Topic 1: Other risk factors for CVD

Question 1

Key Summary: List the 3 non-controllable risk factors for CVD

Answer 1

Non-controllable:

1. Increasing age
2. Gender
3. Genetic predisposition

Question 2

Key Summary: List the 8 controllable risk factors for CVD

Answer 2

Controllable:

1. High blood pressure
2. Stress
3. Smoking
4. Lack of exercise
5. High saturated fat
6. Excessive alcohol intake
7. High salt
8. High cholesterol

Question 3

Define risk (1 point)

Answer 3

The probability of the occurrence of some unwanted event or outcome.

Question 4

Define risk factor (1 point)

Answer 4

Anything that {affects/increases} the chance of harm

Question 5

Define multifactorial disease (1 point)

Answer 5

1. Many factors (eg. heredity, physical environment, social environment and lifestyle choices) all contribute to the risk of developing the disease

Question 6

How does high blood pressure increase the risk of CVD?

2 steps

Answer 6

1. High blood pressure can lead to damage to the artery endothelium and trigger the events that lead to atherosclerosis
2. Atherosclerosis can then lead to blood clots forming in arteries, then {CHD/heart attack} or stroke

Question 7

Why does smoking increase risk of developing CVD?

6 points

Answer 7

1. Toxins may CAUSE DAMAGE TO ENDOTHELIUM OF ARTERY WALLS (continue with description of atherosclerosis)
2. Nicotine increases adrenaline which leads to increased heart rate and constriction of arterioles, INCREASING BLOOD PRESSURE
3. Nicotine increases stickiness of platelets, INCREASING THE RISK OF A BLOOD CLOT FORMING (include blood clotting detail)
4. REDUCED HDL CHOLESTEROL levels
5. Reduces antioxidants so more free radicals present to damage cells
6. Carbon monoxide decreases the oxygen carried by the blood

Question 8

How does inactivity increase risk of developing CVD? (4 steps)

Answer 8

1. LACK OF EXERCISE (when coupled with excessive energy / calorie intake /energy imbalance) may lead to weight gain and obesity
2. Obesity can lead to high blood pressure
3. High blood pressure can lead to atherosclerosis
4. Atherosclerosis can lead to blood clots forming in arteries (and CHD or stroke)

Question 9

What are the benefits of exercise?

6 benefits

Answer 9

NOTE: Being active HALVES the risk of coronary heart disease.

1. lowers blood pressure
2. helps maintain a healthy weight
3. reduces cholesterol (LDL) levels
4. reduces chance of developing type II diabetes
5. strengthens heart (more likely to survive a heart attack/stroke)
6. helps to reduce stress

Question 10

What are the Dietary factors which increase risk of developing CVD? (4 factors)

Answer 10

1. High salt in food
2. Excessive {sugar/alcohol/calorie} intake
3. High cholesterol in food
4. High saturated fat in food

Question 11

How can too much salt lead to atherosclerosis? (3 steps)

Answer 11

1. increases the water potential of the blood, so more water enters and is held in the blood and BLOOD PRESSURE INCREASES.
2. this can lead to HYPERTENSION (persistently high blood pressure)
3. hypertension can damage the endothelium of the arteries which is an early step in the events that lead to atherosclerosis.

Question 12

What are carbohydrates important for? (3 points)

Answer 12

1. Immediate energy
2. Energy storage for future need
3. Receptors on cell membranes

Question 13

How can excessive {sugar/carbohydrate} increase the risk of developing type II diabetes? (2 steps)

Answer 13

1. Excessive {sugar/calorie intake}, coupled with lack of exercise (energy imbalance), CAN LEAD TO WEIGHT GAIN AND OBESITY
2. Obesity INCREASES BLOOD PERSSURE and BLOOD CHOLESTEROL OFTEN ALSO INCREASES (which increases risk of atherosclerosis, blood clots blocking arteries, CVD) and INCREASED RISK OF DEVELOPOING TYPE II DIABETES

Question 14

How can excessive alcohol intake lead to atherosclerosis? (2 steps)

Answer 14

1. If energy consumed in alcohol (and rest of diet) is not used up, the person may become obese
2. Obesity increases blood pressure, which may lead to atherosclerosis

Question 15

How can {high cholesterol / high saturated fat} intake lead to atherosclerosis? (2 points)

Answer 15

1. {high cholesterol / high saturated fat} intake leads to HIGH BLOOD LDL CHOLESTEROL LEVELS
2. Cholesterol contributes to atherosclerosis - cholesterol may accumulate in artery wall

Question 16

How does stress increase the risk of CVD? (3 steps)

Answer 16

1. adrenaline released
2. arterioles and arteries constrict
3. raised blood pressure (can lead to atherosclerosis)

NOTE: can also lead to overeating, poor diet, high alcohol intake

Question 17

How does age play a part in CVD risks? (2 points)

Answer 17

As a person becomes older:

1. Arteries become less elastic and more easily damaged
2. Blood pressure increases with age

Question 18

How does gender play a part in CVD risks? (1 point)

Answer 18

1. Women in pre-menopause are less likely to develop CVD than men because oestrogen offers some protection to women against CVD

Question 19

Mutations in several genes (DUE TO GENETIC PREDISPOSITION) can affect the likelihood of developing CVD.
Name 2 of them. (name the genes)

Answer 19

1. LDL receptor gene (if mutated, cholesterol not taken up by cells and removed from blood, so stays in blood and causes high blood LDL cholesterol levels)
2. Apolipoprotein genes (Apolipoproteins are part of the protein component of lipoproteins which stabilise the lipoprotein and recognise LDL receptors on cells, if mutated then cholesterol not taken up by cells and removed from blood, so stays in blood and causes high blood LDL cholesterol levels)

Question 20

Key summary: How do THESE risk factors (high salt, stress, obesity, smoking, lack of exercise) lead to increased risk of CVD?
(4 steps)

Answer 20

1. high {salt/stress/obesity/smoking/lack of exercise} leads to INCREASED BLOOD PRESSURE
2. INCREASED RISK OF ATHEROSCLEROSIS
3. INCREASED RISK OF BLOCKED ARTERY e.g. coronary artery or artery to brain (read question) – by plaque or blood clot
4. increased risk of heart attack or stroke

Question 21

Key Summary: How do THESE risk factors (high saturated fat, high dietary cholesterol, high blood cholesterol) lead to increased risk of CVD?
(4 steps)

Answer 21

1. high saturated fat leads to INCREASED BLOOD LDL CHOLESTEROL
2. INCREASED RISK OF ATHEROSCLEROSIS
3. INCREASED RISK OF BLOCKED ARTERY e.g. coronary artery or artery to brain (read question) – by plaque or blood clot
4. increased risk of heart attack or stroke

Question 22

Key Summary: How can the risk of CVD be reduced?

8 ways

Answer 22

1. reduce energy intake - {weight/ BMI} decreases if energy expenditure greater than intake
2. reduce cholesterol in diet - cholesterol has been associated with {high blood pressure /atherosclerosis}
3. reduce SATURATED fat in diet - reduces {blood cholesterol / LDL}
4. {INCREASE / MORE} exercise – {weight/BMI} decreases if energy expenditure is greater than intake and exercise helps {maintain a healthy heart/reduces blood pressure}
5. stop smoking - smoking {reduces oxygen uptake / increases stickiness of platelets /increases blood pressure / increases risk of atheroma}
6. reduce salt in diet - high salt associated with high blood pressure
7. reduce alcohol intake - high alcohol associated with high blood pressure
8. reduce stress

Question 23

(Drugs prescribed to reduce the risk of CVD)

What type of drug lowers blood pressure? (name drug and give 3 examples of the type of drug)

Answer 23

1. Antihypertensives

e. g. diuretics, calcium channel blockers, ACE inhibitors

Question 24

(Drugs prescribed to reduce the risk of CVD)

What drug lowers blood cholesterol? (1 point)

Answer 24

1. Statins

Question 25

(Drugs prescribed to reduce the risk of CVD)

What 2 drugs prevent blood clotting? (2 drugs)

Answer 25

1. Anticoagulants

2. Platelet inhibitors

Question 26

What is an epidemiologist? (2 points)

Answer 26

1. A scientist who studies the patterns and occurrences of diseases.
2. They look for and investigate relationships and correlations between a disease and specific risk factors.