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HUNT243 Exam > Lecture 21: CVD > Flashcards

Lecture 21: CVD Flashcards

1
Q

What is coronary heart disease (CHD)?

A

damage that occurs when blood vessels carrying blood to the heart become narrow and blocked

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2
Q

What is cardiovascular disease (CVD)?

A

general term for all diseases of the heart and blood vessels

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3
Q

What is cerebrovascular disease (stroke)?

A

Damage to arteries to the brain

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4
Q

What is peripheral vascular disease?

A

Narrowing of the arteries other than those that supply the heart or brain

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5
Q

What is hypertension?

A

High blood pressure

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6
Q

What is atherosclerosis?

A

Characterised by plaques along inner walls of arteries

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7
Q

What do mortality rates of CVD look like over time?

A

Rates are actually decreasing

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8
Q

Why are rates of CVD mortality decreasing?

A
  • Better control of major risk factors
  • Better evidence-based treatments
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9
Q

What major risk factors are under better control nowadays?

A
  • Cholesterol
  • Systolic blood pressure
  • Smoking prevalence
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10
Q

What are some of the evidence-based treatments that have improved?

A

Diagnostic and therapeutic procedures:
- Pharmacological treatment of hypertension and hypercholesterolemia
- Hypertension screening
- Bypass surgery
- Access to healthcare

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11
Q

What is the highest cause of death?

A

Ischemic heart disease (CVD)

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12
Q

Maori vs. Non Maori total CVD mortality

A

Rates much higher in both Maori men and women

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13
Q

Why is it wrong that CVD is referred to as a ‘man’s disease’?

A

Because CVD is the leading cause of death in women worldwide

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14
Q

How many women die of heart disease or stroke compared to breast cancer?

A
  • 1 in 2 will die of heart disease or stroke
  • 1 in 25 will die of breast cancer
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15
Q

Women vs. Men: Onset of CVD

A

Age-specific risk is apparently lower in women
- Women get the disease on average 7-15 years later

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16
Q

How many layers do our blood vessels have?

A

3 layers

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17
Q

How does atherosclerosis begin?

A

The inner lining of an artery gets damaged by factors like high blood pressure, smoking, or high cholesterol levels

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18
Q

What happens when arteries get damaged?

A

fats (especially cholesterol) and other substances start to stick to the artery wall. This build-up is called plaque.

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19
Q

What happens once there is plaque build up on arteries?

A

The body sends white blood cells called macrophages to the plaque as a response. These cells try to “eat up” the irritants (e.g. cholesterol), but they will die, adding to the growing plaque and causing inflammation

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20
Q

What happens over time to plaque on arteries?

A

Over time, the plaque hardens and grows, narrowing the artery and making it less flexible. This means less room for blood to flow through the artery - increasing blood pressure

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21
Q

What happens when the arteries eventually rupture?

A

will spill their contents into the bloodstream causing blood to clot around it, which can block arterties entirely. If this happens in an artery supplying the heart, it can result in a heart attack; in arteries to the brain, it may cause a stroke

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22
Q

How many types of lipoproteins are there?

A

4

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23
Q

What are the 4 types of lipoproteins?

A
  • Chylomicrons
  • LDL
  • VLDL
  • HDL
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24
Q

What is the function of chylomicrons?

A

To transport dietary lipids from intestines to peripheral tissues and the liver

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25
Q

What is the function of VLDL?

A

Transports lipids from liver to peripheral tissues

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26
Q

What is the function of LDL?

A

Transports cholesterol to peripheral tissues and liver

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27
Q

What is the function of HDL?

A

Removes cholesterol from tissues and transfers it to the liver or other lipoproteins

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28
Q

What is intermediate density lipoprotein?

A

Precursor of LDL

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29
Q

Where do chylomicrons come from?

A

The intestine

30
Q

Where does VLDL come from?

A

The liver

31
Q

Where does LDL come from?

A

VLDL

32
Q

What is albumin?

A

a protein made by the liver

33
Q

What is the function of albumin?

A

Transports free fatty acids from adipose tissue to peripheral tissues

34
Q

Increasing which lipoproteins increases CVD risk?

A
  • LDL
  • Apo-B
  • Lipoprotein A
  • TAGs
35
Q

Does increasing HDL increase CVD risk?

A

We don’t know

36
Q

Saturated fat increases…

A

LDL

37
Q

What is the relationship between VLDL and obesity?

A

In obese individuals, the liver often produces more VLDL

38
Q

What is the relationship between LDL and obesity?

A

Obesity is often associated with higher levels of LDL cholesterol

39
Q

What is the relationship between HDL and obesity?

A

Obesity is generally associated with lower levels of HDL cholesterol, which is known as “good” cholesterol

40
Q

Most fats are a mixture of…

A

saturated, mono-unsaturated and polyunsaturated fatty acids

41
Q

Animal fats and the tropical oils are mostly…

A

Saturated fatty acids

42
Q

What are examples of saturated fat (from highest proportion of SAFA to lowest)?

A
  • Coconut oil
  • Butter
  • Beef tallow
  • Palm oil
  • Lard
43
Q

Vegetable oils, such as olive and canola are rich in…

A

Monounsaturated fatty acids

44
Q

What are examples of monounsaturated fat (from highest proportion of MUFA to lowest)?

A
  • Olive Oil
  • Canola Oil
  • Peanut Oil
45
Q

Many vegetable oils are rich in….

A

Polyunsaturated fatty acids

46
Q

What type of PUFA’s are vegetable oils typically very high in?

A

Omega-6

47
Q

What oil is very high in Omega-3?

A

Flaxseed oil (PUFA)

48
Q

What did a meta-analysis look at about saturated fat intake replacements?

A

Looked at what we are replacing saturated fat with

49
Q

What things were saturated fat replaced with in the meta-analysis?

A
  • CHO
  • PUFA
  • MUFA
  • Protein
50
Q

What was the overall risk ratio of replacing saturated fat with CHO, PUFA, MUFA or protein?

A

The risk ratio is 0.83 - a reduction of 17%
- This is good

51
Q

What was the reduction in risk when SAFA was replaced with PUFA’s?

A

27% reduction

52
Q

What was the reduction in risk when SAFA was replaced with MUFA’s?

A

0% reduction

53
Q

What was the reduction in risk when SAFA was replaced with CHO’s?

A

? Reduction

54
Q

What was the reduction in risk when SAFA was replaced with Protein?

A

? Reduction

55
Q

How does PUFA work to reduce CVD risk?

A

By lowering cholesterol

56
Q

In studies which achieved at least 0.2mmol/L reduction in TC, what happened to CV events?

A

They reduced by 26%

57
Q

There were no effects seen in studies replacing SAFA with…

A

CHO, protein or MUFA

58
Q

The degree of reduction in CVD was related to….

A

The degree of reduction in serum total cholesterol

59
Q

Most CVD events are not…

A

Fatal - only about 1/3 of total deaths were attributed to CVD

60
Q

How does SAFA increase cholesterol?

A
  • By decreasing LDL receptor activity
  • Suppresses ACAT (rate limiting enzyme of cholesterol esterification) resulting in a greater proportion remaining in the regulatory pool
61
Q

What do omega-6 PUFA’s do to LDL receptor activity?

A

Increases it

62
Q

What do omega-6 PUFA’s do to CYP7 enzyme activity?

A

Increases CYP7 (rate limiting enzyme in converting cholesterol to bile acids)

63
Q

What happened when large amounts of cholesterol was fed to rabbits?

A

Induced atheroclerosis

64
Q

What is the recommendation for people with CVD risk and egg consumption?

A

Intake of less than 6-7 eggs per week is unlikely to have an influence on risk

65
Q

What people should not eat eggs?

A

People with T2D

66
Q

Why do people thing Omega-6 PUFA’s are bad?

A
  • They are oxidised and this could cause problems within the body (there is no evidence that it increases oxidation in humans)
  • Fat in the body is changed to a longer chain acid, which has a pro-inflammatory effect (this acid is also associated with anti-inflammatory effects so it is quite complicated)
67
Q

What percent of EPA + DHA is undesirable as a percent of total RBC membrane fatty acids?

A

0-4%

68
Q

What percent of EPA + DHA is intermediate as a percent of total RBC membrane fatty acids?

A

4-8%

69
Q

What percent of EPA + DHA is desirable as a percent of total RBC membrane fatty acids?

A

> 8%

70
Q

What are the Omega-3 recommendations?

A
  • 1g/day of EPA + DHA
  • At least 2 serves of fish (preferably oily)

HUNT243 Exam (18 decks)

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