cardiovascular risk factors Flashcards
Whats is the most common cause of premature death?
CHD
How many people die prematurely in the UK from CHD?
43,000
What is the leading cause of death worldwide?
cardiovascular disease
What are examples of changes in habit that contribute to the global epidemic of CVD?
increases in smoking, dietary changes leading to increases in cholesterol, and rises in blood pressure levels
What is atherosclerosis?
a progressive disease that is characterized by a buildup of plaque within the arteries
How is plaque formed?
Plaque is formed from fatty substances, cholesterol, cellular waste, calcium, and fibrin
Plaque may partially or totally block the blood’s flow through an artery
What two things can occur with these plaques?
bleeding into the plaque, or formation of a clot on the surface of the plaque. If either of these happens and blocks the artery, a heart attack or stroke may result
What is the largest tissue in the body?
vascular endothelium
What is an atherothrombosis?
a term used to describe the formation of an acute thrombus in a vessel affected by atherosclerosis
Describe the progression of atherothrombosis?
- normal
- fatty streak
- fibrous plaque
- atherosclerotic plaque
- plaque rupture/fissure and thrombosis
- leading to MI, stroke, CVD, leg ischemia
Name some CVD risk factors
- alcohol
- smoking
- obesity
- high BP
- diabetes
What are examples of modifiable risk factors for CVD?
- smoking
- obesity
- lack of exercise
What are examples of non modifiable risk factors for CVD?
- personal history of CHD
- Family history
- Age
- Gender
Which cholesterol is strongly associated with increased CHD?
LDL and triglycerides
What does a 10% increase in LDL lead to?
20% increase in CHD risk
What are normal triglyceride levels?
2.3mmol/l
What is the relationship between HDL and atherosclerosis and CHD
HDL cholesterol has a protective effect.
-The higher the HDL cholesterol, the lower the risk for atherosclerosis and CHD
When does HDL cholesterol tend to be low?
When triglyceride is high.
-It is also lowered by smoking, obesity and physical inactivity
What happens when LDL receptor doesn’t work?
LDL doesn’t get absorbed and so leads to build up of plaque for atherosclerosis
Is total cholesterol a modifiable risk factor?
yes
What does a 10% reduction in total cholesterol result in?
- 15% reduction in CHD mortality and
- 11% reduction in total mortality
What are the effects of statins?
- reduce CHD end points
- reduce total and LDL cholesterol
- It is pleotropic
What is pleotropic?
- improves endothelial dysfunction
- increased nittic oxide availability
- antioxidant
What is xanthelasma?
build up of plaque deposits on the eyelids. may or may not be associated with hyperlipidemia
Whats a tendon xanthomas?
build up of plaques on tendons of fingers, patella, elbows, achilles
Whats tuberous xanthomas?
lipid deposits in the dermis and subcutis; papuler, nodular or plaques; extensor surfaces of large joints, hands, buttocks, heels, flexures
Whats eruptive xanthomas?
small reddish-yellow papules; buttocks, posterior thighs, body folds
usually abrupt increase in serum triglyceride levels
Name a few diseases attributable to hypertension
- aortic aneurysm
- MI
- cerebral haemorrhage
- blindness
- left ventricular hypertrophy
What are the two types of hypertension?
essential hypertension and secondary hypertension
What is essential hypertension?
One with no underlying cause.
-makes up 90% of cases
What is secondary hypertension?
One with an underlying cause
What is the most common form of blood pressure elevation in people over 60?
isolated systolic hypertension
What link does BP have in CHD?
increasing systolic and diastolic BP are risk factors for CHD
What does hypertension treatment reduce the risk of??
- ischaemic heart disease
- stroke
- mortality
What percentage of hypertensives have other risk factors ie diabetes, smoking
more than 95%
What is the best drug treatments plan for hypertension?
-combination therapies are more efficient than titration of a drug
What is the link between diabetes and CVD?
diabetes is more powerful as a singe factor than hypertension, total cholesterol or smoking
Why is diabetes such a powerful risk factor in CVD?
oType 2 diabetes is associated with hypertension, abnormalities in lipoprotein metabolism and increased propensity to oxidative stress and endothelial dysfunction. Hyperglycaemia itself may accelerate vascular damage. Type 2 diabetes is also a hypercoagulable state with enhanced coagulation, decreased fibrinolysis, and platelet hyperaggregability
When do microvascular complications occur?
At onset of hyperglycaemia
When do macro vascular complications occur?
Before the diagnosis of hyperglycaemia
What is the link between diet and CVD?
Diet is very important. A Mediterranean diet could significantly reduce CVD.
What is the percentage difference in premature deaths from CHD in manual workers compared to non-manual workers?
premature death from CHD lower for non manual workers than manual workers (58% lower)
What is the link between deprivation and CHD?
More depraved more the risk of CHD?
What ethnicity has the highest death rate for CHD in UK?
South Asians
