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Flashcards in Heart Disease Deck (33)
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1

Estrogen supplementation including BCP will deplete the body of what?

B Vitamins. This includes natural and synthetic

2

What are the symptoms of angina or MI in women?

Dull and achy chest discomfort (not sharp). Left, middle or right
Back discomfort
Pain or tingling of the jaw, elbow or arm (usually the left)
Throat tightness
SOB
Indigestion
Nausea and vomiting
Lightheaded with exertion, dizziness or vertigo
Disproportionate sweating with activity
Sudden profound fatigue

3

Risk factors for heart disease

Age
Low HDL
Elevated triglycerides
Early menopause (andropause in men because T helps prevent CVD)
Diabetes
Positive family history
HTN
Insulin resistance
Physical inactivity
Poor diet
Smoking: increases platelet stickiness and lowers HDL
Overweight
Stress

4

Secondary risk factors for Heart disease

High homocysteine
High fibrinogen
High Lp(a)
High CRP
High ferritin
High Il-6

5

Elevated homocysteine increases your risk for what diseases?

MI
Stroke
Alzheimer's
Neural tube defects
Spontaneous abortion
Low birth weight
Neuropsychiatric disorders
Breast cancer
Prostate cancer
Osteoporosis

6

What are the causes for an elevated homocysteine?

Age
Hereditary
Toxins
Medications (BBs, BCPs, metformin: all lower B vitamins)
Hypothyroidism
Smoking
Renal failure
MTHFR polymorphism

7

What is the pathophysiology of homocysteine damage?

Endothelial dysfunction
Oxidative stress/free radicals
Neuronal DNA damage
Cerebral microangiopathy
Apoptosis of neural cells
Mitochondrial membrane damage

8

Elevated homocysteine increases your risk for what diseases?

MI
Stroke
Alzheimer's
Neural tube defects
Spontaneous abortion
Low birth weight
Neuropsychiatric disorders
Breast cancer
Prostate cancer
Osteoporosis

9

What are the causes for an elevated homocysteine?

Age
Hereditary
Toxins
Medications (BBs, BCPs, metformin: all lower B vitamins)
Hypothyroidism
Smoking
Renal failure
MTHFR polymorphism

10

What is the pathophysiology of homocysteine damage?

Endothelial dysfunction
Oxidative stress/free radicals
Neuronal DNA damage
Cerebral microangiopathy
Apoptosis of neural cells
Mitochondrial membrane damage

11

What are optimal, ok and unacceptable homocysteine levels?

6-8 = ideal
10 unacceptable

A too low homocysteine usually means the patient is over-methylated

12

How to lower homocysteine levels

Vitamins B6, B12 and folate
Betaine hydrochloride (TMG) 500-1000 mg
MTHF
Garlic 1000 mg
SAMe 400 mg
Beets, broccoli
Fish oil is somewhat helpful

13

What is fibrinogen

A blood protein that is important for clotting. It is also an acute phase reactant and can be seen in inflammation, tissue damage, infection, cancer, acute coronary syndrome and strokes

14

What happens to fibrinogen as estrogen decreases?

It increases

15

What does smoking do to fibrinogen?

It increases it

16

Treatment for elevated fibrinogen

Estrogen replacement for women
Garlic
Cold water fish
Vitamin E
Ginkgo
Bromelian (proteolytic enzyme derived from the stems of pineapples)
EPA/DHA
Ginger
Green Tea

17

What is Lp(a)

It is a lipoprotein that is rich in cholesterol. It differs from LDL as it contains an additional apolipoprotein (a). Similar to LDL, it also contains apolipoprotein B.

18

A research study showed that people with high Lp(a) have an increase risk of developing heart disease over the next 10 years. How much?

70%

19

What can cause an increased Lp(a)?

Genetics
Statin drugs can elevate it

20

How to lower Lp(a)

Natural HRT
Vitamin C (2-4 grams)
CoQ10 (120 mg)
L-carnitine (1-2 grams)
DHA (1-2 grams)
Niacin (1-2 grams)
L-lysine (500-1000 mg)
L-proline (500-1000 mg)
Flax seed
Policosanol: A mixture of a few fatty alcohols derived from the waxes of plants such as sugar cane and yams. Also found in beeswax.

21

An elevated CRP can predict future MI even if the patient has a normal what?

Cholesterol

22

What bacteria and 2 viruses can cause inflammation and plaque formation?

Chlamydia, herpes and CMV

23

A study on 28,263 patients showed that elevated HS CRP was what?

The strongest of 12 markers as a predictor of future cardiac events in women

24

What has a significant correlation with periodontal disease?

CAD

25

How to lower CRP

Exercise
Essential fatty acids
Quercetin as a supplement
CoQ10
Natural Cox 2 inhibitors (grapeseed extract 100 to 200 mg per day, curcumin 300 to 600 mg per day, green tea 3 cups per day)
Rosemary
Statin drugs
ACEI
Beta blockers

26

Every 1% increase in serum ferritin causes what percentage increase in risk of MI?

4%

27

Increased ferritin can do what to LDL?

Oxidize it
Use vitamin C cautiously since it can increase iron absorption

28

Name several causes of inflammation

Low EPA
High arachidonic acid
Increase in hydrogenated oil's
Environmental toxins, chemicals and heavy metals
Cigarette smoke
Radiation
Obesity
Infection
Medications
Vaccinations
Stress

29

What are estrogen's positive cardiac effects?

Keeps blood vessels flexible
Dilates arteries
Protects the endothelium
Decreases serum glucose
Is an antioxidant

30

What is fibrinogen?

An acute phase reactant which increases with any condition that causes inflammation or tissue damage