CVD: hypertension, Increased blood lipids, atherosclerosis and thrombosis

Question 1

How is hypertension and pre-hypertension defined?

Answer 1

= systolic blood pressure > 140 mmHg, diastolic blood pressure > 90 mmHg, averaged over time.
 Values between 120/80 and 140/90 may be called pre-hypertension.

Question 2

What part of adults has hypertension?

Answer 2

1/3 of adults has hypertension (= high blood pressure)

Question 3

The systolic pressure = A
The diastolic pressure = B

Answer 3

A pressure in the arteries when the heart ventricles contract.
B pressure in the arteries when the ventricles are relaxing and filling with blood.

Question 4

Where is bp most often measured? In what unit?

Answer 4

 Blood pressure is most often measured in the brachial artery.
 Pressure is measured in millimeters of mercury (mmHg).

Question 5

What are symptoms of hypertension?

Answer 5

Most likely asymptomatic.

Sudden onset of hypertension = combination of symptoms that range from severe headache, nosebleeds, and nausea to neurological symptoms, like confusion and blurred vision.

Question 6

• explain why a high blood pressure may lead to cardiovascular disease

Answer 6

= high blood pressure causes damage to the epithelial cells that line the inside of the blood vessels, which can lead to CVD

Question 7

• list the risk factors for hypertension

Answer 7

= old age, obesity, salt-heavy diet, sedentary lifestyle

Question 8

• explain how a low blood flow to the kidneys leads to (secundary) hypertension

Answer 8

primary = without clear cause
secondary = clear cause of the condition (e.g. tumor)
Kidneys are important for blood pressure regulation: Without enough blood, the kidney secretes renin which help the kidneys retain more water. This contributes to more blood in the arteries, making them more full, which leads to hypertension.

Question 9

Atherosclerosis = plaque (a combination of A, B, C, D and other substances) builds up in the arteries.

Answer 9

A cholesterol
B fat
C calcium
D white blood cells

Question 10

Describe the development of atherosclerosis:

Answer 10

1. Endothelial dysfunction: increased permeability, accumulation of oxidized lipoproteins
2. Lipoproteins are taken up by macrophages within the endothelium: produce lipid-laden foam cells
3. Macroscopically, these lesions are seen as flat yellow dots/lines on the endothelium of the artery and are known as ‘fatty streaks’.
4. The ‘fatty streak’ may further progress into plaques (with a soft interior and a fibrous cap as shell) that may undergo thrombosis and produce an obstruction

Question 11

What is it called when there is too much cholesterol in the blood, that contributes to atherosclerosis?

Answer 11

hyperlipidemia

Question 12

What do LDL cholesterol particles do?

Answer 12

LDL particles: main carrier of cholesterol in fasting plasma, and deliver it both to the liver + peripheral cells.

Question 13

What do HDL cholesterol particles do?

Answer 13

HDL particles take up cholesterol from cells. It transports excess cholesterol from
the periphery and deliver cholesterol to the liver (reverse cholesterol transport) or to steroid- synthetic tissues (ovaries, testes, adrenal cortex).

Question 14

Arterial thrombosis and deep vein thrombosis are caused by…

Answer 14

Arterial: this is a consequence of atherosclerosis.
Deep vein thrombosis: most often caused by blood clotting disorders, but it can also happen if you stay sedentary for too long