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HUNT243 > Lecture 22-Cardiovascular disease > Flashcards

Lecture 22-Cardiovascular disease Flashcards

Cardiovascular disease

1
Q

what is cardiovascular disease (CVD)

A

general term for all diseases of heart and blood vessels

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2
Q

what is coronary heart disease (CHD) - what is it also referred to as

A

also referred to as coronary artery disease (CAD) or Ischemic heart disease (IHD)

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

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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 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

why are rates of death from heart disease decreasing

A
  • better control of major risk factors
  • better evidence based treatments
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8
Q

Heart disease reached a peak in the …. and has come back down from then

A

60s

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9
Q

The major risk factors that we have better control over now

A
  • cholesterol
  • systolic blood pressure
  • smoking prevalence
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10
Q

The evidence based treatments that we now having which decrease the death from heart dieseas

A

diagnostic and therapeutic procedures

e.g phramacological treatment of hypertension, hypertension screening, bypass surgery, access to healthcare

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11
Q

what is the leading cause of death globally

A

coronary heart disease

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12
Q

what is the CVD mortality in maori compared to non maori

A

much higher in maori than non maori

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13
Q

Men vs women CVD

A

higher in men, but CVD is still the leading cause of death in women worldwide

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14
Q

1 in how many women die of heart disease or stroke compared to die of breast cancer

A

1 in 2 women will die of heart disease or stroke

1 in 25 women will die with breast cancer

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15
Q

age specific risk of CVD is lower in what gender

A

lower in women

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16
Q

How much longer after do women present with CVD than men

A

7-15 years later compared to men

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17
Q

Atherosclerosis process

A

We start with blood vessels and blood is flowing quite nicely

  • We have the endothelium layer which acts as a nice barrier to the blood vessel and the blood going through produces protein which stops the build up of material
  • We have irritation toward the blood vessels which allows things to get in that should be in
  • Once they are in the blood vessel wall they start to oxidise
  • It send signals to the immune system and itywill gobbel it up that they then die and they become foam cells and these are known as the dead macrophages
  • So then the immune system will then be sent to get rid of the macrophages which will then end up in an inflammation
  • Smooth muscle cell will produce which makes blood flow slow (increases blood pressure)
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18
Q

what are some examples of irritants to blood vessels that can lead to the process of atherosclerosis and what do these do

A

high levels of LDL cholesterol, high blood pressure or toxins from smoking damages the blood vessel allows things to get in, once they are in the wall they start to be oxidised

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19
Q

what happens if all the inflammation covered in the blood vessel ruptures

A

all this inflammation and mess will enter the blood vessel

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20
Q

LDL cholesterol is an

A

irritant to start the atherosclerosis process

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21
Q

chylomicrons are full of

A

triglycerides

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22
Q

what is the function of chylomicrons

A

transport dietary lipids from intestine to peripheral tissues

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23
Q

what is the function of VLDL

A

transports lipids from liver to peripheral tissues

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24
Q

what is the function of intermediate density lipoprotein

A

precursor of LDL

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25
Q

what is the function of LDL

A

transports cholesterol to peripheral tissues and liver

26
Q

what is the function of lipoprotein a (Lpa)

A

associated with CHD risk, similar to LDL

27
Q

what is the function of HDL

A

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

28
Q

what is the function of albumin

A

transports free fatty acids from adipose tissue to peripheral tissues

29
Q

low density lipoprotein cholesterol is associated with what risk of

A

increased risk of CVD

30
Q

Apo B containing lipoproteins are associated with what risk of

A

increased risk of CVD

31
Q

high density lipoprotein cholesterol is associated with what

A

unsure, it wasn’t found that increasing this reduced risk

32
Q

Lpa is associated with increased risk of what

A

increased risk of CVD

33
Q

triglycerides is associated with increased risk of what

A

increased risk of CVD

34
Q

why is it important to keep cholesterol levels low when you are young

A

its like smoking in your 20s isnt going to give you heart disease in your 30s, its about the long term effects that is important

35
Q

what types of saturated fat increase our LDL cholesterol

A
  • lauric acid : main fatty acid in coconut
  • myristic : high in some dairy products
  • palmitic acid : found in palm oil
36
Q

what saturated fat has a neutral affect on our LDL cholesterol

A

steric acid seems to have a neutral affect : main fat found in dark chocolate

37
Q

what monounsaturated fat reduces our LDL cholesterol

A

Oleic (cis)

38
Q

what monounsaturated fat increases our LDL cholesterol

A

elaidic (trans)

39
Q

what type of fats really reduce our cholesterol

A

polyunsaturated fats

40
Q

how does omega 3 reduce our cholesterol, what is it found in

A

reducing triglycerides like VLDL

found in things like fatty fish

41
Q

what does omega 6 reduce

A

reduce LDL

42
Q

what did the keys equation look at

A

how much would our blood cholesterol change if we changed the amount of polyunsaturated fat, saturated fat and dietary cholesterol in our diets

43
Q

for a given amount of saturated fat, it will raise our blood cholesterol levels …… as much as given polyunsaturated fat would decrease it

A

raise it twice as much

44
Q

what is the keys equation

A

change in cholesterol = 2.74 x change in sat fat - 1.13 x change in polyunsat fat

45
Q

what fat is highest in saturated fat

A

coconut oil

46
Q

what oils are high in monounsaturated fats

A

olive, canola, peanut oil

47
Q

what oils are high in polyunsaturated fats

A

safflower, flaxseed, walnut, sunflower oil

48
Q

If you are changing one thing in someones diet then …

A

Something else is going to higher or lower

49
Q

The meta analysis is to asses the affects of reducing saturated fat intake and replacing it with ..

A

-Carbohydrate
-PUFA
-MUFA
-Protein

50
Q

a meta analysis found that reducing saturated fat intake had a what reduction in CVD risk

A

17% reduction in CVD risk

51
Q

what was found from the meta analysis if the reduction in saturated fat was replaced with polyunsaturated fat

A

27% reduction

52
Q

what was found in the meta analysis if reduction in saturated fat was replaced with carbohydrates or protein

A

not statistically significant

53
Q

in studies that achieved at least a 0.2 mmol/L reduction of total cholesterol, events of CVD reduced by

A

26%

54
Q

the reduction in CVD events was related to the degree of reduction in

A

serum total cholesterol

55
Q

how does saturated fat increase cholesterol

A
  • decrease LDL receptor activity
  • suppress ACAT (rate limiting enzyme of cholesterol esterification) : resulting in greater proportion remaining in the regulatory pool
56
Q

how does N-6 polyunsaturated fat decrease cholesterol

A

increase LDL receptor activity

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

57
Q

what did the early studies of cholesterol do and what did they find (BUT and SO)

A

fed large amounts of cholesterol to rabbits

this induced atherosclerosis

BUT …. rabbits are herbivores, who are hypersensitive to cholesterol and were fed large amounts of cholesterol

SO …. useful between the link of blood cholesterol and atherosclerosis but not useful for dietary cholesterol for humans

58
Q

why do some people say that seed oils are toxic and are going to kill us, why are these claims not true

A

they say they will be oxidised and cause problems in the body……. but in the body vitamin E is often associated with it which helps prevent oxidation

Regardless of the mechanism they are looking at the people with the most seed oil in their diet and they were the least likely to get heart disease -its associated with some inflammatory effects

59
Q

what is not true about the claims saying we shouldnt have too much omega 6

A

its not about having too much omega 6 its about not having enough omega 3

60
Q

what are the omega 3 recommendations from the American Heart Association

A

1.0 g/day of EPA + DHA to reduce risk of death from coronary heart disease in a secondary prevention setting

at least 2 serves of (preferably oily) fish per week (500mg of EPA + DHA) in a primary prevention setting

HUNT243 (29 decks)

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