HDL/LDL

Question 1

All Lipoproteins Contain the following

Answer 1

• Triglicerides
• Esterfied and Unesterfied Cholesterol
• Phospholipids
• Proteins

Question 2

function of lipoproteins

Answer 2

Transport lipids in plasma for metabolic purpose

Question 3

cholesterol

Answer 3

essential for biological function as structural component of biological membranes

as a precursor for steroid hormones and other essential functions.

*essential for healing process

Question 4

HDL relationship to exercise

Answer 4

potentially increases HDL

exercise most if not every day at a high enough intensity to see benefits (ACSM guideline - only applies to healthy people)

Question 5

5 major lipoprotein categories

Answer 5

• Chylomicrons
• VLDL’s
• IDL’s
• LDL’s
• HDL’s

Question 6

How do Lipoproteins differ?

Answer 6

• Size
• Density
• Quantity of ingredients

Question 7

triglyceride

Answer 7

1 glycerol (sugar)

3 FFA (saturated, unsaturated)

Question 8

Lipid Production and Synthesis of Cholesterol

intestine

Answer 8

• Triglycerides accumulate from dietary fat
• Transported in LDL and HDL as well as Chylomicrons and VLDL

Question 9

Lipid Production and Synthesis of Cholesterol

exogenous

Answer 9

Cholesterol production from consumption of fat

Question 10

Lipid Production and Synthesis of Cholesterol

Liver

Answer 10

Synthesizes carbohydrates (Glycerides) that are not used for fuel with free fatty acids to form Triglycerides

Question 11

lipid production and synthsis of cholesterol

endogenous

Answer 11

cholesterol synthesis from other sources

Question 12

Cost of CHD

Answer 12

$50,000,000,000 to $100,000,000,000 per year in lost wages and medical treatment

Question 13

Total cholesterol classifications

Answer 13

1. Desirable <200 mg/dL
2. Borderline-high 200-239 mg/dL
3. High ≥ 240 mg/dL

Question 14

risk factors for CAD

Answer 14

• Male ≥ 45 years
• Female ≥ 55 years
• Family history of CHD
• Smoker
• Hypertension
• Diabetes
• Total Cholesterol
  
  • HDL ≤ 40 mg/dL

Question 15

What reduces 1 risk factor for CHD?

Answer 15

HDL ≥ 60 mg/dL

Question 16

recommended follow up care (1993)

< 200 mg/dL

Answer 16

Repeat within 5 years

Question 17

recommended follow up care (1993)

200-239 mg/dL without CHD or 2 risk factors

Answer 17

Dietary info and recheck annually

Question 18

recommended follow up care (1993)

total cholesterol 200-239 mg/dL without CHD or 2 risk factors

Answer 18

Lipoprotein analysis and further action based on LDL-cholesterol level

**this is now the standard of care**

Question 19

Classification based on

Answer 19

LDL levels

Question 20

LDL Classifications

Answer 20

• Optimal: < 100
• Desirable: 100-129
• Borderline-high risk: 130-159
• High risk: 160-189
• Very high risk: ≥ 190

Question 21

Why look at HDL and LDL levels for risk of CHD?

Answer 21

A substantial amount of persons with CHD have total cholesterol in normal range

Question 22

HDL guidelines

2001

Answer 22

< 40 mg/dL low

> 60 mg/dL high

Question 23

Increasing HDL and Lowering Triglicerides

Public Health approach to treatmen

Answer 23

• Obesity
• Smoking
• Sedentary life-style

Question 24

Services of Health Professionals

Answer 24

Dietitians/Nutritionists
Exercise Physiologists
Health Educators

Question 25

research on puberty and HDL

Answer 25

* Boys and girls have similar HDL levels * Puberty boys Increase testosterone and decrease HDL * Exercise and Ethanol raise HDL

Question 26

HDL- The Clinical Implications of 1989 study

Answer 26

Conclusion not enough evidence showing increase HDL decrease risk CHD

Question 27

Acute Effects of Exercise on HDL, LDL, and Triglicerides

Answer 27

* Triglyceride- reduction 18-24h post exercise, especially in trained endurance athletes * HDL- Increases similar to triglyceride reduction * LDL- Reduced with prolonged exercise

Question 28

Physical Fitness Vs Physical Activity and CAD risk factors

Answer 28

Physical activity must be at high enough intensity to impact physical fitness level in order to effect CAD risk factors

Question 29

Physical Activity and Cardiovascular Health NIH Consensus Conference (1996)

Answer 29

* 12 week exercise- increases HDL levels * Endurance exercise * decreases in systolic and diastolic BP in Hypertensive persons * improved insulin sensitivity * lowers risk of clotting factors * Moderate activity 30 minutes most days but preferably all days of the week

Question 30

Increased intensity- Benefits and Risks NIH

Answer 30

* Lowers cardiovascular morbidity and mortality rates * Increase risk of injury * Discontinuation of activity * Acute cardiac events during activity

Question 31

Frequency, Intensity, Duration, Mode or FITT How often should you get: * high intensity and duration * low intensity and duration

Answer 31

High intensity and duration- 3X/week Low intensity and duration- daily

Question 32

Frequency, Intensity, Duration, Mode or FITT endurance vs. strength

Answer 32

**Endurance**- variety of activities produce similar benefits **Strength**- further research is necessary but initial studies suggest benefits for reducing risk of CHD especially in elderly

Question 33

Cardiac Rehabilitation Referral and Enrollment Rates group centers

Answer 33

* 10 to 25% of persons with CHD * Lower for women than men * Lower for non-whites than whites

Question 34

Cardiac Rehabilitation Referral and Enrollment Rates home based programs

Answer 34

Less hospital time combined with in home follow-up

Question 35

cardiac rehab benefits

Answer 35

* Lower incidence of rehospitalization * Lower charges per hospitalization

Question 36

**Diet and exercise study: What were the changes in HDL, LDL, and total cholesterol?** Men and Women with HDL’s below 35mg/dL and LDL’s above 130mg/dL Diet group, Diet and Exercise group, control group

Answer 36

* Decrease in total cholesterol and LDL’s for both treatment groups * Significant increase in HDL’s in Diet and Exercise group

Question 37

**CHD** **Initial LDL level: \> 100 mg/dL** 1. minimal goal 2. treatment

Answer 37

1. ≤ 100 mg/dL 2. dietary therapy with CHD

Question 38

**CHD** **Initial LDL level: ≥ 130 mg/dL** 1. minimal goal 2. type of therapy

Answer 38

1. **minimal goal:** ≤ 100 mg/dL 2. drug therapy

Question 39

1993 treatment guidelines **LDL ≥160 mg/dL w/o CHD or two risks** 1. minimal goal 2. treatments

Answer 39

1. **goal:** \< 160 mg/dL 2. **treatments:** dietary

Question 40

1993 treatment guidelines **≥130 mg/dL LDL w/ CHD or two risks** minimal goal treatments

Answer 40

1. **goal:** \< 130 mg/dL 2. **treatment:** dietary

Question 41

1993 treatment guidelines **LDL ≥190 mg/dL w/o CHD or two risks** minimal goal treatments

Answer 41

1. **goal:** \< 160 mg/dL 2. **treatment:** drug

Question 42

1993 treatment guidelines **≥160 mg/dL w/ CHD or two risks** minimal goal treatments

Answer 42

1. **goal:** \< 130 mg/dL 2. **treatment:** drug