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28 Cards in this Set

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  • Back
Between ages __ and __, incidence of myocardial infarction increases 5x.
40 and 60
ATH is much more common in men or women?
MEN
Myocardial infarction and other complications of ATH are uncommon in premenopausal women unless they are predisposed by what 3 things?
Diabetes

Hyperlipidemia

Severe hypertension
Why does incidence of ATH-related diseases increase after menopause?
Probably due to decrease in natural estrogen levels
When does the frequency of myocardial infarction become equal in both sexes?
70-80 years old
What are 4 major risk factors for atherosclerosis (ATH) that can be modified?
Hyperlipidemia

Hypertension

Cigarette smoking

Diabetes
Higher levels of _____-density lipoprotein lowers the risk of ATH.
High-density (HDL)
What accounts for the relatively recent increase in incidence and severity of ATH in women?
Cigarette smoking
When one or more packs of cigarettes are smoked per day for several years, death rate from IHD increases by ___%.
200%
What condition induces hypercholesterolemia and an increased predisposition to ATH?
Diabetes mellitus
What is homocystinuria?
A rare inborn error of metabolism that leads to high levels of circulating homocysteine. Patients have premature vascular disease
Hyperhomocystinemia is caused by a low dietary intake of what?
Folate and Vitamin B
Multiple risk factors for ATH have a ___________ effect.
Multiplicative
Can ATH and its consequences develop without any apparent risk factors?
YES
Regarding ATH, what is the “Response to injury” hypothesis?
Considers ATH to be a chronic inflammatory response of the arterial wall initiated by injury to the endothelium
What are the potential agents that may cause endothelial dysfunction in early ATH?
Circulating derivatives of cigarette smoke
Homocysteine
Possibly viruses and other infectious agents
What are the 2 most important determinants of endothelial alterations?
Hemodynamic disturbances that accompany normal circulatory function
Adverse effects of hypercholesterolemia
What characteristic of plaques support a hemodynamic effect?
Plaques have a well-defined tendency to occur at areas where there are disturbed flow patterns (Ostia of exiting vessels, branch points, posterior wall of abdominal aorta)
What 4 disorders can cause dyslipoproteinemias (abnormal concentrations of lipoproteins in the blood)?
Nephrotic syndrome
Alcoholism
Hypothyroidism
Diabetes mellitus
What does lowering the levels of serum cholesterol by diet or drugs do?
Slows rate of progression of ATH.
Causes regression of some plaques.
Reduces risk of cardiovascular events
Coronary arterial ATH may be decreased by ______ vitamins.
Antioxidant vitamins (Beta-carotene and vitamin E)
What 2 types of cells play a key role in ATH, which adhere to the endothelium early in ATH and migrate between ECs to localize in the intima?
Monocytes and Macrophages
What type of cell releases lipids into the intima?
Macrophages
What converts a fatty streak into a mature fibrofatty atheroma?
SMC proliferation and the extracellular matrix that SMCs deposit in the intima
Evidence for what infectious organism is strongest in its role of atheroma formation?
C. pneumonia
Morphologic studies have established that atherosclerotic _______ artery disease begins in childhood.
coronary
What drugs are lipid-lowering drugs?
Statins
What are 2 antiplatelet drugs?
Aspirin, Plavix