Discuss with the students. Was prev. Covered in the lifestyle section so they should have some ideas.
CORONARY VASULAR DISEASE
KEY WORDS TO BE ABLE TO DEFINE:
From the EDEXCEL specification:
Describe the blood clotting process
thromboplastin release, conversion of prothrombin to thrombin and fibrinogen to fibrin and its role in cardiovascular disease (CVD).
Explain the course of events that leads to atherosclerosis
endothelial damage, inflammatory response, plaque formation, raised blood pressure
Describe the factors that increase the risk of CVD
genetic,diet, age, gender, high blood pressure, smoking and inactivity
Describe the benefits and risks of treatments for CVD
antihypertensives, plant statins, anticoagulants and platelet inhibitory drugs
Analyse and interpret data on the possible significance for health of blood cholesterol levels and levels of high-density lipoproteins
(HDLs) and low-density lipoproteins (LDLs).
Describe the evidence for a causal relationship between blood cholesterol levels (total cholesterol and LDL cholesterol) and CVD.
Discuss how people use scientific knowledge about the effects of diet (including obesity indicators), exercise and smoking to reduce
their risk of coronary heart disease.
• In 2011, almost 160,000 people in the UK died from
• 74,000 of these deaths were caused by coronary
heart disease - the UK's single biggest killer.
• Other types of cardiovascular disease include heart
valve disease and cardiomyopathy.
CVD includes all the diseases of
Heart and circulation
Coronary heart disease
Angina and heart attack
Congenital heart disease
It is also known as heart and
ATHEROSCLEROSIS is a narrowing of the artery caused
by built up fatty deposits called ATHEROMA
• It begins as fatty streaks, accumulations of
white blood cells that have taken up lowdensity lipoproteins (LDLs).
• LDLs are the “bad” form of cholesterol.
• Fatty streak laid down by
LDL-carrying white blood cells.
• Streaks start to enlarge to form a
PLAQUE (commonly occur in
• The plaques bulge into the
lumen of arteries and restrict the
flow of blood, increasing blood
• Sources:– Made by the liver
– Ingestion of dairy
• Insoluble in blood
plasma so transported as
2 types: Low density:– Transport cholesterol
from liver to tissues,
– Deposit cholesterol.
High density:– Transport cholesterol
from tissues to liver,
– Remove cholesterol from
• As the blood flow is restricted,
blood pressure increases.
• This causes some damage to the
lining (endothelium) of the
• Platelets start to aggregate and
lay down a BLOOD CLOT
• This is now called a THROMBUS
• Sometimes a thrombus may
become dislodged and move
around the body now called an
• This mobile thrombus can
settled elsewhere and block
other arteries and veins.
• This is particularly problematic if
the thrombus moves to the
• Atheromas that lead to the
formation of a thrombus also
weaken the artery walls.
• These weakened points swell to
form a balloon-like blood-filled
structure called an ANEURYSM.
• Aneurysms frequently burst,
leading to haemorrhage.
• This then leads to a loss of blood
in that region of the body.
• A brain aneurysm is known as a
cerebrovascular aneurysm (CVA),
• Also known as a HEART ATTACK.
• The term literally means a reduced
supply of oxygen to the muscle of the
• MI is a symptom of CHD.
• MI results from a blockage in one of the
• If the blockage is close to the junction of
the coronary artery and the aorta, then
the heart will stop beating because the
blood supply is completely cut off.
Artery in brain bursts or
Part of the brain is
starved of oxygen.
Effects usually on one
Effects depend upon site.
Prognosis depends upon
ANGINA- In time, your arteries may become so narrow that they cannot
deliver enough oxygen-rich blood to your heart. This can cause chest a pain or
THROMBUS- If a piece of the atheroma in your arteries breaks away it may
cause a blood clot to form.
EMBOLISM- If the blood clot moves to other parts of the body causing
MYOCARDIAL INFARCTION/HEART ATTACK- If the blood clot blocks your
coronary artery and cuts off the supply of oxygen-rich blood to your heart
muscle, your heart muscle may become permanentlydamaged
STROKE- When a blood clot blocks an artery that carries blood to your brain
Saturated Fats (lipids)
• Saturated fatty acids have no double bonds between
the individual carbon atoms of the fatty acid chain.
That is, the chain of carbon atoms is fully "saturated"
with hydrogen atoms.
• An unsaturated fat is a fat or fatty acid in which there is at least
one double bond
• A fat molecule is monounsaturated if it contains one double
bond, and polyunsaturated if it contains more than one double
• Where double bonds are formed, hydrogen atoms are
There are two main constituents of tobacco
smoke which increase likelihood of heart
• Combines irreversibly with Hb of RBCs.
• This means that the oxygen carrying capacity
of the blood is reduced.
• This will remain throughout the whole lifespan
of the RBC (~120 days).
• This could lead to insufficient supply of oxygen
to the heart during exercise.
• Stimulates the production of adrenaline which
increases heart rate and blood pressure.
• This increases the risk of CHD or CVA.
• Nicotine also makes RBCs more “sticky” –
leading to a higher risk of thrombosis.
• As there is already pressure in the arteries, the
heart must work harder to pump blood into them
and is therefore more prone to failure.
• Higher blood pressure within the arteries means
that they are more likely to develop an aneurysm
• To resist the higher blood pressure within them,
the walls of the arteries may become hardened
and thickened – leading to restricted flow of
Cholesterol is an essential component of
membranes. As such, it is an essential
biochemical which must be transported in the
blood. It is carried in the plasma in tiny
spheres of lipoprotein (lipid and protein).
There are two main types:
High-density liproprotein (HDLs)
Low-density liprorotein (LDLs)
• These remove cholesterol from tissues and
transport it to the liver for excretion. They
help protect arteries against disease.
• These transport cholesterol from the liver to
the tissues, including the artery walls, which
they infiltrate, leading to the development of
atheroma and hence heart disease.
There are a number of aspects of diet which
increase the risk of heart disease, both
directly and indirectly:
• High levels of salt raise blood pressure.
• High levels of fat increase LDL level and hence
blood cholesterol concentration.