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lipid disorders & heart diseases

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  1. 1. DIFINITION A lipoprotein is a biochemical assembly that contains both proteins and lipids water-bound to the proteins. Many enzymes, transporters, structural proteins, antigens, adhesins, and toxins are lipoproteins. Examples include the high-density (HDL) and low-density (LDL) lipoproteins, which enable fats to be carried in the blood stream, the transmembrane proteins of the mitochondrion and the chloroplast, and bacterial lipoproteins. FunctionThe function of lipoprotein particles is to transport lipids (fats) (such astriacylglycerol) around the body in the bloodAll cells use and rely on fats and cholesterol as building-blocks to create themultiple membranes that cells use both to control internal water content andinternal water-soluble elements and to organize their internal structure andprotein enzymatic systemsThe lipoprotein particles have hydrophilic groups of phospholipids, cholesterol,and apoproteins directed outward. Such characteristics make them soluble in thesalt water-based blood pool. Triglyceride-fats and cholesterol esters are carriedinternally, shielded from the water by the phospholipid monolayer and theapoproteins
  2. 2. The interaction of the proteins forming the surface of the particles (a) withenzymes in the blood, (b) with each other, and (c) with specific proteins on thesurfaces of cells determine whether triglycerides and cholesterol will be added toor removed from the lipoprotein transport particles Transmembrane lipoproteinsThe lipids are often an essential part of the complex, even if they seem to have nocatalytic activity by themselves. To isolate transmembrane lipoproteins from theirassociated membranes, detergents are often needed
  3. 3. Classification By densityLipoproteins may be classified as follows, listed from larger and less dense tosmaller and denser. Lipoproteins are larger and less dense, if they consist of morefat than of protein. They are classified on the basis of electrophoresis andultracentrifugationChylomicrons carry triglycerides (fat) from the intestines to the liver, to skeletalmuscle, and to adipose tissueVery-low-density lipoproteins (VLDL) carry (newly synthesised) triacylglycerol fromthe liver to adipose tissueIntermediate-density lipoproteins (IDL) are intermediate between VLDL and LDL.They are not usually detectable in the bloodLow-density lipoproteins (LDL) carry cholesterol from the liver to cells of the body.LDLs are sometimes referred to as the "bad cholesterol" lipoproteinHigh-density lipoproteins (HDL) collect cholesterol from the bodys tissues, andbring it back to the liver. HDLs are sometimes referred to as the "good cholesterol"lipoproteincholesterol % protein Diameter (nm) Class Density (g/mL)triacylglycerol phospholipid – HDL – LDL – – IDL –
  4. 4. – VLDL – - Chylomicrons Alpha and betaIt is also possible to classify lipoproteins as "alpha" and "beta", according to theclassification of proteins in serum protein electrophoresis. This terminology issometimes used in describing lipid disorders such as Abetalipoproteinemia Lipoprotein(aLipoprotein(a) – Lp(a), Cardiology diagnostic testsmg/dL : Normal mg/dL - mg/dL : High risk
  5. 5. What Is AtherosclerosisAtherosclerosis (ath-er-o-skler-O-sis) is a disease in which plaque (plak) builds upinside your arteries. Arteries are blood vessels that carry oxygen-rich blood to yourheart and other parts of your bodyPlaque is made up of fat, cholesterol, calcium, and other substances found in theblood. Over time, plaque hardens and narrows your arteries. This limits the flow ofoxygen-rich blood to your organs and other parts of your bodyAtherosclerosis can lead to serious problems, including heart attack, stroke, oreven deathAtherosclerosisFigure A shows a normal artery with normal blood flow. Figure B shows an arterywith plaque buildupAtherosclerosis-Related DiseasesAtherosclerosis can affect any artery in the body, including arteries in the heart,brain, arms, legs, pelvis, and kidneys. As a result, different diseases may developbased on which arteries are affected
  6. 6. Coronary Heart DiseaseCoronary heart disease (CHD), also called coronary artery disease, is the #1 killer ofboth men and women in the United States. CHD occurs if plaque builds up in thecoronary arteries. These arteries supply oxygen-rich blood to your heartPlaque narrows the coronary arteries and reduces blood flow to your heart muscle.Plaque buildup also makes it more likely that blood clots will form in your arteries.Blood clots can partially or completely block blood flowIf blood flow to your heart muscle is reduced or blocked, you may have angina(chest pain or discomfort) or a heart attackPlaque also can form in the hearts smallest arteries. This disease is called coronarymicrovascular disease (MVD). In coronary MVD, plaque doesnt cause blockages inthe arteries as it does in CHDCarotid Artery DiseaseCarotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on eachside of your neck (the carotid arteries). These arteries supply oxygen-rich blood toyour brain. If blood flow to your brain is reduced or blocked, you may have astrokePeripheral Arterial DiseasePeripheral arterial disease (P.A.D.) occurs if plaque builds up in the major arteriesthat supply oxygen-rich blood to your legs, arms, and pelvis
  7. 7. If blood flow to these parts of your body is reduced or blocked, you may havenumbness, pain, and, sometimes, dangerous infectionsChronic Kidney DiseaseChronic kidney disease can occur if plaque builds up in the renal arteries. Thesearteries supply oxygen-rich blood to your kidneysOver time, chronic kidney disease causes a slow loss of kidney function. The mainfunction of the kidneys is to remove waste and extra water from the bodyOverviewThe cause of atherosclerosis isnt known. However, certain traits, conditions, orhabits may raise your risk for the disease. These conditions are known as riskfactorsYou can control some risk factors, such as lack of physical activity, smoking, and anunhealthy diet. Others you cant control, such as age and a family history of heartdiseaseSome people who have atherosclerosis have no signs or symptoms. They may notbe diagnosed until after a heart attack or stroke
  8. 8. The main treatment for atherosclerosis is lifestyle changes. You also may needmedicines and medical procedures. These treatments, along with ongoing medicalcare, can help you live a healthier lifeOutlookImproved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life forpeople who have these diseases. However, atherosclerosis remains a commonhealth problemYou may be able to prevent or delay atherosclerosis and the diseases it can cause.Making lifestyle changes and getting ongoing care can help you avoid the problemsof atherosclerosis and live a long, healthy life
  9. 9. TREATMENT OF atherosclerosisCholesterol medications. Aggressively lowering your low-density lipoprotein (LDL)cholesterol, the "bad" cholesterol, can slow, stop or even reverse the buildup offatty deposits in your arteries. Boosting your high-density lipoprotein (HDL)cholesterol, the "good" cholesterol, may help, too. Your doctor can choose from arange of cholesterol medications, including drugs known as statins and fibratesAnti-platelet medications. Your doctor may prescribe anti-platelet medications,such as aspirin, to reduce the likelihood that platelets will clump in narrowedarteries, form a blood clot and cause further blockageBeta blocker medications. These medications are commonly used for coronaryartery disease. They lower your heart rate and blood pressure, reducing thedemand on your heart and often relieve symptoms of chest pain. Beta blockersreduce the risk of heart attacks and heart rhythm problemsAngiotensin-converting enzyme (ACE) inhibitors. These medications can help slowthe progression of atherosclerosis by lowering blood pressure and producing otherbeneficial effects on the heart arteries. ACE inhibitors can also reduce the risk ofrecurrent heart attacksCalcium channel blockers. These medications lower blood pressure and aresometimes used to treat anginaWater pills (diuretics). High blood pressure is a major risk factor foratherosclerosis. Diuretics lower blood pressure
  10. 10. Other medications. Your doctor may suggest certain medications to control specificrisk factors for atherosclerosis, such as diabetes. Sometimes specific medicationsto treat symptoms of atherosclerosis, such as leg pain during exercise, areprescribedSometimes more aggressive treatment is needed. If you have severe symptoms ora blockage that threatens muscle or skin tissue survival, you may be a candidatefor one of the following surgical proceduresAngioplasty. In this procedure, your doctor inserts a long, thin tube (catheter) intothe blocked or narrowed part of your artery. A second catheter with a deflatedballoon on its tip is then passed through the catheter to the narrowed area. Theballoon is then inflated, compressing the deposits against your artery walls. Amesh tube (stent) is usually left in the artery to help keep the artery openEndarterectomy. In some cases, fatty deposits must be surgically removed fromthe walls of a narrowed artery. When the procedure is done on arteries in the neck(the carotid arteries), its known as carotid endarterectomyThrombolytic therapy. If you have an artery thats blocked by a blood clot, yourdoctor may insert a clot-dissolving drug into your artery at the point of the clot tobreak it upBypass surgery. Your doctor may create a graft bypass using a vessel from anotherpart of your body or a tube made of synthetic fabric. This allows blood to flowaround the blocked or narrowed artery
  11. 11. HOW TO PROTECT YOUR HEART ?Limit how much saturated and trans fats you eat that contribute toa buildup of plaque in your arteriesTypes of Fat RecommendationSaturated Fat Less than 7 percent of your total daily caloriesTrans Fat Less than 1 percent of your total daily caloriesCholesterol Less than 300 milligrams a day for healthy adults; less than200 milligrams a day for adults with high levels of low-densitylipoprotein (LDL), or "bad," cholesterol or those who are takingcholesterol-lowering medicationThe best way to limit saturated and trans fats is to limit the amount ofsolid fats such as butter, margarine, and shortening. These arecommonly used and included into our foods. Avoid fried foods or usesubstitutes where ever possible. For example use low-fat sour cream orsalsa on a baked potato instead of butter and sour-cream, or avoidfrying meats but rather broil, bake or barbeque instead. Use Olive oilinstead of shortening, and avoid deep fried foods or battered fried foodsDo check the food labels, especially those that are labeled "reducedfat" because you may find that these items are substituting fat with
  12. 12. oils that contain trans fats. "Partially hydrogenated" is a typical phrasethat indicates trans fat so use this a a clue when reading those labelsThe healthier solution is to choose foods that containmonounsaturated fats, such as olive or canola oil. Polyunsaturated fatsare found in nuts and seeds, which are also good choices. Both of thesetypes of fat may help to lower your total blood cholesterol - but with moderation because these are still "fatsChoose from sources of low-fat proteinsLean meats, skinless poultry and fish, or low-fat dairy products and eggwhites are your best sources of low-fat protein. Legumes (beans, peasand lentils) are also great sources and contain less fat and nocholesterol which makes them great alternatives to meatMore fruits and vegetablesFruits and vegetables are is a great source for vitamins and minerals;they are lower in calories and rich in fiber. Fruits and vegetables alsocontain substances that help prevent cardiovascular disease. Eatingmore fruits and vegetables will fill you up more, helping you to eat lesshigh-fat foods and snacks
  13. 13. Eating more fruits and vegetables is actually easier than you think.Choose recipes that include fruits and vegetables in them, keep apples,grapes, peaches on hand and try new foods such as stir-fry, fruit salads,or even canned fruits and vegetables (with lower sodium and sugarcontent) Avoid drenching your fruits and vegetables in butter,dressings, sugar, and sauces because these will add back fats andcalories which will in the end, defeat your purpose. Also try to avoidbreaded and fried vegetables, canned fruits in heavy syrup, andcoconutSelect whole grainsWhole grains are a great source of fiber, vitamins, minerals and iron.The nutrients found in whole grains also help regulate blood pressureand maintain your heart’s healthChoose breads, pasta and cereals made from 100 percent whole grainand avoid refined white flour. Select high-fiber breakfast cereals oroatmeal instead of sugary cereals, muffins or doughnutsFlaxseed is another whole grain to add to your diet. Ground flaxseed ishigh in omega-3 fatty acids which lower your total blood cholesterol.You can easily add ground flaxseed to your foods by stirring in a
  14. 14. teaspoon over hot cereal, applesauce or yogurtReduce salt intakeEveryone uses it, it’s hard to avoid – eating a lot of salt can contributeto high blood pressure. Reducing the salt in your food is an importantpart of a heart-healthy diet. The American Heart Associationrecommends that healthy adults eat less than 2,300 milligrams ofsodium a day which is about 1 teaspoonSalt is added to many foods that are canned, processed, frozen andprepared. Snacks, chips, crackers, soups, frozen dinners all add salt toimprove flavor. The best way to reduce salt intake is to eat fresh foodsand making your own soups. Another way is to replace salt with saltsubstitutes, herbs and spices or choose reduced-salt condiments orprepared / processed foodsEat in moderationYes, diet means eating in moderation. Overloading your plate, eatingtill you feel stuffed or taking seconds leads to consuming more caloriesand fat than you actually need. Eating out lends to eating more thanyou should and often are foods that shouldn’t be consumed on a
  15. 15. regular basis. Use methods to keep track of your food intake, you’ll besurprised by how much you consume and of what types of food youeat regularlyA heart-healthy diet also is about maintaining a balance, control andmoderation. Eating enough fruits and vegetables and not overindulgingwith filler calories keeps our bodies healthy, not just our heart. It’s okto treat yourself to your favorite ice-cream or candy, just moderatethat to once a week and even then moderate the amount youconsume. Don’t let your favorite treat indulgence become an excuse toabandon your healthy-eating plan but rather adopt healthy eatinghabits as the normCreate daily menus and planPut your plans in action by creating daily menus. Using the strategieslisted above, emphasize vegetables, fruits and whole grains, chooselean protein and limit high-fat and salty foods. Planning your mealshelps you to plan when you go to the store – having money as well.Variety also helps make mealtime and snacks interestingUse these seven tips as a guide into a heart-healthy way to preventheart disease and you’ll be surprised how quickly you’ll be able toregain control of your cholesterol. You’ll also be pleased by how easy it
  16. 16. can be to lose weight, as well. Incorporate healthy habits to create ahealthy life style