Clinical Laboratory Studies Flashcards
Risk Factors for CHD
- Age
- Family history
- Gender-specific male
- Uncontrolled HTN
- Elevated total cholesterol
- Uncontrolled DM
- Smoking/componentes of cigarette smoke
- Physical Inactivity
- Obesity/overweight
- Post menopausal
- Pro-inflammatory state: high levels of C-reactive protein
- Uncontrolled stress
- Poor diet
- Alcohol use
Cholesterol
a waxy, fat-like substance found in all cells of the body. It is an essential component of cell walls/cell fluidity and is a precursor molecule for VitD and steroid hormones.
How is cholesterol transported in the blood?
with a carrier molecule (a lipoprotein)
LDL, HDL, VLDL
What cholesterol is associated with chronic inflammation?
(ex: atherosclerotic plaques)
LDL and VLDL
Total Cholesterol
HDL + LDL + triglycerides
What components are present on a lipid panel?
- Total cholesterol
- HDL
- LDL
- Triglycerides
How are high density lipoproteins (HDL) associated with coronary heart disease risk?
Inversely
Your patient has low HDL concentrations on their blood work. What education can you provide to improve HDL value?
participate in regular aerobic exercise
Low Density Lipoproteins (LDL) are accepted as a causal risk factor of:
- myocardial infarction
- Atherosclerotic cardiovascular disease
How is atherosclerotic plaque formed?
LDLs invade tunica interna blood vessels + form atheroma»_space; WBCs establish low grade inflammation»_space; smooth muscle cells proliferate and enter this area»_space; fibrous connective tissue accumulates»_space; macrophages are attracted to the area»_space; forms a swelling in the artery
Plaque formation is
self propagating
How are VLDL values calculated?
usually estimated as a % of your trigylceride value
Which lipoprotein is an independent risk factor for CAD and also a risk factor for CHD, stroke, thrombosis?
Lipoprotein A
When are cholesterol ratios helpful?
When an individual has high HDL
How does a cholesterol ratio associate with risk of heart disease?
Lower ratio = lower risk of heart disease
Reccomendation: 5 or less
Types of Trigylcerides
- Saturated fats
- Unsaturated fats: Monounsaturated or polyunsaturated; cis- or trans- fatty acids
Saturated fats
fat molecules that have NO double bonds (saturated with H)
How do saturated fats impact risk of heart disease?
high levels of saturated fats = increased heart disease risk
Unsaturated fats
fat molecules in which there are one or more double bonds
Monounsaturated fats
one double bond
Polyunsaturated fats
multiple DB
Cis Fatty Acids
chains of carbon atoms are on the same side of the double bond resulting in a kink
Trans-fatty acids
uncommon in nature, commonly produced industrially from vegetable fats.
Increased intake associated with coronary vascular disease
How are triglycerides managed?
Medications (statins) and lifestyle
Diabetes in a disease of hyperglycemia that creates a proinflammatory state. How does this increase the risk for stroke/ischemic injury?
tumor necrosis factor-a and cytokines cause adipose tissue to release proinflammatory markers causes platelet activation = increased risk for stroke and ischemic injury
Structural abnormalities that are characteristic of the diabetic heart.
- Fibrosis
- Cardiac hypertrophy
- Impaired coronary microvascularization perfusion
- Mitochondria perfusion
- Impaired calcium handling
