Cardiovascular Health Flashcards
(25 cards)
Define CVD
Group of diseases that involve the heart and blood vessels
Which conditions are included in CVD?
- Coronary Heart Disease (including atherosclerosis)
- Atrial Fibrillation and other Arrythmias
- Peripheral artery Disease (e.g. narrowing of arteries due to diabetes or obesity)
- Cerebrovascular disease (including stroke)
Ischaemic Disease is the leading cause of death in Australia. True or False
True
Deaths from Cerebrovascular Disease (inc. stroke) has been seen decreasing. Whats the reason for this?
- Better identification of signs and symptoms of stroke
- Medicines are available that can immediately treat stroke
Identify non-modifiable risk factors
- Age
- Gender
- Genetic Factors/ethnic background
- Family history
Identify modifiable risk factors. These are the 7 criterias that are included in most of the international guidelines
- Blood pressure
- Plasma lipid levels
- Fasting glucose
- BMI
- Smoking status
- Dietary Factors
- Exercise Level
CVD is more common in males than females. This is a true statement however among females their risk of CVD increases due to menopause (After menopause: decline of protective hormones - higher risk of developing CVD). True or False
True
How do genetic factors increase the risk of CVD
Examples of single genetic factor
1. Apolipoprotein E genotype
2. LDL receptor mutations
3. Mutations in ion channels in the heart
List examples of ethnic backgrounds that are at higher risk of CVD
- First nations people
- African-americans
Discuss the prevalence of CVD risk in Indigenous Australians compared to non-indigenous Australians
- Indigenous Australians are more likely to suffer from CVD disease - much higher hospitalisation rates compared to non-indigenous
- The age of onset of CVD is 10-20 yrs earlier in Indigenous Australians
Is HDL good or bad cholesterol
HDL is good cholesterol
Is LDL good or bad cholesterol
LDL is bad cholesterol
Why is LDL (low-density lipo-protein) bad?
- [Increase in LDL levels] –> Modification of LDL (oxidation of lipid particles and protein components of LDL)
- Migration into arterial walls
- Recognition by immune cells - gobbles it up - turns into macrophage foam cell - turns into plaque
**More LDL makes LDL atherogenic (higher chances of LDL developing into plaque inside the blood vessel) ** - just need to know this information
What medications are used to reduce cholesterol levels in the body?
Statins - reduce cholesterol synthesis in the liver which then upregulates the LDL receptor and the LDL receptor takes the cholesterol away from the system
**Ezetimibe: ** changes how much cholesterol is absorbed from diet
PCSK9 inhibitors: make more LDL receptors available - cleans up bad cholesterol
Fibrates: to treat patients that have very high triglyceride levels
How does hypertension (i.e. high blood pressure) increase the risk of CVD?
- Puts stress on the endothelium in large and small vessels - endothelial damage
- Increases the workload of the heart (heart has to pump harder to get the blood around the body) –> heart failure
What are the 5 drugs in the tool kit that treat hypertension?
- ACE inhibitors
- Angiotensin Receptor Blockers
- Diuretics
- Calcium channel blockers
- Beta-blockers
What are the long term risk factors of type 2 diabetes?
- Glucose levels in circulation in type 2 dabetes even if they are on stable medications are higher compared to healthy non-diabetic controls
2.High glucose levels (seen in type 2 diabetetic patients) can lead to (long term risk factors of type 2 diabetes)
- **CVD
- vision problems
- Renal disease
- Nerve damage
- Issues with wound healing; foot ulcers **
What happens in the vessels when glucose levels are too high?
- Changes in the way in that the liver actually metabolised the lipids –> dyslipidemia (abnormal levels of lipids in the blood)
- Immune system is triggered –> inflammation
- Oxidative stress
What are the 3 drugs in the tool kit that treat type 2 diabetes (high glucose levels)
- Metformin
- SGLT2 inhibitors
- Insulin
How does smoking increase the risk of CVD?
Reactive oxygen species (bad chemicals in ciggarettes):
- activate immune cells
- modify lipids in LDL
- damage to endothelium
–> SMOKING CESSATION IS KEY
Outline the mechanisms that are common in smoking, dyslipidaemia and type 2 diabetes
- Oxidation of lipids and proteins on the LDL - makes them more atherogenic –> migrate to the arterial wall and form a plaque
- Inflammation
- Endothelial damage
- Cell death
- Activation of immune cells
Outline the food components that increase the risk of CVD
- High salt intake –> increases blood pressure
- Dietary cholesterol
- A high intake of dietary fats—especially saturated fats (found in animal products) and trans fats—can raise cholesterol levels.l
- Weight management: Losing body weight will decrease blood pressure, decrease lipid levels and decrease glucose levels to baseline
- High sugar intake can increase glucose levels –> type 2 diabetes
Outline the dietary recommendations to prevent CVD
- Consume more fruits, vegetables and wholegrains
- A variety of healthy protein sources including fish, seafood, lean meat, poultry, legumes, nuts and seeds
- Reduced fat diary such as unflavoured milk and yoghurt
- Healthy fat choices: nuts, seeds, avocados, olives and their oils for cooking
- Herbs and Spices to flavour food instead of adding salt
- Water as a drink of choice
How can physical activitiy reduce the risk of CVD?
- Leads to weight loss
- Increases HDL (good cholesterol)
- Lowers blood sugar levels and reduces insulin resistance
- Releases NO, which dilates your blood vessels and reduces BP
