CVD risk factors & Cardiac Biomarkers

Question 1

What is angina?

Answer 1

Lack of oxygen to heart (ischaemia)

Question 2

What is myocardial infarction (MI)?

Answer 2

• ‘Heart attack’
• Coronary thrombosis
• Death of heart muscle

Question 3

What are underlying causes of CVD?

Answer 3

• Arteriosclerosis
• Thrombosis/thrombogenesis
• Hypertension
• Metabolic syndrome
• Diabetes, especially type 2 diabetes mellitus
• Inflammation

Question 4

What are risk factors for CVD/CHD?

Answer 4

• Family history
• Gender
• Age
• Blood lipids
• Hypertension
• Cigarette smoking
• Obesity
• Lifestyle
• Diet

Question 5

What to asses for CVD?

Answer 5

• Gender, age
• Family history, premature coronary artery disease
• Hyperlipidemias/dyslipidemia
• Primary hyperlipidemia
• Secondary hyperlipidemia
• Metabolic syndrome, DM2

Question 6

What to lipoproteins do?

Answer 6

• Transport cholesterol and TG around the blood

- Made in the body, not absorbed from diet

Question 7

What are the different types of lipoproteins?

Answer 7

• VLDL, IDL, LDL = increased risks

- HDL = decreased risks

Question 8

What factors affect lipoprotein levels?

Answer 8

• Diet - fat, type of fat
• Dietary fibre
• Protective components - folate, anti-oxidants, phytosterols
• Alcohol - limit
• Sugar, salt - reduce intake
• DASH diet, mediterranean diet

Question 9

What is a dietary intervention for high cholesterol levels?

Answer 9

Introduce a blood cholesterol lowering diet (not a low cholesterol diet) since cholesterol is produced in the liver as a main source

• Lifestyle changes
• Mediterranean diet
• DASH (dietary approaches to stop hypertension) diet

Question 10

What are specialised tested for CVD?

Answer 10

• Lp(a) protein - increased levels increased risk
• CT scan for calcium levels in coronary artery
• C-reactive protein- elevated levels impendent risk - inflammatory marker, non –specific
• Homocysteine levels - elevated levels increased risk - link with folic acid, B12, B6 deficiency
• Elevated plasma fibrinogen - thrombogenesis

Question 11

How do cardiac biomarkers occur?

Answer 11

• Cardiac markers released when heart muscle dies

Question 12

What are the cardiac biomarkers?

Answer 12

• Tropinin T (or Tn I)

- Creatine Kinase - CKMB, Myoglobin

Question 13

How to reduce risk for CVD?

Answer 13

• Smoking cessation
• Stress management
• Physical activity
• Body weight management
• Low alcohol

Question 14

What medications reduce CVD risk?

Answer 14

• Anti-coagulants e.g Low dose aspirin
• Drugs promoting cholesterol removal, reduce absorption from the digestive system e.g. Cholestyramine, Colestipol
• Drugs reducing production of cholesterol e.g. statins
• Triglycerides lowering e.g. Fibrates
• Metformin