Cardiovascular Disease Flashcards
What is Hyperlipidemia?
Increased cholesterol, phospholipids, and triglyceride levels in blood
How are lipids transported in the blood?
Apoproteins
What is a lipoprotein?
Apoprotein-lipid complex
What are the different lipid densities?
LDL
VLDL
HDL
Which lipids don’t you want in your blood?
LDL
VLDL
Which lipids are good lipids?
HDL
How are lipids transported into the blood through the intestinal tract?
Cholymicrons
What is atherosclerosis?
Atheroma that forms in the intima of a larger blood vessel wall
What is an atheroma?
Fibrofatty tissue
What does atherosclerosis result in?
Hypoperfusion (ischemia) of tissues
What is an infarction and what is it a result from?
Cell death due to ischemia
What are the three stages of a lesion in atherosclerosis?
Fatty streak
Fibrous atheromatous plaque
Complicated lesion
What is the “fatty streak” stage of a lesion?
Cells and lipids are deposited in the vessel wall resulting in discolouration. Change only occurs in blood vessel wall. There is still 90% patency of BV
Describe the “fibrous atheromatous plaque” stage
Further deposition of cells (macrophage and platelets) lipids, fibres and smooth muscle cells. Change still only occurs in the vessel wall. 40%-50% compromise
Describe “complicated lesion” stage
This stage triggers an MI, stroke. Change occurs in the lumen of the BV. The thrombus can be dislodged and travel elsewhere in the body and cause a blockage.
Describe the pathogenesis of atherosclerosis
Monocytes and other inflammatory cells bind to endothelium, once monocytes enter endothelium they become macrophages. Macrophage release free radicals (causing more injury) and engulf lipids, foam cells release growth factor causing muscle cell proliferation in BV forming an atheroma, blood then hemorrhage a into plaque/atheroma resulting in a thrombus
What is a macrophage that has engulfed a lipid called?
Foam cell
Where are the most common sites for atherosclerosis?
Abdominal aorta and iliac arteries
Proximal coronary arteries
Thoracic aorta, femoral and popliteal arteries
Vertebral, basilar, and middle cerebral arteries
What is hypertension?
Persistently increased blood pressure that cannot be brought back to normal
Why is a normal blood pressure needed?
To properly perfuse tissues
What are four major control systems of BP?
Arterial baroreceptors
Renin-angiotensin system
Vascular auto regulation
Regulation of fluid volume
Where are arterial baroreceptors located?
Carotid artery and aorta
How does the RAAS system regulate BP?
Enzyme renin is released by kidney which coverts angiotensin I to angiotensin II which increases BP by vasoconstriction, increases Na+ reabsorption in kidney
How does the vascular auto regulation system regulate BP?
Vessels constricting or dilating on their own
How does the regulation of fluid volume occur to regular BP?
ADH and aldosterone act on kidney to increase water and sodium reabsorption
If someone has a BP that overlaps in two categories, how do we categorize their HTN?
Err on side of caution and categorize their HTN in the higher category
What are risk factors of CVD?
Smoking HTN Hyperlipidemia High cholesterol Diabetes Obesity Physical inactivity
What is malignant HTN?
When the diastolic BP is >120, very serious
What are the manifestations of HTN
Increased BP
What are late complications of HTN
Palpitations, AM headache, blurred vision, dizziness, organ damage
What is the first type of treatment for HTN?
Lifestyle modifications (diet, exercise, weight loss)
What is the first line drug therapy used for HTN?
Diuretic
How does a diuretic decrease BP?
Kidneys excrete more water which decrease blood volume and decreases BP
What do calcium channel blockers do to decrease BP?
They block the channel calcium takes to cross the cell membrane and is necessary for creating an action potential. The less calcium that crosses means the hearty decrease number or strength of beats
What does an angiotensin II reception blocker do to decrease BP?
It blocks receptors that angiotensin II binds to and prevents vasoconstriction
What do ACE I medications do to decrease BP?
They inhibit the enzyme (ACE) that conveys angiotensin I to angiotensin II
