Lecture 1: Risk Factors for Coronary Disease Flashcards
What are the six established CHD risk factors and are they reversible?
Age Cholesterol BP BMI Smoking Diabetes All are reversible except for age
What are the four other CHD risk factors?
Left ventricular size (bigger heart = greater risk)
Fibrinogen (clotting factors)
Other lipids
Homocysteine
How does weight gain promote major CHD traits?
Increases BP and cholesterol and insulin resistance
What is the single most important risk factor for CHD?
AGE
__% of CHD occur in people older than __ years
80% of CHD occur in people older than 65 years
Does hormone therapy after menopause reduce CHD?
No
Makes it worse
Vascular and cancer problems
Who die earlier and more frequently from CHD, men or women? Why
Men
Women are protected by menopause (circulating hormones)
Male risk is higher after menopause
Why is there a greater risk of CHD if there is someone else in your family with CHD?
You have the same genes and environment
How much does your risk of CHD increase if you have a first degree relative with CHD?
Your risk increases 4 - fold
What traits do insulin receptor substrate-1 (IRS-1) cause?
Insulin resistance Hypertension Impaired endothelial function High TAGs Coronary artery disease
Which chromosome is IRS-1 gene associated with?
Chromosome 2
Why aren’t triacylglycerols used as a measure of coronary heart disease?
Fluctuate with meals
Not a stable measure
What is the difference between good cholesterols and bad cholesterols?
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
Can stress cause CHD?
Unproven but popular explanation
Not easily measured
Depends if you have put already diseased CV under stressed
Type A vs Type B personalities
How does alcohol impact CHD?
No more than two units a day otherwise tends to increase cholesterol
What are the patterns of CHD in Europe, SE Asia, America, Australia and Japan?
Rising in central and eastern Europe
Falling in western Europe, north America and Australiasia
Falling from low levels in Japan
What is the pattern of CHD in wealthy countries?
Decline in CHD is fastest in higher socio-economic groups
CHD is more common in less wealthy groups
What are the most important factors in CHD and societies?
Nutrition
Cigarette smoking
What are the two of the five stages of epidemiological transition?
Low wealth
- Infectious disease
- Poor life expectancy
Wealth
- CV disease and cancer
- Better life expectancy
Does wealth and decline in infectious disease always mean CHD?
No
What is the life expectancy in Japan compared to UK?
5 years greater in Japan (80 years)
UK (75 years)
How may Japan have escaped the CHD epidemic?
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
What is the French paradox?
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?
