Ch. 27 Cardiovascular Diseases Flashcards
Leading Causes of Death in the U.S.?
- Heart disease (leading cause of death as you get older)
- Cancer
- Chronic lower respiratory disease
- Stroke
- Accidents
- Alzheimer’s disease
- Diabetes
Atherosclerosis
Hardening of the arteries
Monocytes circulate in the bloodstream and respond to injury on the artery wall
Monocytes slip under blood vessel cells and engulf LDL cholesterol, becoming foam cells. The thin layers of foam cells that develop on artery walls are known as fatty streaks.
A fatty streak thickens and forms plaque as it accumulates additional lipids, smooth muscle cells, CT, and cellular debris.
The artery may expand to accommodate plaque. When this occurs, the plaque that develops often contains a large lipid core with a thin, fibrous covering and is vulnerable to rupture and thrombosis.
Major Risk factors for chronic heart disease (CHD) (not modifiable)
Increasing age
Male gender
Family history of premature heart disease
Major Risk factors for CHD (modifiable)
High blood LDL cholesterol
Low blood LDL cholesterol
HTN
T2 Diabetes
Obesity ("apple shape")
Physical inactivity
Cigarette smoking
"Atherogenic diet" (high in saturated fats and low in vegetables, fruits, and whole grains)Consequences for Atherosclerosis
In coronary arteries:
- Angina: pain in the chest
- stable-predictable/reliable stressor: pattern in heart pain >4 weeks (ex. every time they exercise)
- Unstable- first time,
Ischemic Stroke
85-90% of strokes fall within this category
Brain cells can die within minutes
Blood flow to brain is temporarily RESTRICTED
Hemorrhagic Stroke
LEAK/RUPTURE in blood flow to brain –> hemorrhagic stroke
Problems leading to this:
- -uncontrolled HTN - can cause weakening of blood vessels and lead to hemorrhage
- -aneurysm
The Minnesota Vikings punt return team runs ____. This is also an acronym for stroke intervention.
FAST
Stroke: FAST
F: face
–smile - does face droop?
A: arm
–can the individual lift their arms?
S: speech
–does the individual slur their words? Confusion may go along with this…
T: time
–call 911
Other warning signs of stroke
Vision related issues (blurred vision, blackened vision, unable to see out of one eye, seeing double)
Sudden severe headache like no other
Any kind of weakness (not restricted to just arms…can be in legs –> difficulty walking)
Lipoproteins
• Major carriers of lipids in the plasma
• Clusters of lipids associated with proteins that serve as transport vehicles for lipids in the lymph and blood (fat + proteins)
• Primarily transport lipids from liver
–> Made of triglycerides, cholesterol, and phospholipids
Classes of Lipoproteins
Chylomicrons: transport of lipids from gut to various tissues
VLDL: very low density lipoprotein
IDL: intermediate density lipoprotein
LDL: low density lipoprotein
HDL: high density lipoprotein (GOOD)
Classes of Lipoproteins: LDL
Low density lipoprotein…impacted by diet
“most atherogenic”
Transports cholesterol to cells in the body (essentially putting the cholesterol out into the circulation)
We don’t eat LDL, we consume cholesterol associated with this carrier
Classes of Lipoproteins: HDL
High density lipoprotein…impacted by physical inactivity
Taking cholesterol from tissues and sending it back to liver
We don’t eat HDL, we consume cholesterol associated with this carrier
Managing LDL and HDL levels
A lower LDL and a higher HDL is preferred
Soluble fiber (such as oatmeal) can decrease LDL cholesterol
Trans fats can increase LDL cholesterol
HDL: physical inactivity is the lifestyle intervention we look for to increase HDL
–not impacted by diet as strongly as LDL
Dietary Intervention: Total Fat
20-35% total kcal from fat
Dietary Intervention: Saturated Fat
less than 10% total kcal from saturated fat
less than 7% total kcal from saturated fat if at risk for CVD
Animal products, palm kernel oil, coconut oil, palm oil, lard, butter are products high in saturated fats
Dietary Intervention: Monounsaturated Fat (MUFA)
less than 20% total kcal from MUFA
Olive oil, canola oil, peanut oil
Dietary Intervention: Polyunsaturated Fat (PUFA)
less than 10% total kcal from PUFA
Omega 3 (oily fish, flaxseed)
Dietary Intervention: Dietary Cholesterol
less than 300 mg/d for general population
less than 200 mg/d for LDL-cholesterol or preexisting CVD
Animal products
