Atherosclerosis

Question 1

Explain the difference between arteriosclerosis and atherosclerosis.

Answer 1

Arteriosclerosis

• Generalized condition
• A nonmodifiable change in small arteries and arterioles
• Associated with aging

Atherosclerosis

• Type of Arteriosclerosis
• A modifiable change in small arteries and arterioles related to fat build up
• Reduce risk through modifiable risk factors
• Consequences of atherosclerosis depends on level of occlusion

   - Total occlusion leads to heart attack or stroke
   - Partial occlusion leads to TIA or angina

Question 2

List risk factors for the development of atherosclerotic blood vessel disease. Which ones pose the greatest risk?

Answer 2

• Non-modifiable: Factors you can’t change or influence.

   - Age
   - Sex
   - Genetic predisposition
   - Family history 

• Modifiable: Factors you can change or influence.

   - High cholesterol and triglyceride levels
   - HTN
   - Smoking
   - Diabetes
   - Obesity
   - Physical inactivity
   - Diet high in saturated fats

Question 3

Compare LDL and HDL cholesterol.

Answer 3

LDL

-High fat diets increase levels
- Treatment aims for low levels
- Associated with atherosclerosis

HDL
- Low lipid content
- High levels are therapeutic
- Transports cholesterol away from peripheral cells

Question 4

If a person has coronary artery disease due to atherosclerosis, their risk of stroke is increased. (True, False)

Answer 4

TRUE - A person with atherosclerosis is at higher risk for stroke, especially if the disease affects the arteries that supply the brain (such as the carotid arteries).

Question 5

Explain the mechanism of action of Statins.

Answer 5

HMG-CoA Reductase Inhibitors (Statins)

• Inhibits the enzyme HMG-CoA reductase, which is a catalyst in the formation of cholesterol
• Lowers LDL levels by 20-40% and boosts HDLs
• E.g. Atorvastin, Simvastatin

Question 6

What are 4 important health teaching points for statin drugs?

Answer 6

• Requires lifelong administration of the drug
• Given orally in the evening (when cholesterol production is highest)
• Give with food to decrease GI side effects
• Obtain baseline liver function tests and monitor regularly
• Discourage use of alcohol
• Monitor for muscle weakness (myopathy)
• Utilize appropriate birth control to avoid pregnancy
• Grapefruit juice inhibits metabolism

Question 7

List 6 manifestations of peripheral arterial disease.

Answer 7

1. Fatigue and weakness of legs especially with activity due to higher O2 demand to muscles
2. Open sores or infections that do not heal
3. Intermittent claudication (muscle ischemia)
4. Cool pale extremities with hard to palpate pulses
5. Skin appears red when dependent; returns to normal when elevated
6. Slow nail growth, absence of hair