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The plaques in the arterial walls of patients with atherosclerosis contain large amounts of cholesterol The higher the level of low-density lipoproteins (LDL) cholesterol, the greater the risk of atherosclerotic heart disease; conversely, the higher the high-density lipoproteins (HDL) cholesterol, the lower the risk of coronary heart disease (CHD) This is true in men and women, in different racial and ethnic groups, and at all ages up to age 75 years Because most cholesterol in serum is LDL, high total cholesterol levels are also associated with an increased risk of CHD Middle-aged men whose serum cholesterol levels are in the highest quintile for age (above about 230 mg/dL) have a risk of coronary death before age 65 years of about 10%; men in the lowest quintile (below about 170 mg/dL) have a 3% risk Death from CHD before age 65 years is less common in women, with equivalent risks one-third those of men In men, each 10-mg/dL increase in cholesterol (or LDL cholesterol) increases the risk of CHD by about 10%; each 5-mg/dL increase in HDL reduces the risk by about 10% The effect of HDL cholesterol is greater in women, whereas the effects of total and LDL cholesterol are smaller All of these relationships diminish with age There are several genetic disorders that provide insight into the pathogenesis of lipid-related diseases Familial hypercholesterolemia, rare in the homozygous state (about one per million) is a condition in which the cell-surface receptors for the LDL molecule are absent or defective, resulting in unregulated synthesis of LDL Patients with two abnormal genes (homozygotes) have extremely high levels up to eight times normal and present with athero-

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The first difference you ll notice between the applications in this chapter and the ones you ve written up to this point is that Windows applications have a visual component, called a form. The interface you see is the form, and the buttons, text boxes, and other widgets that make up the form are called controls. You build simply by dragging and dropping controls onto a work area. Some code goes into creating the appearance and default behavior of the controls, but all of that is created for you by Visual Studio, and you never have to see it.

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sclerotic disease in childhood Homozygotes may require liver transplantation to correct their severe lipid abnormalities Those with one defective gene (heterozygotes) have LDL concentrations twice normal; persons with this condition may develop CHD in their 30s or 40s Another rare condition is caused by an abnormality of lipoprotein lipase, the enzyme that enables peripheral tissues to take up triglyceride from chylomicrons and verylow-density lipoproteins (VLDL) particles Patients with this condition, one cause of familial hyperchylomicronemia, have marked hypertriglyceridemia with recurrent pancreatitis and hepatosplenomegaly in childhood Numerous other genetic abnormalities of lipid metabolism are named for the abnormality noted when serum is electrophoresed (eg, dysbetalipoproteinemia) or from combinations of lipid abnormalities in families (eg, familial combined hyperlipidemia) Thus, family members of patients with severe lipid disorders are appropriately studied Other patients have abnormalities in the production of apoproteins, such as increased apoprotein B and its affiliated lipoproteins, LDL and VLDL; reduced apoprotein AII and its affiliated particle; or excess lipoprotein(a) Other mutations occur in lipoprotein lipase and in the gene encoding for cholesterol efflux regulatory protein

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Ansell BJ et al High-density lipoprotein function recent advances J Am Coll Cardiol 2005 Nov 15;46(10):1792 8 [PMID: 16286161] Berneis K et al Low-density lipoprotein size and subclasses are markers of clinically apparent and non-apparent atherosclerosis in type 2 diabetes Metabolism 2005 Feb;54(2):227 34 [PMID: 15690318] Drexel H et al Is atherosclerosis in diabetes and impaired fasting glucose driven by elevated LDL cholesterol or by decreased HDL cholesterol Diabetes Care 2005 Jan;28(1):101 7 [PMID: 15616241] Nam BH et al Search for the optimal atherogenic lipid risk profile: from the Framingham study Am J Cardiol 2006 Feb 1;97(3):372 5 [PMID: 16442398]

ACE inhibitors are being increasingly used as the initial medication in mild to moderate hypertension (Table 11 8)

And that s the second thing you ll notice: up until now, just about every bit of code that you worked with was written exclusively by you. You saw back in 2, though, that Visual Studio is capable of inserting prefabricated code snippets to save you time. This is a larger extension of the same idea. In fact, you won t see Main( ) anymore, because Windows takes care of that part. Your functional code will be contained in event handlers, and the objects you create will be called from those event handlers. In effect, moving from the command line to Windows programming entails an entirely different metaphor of programming a visual metaphor, hence the name of Visual Studio.

Cost of 30 Days Treatment (Based on Average Dosage)1 $4020 Special Properties 2 Selectivity 2 + Lipid Solubility + Renal vs Hepatic Elimination H>R

Comments5 Positive ANA; rare LE syndrome; also indicated for arrhythmias Doses > 800 mg have 1 and 2 effects Also indicated for angina pectoris and post-MI Doses > 100 mg have 1 and 2 effects

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