47. Atheroscolerosis and Vascular diseases

Question 1

Cardiovascular disease

Answer 1

CVD is leading cause of death in US.

Takes decades to build plaque in arteries.

Question 2

CVA risk factors - general

Answer 2

HTN, advanced age, DM, high LDL/cholesterol or low HDL, family hx, obesity, smoking.

Question 3

CVA risk equivalents (20% or higher in next 10 yrs)

Answer 3

Metabolic syndrome, type 2 DM, peripheral arterial disease, AAA, carotid artery disease.

Question 4

Metabolic syndrome

Answer 4

Distinctive body shape - pear-shaped, increased abd circumference.
High TG, low HDL, HTN, high fasting glucose.

Question 5

Diabetes

Answer 5

Having DM presents same risk of MI as someone who already had MI.
Having both DM and MI leads to 45% risk of MI in 7 years.

Question 6

Hyperlipidemia

Answer 6

Dyslipidemia: elevated TG, reduced HDL, overall normal LDL.

when TG is high, LDL fragments to become more atherogenic.

Question 7

Risk of CDH.

Answer 7

Framingham study: high serum cholesterol.
High LDL associated with high CDH.
Low HDL associated with high CDH, worse if coupled with high TG.
CRP: independent clinical predictor. From any inflammation.

Question 8

Statin - drug

Answer 8

HMG-CoA reductase inhibitor (rate-limiting step in lipid synthesis.)
Therapuetic benefits include lower LDL, lower TG and higher HDL. (lowering CRP has no clinical implications yet.)
Non-lipid effects include increased endothelial function, reduce inflammation and reduce coagulation/raise fibrionylsis.