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ATHEROSCLEROSIS
-PRESENTATION BY DR.RITHIK KATARIYA
ATHEROSCLEROSIS:
• Atherosclerosis is a disease of large and medium-sized muscular arteries and is
characterized by –
• endothelial dysfunction,
• vascular inflammation, and
• the buildup of lipids, cholesterol, calcium, and cellular debris within the intima of
the vessel wall.
RISK FACTORS FOR
ATHEROSCLEROSIS:
• Major risk factors (Non Modifiable)-
• Increasing Age
• Male gender
• Family history
• Genetic abnormalities
RISK FACTORS FOR
ATHEROSCLEROSIS
• Lesser, Uncertain, or Nonquantitated Risks-
• Obesity
• Physical Inactivity
• Postmenopausal estrogen deficiency
• High carbohydrate intake
• Lipoprotein(a)
• Hardened (trans)unsaturated fat
• Chlamydia pneumoniae infection
CIGARETTE SMOKING :
• Cigarette smoking is a well-established risk factor in men
• An increase in the number of women who smoke probably accounts for the
increasing incidence and severity of atherosclerosis in women.
• Prolonged (years) smoking of one pack of cigarettes or more daily increases the
death rate from IHD by 200%
• . Smoking cessation reduces that risk substantially.
DIABETES MELLITUS :
• Diabetes mellitus induces hypercholesterolemia as well as a markedly increased
predisposition to atherosclerosis.
• Other factors being equal, the incidence of myocardial infarction is twice as
high in diabetic as in Nondiabetic individuals.
• There is also an increased risk of strokes and a 100-fold increased risk of
atherosclerosisinduced gangrene of the lower extremities.
LIPOPROTEIN A
OR LP(A) :
• Lipoprotein a or Lp(a), is an altered form of
LDL that contains the apolipoprotein B-100
portion of LDL linked to apolipoprotein A;
• Increased Lp(a) levels are associated with
a higher risk of coronary and cerebro
vascular disease, independent of total
cholesterol or LDL levels.
HYPERLIPIDEMIA:
• LDL cholesterol has an essential
physiologic role delivering cholesterol to
peripheral tissues.
• In contrast, high-density lipoprotein (HDL,
"good cholesterol") mobilizes cholesterol
from developing and existing atheromas
and transports it to the liver for excretion in
the bile.
• Consequently, higher levels of HDL
correlate with reduced risk.
ATHEROSCLEROSIS-
SYMPTOMS
• Symptomatic atherosclerotic disease most often
involves the arteries supplying the heart, brain,
kidneys, and lower extremities.
• Myocardial infarction (heart attack), cerebral
infarction (stroke), aortic aneurysms, and
peripheral vascular disease (gangrene of the legs)
are the major consequences of atherosclerosis.
PREVENTION OF
ATHEROSCLEROTIC
VASCULAR DISEASE
:
• Primary prevention of atherosclerosis
• Cessation of cigarette smoking
• Control of hypertension
• Weight loss
• Exercise, and lowering total and LDL blood
cholesterol levels while increasing HDL (e.g., by
diet or through statins).
• Statin use may also modulate the inflammatory
state of the vascular wall.
• Risk factor stratification and reduction should
even begin in childhood.
PREVENTION OF
ATHEROSCLEROTIC
VASCULAR DISEASE
• Secondary prevention involves use of –
• Aspirin (anti-platelet agent),
• Statins, and beta blockers (to limit cardiac
demand),
• Surgical interventions (e.g., coronary artery
bypass surgery, carotid endarterectomy). These
can successfully reduce recurrent myocardial or
cerebral events.
THANKYOU

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Atherosclerosis

  • 2. ATHEROSCLEROSIS: • Atherosclerosis is a disease of large and medium-sized muscular arteries and is characterized by – • endothelial dysfunction, • vascular inflammation, and • the buildup of lipids, cholesterol, calcium, and cellular debris within the intima of the vessel wall.
  • 3.
  • 4. RISK FACTORS FOR ATHEROSCLEROSIS: • Major risk factors (Non Modifiable)- • Increasing Age • Male gender • Family history • Genetic abnormalities
  • 5. RISK FACTORS FOR ATHEROSCLEROSIS • Lesser, Uncertain, or Nonquantitated Risks- • Obesity • Physical Inactivity • Postmenopausal estrogen deficiency • High carbohydrate intake • Lipoprotein(a) • Hardened (trans)unsaturated fat • Chlamydia pneumoniae infection
  • 6. CIGARETTE SMOKING : • Cigarette smoking is a well-established risk factor in men • An increase in the number of women who smoke probably accounts for the increasing incidence and severity of atherosclerosis in women. • Prolonged (years) smoking of one pack of cigarettes or more daily increases the death rate from IHD by 200% • . Smoking cessation reduces that risk substantially.
  • 7. DIABETES MELLITUS : • Diabetes mellitus induces hypercholesterolemia as well as a markedly increased predisposition to atherosclerosis. • Other factors being equal, the incidence of myocardial infarction is twice as high in diabetic as in Nondiabetic individuals. • There is also an increased risk of strokes and a 100-fold increased risk of atherosclerosisinduced gangrene of the lower extremities.
  • 8. LIPOPROTEIN A OR LP(A) : • Lipoprotein a or Lp(a), is an altered form of LDL that contains the apolipoprotein B-100 portion of LDL linked to apolipoprotein A; • Increased Lp(a) levels are associated with a higher risk of coronary and cerebro vascular disease, independent of total cholesterol or LDL levels.
  • 9. HYPERLIPIDEMIA: • LDL cholesterol has an essential physiologic role delivering cholesterol to peripheral tissues. • In contrast, high-density lipoprotein (HDL, "good cholesterol") mobilizes cholesterol from developing and existing atheromas and transports it to the liver for excretion in the bile. • Consequently, higher levels of HDL correlate with reduced risk.
  • 10. ATHEROSCLEROSIS- SYMPTOMS • Symptomatic atherosclerotic disease most often involves the arteries supplying the heart, brain, kidneys, and lower extremities. • Myocardial infarction (heart attack), cerebral infarction (stroke), aortic aneurysms, and peripheral vascular disease (gangrene of the legs) are the major consequences of atherosclerosis.
  • 11. PREVENTION OF ATHEROSCLEROTIC VASCULAR DISEASE : • Primary prevention of atherosclerosis • Cessation of cigarette smoking • Control of hypertension • Weight loss • Exercise, and lowering total and LDL blood cholesterol levels while increasing HDL (e.g., by diet or through statins). • Statin use may also modulate the inflammatory state of the vascular wall. • Risk factor stratification and reduction should even begin in childhood.
  • 12. PREVENTION OF ATHEROSCLEROTIC VASCULAR DISEASE • Secondary prevention involves use of – • Aspirin (anti-platelet agent), • Statins, and beta blockers (to limit cardiac demand), • Surgical interventions (e.g., coronary artery bypass surgery, carotid endarterectomy). These can successfully reduce recurrent myocardial or cerebral events.