Lecture 6 - Cardiovascular Risk Factors Flashcards Preview

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Flashcards in Lecture 6 - Cardiovascular Risk Factors Deck (21):
1

Two broad types of cardiovascular disease

1) Heart attack (death of heart muscle)
2) Stroke (issue with blood supply to the brain)

2

Broad types of strokes

1) Issue with blood supply to the brain
2) Haemorrhage in the brain

3

Why is the heart particularly prone to death?

Cardiac muscle cells can't divide
No collateral blood supply to the heart

4

Established CVD risk factors
1)
2)
3)
4)
5)
6)

1) Age
2) Cholesterol
3) Blood pressure
4) Body mass index
5) Smoking
6) Diabetes

5

Other, more poorly-characterised CVD risk factors
1)
2)
3)
4)

1) Left ventricular size
2) Fibrinogen levels (elevated->CVD)
3) Other lipids
4) Homocysteine levels

6

CVD risk factor that tends to precede others

Obesity

7

Single most important CVD risk factor

Age.
Over 80% of CVD occurs in people over 65

8

Why is high fibrinogen a CVD risk factor?

Atherosclerosis leading to narrower blood vessels and turbulent flow.
Endothelium over plaque can bind clotting factors.
High fibrinogen increases risk of clot forming over plaque, occluding blood vessel

9

Gender-specific risks

Men more likely to die from CVD
Women before menopause have reduced CVD risk (though have lower risk even after menopause)
Hormone therapy in menopause doesn't reduce CVD risk

10

How strong is family history in CVD?

First-degree relative with CVD increases your risk fourfold

11

Amount that genetics contributes to CVD risk

Probably polygenic.
Individual genes explain small amount of risk

12

Lipids implicated in CVD

LDL, VLDL, triacyl glycerides associated with increased risk
HDL associated with decreased risk

13

Type of obesity particularly associated with CVD risk

Central obesity (particularly prevalent in men)

14

Effect of alcohol on CVD risk

Below or above two standard units of alcohol increases risk

15

HDL role

Transports cholesterol from peripheral tissues to liver

16

LDL role

Transports cholesterol from liver to peripheral tissues

17

Relative risk vs absolute risk of CVD, by blood pressure

Relative (personal) risk is highest at higher blood pressures.

Absolute (population) risk is highest at the average blood pressure (systolic=140mmHg), as more people have this blood pressure, therefore more people with 140mmHg die of CVD.

18

What is defined as a high cardiovascular risk?

Over 15% event risk over 5 years (according to the national heart foundation)

19

Blood pressure thresholds for treatment
1)
2)
3)

1) Systolic over 180mmHg
2) Diastolic over 110mmHg
3) Systolic over 160mmHg and diastolic under 70mmHg
4) Systolic over 140mmHg or diastolic over 90mmHg with associated heart conditions

20

Conditions that increase CVD risk

Diabetes, renal disease, preexisting cardiovascular disease

21

End organ damage of CVD
1)
2)
3)
4)
5)

1) Left ventricular hypertrophy
2) Microalbuminuria (indicates renal damage)
3) Low eGFR (estimated glomerular filtration rate)
4) Intima-media thickness (measuring arterial wall thickness)
5) Pulse wave velocity (speed at which blood travels through a vessel