Risk Factors for Cardiovascular disease

CVD is the #1 killer of adults in the US

yes, even more than cancer

Uncontrollable risk factors include..

• males > females

• Age (greater after age 55)

• family history

Controllable risk factors

• smoking

• obesity

• sedentary lifestyle

• untreated hypertension

The relationship between blood pressure and the risk of developing cardiovascular disease

it’s a direct relationship!

• essential hypertension has no clear cause other than hereditary

Hypertension increases the risk of developing …

Atherosclerosis

• starts by causing carotid and aortic baroreceptors to adapt and become less sensitive to the elevated pressure

as a result, the Heart muscle hypertrophies

• heart tissue becomes less flexible and begins to decrease in function overall

• causes pulmonary edema

→ back up blood in lungs, which causes swelling

• leads to congestive heart failure

Treatment options

• calcium channel blockers and beta-blocking drugs affect heart function

→ L type Calcium channels, more calcium = increasing influx, increasing contraction ~ so if we block these, heart contracting slower

→ if we block beta-blocking drugs, we have less heart stimulation (bc beta-receptors are sympathetic)

• Diuretics, renin inhibitors, and angiotensin-converting enzyme (ACE) inhibitors all manipulate blood volume via the urinary system

Some uncontrollable genetic risk factor can be modified or mitigated by healthy lifestyle choices

• high levels of lipids in the blood

→ lead to atherosclerosis

→ carried in the blood by lipoproteins

— HDL-C versus LDL-C

— modify diet to increase cholesterol intake, have high lvls of HDL’s and low levels of LDLs to maintain CVS health

— exercise stimulates the production of HDL

• diabetes mellitus increases risk of developing CVD

→ this metabolic disorder contributes to development of atherosclerosis

→ modify diet to include as little processed sugar as possible

The development of atherosclerotic plaques entails…

• Hypertension weakens or tears artery walls

• LDL-C transported under weakened endothelial cell lining

• Macrophages are called in to ingest excess cholesterol, but become foam cells and cause smooth muscle to divide

As foam cells, and smooth muscle cells accumulate, a bulging plaque forms

• can block artery by itself

• can become fibrous and initiate a blood clot

• can break off and travel to another part of the body causing a thrombosis or stroke (in the brain)

Angiogenesis

New blood vessel development!

• necessary for normal development, wound healing, and uterine lining growth during a woman’s menstrual cycle

• controlled by cytokines

→ regulatory proteins for growth

These cytokines could be used to fight coronary heart disease

could stimulate growth of collateral circulation, or arterial branches to by-pass blocked regions

Inhibiting angiogenesis could be used to fight cancerous masses

• tumors require extensive blood supply to provide nutrients for their rapid cell division

• starving them of their blood supply could destroy some tumors

Angiogenesis also occurs as a consequence of exercise

Increase capillary density for increased energy need and surface area of growing muscles