By Gerald C. Timmis
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Extra resources for Cardiovascular Review 1984
Moreover, Nanthey and Kubler (AJC 45:940, 80) showed that the increase in chromium in patients with metallic prostheses failed to decrease glucose, cholesterol, or triglycéride levels (which are allegedly increased in chromium deficiency). Thus, chromium deficiency as a risk factor for CHD was not supported by this study since blood lipid levels were higher in these patients. However, Mertz (Practical Cardiol 8:145, 82) indicated that chromium supplementation may reduce LDL and total cholesterol levels and increase HDL cholestrol.
Cadmium (which in excess may uncouple o x i d a t i v e p h o s p h o r y l a t i o n ) was increased in p r o p o r t i o n t o t h e number of c i g a r e t t e s smoked and was f e l t t o p o s s i b l y c o n t r i b u t e t o sudden death in smokers. R o b e r t s and W a l l e r (Am J Med 7 1 : 3 7 1 , 81) suggested t h a t chronic hypercalcemia may be a CHD r i s k f a c t o r because i t was a s s o c i a t e d w i t h a c c e l e r a t e d d e p o s i t i o n of calcium in t h e v a l v e s , media, and intima of coronary a r t e r i e s and in i n d i v i d u a l myocardial f i b e r s .
Young women who smoke have a greater risk of CHD if they are also taking oral contraceptives (Am J Obstet Gynecol 126:301, 76; Modern Medicine, Feb 1, 77 p. 92; NEJM 298:1273, 78). See also p. 12. Most smokers have abnormal pulmonary function tests (Chest 65:148, 74), polycythemia, elevated carboxyhemoglobin, and show a leftward shift in the oxygen-hemoglobin dissociation curve (NEJM 298:6, 78). The increased affinity of hemoglobin for carbon monoxide reduces myocardial oxygen supply, and thus decreases exercise time to angina (AHJ 101:154, 81; Circ 63:253A, 81); at the anginal threshold, the rate-pressure product was decreased and the incidence of ischémie ECG changes and arrhythmias was higher.