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Pathology of CVD

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Pathology of CVD

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

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