Lecture 3 Flashcards
What is the association between kidneys and cardiovascular disease (CVD)?
Blood pressure in kidneys can result in hypotension and hypertension, leading to CVD.
What are the different mortality rates of CVD?
There is a North and South divide due to socioeconomic status. Age increases mortality, with more women dying from CVD due to menopause.
What is the epidemiology of CVD?
CVD is one of the leading causes of death, with 17.9 million people dying in 2019, particularly affecting those from low or middle-income countries.
What is CVD (Cardiovascular Disease)?
A class of disorders affecting the heart, blood vessels, or both, leading to a build-up of fatty plaques inside the arteries.
What are the different disease causes of CVD?
- Coronary heart disease
- Cerebrovascular disease
- Hypertensive heart disease
- Peripheral arterial disease
- Rheumatic heart disease
- Deep vein thrombosis
What is the precursor of CVD?
Atherosclerosis, characterized by the formation of atheroma, reduced arterial lumen, loss of perfusion, and loss of elasticity.
What is the cardiovascular risk?
Epidemiology calculates the risk of CVD by studying populations over time.
How did the Framingham study occur?
President Roosevelt’s physician noted high blood pressure (188/104 mmHg), which led to symptoms of hypertension and ultimately his death from cerebral hemorrhage.
What are the risk factors of atherosclerosis?
Genetics, Sex, Age, Smoking, Hypertension, Obesity, Diabetes, Stress, Exercise, Diet, Insulin resistance, Hyperlipidaemia, Hypercoagulable states, Hyperhomocysteinaemia.
What are ways to measure risk for CVD?
Total Cholesterol levels: < 5mmol/L (healthy), < 4mmol/L (high risk); LDL levels: < 3mmol/L (healthy), < 2mmol/L (high risk); TG < 1.7mmol/L; HDL > 1mmol/L.
What defines a high-risk category for CVD?
Individuals over 75 years with a family history of CHD, familial hypercholesterolaemia, known Type 2 Diabetes, or chronic kidney disease.
How are lipids transported in the body?
Lipids are packaged into lipoproteins, which are spherical vesicles made up of triglycerides and apolipoproteins.
What are the classifications of lipoproteins according to their density?
- Chylomicron
- Very low-density lipoprotein (VLDL)
- Intermediate-density lipoprotein (IDL)
- Low-density lipoprotein (LDL)
- Lipoprotein A
- High-density lipoprotein (HDL)
What is the structure of lipoproteins?
The inner core is composed of triglycerides and cholesterol esters, while the outer shell consists of phospholipids and protein components called apolipoproteins.
What occurs during the exogenous lipid transport pathway?
Dietary fat is emulsified, absorbed, repackaged, and transported in the blood as chylomicrons, which offload triglycerides into surrounding tissues.
What occurs during the endogenous lipid transport pathway?
Nascent LDL contains triglycerides and cholesterol, interacts with lipoprotein lipase, and forms IDL and HDL through exchanges.
What is reverse cholesterol transport?
The process by which HDL picks up cholesterol from tissues and transports it to the liver.
How do plaques occur in atherosclerosis?
- Lipid deposition in the lining
- Smooth muscle and ECM proliferation
- Production of a protruding fibrous plaque.
What are the mechanisms underlying atherosclerosis?
- Lipid hypothesis
- Response to injury hypothesis
- Inflammation hypothesis.
What occurs in Stage I of atherosclerosis?
Endothelial damage due to hypertension leads to sticky endothelial cells, attracting cells.
What occurs in Stage II of atherosclerosis?
Increased cell adhesion, release of chemokines and cytokines, and formation of foam cells from macrophages.
What occurs in Stage III of atherosclerosis?
Increased lipid build-up, more foam cells, and fragile structures due to increased collagen and ECM.
What occurs in Stage IV of atherosclerosis?
Formation of a fibrous cap and ECM, leading to a rigid structure and potential thrombus formation.
What is an atherosclerosis plaque?
Plaque behavior is determined by its composition; plaques with large lipid cores and thin fibrous caps are likely to rupture.
What are the treatments and prevention strategies for CVD?
Lifestyle changes, targeting hypertension with ACE inhibitors, reducing cholesterol with statins, and using antiplatelets.
What are statins?
Drugs used to lower cholesterol by reducing synthesis in hepatocytes and increasing clearance of LDL from circulation.
What is the impact of statins?
Statins can increase diabetes risk; however, the absolute risk is low compared to the reduction in CVD.
Is high blood cholesterol the cause or a secondary effect of CVD?
While statin therapy offers benefits, 60-70% of major CVD events are still not prevented, suggesting other factors are involved.
