Atherosclerosis

Coronary Atherosclerotic Heart Disease DR.LIU LIXIN

Atherosclerosis 

Atherosclerosis is a syndrome affecting arterial blood vessels. It is a chronic inflammatory response in the walls of arteries . It is commonly referred to as a hardening or furring of the arteries. It is caused by the formation of multiple plaques within the arteries

Risk Factors for Atherosclerosis 

Age:  

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Male > 45 years Female > 55 years or premature menopause without estrogen replacement therapy

Family History of premature disease  

Male first-degree relative <55 years Female first-degree relative < 65 years

Risk Factors for Atherosclerosis 

Hypertension 

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Appears to weaken the artery wall at points of high pressure leading to injury and invasion of cholesterol.

Cigarette Smoking #1 cause of preventable death in US  1 in 5 CHD deaths attributable to 

Risk Factors for Atherosclerosis 

Diabetes 

50% of deaths related to DM is due to CHD

Risk Factors for Atherosclerosis 

Inactivity 

Sedentary person has 2x risk for developing CHD as a person who is active.

Risk Factors for Atherosclerosis 

Obesity

Risk Factors for Atherosclerosis 

Abnormal Blood Lipids

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LDL Cholesterol (low density lipoprotein)

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HDL Cholesterol (high density lipoprotein)

Risk Factors Uncontrollable

Controllable

•Sex

•High blood pressure

•Hereditary

•High blood cholesterol

•Race

•Smoking

•Age

•Physical activity •Obesity •Diabetes •Stress and anger

Atherosclerosis 

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.  Over time, plaque hardens and narrows your arteries.  The flow of oxygen-rich blood to your organs and other parts of your body is reduced.  This can lead to serious problems, including heart attack, stroke, or even death.

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Plaque (the build-up of lipid/cholester ol) in the artery wall forms as a response to injury to the endothelium in the artery wall.

Plaque vulnerability factors Intrinsic factors

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Many people are able to manage coronary artery disease with lifestyle changes and medications.

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Other people with severe coronary artery disease may need angioplasty or surgery.

Treatment:  

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Weight Loss Low cholesterol, low saturated fat diet Increased physical activity Smoking cessation Management of Diabetes Restricted alcohol use

Medicine 

1. antiplatelet aggregation Aspirin ,ticlopidine, clopidogrel, GPIIb/IIIa receptor antagonist

2. regulate lipid For hypercholesterolemia: Statins, Cholestyramine, Colestipol, Nicotininc acid;       For Hypertriglyceridema: Clofibrate. 3 .thrombolysis

streptokinase, urokinase

Angioplasty

Bypass surgery

•Get regular medical checkups. •Control your blood pressure. •Check your cholesterol. •Don’t smoke. •Exercise regularly. •Maintain a healthy weight. •Eat a heart-healthy diet. •Manage stress.