Lotensin (Benazepril)

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Lotensin (Benazepril)
HEART ATTACK AND HEREDITY: WHAT IS IT THAT ONE INHERITS?
Is the proneness of some families due to the fact that relatives resemble each other in blood pressure, in cholesterol and triglyceride levels, in liability to diabetes and obesity, and even in smoking habits? As yet we have only limited answers. These family similarities are not very strong. Yet Professor Esko Nikkila’s research in Helsinki suggests that inheritance of similar blood-cholesterol levels and blood pressures largely explains why some families are prone to heart attack. This is a hopeful conclusion, for these disorders are readily treated. Professor Fred Epstein’s calculations suggest that other factors contribute to inherited risk too. Among these, lack of the protective lipoprotein HDL could be important; there is reason to believe that HDL levels are partly controlled by our genes. Very recently, Dr Feinleib has found that a tendency to low levels of HDL (often found in young men with coronary disease) may be inherited.
Whatever the inherited tendency is due to, it is chiefly operative in younger people. If a man is older than fifty-five years when he has a heart attack, his relatives have little or no excess risk; the same applies to women of sixty-five and over. As most heart attacks occur at more advanced ages, the impact of inherited risk on the population is small. In early-onset heart disease genes can play a more substantial role.
There are rare strongly inherited diseases which clearly predispose to heart attack. About one person in 300 has this disorder. Somewhat commoner is another inherited condition which causes high levels of cholesterol, triglyceride or both; this is called familial combined hyperlipidaemia. These conditions are inherited by about half of the members of affected families. To such families these disorders are certainly important: it is wise for all relatives to be screened and we believe that treatment should be offered to those found to be affected. They should in addition take particular care to guard against other risk factors. Familial hypercholesterolemia tends to increase the risk of heart attack, even in young people, if untreated.
But because these strongly inherited disorders are so uncommon, they make only a small contribution to the coronary disease problem as it affects the community. To reduce the risk of heart attack doctors must do more to detect people with these disorders, and so offer them the probable benefits of early treatment. But such conditions are uncommon and efforts at prevention must be made available to a far wider range of people.
*45/202/5*

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