. Methods: A cross-sectional population-based study, a randomly collected sample of men and women living in three counties in central Iran participating in the baseline survey of a community –based program in 2000-2001 were examined. A questionnaire was completed for all participants to collect data regarding their demographic characteristics, medical status and history of medication use. In this study we determined the association between clustering of MetS components and pharmacological treatment of cardiovascular risk factors. Finding: The most common pharmacologic agent received by individuals with MetS were beta blockers (72.8%) used for controlling high blood pressure, followed by lipid lowering agents (36%) without significant gender difference. Conclusion: Our results exhibited Beta blockers, statins, fibrates and glybenclamid are more prevalent drugs among subjects with metabolic syndrome. Further research is needed to better elucidate the compliance behavior of patients who have been diagnosed with MetS.

Background: The aim of this study was to evaluate the relationship between postoperative serum lactate levels and outcome in patients undergoing coronary artery bypass graft surgery (CABG) and verify the clinical impact of hyperlactatemia (HL) during CABG in terms of postoperative morbidity and mortality rate. Methods: In this prospective study, 92 patients underwent open heart surgery. Demographic data, lactate levels, PH, 48 hours serum creatinin after surgery (mg per cent), left ventricular ejection fraction, Inotropic Drugs and the duration of use and the duration of intensive care unit (ICU) admission t and deaths were collected. Finding: Mortality rate was 3.3 percent, the average duration of hospitalization was 8.8 days and the duration of ICU admission was 47.27 hours. In 82.6% of the patients increased lactic acid was observed; while 17.4% of patients had a low lactate serum concentration during ICU admission. Conclusion: The findings of this study showed an association between lactate serum levels and the duration of ICU admission and duration of hospitalization, so hyperlactatemia could be a prognostic factor and could predict the mortality and the severity of complications in the patients undergone CABG.

Abstract INTRODUCTION: Myocardial ischemia, cerebral ischemia and myocardial infarction are the most important complications of hypertension and atherosclerotic disease in developing countries. Angiotensin converting enzyme (ACE) inhibitors are among the drugs used to treat hypertension and heart failure. Captopril is an ACE-inhibitor which also has antioxidant properties. This study was conducted to assess the antioxidant effects of Iranian Captopril on malondialdehyde (MDA), conjugated dienes (CD) and serum antioxidant capacity before and after treatment. methods: This interventional prospective single-blind study was conducted on 34 mildly hypertensive individuals and 34 patients with stage I and II heart failure. MDA, CD and serum antioxidant capacity were measured in all samples. The patients were then given 50 mg Captopril tablets 2-3 times daily. The measurements were repeated 1.5 months later. results: Comparison of mean MDA, CD and serum antioxidant capacity in hypertensive patients and patients with heart failure before and after drug administration revealed no significant difference in any of the parameters studied. Discussion: Existing evidence is suggestive of the strong antioxidative properties of Captopril in vitro, although these effects have not been borne out by some studies. In the present study, comparison of MDA, CD and serum antioxidants before and after the period of treatment with Iranian Captopril did not reveal any statistically significant difference.Keywords • Antioxidant • ACE inhibitor • High blood pressure • Heart failure • Clinical trial

AbstractINTRODUCTION: The prevalence of cardiovascular risk factors is increasing inindustrialized communities. Dyslipidemia is a modifiable cardiovascular risk factor whichis related to diet, especially consumption of hard margarine and hydrogenated fat.The prevalence of cardiovascular diseases and their risk factors differs in communities.We studied the prevalence of consumption of different types of oil and fat in areas ofCentral Iran.METHODS: The subjects were selected using randomized cluster sampling and dividedinto rural and urban groups. A 48-item standard food frequency questionnaire was filledout for every subject by a trained interviewer, who also obtained demographic data. Datawere analyzed with SPSS. Different educational groups and the two sexes in urban andrural areas were compared using chi square test and paired t-test. P values below 0.05were considered as significant.RESULTS: This cross-sectional descriptive study was performed on 12600 adultsubjects aged above 19 years in the cities of Isfahan, Najafabad, and Arak. Consumptionof olive oil and other types of oil in the urban community of Isfahan was higher than inthe rural community. Consumption of animal oil and fat was higher in the ruralcommunity of Isfahan. In subjects with high school education and higher, consumptionof different types of oil was not found to be different between urban and ruralcommunities, or between men and women. In Arak, no difference was found betweenrural and urban subjects with high school education and higher, in respect ofconsumption of different types of oil. Among subjects with lower education, however,consumption of olive oil and other types of oil was higher in urban areas andconsumption of animal oil and fat was higher in rural men. In Najafabad, no differencewas found between different educational groups in respect of the different types of oilconsumed; only consumption of animal oil in rural subjects educated below high schooldiploma was higher than in cities.CONCLUSIONS: Among individuals with high school education and higher, nodifference was found between rural and urban populations in respect of the types of oilconsumed. However, among individuals with low education, consumption of animal oiland fat as well as hard margarine was higher in the rural population, while the urbanpopulation consumed higher amounts of oil and olive oil. The pattern of oil and fatconsumption in men and women was different in the cities of Najafabad and Arak, butalmost similar in Isfahan. Geographical location and education affect the pattern of oiland fat consumption. Unhealthy lifestyle habits are more prevalent in members of therural population with low education.Key Words: Fat, oil, urban population, rural population, education.

Abstract INTRODUCTION: Cerebrovascular accident (CVA) or stroke remains a devastating complication of cardiac surgical procedures, especially coronary artery bypass graft (CABG) despite advances in perioperative monitoring and management. An individual's risk of stroke is based in part on preoperative characteristics, but also on intra- and postoperative factors. The purpose of this study was to determine the prevalence and predictors of stroke in a large group of patients undergoing cardiac surgery. methods: Data were collected on 1467 patients who underwent CABG at Chamran Heart Center from 1995 to 2003. Stroke was defined as "a new focal neurological deficit which appears and is still at least partially evident more than 24 hours after its onset". Logistic regression identified significant predictors of stroke. results: Among the preoperative and postoperative factors, significant correlates of stroke included chronic renal insufficiency (P=0.0001), hypertension (P=0.0001), diabetes (P=0.0001), and atrial fibrillation (P=0.0001). However, stroke had no significant correlation with sex (P=0.054), age (P=0.28), severe LV failure (P=0.062), history of CVA (P=0.723) or shock state (P=0.802). Discussion: Neurologic complications after cardiac surgical procedures remain a relatively common problem despite improvements in anesthetic and surgical techniques, as well as in perioperative monitoring and management. Increased stroke risk can be predicted by preoperative and postoperative clinical factors.Keywords • Stroke • Cerebrovascular accident • Coronary artery bypass graft (CABG)

Abstract INTRODUCTION: Cardiovascular disease, coronary artery disease (CAD) in particular, is the main cause of morbidity and mortality in Iran. This study was designed to determine the prevalence of CAD in Central Iran using the Rose Questionnaire and Electrocardiography. methods: 6498 people aged above 35 years were evaluated in this cross-sectional study. Multi-stage cluster sampling was conducted in the provincial cities of Isfahan, Najaf-Abad and Arak. A questionnaire was used to collect demographic and job data. The Rose chest pain questionnaire with five questions was filled out by trained physicians. ECG and Minnesota coding were performed. Data were analyzed with chi-square test using SPSS 11. results: 3338 women and 3160 men participated in the study. The prevalence of CAD based on the Rose questionnaire and Minnesota coding was 37.5% in women and 22.2% in men. The prevalence of CAD increased with age in both sexes. The prevalence of definite and possible MI based on ECG was higher in men; however, a higher prevalence of possible and definite ischemia was found in women. The prevalence of CAD based on the Rose questionnaire was higher in women of all age groups. CONCLUSIONS: The high prevalence of CAD in the Iranian community warrants a comprehensive primary and secondary prevention program. Keywords: Coronary artery disease, Rose questionnaire, Minnesota code, ECG, prevalence.

BACKGROUND: Atherosclerosis is one of the leading causes of mortality all around the world. Obesity is an independent risk factor for atherosclerosis and cardiovascular diseases (CVD). In this respect, we decided to examine the effect of the subgroups of weight on cardiovascular risk factors. METHODS: This cross-sectional study was done in 2006 using the data obtained by the Iranian Healthy Heart Program (IHHP) and based on classification of obesity by the World Health Organization (WHO). In this study, the samples were tested based on the Framingham risk score, Metabolic Measuring Score (MMS) and classification of obesity. Chi-square and ANOVA were used for statistical analysis. RESULTS: 12514 people with a mean age of 38 participated in this study. 6.8% of women and 14% of men had university degrees (higher than diploma). Obesity was seen in women more than men: 56.4% of women and 40% of men had a Body Mass Index of (BMI) ≥ 25 Kg/m2. 13% of the subjects had FBS > 110 and 13.9% of them were using hypertensive drugs. In this study, we found that all risk factors, except HDL cholesterol in men, increased with an increase in weight. This finding is also confirmed by the Framingham flow figure for men and women. CONCLUSION: One of every two Americans, of any age and sex, has a Body Mass Index of (BMI) ≥ 25 Kg/m2. Obesity associated CVD and other serious diseases. Many studies have been done in different countries to find the relationship between obesity and CVD risk factors. For example, in the U.S.A and Canada they found that emteropiotic parameters, blood presser and lipids increased by age(of both sexes). Moreover, another study done in China, which is a country in Asia like Iran, shows that BMI has an indirect effect on HDL cholesterol, LDL cholesterol and triglyceride. This data is consistent with the results of the current study. However, In China they found that this relationship in men is stronger than women, but our study reveals the opposite. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the relationship between postoperative serum lactate levels and outcome in patients undergoing coronary artery bypass graft surgery (CABG) and verify the clinical impact of hyperlactatemia (HL) during CABG in terms of postoperative morbidity and mortality rate. Methods: In this prospective study, 92 patients underwent open heart surgery. Demographic data, lactate levels, pH, 48 hours serum creatinin after surgery (mg per cent), left ventricular ejection fraction, Inotropic Drugs and the duration of use and the duration of intensive care unit (ICU) admission t and deaths were collected. Findings: Mortality rate was 3.3 percent, the average duration of hospitalization was 8.8 days and the duration of ICU admission was 47.27 hours. In 82.6% of the patients increased lactic acid was observed; while 17.4% of patients had a low lactate serum concentration during ICU admission. Conclusion: The findings of this study showed an association between lactate serum levels and the duration of ICU admission and duration of hospitalization, so hyperlactatemia could be a prognostic factor and could predict the mortality and the severity of complications in the patients undergone CABG. [ABSTRACT FROM AUTHOR]