Cardiovascular Path Flashcards
what occurs at the vascular endothelium
Transfer of molecules
Platelet adhesion & blood clotting
Vasodilation/constriction
Susceptible to endothelial dysfunction
what occurs at the vascular smooth muscle
Vessel diameter reacts to cytokines (dialate and constrict), growth factors
Synthesis of collagen(makes muscle bulk up), elastin(makes the muscle stretchy)
What is Arteriosclerosis?
Abnormal thickening and hardening of the endothelium
Atherosclerosis – Plaque producing process that leads to disease
Process takes 20-40 years
Many arteries affected
Coronaries are a frequent site and often the first to show trouble
What are the non-modifiable and modifiable risk factors?
Non-modifiable risks factors
Age, male gender, family history
If you have a 1st degree relative that has heart disease before 65 it increase your chance by 7%
Modifiable risk factors
Hyperlipidemia
Cigarette smoking
Nicotine →↑ catecholamines (epi and norepi), vasoconstriction, HTN, ↑LDL, ↓HDL, platelet aggregation
Hypertension – sheer stress, endothelial injury
Diabetes mellitus/insulin resistance
Prolonged hyperglycemia, ↑ lipoproteins → endothelial damage, inflammation, ↑ oxidation of LDL
Obesity – adipokines (cytokine released by fat tissue) produced in adipose tissue and ^ risk of cardiovascular disease
Sedentary lifestyle
“Soft factors” such as stress
Infection including periodontal disease
CMV (cytomegalovirus), clamydia pneumonia
Inflammation and endothelial dysfunction
C-reactive protein (CRP) serum marker for systemic inflammation (can be measured in the blood), tells us just that something’s going on
Produced in liver in response to inflammation
Hs-CRP is predictive in patients with low lipids
CRP & inflammation can be lowered with statins, exercise, ↓ stress
