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Pathology of CVD
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Pathology of CVD

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  • 1. Pathology of Cardiovascular Disease
    • Cardiovascular disease (CVD) is the general name given to diseases which affect the heart and blood vessels.
    • Coronary heart disease (CHD) refers to diseases affecting the heart and coronary blood vessels.
    • Examples of CVD are: thrombosis, angina pectoris, myocardial infarction (heart attack), stroke
    • The main processes involved in cardiovascular and coronary heart disease are ATHEROSCLEROSIS and HYPERTENSION
  • 2. Hypertension
    • Hypertension is said to occur when the blood pressure is greater than 160/95 mm Hg
    • Nearly 20% of the adult population in the UK suffer from hypertension (high blood pressure) which often goes undetected until a heart attack or stroke occurs
    • Therefore, it is important to have blood pressure checked on a regular basis and to adopt a healthy lifestyle to prevent hypertension
  • 3. What complications are caused by high blood pressure?
    • Atherosclerosis: narrowing of the arteries.
    • Stroke: haemorrhage or blood clot in the brain
    • Aneurysm: dangerous expansion of the main artery either in the chest or the abdomen,which becomes weakened and may rupture
    • Heart attack
    • Heart failure: reduced pumping ability
    • Kidney failure
    • Eye damage
  • 4. Atherosclerosis
    • Build up of plaque ( a substance containing fats and cholesterol ) on the inner layers of artery walls
    • Instead of being smooth and elastic, the layers become thickened and irregular with the lumen of the artery becoming narrower
    • This in turn reduces the circulation of blood and can lead to an INCREASE in BLOOD PRESSURE
  • 5. Thrombosis
    • A thrombosis occurs when a blood clot forms in a artery, completing blocking the flow of blood
    • If this happens in one of the coronary arteries in the heart it causes a HEART ATTACK or MYOCARDIAL INFARCTION
    • If it occurs in an artery in the brain it causes a STROKE
  • 6. Angina pectoris
    • Angina pectoris occurs when the blood vessels in the heart are partially blocked due to ATHEROSCLEROSIS
    • During exercise blood flow cannot increase to meet the needs of the heart muscle and chest pain results
    • The pain disappears when the exercise stops
  • 7. Myocardial infarction
    • A heart attack (MI) occurs when an area of heart muscle dies or is permanently damaged because of an INADEQUATE SUPPLY OF OXYGEN to that area
    • Most MIs are caused by a CLOT that blocks one of the coronary arteries (the blood vessels that bring blood and oxygen to the heart muscle)
    • The clot usually forms in a coronary artery that has been previously narrowed from changes related to ATHEROSCLEROSIS
    • The atherosclerotic plaque (buildup) inside the arterial wall sometimes cracks, and this triggers the formation of a clot, also called a thrombus
  • 8.
    • A clot in the coronary artery interrupts the flow of blood and oxygen to the heart muscle, leading to the death of heart cells in that area
    • The damaged heart muscle loses its ability to contract, and the remaining heart muscle needs to compensate for that weakened area
    • Occasionally, sudden overwhelming STRESS can trigger a heart attack
  • 9. Stroke
    • A stroke is an interruption of the blood supply to any part of the brain
    • A stroke can happen when:
      • A blood vessel carrying blood to the brain is blocked by a blood clot
      • A blood vessel breaks open, causing  blood to leak into the brain
    • If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage
  • 10. Incidence of CHD
    • Coronary heart disease (CHD) is more common in countries with HIGH FAT diets, HIGH SMOKING RATES and SEDENTARY LIFESTYLES (such as the UK & USA)
    • Developing countries tend to have lower incidences of CHD but numbers there are increasing
  • 11. CHD MORTALITY INCIDENCE
  • 12. Risk Factors for CVD
    • There are a variety of risk factors that contribute to CVD morbidity and mortality
    • Through extensive research, many of these risk factors for CVD have been identified and are well documented and understood
    • Each of these risk factors can be categorized as
      • PREVENTABLE (individual has control over them)
      • NON-PREVENTABLE (individual has no control over them)
    • Fortunately, research has identified almost all of the risk factors for CVD and has shown that most are modifiable through simple lifestyle choices
  • 13. Risk Factors for CVD Unhealthy Eating Overweight and Obesity Smoking Family History of Premature CVD Lack of Physical Activity Race/Ethnicity High Blood Pressure Male Gender High Blood Cholesterol Increasing Age Type-2 Diabetes NON-PREVENTABLE RISK FACTORS PREVENTABLE RISK FACTORS
  • 14. Risk Factors for Hypertension
        • SMOKING
        • DIET [high fat / high salt]
        • OBESITY
        • GENETIC PREDISPOSITION
        • STRESS
    • Most cases of hypertension can be controlled by lifestyle changes alone, however antihypertensive medications can help control the condition and keep the heart healthy.
  • 15. Role of cholesterol in CHD
    • Cholesterol is a major component of cell membranes and is needed to make STEROID HORMONES
    • But because the body makes all the cholesterol it needs, the extra fat and cholesterol that you eat sit in the walls of arteries that carry blood to the heart
    • These fatty deposits cause the arteries to narrow, less blood gets to the heart, and the risk for coronary heart disease INCREASES
    • There are 2 important types of cholesterol-carrying proteins in the blood:
      • High-density lipoprotein (HDL) - known as "good" cholesterol because it removes cholesterol from the blood and protects the heart
      • Low-density lipoprotein (LDL) -known as " bad" cholesterol
  • 16. HDL : LDL Ratios
    • As LDL level INCREASES [bad], the heart-disease risk INCREASES
    • In contrast, as the HDL level INCREASES , the heart-disease risk DECREASES
    • The risk of developing CHD can be predicted by measuring the ratio of HDL : LDL in the blood
    High Ratio = High HDL/ Low LDL levels = HEALTHY Low Ratio = Low HDL/ High LDL levels = UNHEALTHY