Lecture 2 - Introduction to CVD Flashcards
1
Q
What is Cardio-Vascular Disease?
A
Broke down in two things::
- Heart disease
- Vascular disease
2
Q
Systole vs. Diastole
A
Systole - phase when CONTRACTION is causing blood to be pumped to arteries (pressure is high)
Diastole - phase when muscle is RELAXED and the heart is filling with blood (pressure is low)
3
Q
Cardiac Output (CO)
A
CO = HR x SV
Heart rate x Stroke Volume
4
Q
Ejection fraction
A
Measurement of the % of blood that leaves your heart for each contraction
5
Q
Ischemia
A
Not enough oxygen
Supply and demand not met
6
Q
Consequences of Atherosclerosis-What Could Go Wrong?
A
- Coronary Heart Disease (CHD)
- Carotid Artery Disease (CAD)
- Peripheral Artery Disease (PAD)
- Renal Arter Stenosis (RAS)
7
Q
What can smoke do to our bodies?
A
- Raise triglycerides
- Lower “good” cholesterol
- Increase risk of clots
- Damage cells that line the blood vessels
- Increase the buildup of plaque in blood vessels
- Cause thickening and narrowing of blood vessels
8
Q
The Global Severity of Cardiovascular Disease
A
- CVDs are the number 1 cause of death globally
- Americanized diets are the cause as well as smoking and drinking
9
Q
Hyperlipidemia:
A
• An abnormally high concentration of fats or lipids in the blood
10
Q
Dyslipidemia:
A
A condition in the body that is marked by abnormal concentrations of lipids or lipoproteins in the blod
11
Q
Hypertriglyceridemia:
A
• A condition in which triglyceride levels are elevated
12
Q
Etiology of Dyslipidemia
A
Primary:
• Familial (two alleles if you have hetero you are premature for CVD if homo you have severe child CVD issues and is an issue with the receptor or lipoprotein)
Secondary/Acquired: • Diet/lifestyle • Drugs • Diseases Disorders & altered states of metabolism
13
Q
Major lipids in body:
A
- Cholesterol
- Triglycerides
- Lipoproteins
14
Q
Major classes of lipoproteins found in
serum are:
A
- Chylomicrons
- VLDL
- Intermediate density lipoproteins
- LDL
- HDL
15
Q
Lipid metabolism: Chylomicrons
A
- Eat fat, carbs, proteins,
- Lipid droplets absoced into intestinal cells as monoglyercols
- Packaged into chylomicrons
- Absorbed into blood
- Circulate and devlier chylomicrons to tissues in need
- Remnants of chylomicrons arrive at liver
- Bind LDL receptors and are endocysoed by heptic cells
16
Q
Lipid metabolism: Glucose
A
- Glucose in blood.
- Absorbed by liver
- Glycolysis –> pyruvate
- Pyruvate –> Acetyl CoA
- Acetyl-CoA eventualy converted to cholesterol voa HMG CoA reductase
- Acetyl-CoA can form Malonyl CoA –> Fatty Acids
- TG, Cholestoerols, phospholupids are packaged together in golgi to form lipoproteins
17
Q
How does the body respond to lack of oxygen?
A
- Body wants to increase BP
1. Constricts vessels
2. Retain water
3. Increase cardiac output
18
Q
Heart Disease vs. Vascular Disease
A
- Heart disease is within your heart (CAD, arrhythmias, failure)
- Vascular disease is stuff like hypertension, lipid disorders, atherosclerosis
19
Q
Describe the path blood takes through the heart starting at the superior vena cava
A
- Superior vena cava
- Right atrium
- Tricuspid valve
- Right ventricle
- Pulmonary valve
- Pulmonary artery
- Lungs
- Left atrium
- Left ventricle
- Aorta
- Rest of the body
20
Q
What is damaged when atherosclerosis occurs?
A
Inside lining of the endothelial
21
Q
Blocked vessels caused by Atherosclerosis can lead to __________
A
Ischemia
22
Q
Atherosclerosis
A
Plaque buildup in arterial walls
23
Q
Ischemia is when
______ does not meet _______
A
Supply (Coronary blood flow)
Demand (Heart rate, contractility)
24
Q
List the four consequences of Atherosclerosis - What Could Go Wrong?
A
- CHD/CAD (Coronary)
- Carotid Artery Disease
- PAD (Peripheral)
- Renal Artery Stenosis (RAS)
25
What can smoke do to our bodies?
| 6
- Raise triglycerides
- Lower "good" cholesterol
- Increase risk of clots
- Damage cells that line blood vessels
- Increase plaque
- Cause thickening and narrowing of blood vessels
26
Hyperlipidemia
An abnormally HIGH concentration of lipids and fats in blood
27
Dyslipidemia
A condition in the body that is marker by abnormal (high or low) concentrations of lipids or lipoproteins in the blood
28
Hypertriglyceridemia
A condition in which triglyceride levels are elevated
29
** Major lipids in the body
| 4
Cholesterol
Triglycerides
Lipoproteins
Phospholipids
30
Chylomicrons transport ______
| 3
Cholesterol
Triglycerides
Lipids (Lipoproteins, Phospholipids)
31
** Major classes of lipoproteins found in serum are:
```
Chylomicrons
VLDL
Intermediate density lipoproteins
LDL
HDL
```
32
**Chylomicrons deliver ______ to tissues in need
Triglycerides
33
Remnants of chylomicrons go where?
Liver
| After bind LDL receptors and are endocytosed by hepatic cells
34
**Acetyl-CoA is eventually converted to cholesterol via_______
HMG CoA Reductase
35
Acetyl-CoA can form _______ --> Fatty Acids
Malonyl CoA
36
What enzyme plays a viatable role in fatty acid biosynthesis
Malonyl CoA
37
Liver produces which two lipoproteins?
HDL
| VLDL
38
Describe fate of HDL after production from the Liver
- Enters circulation
- Picks up excess cholesterol from tissues
- Binds scavenger receptors on hepatocytes
(Empty)
39
Describe fate of VLDL after production from the Liver
1. Transport fatty acid to tissue to create energy or be stored as fat
2. Become an intermediate before becoming LDL which transports cholesterol to tissues
3. Recycled
40
What is cholesterol the precursor for synthesis for (3)
Steroid hormones
Bile acides
Vitamin D
41
What is the structure of triglycerides and what is their function?
Formed from glycerol and three fatty acids
Function as energy storage
42
What is cholesterol transported by?
Chylomicrons
LDL
HDL
43
What are triglycerides transported by?
Chylomicrons
| VLDL
44
What are foam cells
A sign of early stage of atherosclerosis when LDLs(cholesterol) are devoured by macrophages to become these fat-laden cells?
45
**Maintenance of arterial blood pressure is necessary for organ ____
perfusion
46
The primary factors determining the blood pressure: (3)
1. Sympathetic nervous system
2. Renin angiotensin-aldosterone system (RAAS)
3. Plasma volume
47
**Hypertension is quantitatively the major ____for premature
| cardiovascular disease
Modifiable
48
Prevalence of hypertension in the US is strongest in which ethnic group?
Non-hispanic blacks
49
Primary vs secondary hypertension
Primary - idiopathic
| Secondary - lifestyle ( illness, drugs)
50
**Drugs That Can Cause or Worsen HTN
| 7
- Oral contraceptives
- NSAIDs
- Corticosteroids
- Decongestants
- Sodium containing antacids
- Stimulants
- Illicit drug use
51
Physiological Causations of Essential HTN
| 7
- Excess sodium intake
- Abnormalities in RAAS system
- Over-activity of sympathetic nervous system
- Increased CO
- Obesity
- Aging
- Increased PVR
52
Renin cleaves _____ to ________
Angiotensinogen to Angiotensin I
53
What enzyme converts Angiotensin I to Angiotensin II
ACE
| Angiotensin converting enzyme
54
Angiotensin II increases or decreases BP
How?
Increases
via fluid retention and VASOCONSTRICTION
55
Volume regulation can occur by which two ways?
Angiotensin II
| Sympathetic Nervous System
56
Angiotensin II increases BP how?
- Vasoconstriction
- Release of aldosterone (adrenal gland)
- Release of Vasopressin/ADH (pituitary)
57
Aldosterone from the adrenal gland does what to volume regulation
Increase BP by Na+ retention
58
Vasopressin/ADH from the pituitary gland does what to volume regulation
Increase BP by vasoconstriction and water retention via aquaporins
59
Sympathetic nervous system increases BP how?
Norepinephrine increases heart rate and constricts blood vessels that increase the systemic vascular resistance (SVR)
60
Increase in systemic vascular resistance (SVR) does what to BP?
(Think vasoconstriction)
| It increases BP
61
Hypertension
Medical condition in which the blood pressure in the arteries is persistently elevated
62
What is Metabolic Syndrome?
Clustering of several metabolic risk factors in one patient
63
**Current ATP III criteria define the metabolic syndrome as the
presence of any ____of the following five traits:
Three
64
What are the five risk factors that are a part of the ATP III criteria for metabolic syndrome
```
Large waistline
High Triglyceride
High BP
High sugar
Low HDL
```
65
** Abdominal obesity, defined as a waist circumference in ____________
men ≥ 40 in
| women ≥ 35 in
66
**Serum triglycerides ≥ _________ for elevated
| triglycerides
150 mg or drug treatment
67
**Serum high-density lipoprotein (HDL) cholesterol:
_____ in men
_____ in women
_________
* <40 mg/dL in men
* <50 mg/dL in women
* or drug treatment for low HDL cholesterol
68
Blood pressure ≥ ___________ for HTN
130/85 mmHg or drug treatment
69
Fasting plasma glucose (FPG) ______ or drug treatment for elevated blood glucose
≥100 mg/dL
70
95 million U.S. adults age 20 or older have TC > _____mg/dL.
200
71
______% of U.S. children and adolescents ages 6 to 19 have high total cholesterol
7%
72
Slightly more than _____ of U.S. adults who need cholesterol medicine are currently taking it
half
73
TG > _____ can lead to pancreatitis
500
74
Approximately ______ adult Americans have elevated BP, defined as ≥140/90 mm Hg
1 in 3
75
Worldwide, raised blood pressure is estimated to cause 7.5 million deaths, about _____% of the total of all deaths
12.8
