Cardiovascular Disease Flashcards
What is atherosclerosis?
The build-up of plaque within arteries
What can form a plaque within arteries?
- Fatty substances
- Cholesterol
- Cellular waste
- Calcium
- Fibrin
Why is atherosclerosis of concern?
It decreases the lumen of arteries which may lead to an MI, stroke or other ischaemia due to partial or complete vessel occulsion
What are the stages in the formation of atherosclerotic plaques?
- Endothelial damage
- Production of cellular adhesion molecules
- Monocytes and T cells attach to the surface of endothelial cells
- Diapedesis occurs through artery walls into sub-endothelial space
- Macrophages take up oxidised LDL-C
- They then form lipid-rich foam cells
- Formation of a fatty streak (and plaque) occurs due to deposition of foam cells
What is atherothrombosis?
A term used to describe an acute thrombus in a vessel affected by atherosclerosis
Why do platelets adhere to the damaged area after an atherosclerotic plaque ruptures?
The contents of the atherosclerotic plaque (including collagen and von Willebrand factors) are released causing the adherence
What are risk factors for develping an atherosclerosis?
- Inactivity
- Age
- Heart disease and diabetes
- Hypertension
- Alcohol and smoking
- Obesity and eating unhealthy
What is the most atherosclerotic lipoprotein?
Low-density lipoprotein (LDL)
Which lipoprotein does not affect atherosclerosis at all?
High density lipoprotein (HDL)
(protects against it)
What would be considered high triglyceride levels?
4.5-11.3mmol/l
(normal is around 2.3mmol/l)
What is the difference between absolute and relative risk?
- Absolute - the likelihood of of developing disease when considering the whole population’s averge risk
- Relative - the likelihood of developing a disease when taking into consideration your risk factors compared to those of others
Which enzyme does the statin drug class inhibit?
HMG-CoA reductase
Give 2 examples of statins
- Simvastatin
- Lovastatin
Xanthelasma is a sign of what?
Hyperlipidaemia
(raised serum levels of total cholesterol or LDL-C)
Where do tendon xanthomas affect?
Tendons of fingers, patella, elbows and Achilles
Tuberous xanthomas affect where in the body?
Forms nodules, papules or plaques
Affects extensor surface of large joints, hands, buttocks, heels and flexures
What are the two types of hypertension?
- Essential - idiopathic (primary)
- Secondary - as a result of a co-morbidity
Why does hypertension have increased risk of atherosclerosis?
More damage is done to blood vessels
Hypertension causes widening of arteries due to pressure
The artery walls thicken in response narrowing the lumen
This mean plaques can build up easier in the more enclosed space
Which diet is associated with higher survival rates after MI?
Mediterranean
Fasting glucose should not be above which level?
>=5.6mmol/l
When treating atherosclerosis, which two branches of the disease can be targeted? 2 for dead and block
Ischaemia - anti-anginal medication, revascularisation
Atherothrombosis - aspirin, statin, beta blocker, ACEI, smoking cessation etc.
