Cardiovascular diseases

Question 1

What is the underlying cause of cardiovascular disease?

Answer 1

atherosclerosis (lipid plaque) and thrombosis

Question 2

How does atherosclerosis evolve?

Answer 2

1. Damage to endothelium (inner lining artery) (risk factor: LDL, high blood pressure, smoking)
2. Chronic inflammatory response (lesion: white blood cells)
3. The plaque evolves (advanced lesion)
4. Plaque ruptures: thrombosis
5. Ischemia: restricted blood flow + oxygen

Question 3

Clinical vs subclinical CVD?

Answer 3

Clinical CVD “hard endpoint”
- Recognizable symptoms
- Myocardial infarction
- Stroke
- CHD death

Subclinical CVD “below the surface”
- Less recognizable
- Thicker muscle of your heart: needs more contraction
- Endothelial dysfunction
- Electrocardiogram (ECG) abnormalities
- Calcification etc
Risk for clinical CVD

Question 4

Deaths due to CVD yearly? Two main causes? Prevalence?

Answer 4

18.6 mil deaths globally (30%) yearly base
Two main causes: 1. Ischemic heart disease 2. Ischemic stroke
prev = 523 mil

Question 5

CVD mortality de/increases in high income countries

Answer 5

decreases

Question 6

Risk factors CVD?

Answer 6

Modifiable risk factors:

• Alcohol
• Smoking
• Physical activity
• Unhealthy diet
• Hypertension
• Diabetes
• Obesity
• Pshychosocial factors (stress)

Non-modifiable:

• Gender
• Race
• Ageing
• Genetic predisposition

Question 7

CVD death highest increase in :
CVD death highest decrease in :

Answer 7

Africa
Central/west europe

Question 8

What could be reasons for CVD to be more prevalent in men?

Answer 8

• Symptoms are different of females compared to males.
• Risk factors are different: e.g. smoking
• High systolic blood pressure and high LDL are most important risk factors for both
• Hormonal, psychological factors