Hyperlipidemia: Lecture 1 Flashcards
Normal Cholesterol Homeostasis
Dietary cholesterol goes from GI tract and brought to liver by Chylomicrons
Get packaged into VLDL, and travels through blood stream to other tissues. Along the way it gets turned into LDL due to muscles and organs taking TG.
LDL taken up into cells, and then excess cholesterol is put into HDL and sent back to liver in process called Reverse Cholesterol Transport
Cholesterol used to make bile to break down fats
Role of Lipoproteins
transport TGs and Cholesterol from liver to tissues and back
Chylomicrons have…
lowest density but must TGs
TG/Chol/Protein of Chylomicrons
90/5/5
TG/Chol/Protein VLDL
60/30/10
TG/Chol/Protein LDL
10/60/30
TG/Chol/Protein HDL
10/30/60
What APO protein thought to play role in Anti-Atherosclerotic properties of HDL?
APO A-1
Found on HDL
Which APO protein is thought to be Atherogenic
APO B
Found on Chylomicrons, VLDL, LDL
General CV Risk Factors
Hypertension Hyperlipidemia Diabetes Smoking Obesity Physical Inactivity
Examples of ASCVD/CHD/CAD
MI ACS Stable/Unstable Angina CVA (stroke) or TIA CABG PTCA
ASCVD more prevalent in….
nonhispanic black males and females
average life loss to patient after having Heart attack?
11.5 years
How does too much Cholesterol leads to ASCVD
Too much cholesterol start to deposit between layers of artery walls, forming fatty streak.
Body sends macrophages, ingest cholesterol but they turn into foam cells.
This causes fatty streak to become bigger and form into plaque. Body then forms a fibrous cap which is thin nd not very strong.
When cap breaks, a blood clot forms and blocks the artery. Depending where artery is, determines what kind of ASCVD event occurs.
Size of LDL effect on ASCVD
Small dense = more likely to cause ASCVD
Larger, less dense = less likely to cause ASCVD
Effect of decreasing LDL, increasing HDL on ASCVD risk?
1% decrease risk for every 1mg/dL LDL decrease
2% decrease risk for every 1mg/dL HDL increase
Alcohol effect on Lipids
Increase TG
Thiazide Diuretics effect on Lipids
Increase LDL and TC
B Blocker effect on Lipids
Increase TG, decrease HDL
Glucocorticoids effect on Lipids
Increase VLDL,LDL, TC
Olanzapine effect on lipids
Increase LDL, TC
Bile acid specific DI
Don’t take drugs 2hrs before or 4hrs after taking them
Diet changes for Hyperlipidemia
Eat: Veggies, Fruits, Whole Grains, Low-fat Dairy, Poultry/fish, nuts, nontropical veg oil
Limit: Sweet, Sugar sweetened Bev, red meats
Herbal/OTC products that might have some efficacy on Cholesterol
Fish Oil
Soy
Cholestin (Red Yeast)
Plant Stanols
