Atherosclerosis Pathophysiology

Question 1

Pathophysiology of atherosclerosis

Answer 1

Endothelium damaged by sheer stress

Monocytes adhere and penetrate to damage => macrophages

• absorb oxLDL => foam cells => die and form lesion core
• cytokine release => aggregation of more macrophages, SM proliferation

SM forms fibrous cap

Plaque rupture => thrombosis, coronary artery block

Question 2

Risk factors for CVD

Answer 2

Age, male, ethnicity, FHx

HTN (systolic and diastolic)
High LDL, LDL:HDL ratio
DM
Smoking
LVH

Question 3

Dyslipidemia - high LDL and TAGs, low HDL

Answer 3

Statins

Ezetimibe

Question 4

HTN - most significant risk factor

Answer 4

Damages endothelium of conduit artery => atherosclerosis (aorta, coronary, carotid, renal

Increases afterload => LVH, ischemia

Brain and kidney need high flow, low resistance => more prone to damage from increased pulsatility from high BP
-renal failure, strokes

Question 5

Smoking

Answer 5

Endothelial dysfunction and damage => inflammation
Increased plaque vulnerability
Increased thrombosis, decreases fibrinolysis

Increases SNS => HTN
Increased T2DM

Question 6

T2DM and cardiometabolic disease

Answer 6

Increased oxidative stress, endothelial adhesion molceule expression
Increased inflammation

CMD

• high glucose
• HTN
• dyslipidemia
• central obesity

Question 7

Obesity

Answer 7

Increased risk of being metabolically unhealthy

Increases SNS, glucose, cholesterol

Question 8

How does exercise reduce CV risk

Answer 8

Weight loss => reduce obesity related risk factors
Increases HDL, lowers TAGs
Increases NO
Reduces oxidative stress