Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Exercise Physiology > Risk Factors for Atherosclerosis > Flashcards

Risk Factors for Atherosclerosis Flashcards

1
Q

What does it mean for something to a positive risk factor?

A
  • it increases the likeliness of something occurring
  • adding to the probablity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 6 modifiable positive risk factors?

A
  1. dyslipidemia
  2. hypertension
  3. diabetes
  4. physical inactivity
  5. obesity
  6. smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does it mean for something negative risk factor?

A
  • it decreases the likeliness of something occuring
  • subtracts from the probability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is an example of a modifiable negative risk factor?

A

high HDL >60mg/dl (protective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 4 non-modifiable risk factors?

A
  1. older age
  2. gender
  3. race
  4. family history of CAD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Non-modifiable risk factor

Older age

A
  • male > 45
  • female > 55
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Non-modifiable risk factor

Gender

A

male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Non-modifiable risk factor

Race

A

african american, hispanic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Non-modifiable risk factor

Family History of CAD

A
  • father or brother with CAD < 55
  • mother or sister with CAD < 65
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Modifiable Risk Factors

Dyslipidemia: Total Cholesterol

A

greater than 240 mg/dl
(high risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Modifiable Risk Factors

Dyslipidemia: LDL

A

greater than 160 mg/dl
(high risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Modifiable Risk Factors

Dyslipidemia: HDL

A

less than 40 mg/dl
(high risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe th MRFIT Trial.

A
  • multicenter trial of CVD risk factor reduction in middle-aged men (35-57)
  • no CVD at baseline
  • measured age, smoking status, blood pressure and serum cholesterol
  • followed for 6 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MRFIT Trial

How many deaths out of 7840 were due to CVD?

A

2626

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MRFIT Trial

Less than 20th percentile = baseline risk (less than 181 mg/dl)

A
  • reference group
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MRFIT Trial

Greater than 20th percentile (182 - 202 mg/dl)

A

associtaed with 30% increased risk of CVD death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MRFIT Trial

Greater than or equal to 80th percentile (greater/equal 246 mg/dl)

A

associated with 340% increase in CVD death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MRFIT Trial

Greater than or equal to 90th percentile (greater/equal 264 mg/dl)

A

associated with 400% increase in CVD death rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define relative risk

A

the risk of a certian event happening in one group versus another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Put relative risk into a sentence.

A

The risk of developing a disease after an exposure vs. the risk of developing a disease in absence of the exposure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Treatment of dyslipidemia

A

HMG-CoA Reductase Inhibitors
“statins”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

HMG-CoA Reductase Inhibitors

Mechanism of action: blocks the conversion of HMG-CoA to ?? in ?? pathway.

A
  • melavonic acid
  • cholesterol biosynthesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

HMG-CoA Reductase Inhibitors

Reduction of… (3)

A
  1. Total cholesterol
  2. LDL
  3. triglycerides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

HMG-CoA Reductase Inhibitors

Increases in…

A

HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
# HMG-CoA Reductase Inhibitors On average, treatment results in ??% reduction in ??, ??, and ??.
- 20-33% - MI, stroke, and CV death
26
# HMG-CoA Reductase Inhibitors Key Point?
- 1/2 of all myocardial infarctions ocur in individuals with normal cholesterol levels - certain values don't confirm heart disease
27
# Treatment of Dyslipidemia Primary Prevention Trials
no history of CAD when started on statin drug
28
# Treatment of Dyslipidemia Secondary prevention trials
previous MI and high TC and LDL when started on statin drug
29
Describe the CARE Trial (1998)
- secondary prevention trial - patients with normal baseline total cholesterol and LDL - started on statin after myocardial infarction
30
# CARE Trial LDL results
lowered about 32%
31
# CARE Trial HDL results
increased about 5%
32
# CARE Trial Overall results
reduced nonfatal or fatal MI by 24%
33
# CARE Trial CARE conclusion
statin therapy reduced risk of MI and death in CAD patients with normal TC and LDL
34
# Possible mechanisms of Statin reduction function Limits ?? production of ?? cholesterol.
- liver - LDL
35
# Possible mechanisms of Statin reduction function Increases ?? of ?? from blood.
- clearance - LDL
36
# Possible mechanisms of Statin reduction function Stabilizes athersclerotic plaque by either: - ?? - ??
- reducing lipid core of plaque - reducing proteases (MMPs) that degrade fibrous cap
37
# Possible mechanisms of Statin reduction function Increases endothelial function: - increases ?? and ?? production - decreases ?? production = prevents degradation of ??
- eNOS and NO - ROS and NO
38
# MRFIT Hypertension: Optimal BP
less than 120 / less than 80
39
# MRFIT Hypertension: normal but not optimal
120-129 / 80-84
40
# MRFIT Hypertension: High Normal
130-139 / 85-89
41
# MRFIT Hypertension: Stage 1 HTN
140-159 / 90-99
42
# MRFIT Hypertension: Stage 2/3 HTN
greater than 160 / 100
43
# MRFIT HTN Goal?
To compare relationships of systolic BP, diastolic BP, and pulse pressure (PP) separately and jointly with CVD mortality
44
# MRFIT HTN/CAD Results In men age 35-44 (young), CVD risk was greatest for those with...
both systolic HTN and diastolic HTN; compared to one alone
45
# MRFIT HTN/CAD Results In men 45-57 (middle-aged), CVD risk was greatest for men with either: - ?? - ??
- systolic HTN and diastolic HTN - systolic HTN and DBP less than 80 (highest risk group)
45
# MRFIT HTN/CAD Results Conclusion?
Systolic HTN and low diastolic BP were highest risk in middle aged adults; with systolic/diastolic HTN being the next highest risk
46
# Framingham Heart Study: Temporal change in BP over time 1. Mean, systolic and diastolic BP....
increase slowly until mid-life (age 50-60).
47
# Framingham Heart Study: Temporal change in BP over time 2.Only systolic BP continually...
increases in a linear fashion after mid-life.
48
# Framingham Heart Study: Temporal change in BP over time 3.Diastolic BP ?? at mid-life and begins...
- plateaus to decline thereafter.
49
# Framingham Heart Study: Temporal change in BP over time 4.Mean BP ?? at mid-life and remains...
thru lifespan.
50
# Framingham Heart Study: Temporal change in BP over time 5.Pulse Pressure .....
increases exponentially beyond mid-life.
51
# Framingham Heart Study: Take home points Adults less than 50 yrs of age, ?? is the strongest predictor of CVD risk.
diastolic BP
52
# Framingham Heart Study: Take home points ?? and ?? were the strongest predictors of CVD in adults over 60 yrs.
Systolic BP and PP (PP was superior)
53
# Framingham Heart Study: Take home points ?? becomes inversely related with CVD risk over the age of 60.
Diastolic BP
54
# New High BP Guidelines HTN Stage 1
130-139 / 80-89
55
# New High BP Guidelines HTN Stage 2
greater than 140 / greater than 90
56
# HTN Treatment If the risk is less than 10%....
start with healthy lifestyle recommendations and reasses in 3-6 months
57
# HTN Treatment If risk is greater than 10% or the patient hase known CVD, diabetes mellitus, or chronic kidney disease...
recommended lifestyle changes and BP-lowering medication
58
# New HTN BP Guidelines Non-Pharmacological treatment options
- healthy diet - weight loss - sodium (reduce intake) - PA (add aerobic exercises) - PA (add dynamic resistance training) - alcohol (reduce intake)
59
# Diabetes Mellitus ADA Definition (at least 1 of 3)
1. fasting blood glucose: >126 mg/dl 2. oral glucose tolerance test: glucose >200 2 hrs after 75g 3. HbA > 6.4%
60
# Diabetes mellitus ADA Prediabetes
1. FBG: 100 - 126 2. OGTT: 140 - 199 2 hrs after 75g 3. HbA = 5.7 - 6.4%
61
# Diabetes Mellitus Type 1
insulin-dependent - pancreatic beta-cells fail to produce insulin - exogenous insulin required
62
# Diabetes Mellitus Type 2
non-insulin dependent - Insulin resistance: tissues (muscle, fat, liver) do not respond (less sensitive) to insulin's effects to lower glucose - results in over production of insulin
63
# Diabetes and CAD risk KEY POINT?
in general, adults with diabetes are 2-4 times increased risk of developing CAD and stroke
64
# Diabetes and CAD risk incidence of 1st MI
5.5 - 6x higher rate of 1st MI for diabetics
65
# Diabetes and CAD risk incidence of 2nd MI
about 2.5 higher rate of 2nd MI in diabetics
66
# MRFIT PA Describe MRFIT PA.
1st US study to document decreased risk of CAD, CAD death, and all-cause death with increased PA - no CAD, but several risk factors at baseline - based on self-reported amount of leisure-time physical activity (LTPA) by questionnaire
67
# MRFIT PA 1 = low LTPA
- avg 15 min/day - 73 kcal/day
68
# MRFIT PA 2 = moderate LTPA
- avg 47 min/day - 223 kcal/day
69
# MRFIT PA 3 = high LTPA
- 133 min/day - 638 kcal/day
70
# MRFIT PA In regards to group 2 and group 3....
there is no statistical difference between the two
71
# MRFIT PA Results Moderate and high LTPA were associated with: - ?? - ??
- 63% less fatal CAD deaths - 70% less all-cause deaths compared to low LTPA
72
# MRFIT PA Conclusions: 1. LTPA has a ?? to CAD and overall mortality in high-risk men 2. ?? was just as good as ?? in reducing CHD (MI), CHD death, and all-cause death.
1. modest inverse relation 2. Moderate LTPA, high intensity LTPA
73
# Obesity using BMI Overweight BMI?
25 - 29.9
74
# Obesity using BMI Obese I BMI? Obesity class?
- 30 - 34.0 - class I
75
# Obesity using BMI Obese II BMI? Obesity class?
- 35 - 39.9 - class II
76
# Obesity using BMI Morbidly Obese BMI? Obesity class?
- greater than 40 - class III
77
# Obesity using BMI How is BMI calculated?
BMI = weight / height
78
# Obesity and CVD mortality results?
- death rates increased throughout the range of increasing BMI from 24.9 - risk of CVD death increased rapidly with BMIs greater than 30 - low BMI (less than 18.5) predictive of increased CVD and all cause death
79
# Obesity/Physical Fitness and CAD death Fit or Fat key point??
"Lean and unfit" has double the risk compared to "high fit and obese" - PA is more important than BMI
80
# Obesity/Physical Fitness and CAD death Fit or Fat Conclusions: Low fitness...
was an independent predictor of CAD death and all-cause death in all BMI groups.
81
# Obesity/Physical Fitness and CAD death Fit or Fat Conclusions: High fitness...
reduced risk of CAD death and all-cause death compared to low-fitness in each BMI group
82
# Obesity/Physical Fitness and CAD death Fit or Fat Overall Conclusion.
better to be fit and fat, than thin and unfit
83
# Smoking How many people in US are estimated to smoke?
42.1 million - 18.1% of all adults 18 and older
84
# Smoking Is smoking more common among men or women?
men (20.5%) compared to women (15.8%)
85
# Smoking What is the current population trend?
overall decrease in smoking prevalance from 2005 (20.9%) to 2012 (18.1%)
86
# Smoking Cessation and MI risk In adults with no previous CHD, the reduction in cardiac event rate is associated with smoking cessation ranges from...
7 to 47 percent
87
# Smoking Cessation and MI risk In adults with no previous CHD, the risks of MI diminish relatively soon after smoking cesstion by...
1 year compared with smokers
88
# Smoking Cessation and MI risk In adults with no previous CHD, Relative Risk back to level of never smokers beyond...
1 year (2+ years)
89
# Smoking What are the 7 potential mechanisms of by which smoking promotes CVD?
1. enhacned oxidation of lipids - atherosclerosis 2. decreased HDL-C 3. increased platelet adhesiveness 4. excessive stimulation of sympathetic nervous system 5. increased propensity for thrombosis 6. increased vasospasm/constriction of coronary arteries 7. O2 replaced by CO on RBCs - tissue ischemia
90
# Framingham Risk Score What does the framingham risk score NOT predict?
stroke of heart failure
91
# Framingham Risk Score What does the framingham risk score predict?
estimates 10 year risk of CAD in person without diabetes or existing heart disease
92
# Framingham Risk Score Low risk?
10% or less
93
# Framingham Risk Score Moderate risk?
10 - 19%
94
# Framingham Risk Score High risk?
20% or more
95
# Framingham Risk Score CAD equivalent?
diseases that have 10-year high risk of CAD (20% or more) - diabetes, chronic kidney disease, carotid artery disease
96
# Metabolic Syndrome Define Metabolic Syndrome
a clustering of CAD risk factors most notable abdominal obesity, insulin resistance, high BP, increasing the risk of CAD and type 2 diabetes
97
# Metabolic Syndrome How is Metabolic Syndrome diagnosed?
3 or more of the following: 1. glucose intolerance 2. abdominal obesity 3. hypertension 4. high fasting triglycerides 5. low fasting HDL-C
98
# Metabolic Syndrome: possible sign Glucose intolerance (pre-diabetes)
fasting glucose > 100 mg/dl
99
# Metabolic Syndrome: possible sign Abdominal obesity: waist circumference
- men > 40 inches - womens > 35 inches
100
# Metabolic Syndrome: possible sign Hypertension
greater than 130 / greater than 80 mmHg
101
# Metabolic Syndrome: possible sign High fasting triglycerides
greater than 150 mg/dl
102
# Metabolic Syndrome: possible sign low fasting HDL-C
- men < 40 mg/dl - women < 50 mg/dl
103
# Metabolic Syndrome Prevalence Total in US
23.7%
104
# Metabolic Syndrome Prevalance In regards to age?
increases with age - greater than 45% in age 60+ years
105
# Metabolic Syndrome Prevalance In regards to gender?
no difference between men and women
106
# Metabolic Syndrome Prevalance In regards to race?
higher in hispanic women
107
# Metabolic Syndrome Does a diagnosis of MetS increase CVD risk compared to each CVD risk factor individually?
unclear; could possibly be due to cluster effect
108
# Metabolic Syndrome Does diagnosis of MetS alter course of medical treatment?
unclear; not usually

Clinical Exercise Physiology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions