Atherosclerosis Pathophysiology Flashcards
Pathophysiology of atherosclerosis
Endothelium damaged by sheer stress
Monocytes adhere and penetrate to damage => macrophages
- absorb oxLDL => foam cells => die and form lesion core
- cytokine release => aggregation of more macrophages, SM proliferation
SM forms fibrous cap
Plaque rupture => thrombosis, coronary artery block
Risk factors for CVD
Age, male, ethnicity, FHx
HTN (systolic and diastolic) High LDL, LDL:HDL ratio DM Smoking LVH
Dyslipidemia - high LDL and TAGs, low HDL
Statins
Ezetimibe
HTN - most significant risk factor
Damages endothelium of conduit artery => atherosclerosis (aorta, coronary, carotid, renal
Increases afterload => LVH, ischemia
Brain and kidney need high flow, low resistance => more prone to damage from increased pulsatility from high BP
-renal failure, strokes
Smoking
Endothelial dysfunction and damage => inflammation
Increased plaque vulnerability
Increased thrombosis, decreases fibrinolysis
Increases SNS => HTN
Increased T2DM
T2DM and cardiometabolic disease
Increased oxidative stress, endothelial adhesion molceule expression
Increased inflammation
CMD
- high glucose
- HTN
- dyslipidemia
- central obesity
Obesity
Increased risk of being metabolically unhealthy
Increases SNS, glucose, cholesterol
How does exercise reduce CV risk
Weight loss => reduce obesity related risk factors
Increases HDL, lowers TAGs
Increases NO
Reduces oxidative stress