Atherosclerosis Meds Flashcards
CHD risk factors
- age and gender
- lipoprotein disorders
- HTN
- DM
- fam history of premature CHD
- smoking
In the general population, clinical atherosclerosis CVD is strongly related to age, in a gender dependent manner, increasing in the ______ in men and ______ in women.
- 40s in men; 50s in women
- women tend to have more events later in life and are less likely to survive the events
4 lipid categories and their associated with atherosclerotic CV risk
- total and LDL-C: direct
- HDL-C: inverse
- TGs: direct
- Lpa: direct; genetic biomarker of risk
Blood pressure and CVD risk
-linear, direct relationship; lower is better!
DM and CHD
- diabetes is a heart disease “equivalent” because it confers as much risk of future CVD as existing heart disease without DM
- combination of DM and existing heart disease carries remarkable risk of future MI
T/F: Genetics only play a role in early heart disease.
- false; family history of atherosclerotic heart disease, particularly early onset in 1st degree relatives is a major risk factor for future heart disease independent of other factors
- still genetics influencing events happening over the age of 65, but most telling at younger ages
Traditional risk factors confer ______ risk of heart disease.
-additive
4 patient groups that guidelines recommend high or moderate intensity statins for
- clinical ASCVD
- LDL-C >/ 190 mg/dL
- DM
- 10 year risk >/7.5% (meant to capture those with strong family histories)
The fact that 30-40% of subjects with premature CHD are not considered high-risk tells us what?
- traditional risk factors do not identify all high-risk subjects
- there are still unknown risk factors we need to uncover!!
Clinical identification of the metabolic syndrome
- abdominal obesity in men >102 cm, women >88 cm
- TGs >150
- HDL in men 130/>85
- fasting glucose >110 mg/dL
- 3/5= metabolic syndrome and high risk for CHD
Why is it important to measure more than just LDL-C?
- TGs were shown to be an independent, atherogenic risk factor; and thus remnants carrying high TGs are also atherogenic and need to be measured
- basically, all non-HDL-C= atherogenic
6 selective emerging risk factors for atherosclerosis
- Lpa
- homocysteine
- fibrinogen
- inflammatory markers
- subclinical atherosclerosis imaging
- genetic variation
List 4 inflammatory markers looked at as markers of CVD risk
- CRP
- SAA
- siCAM-1
- IL-6
- they are not causal, but mark those at higher risk
- really on CRP is used clinically
If someone is born with a gene that raises their CRP level, are they are heightening risk of CVD?
-no, they are not causal! just markers
Methods for non-invasive imaging of atherosclerosis as a way to measure subclinical atherosclerosis
- B-mode ultrasound of carotids: intimal-medial thickness
- electron beam tomography of coronaries: look for coronary artery calcification; more Ca = more plaque= higher risk
- magnetic resonance imaging of aorta, carotids, coronaries: plaque size and morphology
- molecular imaging
