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Pathophysiology I: Exam I > HDL/LDL > Flashcards

HDL/LDL Flashcards

1
Q

All Lipoproteins Contain the following

A
  • Triglicerides
  • Esterfied and Unesterfied Cholesterol
  • Phospholipids
  • Proteins
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2
Q

function of lipoproteins

A

Transport lipids in plasma for metabolic purpose

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3
Q

cholesterol

A

essential for biological function as structural component of biological membranes

as a precursor for steroid hormones and other essential functions.

*essential for healing process

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4
Q

HDL relationship to exercise

A

potentially increases HDL

exercise most if not every day at a high enough intensity to see benefits (ACSM guideline - only applies to healthy people)

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5
Q

5 major lipoprotein categories

A
  • Chylomicrons
  • VLDL’s
  • IDL’s
  • LDL’s
  • HDL’s
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6
Q

How do Lipoproteins differ?

A
  • Size
  • Density
  • Quantity of ingredients
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7
Q

triglyceride

A

1 glycerol (sugar)

3 FFA (saturated, unsaturated)

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8
Q

Lipid Production and Synthesis of Cholesterol

intestine

A
  • Triglycerides accumulate from dietary fat
  • Transported in LDL and HDL as well as Chylomicrons and VLDL
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9
Q

Lipid Production and Synthesis of Cholesterol

exogenous

A

Cholesterol production from consumption of fat

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10
Q

Lipid Production and Synthesis of Cholesterol

Liver

A

Synthesizes carbohydrates (Glycerides) that are not used for fuel with free fatty acids to form Triglycerides

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11
Q

lipid production and synthsis of cholesterol

endogenous

A

cholesterol synthesis from other sources

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12
Q

Cost of CHD

A

$50,000,000,000 to $100,000,000,000 per year in lost wages and medical treatment

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13
Q

Total cholesterol classifications

A
  1. Desirable <200 mg/dL
  2. Borderline-high 200-239 mg/dL
  3. High ≥ 240 mg/dL
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14
Q

risk factors for CAD

A
  • Male ≥ 45 years
  • Female ≥ 55 years
  • Family history of CHD
  • Smoker
  • Hypertension
  • Diabetes
  • Total Cholesterol
    • HDL ≤ 40 mg/dL
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15
Q

What reduces 1 risk factor for CHD?

A

HDL ≥ 60 mg/dL

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16
Q

recommended follow up care (1993)

< 200 mg/dL

A

Repeat within 5 years

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17
Q

recommended follow up care (1993)

200-239 mg/dL without CHD or 2 risk factors

A

Dietary info and recheck annually

18
Q

recommended follow up care (1993)

total cholesterol 200-239 mg/dL without CHD or 2 risk factors

A

Lipoprotein analysis and further action based on LDL-cholesterol level

**this is now the standard of care**

19
Q

Classification based on

A

LDL levels

20
Q

LDL Classifications

A
  • Optimal: < 100
  • Desirable: 100-129
  • Borderline-high risk: 130-159
  • High risk: 160-189
  • Very high risk: ≥ 190
21
Q

Why look at HDL and LDL levels for risk of CHD?

A

A substantial amount of persons with CHD have total cholesterol in normal range

22
Q

HDL guidelines

2001

A

< 40 mg/dL low

> 60 mg/dL high

23
Q

Increasing HDL and Lowering Triglicerides

Public Health approach to treatmen

A
  • Obesity
  • Smoking
  • Sedentary life-style
24
Q

Services of Health Professionals

A

Dietitians/Nutritionists
Exercise Physiologists
Health Educators

25
Q

research on puberty and HDL

A
  • Boys and girls have similar HDL levels
  • Puberty boys Increase testosterone and decrease HDL
  • Exercise and Ethanol raise HDL
26
Q

HDL- The Clinical Implications of 1989 study

A

Conclusion not enough evidence showing increase HDL decrease risk CHD

27
Q

Acute Effects of Exercise on HDL, LDL, and Triglicerides

A
  • Triglyceride- reduction 18-24h post exercise, especially in trained endurance athletes
  • HDL- Increases similar to triglyceride reduction
  • LDL- Reduced with prolonged exercise
28
Q

Physical Fitness Vs Physical Activity and CAD risk factors

A

Physical activity must be at high enough intensity to impact physical fitness level in order to effect CAD risk factors

29
Q

Physical Activity and Cardiovascular Health NIH Consensus Conference (1996)

A
  • 12 week exercise- increases HDL levels
  • Endurance exercise
    • decreases in systolic and diastolic BP in Hypertensive persons
    • improved insulin sensitivity
    • lowers risk of clotting factors
  • Moderate activity 30 minutes most days but preferably all days of the week
30
Q

Increased intensity- Benefits and Risks NIH

A
  • Lowers cardiovascular morbidity and mortality rates
  • Increase risk of injury
  • Discontinuation of activity
  • Acute cardiac events during activity
31
Q

Frequency, Intensity, Duration, Mode or FITT

How often should you get:

  • high intensity and duration
  • low intensity and duration
A

High intensity and duration- 3X/week

Low intensity and duration- daily

32
Q

Frequency, Intensity, Duration, Mode or FITT

endurance vs. strength

A

Endurance- variety of activities produce similar benefits

Strength- further research is necessary but initial studies suggest benefits for reducing risk of CHD especially in elderly

33
Q

Cardiac Rehabilitation Referral and Enrollment Rates

group centers

A
  • 10 to 25% of persons with CHD
  • Lower for women than men
  • Lower for non-whites than whites
34
Q

Cardiac Rehabilitation Referral and Enrollment Rates
home based programs

A

Less hospital time combined with in home follow-up

35
Q

cardiac rehab benefits

A
  • Lower incidence of rehospitalization
  • Lower charges per hospitalization
36
Q

Diet and exercise study: What were the changes in HDL, LDL, and total cholesterol?

Men and Women with HDL’s below 35mg/dL and LDL’s above 130mg/dL

Diet group, Diet and Exercise group, control group

A
  • Decrease in total cholesterol and LDL’s for both treatment groups
  • Significant increase in HDL’s in Diet and Exercise group
37
Q

CHD

Initial LDL level: > 100 mg/dL

  1. minimal goal
  2. treatment
A
  1. ≤ 100 mg/dL
  2. dietary therapy with CHD
38
Q

CHD

Initial LDL level: ≥ 130 mg/dL

  1. minimal goal
  2. type of therapy
A
  1. minimal goal: ≤ 100 mg/dL
  2. drug therapy
39
Q

1993 treatment guidelines

LDL ≥160 mg/dL w/o CHD or two risks

  1. minimal goal
  2. treatments
A
  1. goal: < 160 mg/dL
  2. treatments: dietary
40
Q

1993 treatment guidelines

≥130 mg/dL LDL w/ CHD or two risks

minimal goal
treatments

A
  1. goal: < 130 mg/dL
  2. treatment: dietary
41
Q

1993 treatment guidelines

LDL ≥190 mg/dL w/o CHD or two risks

minimal goal
treatments

A
  1. goal: < 160 mg/dL
  2. treatment: drug
42
Q

1993 treatment guidelines

≥160 mg/dL w/ CHD or two risks

minimal goal
treatments

A
  1. goal: < 130 mg/dL
  2. treatment: drug

Pathophysiology I: Exam I (6 decks)

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