Flashcards in Lecture 6 - Cardiovascular Risk Factors Deck (21):
Two broad types of cardiovascular disease
1) Heart attack (death of heart muscle)
2) Stroke (issue with blood supply to the brain)
Broad types of strokes
1) Issue with blood supply to the brain
2) Haemorrhage in the brain
Why is the heart particularly prone to death?
Cardiac muscle cells can't divide
No collateral blood supply to the heart
Established CVD risk factors
3) Blood pressure
4) Body mass index
Other, more poorly-characterised CVD risk factors
1) Left ventricular size
2) Fibrinogen levels (elevated->CVD)
3) Other lipids
4) Homocysteine levels
CVD risk factor that tends to precede others
Single most important CVD risk factor
Over 80% of CVD occurs in people over 65
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
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
How strong is family history in CVD?
First-degree relative with CVD increases your risk fourfold
Amount that genetics contributes to CVD risk
Individual genes explain small amount of risk
Lipids implicated in CVD
LDL, VLDL, triacyl glycerides associated with increased risk
HDL associated with decreased risk
Type of obesity particularly associated with CVD risk
Central obesity (particularly prevalent in men)
Effect of alcohol on CVD risk
Below or above two standard units of alcohol increases risk
Transports cholesterol from peripheral tissues to liver
Transports cholesterol from liver to peripheral tissues
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.
What is defined as a high cardiovascular risk?
Over 15% event risk over 5 years (according to the national heart foundation)
Blood pressure thresholds for treatment
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
Conditions that increase CVD risk
Diabetes, renal disease, preexisting cardiovascular disease