Cardiovascular Disease Medical Interventions

Local Hormones

intracellular hormone-like susbtances (usually made and used within the cell)

regulate immunity, platelet aggregation, vascular dilation, inflammation

what are local hormones synthesized from

synthesized from essential fatty acids

EFAs converted to Arachidonic Acid by membrane

AA released by membranes and converted into hormones like prostaglandins (PGs), thromboxanes (TXs) and leukotrienes (LTs)

aspirin

inhibit breakdown of AA by membrane to produce PGs and TXs

inhibits TXs that help platelets clot, so anti-clot

angina

partial blockage in coronary arteries

lack of blood flow to heart muscles, lack of oxygen = pain

anti-anginal drugs

nitrates

beta blockers

nitrates

acute vasodilators - expand coronary arteries quick

contain nitroglycerin which is converted to nitric oxide, which opens up the blood vessels

can develop drug tolerance

beta blockers

beta-adrenergic receptor antagonists (inhibit effects of adrenaline)

decrease heart rate and heart demand for O2

aspirin

inhibit breakdown of arachidonic acid which is used to make PGs and TXs

inhibits TXs (used for platelet clotting), so it’s anti-clot drug

angina

partial blockage of coronary arteries

lack of blood flow to heart and therefore lack of oxygen causes pain

anti anginal drugs

nitrates

beta blockers

nitrates

acute vasodilators - open coronary arteries quick

contain nitroglycerin which is converted to nitric oxide and expands the blood vessels

can develop drug tolerance

beta blockers

beta-adrenergic receptor antagonists (inhibit effect of adrenaline)

lowers heart rate and heart demand for O2

blood pressure

usually measured with artery at heart level

healthy bp for 20 yr old is 120 mm Hg at systole, 70 mm Hg at diastole

Hypertension

promots endothelila damage/dysfunction

results in endothelial cell activation, etc

can treat with vasodilators and diuretics

vasodilators

allieviate smooth muscle contractions in the artery wall

diuretics

reduce blood pressure by reducing blood volume

statins

inhibitors of HMG-CoA (used to make cholesterol in liver)

statins function

lowers cholesterol (incl LDL)

lowers risk of heart attack

primary preventative intervention for people with risk factors for coronary heart disease

Secondary intervention for those with pre existing heart disease or associated complications

eg Atorvastatin (sold by Pfizer)

anti inflammatory approach

inflammation plays role in athersclerosis and thrombus formation

aspirin can inhibit inflammation and reduce risk of heart attack, strokea

anti hypertensive approach

hypertension promotes atherosclerosis and increase risk of heart attack, stroke

can be reduced by dietary changes, vasodilators, diuretics, excercise

statins lower amount of LDL-C and risk of heart attack

red wine

contains antioxidants

antioxidants are proposed to act by inhibiting LDL oxidation and thrombosis