Lecture 1: Risk Factors for Coronary Disease Flashcards

1
Q

What are the six established CHD risk factors and are they reversible?

A
Age
Cholesterol
BP
BMI
Smoking
Diabetes
All are reversible except for age
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2
Q

What are the four other CHD risk factors?

A

Left ventricular size (bigger heart = greater risk)
Fibrinogen (clotting factors)
Other lipids
Homocysteine

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3
Q

How does weight gain promote major CHD traits?

A

Increases BP and cholesterol and insulin resistance

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4
Q

What is the single most important risk factor for CHD?

A

AGE

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5
Q

__% of CHD occur in people older than __ years

A

80% of CHD occur in people older than 65 years

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6
Q

Does hormone therapy after menopause reduce CHD?

A

No
Makes it worse
Vascular and cancer problems

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7
Q

Who die earlier and more frequently from CHD, men or women? Why

A

Men
Women are protected by menopause (circulating hormones)
Male risk is higher after menopause

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8
Q

Why is there a greater risk of CHD if there is someone else in your family with CHD?

A

You have the same genes and environment

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9
Q

How much does your risk of CHD increase if you have a first degree relative with CHD?

A

Your risk increases 4 - fold

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10
Q

What traits do insulin receptor substrate-1 (IRS-1) cause?

A
Insulin resistance 
Hypertension
Impaired endothelial function
High TAGs
Coronary artery disease
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11
Q

Which chromosome is IRS-1 gene associated with?

A

Chromosome 2

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12
Q

Why aren’t triacylglycerols used as a measure of coronary heart disease?

A

Fluctuate with meals

Not a stable measure

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13
Q

What is the difference between good cholesterols and bad cholesterols?

A

Bad: LDL and VLDL, take lipids from liver and out to tissues, get dropped off at blood vessels along the way
Good: HDL, takes cholesterol from periphery back to liver

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14
Q

Can stress cause CHD?

A

Unproven but popular explanation
Not easily measured
Depends if you have put already diseased CV under stressed
Type A vs Type B personalities

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15
Q

How does alcohol impact CHD?

A

No more than two units a day otherwise tends to increase cholesterol

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16
Q

What are the patterns of CHD in Europe, SE Asia, America, Australia and Japan?

A

Rising in central and eastern Europe
Falling in western Europe, north America and Australiasia
Falling from low levels in Japan

17
Q

What is the pattern of CHD in wealthy countries?

A

Decline in CHD is fastest in higher socio-economic groups

CHD is more common in less wealthy groups

18
Q

What are the most important factors in CHD and societies?

A

Nutrition

Cigarette smoking

19
Q

What are the two of the five stages of epidemiological transition?

A

Low wealth

  • Infectious disease
  • Poor life expectancy

Wealth

  • CV disease and cancer
  • Better life expectancy
20
Q

Does wealth and decline in infectious disease always mean CHD?

A

No

21
Q

What is the life expectancy in Japan compared to UK?

A

5 years greater in Japan (80 years)

UK (75 years)

22
Q

How may Japan have escaped the CHD epidemic?

A

Medical care: low consumer
Smoking: high - 2/3 men
Nutrition: dietary fat is less than 25% of diet
Unknown: economic correlate, social support, psychological security

23
Q

What is the French paradox?

A

The French have the second lowest rates of CHD (after Japan) but most of their foods have high amounts of saturated fats (eg. cheese, butter, cream) and are big smokers (like Japan)
This may be due to eating in moderation or red wine drinking?