Tocotrienols have been reported to possess potent cholesterol lowering, anti-hypertensive, antiinflammatory and anti-oxidative properties which are superior to tocopherols. Emerging evidence suggests pure tocotrienols have anti-atherogenic properties. However, optimal doses of oftocotrienolrich fraction (TRF) in progressive atherogenesis remain unclear. This animal model experiment was designed to investigate the effects of a range concentration of TRF supplementation on the extent of atherosclerosis and soluble lipids, inflammatory and oxidative stress biomarkers in high-cholesterol diet (HCD) induced hypercholesterolaemic (HC) rabbits with atherosclerosis. A total of 28 New Zealand white rabbits were given 1% high-cholesterol diet (HCD) for two months and then randomised into five groups: Placebo (n=7), TRF 15 mg/kg (n=5), TRF 30 mg/kg (n=6), TRF 60 mg/kg (n=5) and TRF 90 mg/kg (n=5) daily. The treatment was given for three months and the animals were fed HCD throughout the duration. Aortic vessels were obtained to assess the extent of atherosclerotic lesions at the end of the study. Fasting serum lipids (FSL), C-reactive protein (CRP), malondialdehyde (MDA) and 8-isoprostane levels were measured at baseline, one and two months post-HCD, one, two, and three months postintervention. There were no differences in the extent of the atherosclerotic lesions, percentage changes of FSL, MDA, 8-isoprostane and CRP levels between the placebo and TRF groups. In conclusion, TRF across all doses studied have neutral effects on atherosclerotic lesions, soluble lipids, biomarkers of oxidative stress, coronary risk and inflammation in severely atherosclerotic rabbits with progressive and continuous insult by high cholesterol feeding.
Previous research has shown the beneficial effects of aqueous extract of Piper sarmentosum (P.s) on atherosclerosis. The first stage in atherosclerosis is the formation of foam cell. The aim of this study was to investigate the effect of the methanol extract of P.s on fatty streaks by calculating neointimal foam cell infiltration in rabbits fed with high cholesterol diet. Thirty six male New Zealand white rabbits were divided equally into six groups: (i) C: control group fed normal rabbit chow; (ii) CH: cholesterol diet (1 % cholesterol); (iii) PM1: 1 % cholesterol with methanol extract of P.s (62.5 mg/kg); (iv) PM2: 1 % cholesterol with methanol extract of P.s (125 mg/kg); (v) PM3: 1 % cholesterol with methanol extract of P.s (250 mg/kg); (vi) SMV group fed 1 % cholesterol supplemented with Simvistatin drug (1.2 mg/kg). All animals were treated for 10 weeks. At the end of the treatment, the rabbits were fasted and sacrificed and the aortic tissues were collected for histological studies to measure the area of the neointimal foam cell infiltration using software. The thickening of intima ratio of atherosclerosis and morphological changes by scanning electron microscope were measured. The results showed that the atherosclerotic group had significantly bigger area of fatty streak compared to the control group. The area of fatty streak in the abdominal aorta was significantly reduced in the treatment groups which were similar with the SMV group. Similarly, there was a reduction in the number of foam cell in the treatment groups compared to the atherosclerotic group as seen under scanning microscope. In conclusion, histological study demonstrated that the methanol extract of the P.s could reduce the neointimal foam cell infiltration in the lumen of the aorta and the atherosclerotic lesion.
INTRODUCTION: The objective of this study was to investigate the relationship between hypertensive patients and their coping style and associated lifestyle factors.
METHODS: A total of 502 participants attending nine outpatient clinics completed the validated Bahasa Malaysia version of the Coping Inventory for Stressful Situations and sociodemographic questionnaires. The height, weight, pulse rate and blood pressure of all the participants were measured using standardised methods.
RESULTS: A total of 264 (52.6 percent) participants were hypertensive, while 238 (47.4 percent) were not. Participants with a high task-oriented score showed a significantly lower risk of hypertension compared to those with a low score (odds ratio [OR] 0.546; 95 percent confidence interval [CI] 0.371-0.804). Those with a high emotion-oriented coping score were associated with an increased risk of hypertension (OR 1.691; 95 percent CI 1.107-2.582). Hypertension was also significantly associated with a higher mean body mass index, positive family history of hypertension, history of diabetes mellitus and hypercholesterolaemia. In multiple logistic regression analysis with hypertension status as the dependent variable, a high emotion-oriented coping score, a low task-oriented coping score, age, body mass index, positive family history of hypertension and history of diabetes mellitus remain significant factors in the final model.
CONCLUSION: These results indicated a significant relationship between hypertension and coping styles and lifestyle factors. They underscored the importance of further study as well as the development and implementation of intervention measures to improve coping skills among hypertensive patients, which may be incorporated into the management of hypertension.
Hypercholesterolemia is the major risk factor that leads to atherosclerosis. Nowadays, alternative treatment using medicinal plants gained much attention since the usage of statins leads to adverse health effects, especially liver and muscle toxicity. This study was designed to investigate the hypocholesterolemic and antiatherosclerotic effects of Basella alba (B. alba) using hypercholesterolemia-induced rabbits. Twenty New Zealand white rabbits were divided into 5 groups and fed with varying diets: normal diet, 2% high cholesterol diet (HCD), 2% HCD + 10 mg/kg simvastatin, 2% HCD + 100 mg/kg B. alba extract, and 2% HCD + 200 mg/kg B. alba extract, respectively. The treatment with B. alba extract significantly lowered the levels of total cholesterol, LDL, and triglycerides and increased HDL and antioxidant enzymes (SOD and GPx) levels. The elevated levels of liver enzymes (AST and ALT) and creatine kinase were noted in hypercholesterolemic and statin treated groups indicating liver and muscle injuries. Treatment with B. alba extract also significantly suppressed the aortic plaque formation and reduced the intima: media ratio as observed in simvastatin-treated group. This is the first in vivo study on B. alba that suggests its potential as an alternative therapeutic agent for hypercholesterolemia and atherosclerosis.
Kuala Lumpur is the capital city of Malaysia with an estimated population of 1.55 million. Approximately 12% of the population live in squatter settlements occupying about 7% of the city total area. The squatter settlements generally are provided with basic amenities such as piped water, toilet facilities and electricity. Health indicators for the overall population of Kuala Lumpur are better off than for the rest of the country; however, intra-city differentials prevail along ethnic and socio-economic lines. Malays and Indians have higher rates for stillbirths, and neonatal, infant and toddler mortality than the Chinese. The wide disparity in the socio-economic status between the advantaged and the poor groups in the city is reflected in the dietary practices and nutritional status of young children from these communities. The percentage of preschool children from urban poor households with inadequate intakes of calories and nutrients is two to three times higher than those from the advantaged group. Compared to rural infants, a lower percentage of urban infants are breastfed. A lower percentage of Malays from the urban advantaged group breastfed, compared with the urban poor group. The reversed trend is found for the Chinese community. Growth attainment of young children from the urban poor is worse than the urban advantaged, though better than the rural poor. Health and nutritional practices implications related to both undernutrition and overnutrition are discussed, to illustrate the twin challenges of malnutrition in the city.
Introduction: Diabetes Mellitus is a chronic disease and major cause of chronic renal disease. Chronic renal disease can be prevented if known risk factors were been early detected. Albuminuria is the earliest clinical evidence of chronic renal disease. Objectives of this study is to identify the incidence of albuminuria and relationship between albuminuria with socio demographic and clinical factors such as blood sugar control, blood pressure control, excessive body mass index and hypercholesterolemia.
Methodology: Data been collected from patient’s record that been regularly follow up at Primary Healthcare Clinics in Negeri Sembilan. Duration of study follow up was from the date of they been diagnosed of Diabetes Mellitus Type 2 until detection of albuminuria or 1st July 2007,end date of data collection then survival analysis been done.
Result: Majority of study population was female 60.9% and Malay 69.7%. Mean age was 59.9 ± 10.7 and duration having Diabetes Mellitus was 7.0 ± 6.3 years. Only 22% achieved optimum glucose (HbA1c < 6.5%), controlled blood preassure 130/80 mmHg 42.3%, level of cholesterol <4.5 mmol/L only 22.7 %, 11.4% of patients having ideal body weight < 23 kg/m2. The incidence of Diabetes Mellitus Type 2 was 24.4 cases per 1000 population. The median of follow up duration was 22 years; with minimum follow up was 7 months and maximum 42 years. Survival analysis showed that the median of free albuminuria among cases was 22 years (CI 95%:16.5 – 27.4). The log rank test showed no significant relationship between high blood pressure, excessive body mass index and hypercholesterolemia with albuminuria. This study noted that the occurrence of albuminuria seems to be higher among those were hypertensive (26.6%), and excessive body mass index (24.7%).
Conclusion: Percentage of Diabetes Mellitus Type 2 patient that achieved optimum clinical target still very low. Early detection of albuminuria is very important as preventive measure of diabetes nephropathy. Good blood pressure control and ideal body weight also prevent of occurring diabetes nephropathy complication.
Keywords: Diabetes Mellitus Type 2, albuminuria, survival analysis.
Citation: National Health Morbidity Survey 2006. Kuala Lumpur: Ministry of Health, Malaysia, 2008
Study name: National Health and Morbidity Survey (NHMS-2006)