6 Atherosclerosis RISK factors / Epidemiology Flashcards
Atherosclerosis affects what size arteries ?
large (aorta, carotid, iliac) and medium sized arteries (coronary, renal, cerebral )
atherosclerosis define ?
thickening , narrowing and hardening of the walls of large and medium sized arteries as a consequence of atheroma
atheroma define ?
accumulation of intra- and extracellular lipid in the tunica intima and tunica media of large and medium sized arteries
arteriosclerosis definition ?
thickening and hardening of the walls of arteries and arteriolesfrom any cause (including atherosclerosis)
normal arterial structure
- tunica intima (innermost layer , smooth endothelium, elastic tissue)
- tunica media (smooth muscle, elastic tissue & collagen)
- tunica adventitia (outermost layer)
fundamental lesion in atherosclerosis is called a ….. ?
plaque
3 ish sections: Fat bread of Air
modifiable risk factors of atherosclerosis ?
- carbohydrate excess (western pattern diet)
- sedentary lifestyle
- abdominal obesity
- insulin resistance
- diabetes mellitus
- trans-unsaturated fatty acids
- hypertension
- dyslipidaemia, hyperlipidaemia
- tobacco smoking
Examples of food containing trans-unsaturated FAs ?
- partially hydrogenated oils
- ready-made cookies
- deep-fried foods e.g. elaidic
nonmodifiable risk factors for atherosclerosis ?
- age
- south asian descent
- family history
- genetics
less or uncertain risk factors for atherosclerosis ?
- thrombophilia
- alcohol
- sleep deprivation
- arsenic
- air pollution
- chronic stress
- periodontal disease
- systemic inflammation / infection
Epidemiology of atherosclerosis: AGE (non-modifiable)
throughout adult life it’s …..1… and the risk factors operater over ..2..
- slowly progressive
- years
Epidemiology of atherosclerosis: GENDER (non-modifiable)
1. until when are women relatively protected ?
2. presumed bias …?
3. Incidens in women = that of men by age range ?
- before menopause
- hormonal
- 70s and 80s
Which type of lipoprotein is most significant in contributing to atherosclerosis ?
low-density lipoprotein (LDL) because of it high half-life
what role does HDL play in cardiovascular health ?
HDL is protective as it helps to remove cholesterol from the bloodstream, thereby reducing the risk of plaque formation in the arteries
homozygous familial hypercholesterolaemia
1. type of disorder ?
2. characterised by ?
3. due to ?
- genetic disorder
- extremely high levels of LDL cholesterol
- defects LDL receptor resulting in decreased hepatic uptake of LDL and increased circulating LDL
At what age might individuals with homozygous familial hypercholesterolaemia experience a myocardial infarction ?
before age of 20 years
How are lipids carried in the blood ?
bound to carriers:
* 2% mostly FA bound to albumin (limited capacity to transport FA)
* ~ 98% carried as lipoprotein particles
Lipoprotein particles consist of what ?
- phospholipids
- cholesterols
- cholesterol esters
- proteins
- triacylglycerols
- structure of core of a lipoprotein ?
- what forms outer layer of lipoprotein ?
- hydrophobic lipid core
- hydrophilic outer layer of phospholipid and apolipoprotein (A-E)
How is the prevalence of atherosclerosis distributed among developed and developing nations ?
Atherosclerosis is ubiquitous (present everywhere) among developed nations, with a lower incidence in South America, Africa, and Asia.
Which specific population within Asia is predisposed to atherosclerosis?
south East Asians are predisposed to atherosclerosis.
What factors influence the incidence of atherosclerosis in different regions?
Social circumstances and diet
What happens to migrants who move to high-risk locations and adopt the local lifestyle and diet?
adopt the new lifestyle and diet have the same risk of atherosclerosis as the population in their new location.
What can be inferred about the role of genetics versus lifestyle in the development of atherosclerosis from the information about migrants?
The information about migrants suggests that lifestyle and diet play a significant role in the development of atherosclerosis, as migrants adopt the same risk levels as their new location, regardless of their genetic background.
