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A disease proces of hardening or narrowing of the arteries due to excessive build up of plaque within the artery, reducing the ease of blood flow through artery.
Fatty streaks- damage to inner wall of the artery allows infiltration of fatty substances. Damage is minimal and blood flow not affected, reversible
- Soft plaque - Repeated injury at the site of fatty plaques resulting in thickening of artery's middle layer. Bulges into channel of artery restricting blood flow.
- Change occur by 30 years of age.
- All three artery's wall is affected
- Hard plaque - all three layers of artery's wall affected
- artery's channel is now almost blocked.
Affect of atherosclerosis
Atherosclerosis of the arteries to the brain can lead to stroke
to the leg lead to gangrene
to the heart lead to angina or heart attack
- >When systolic is above 140 and diastolic above 90
- >Bp is the results of cardiac output and peripheral resistance
- >Increase in cardiac output > increase stroke volume> increaes heart rate.
- >Increase peripheral resistance may be due too vasoconstriction of ateries vessels or excessive fluid volume in vascular space
- >Meds control blood pressure level to lower it
- >may experience fatigue, depression, sexual desire
What cause hypertension?
- >Unknown, may be due to high salt intake, genetics and obesity and ageing
- >secondary hypertension causes narrowing of aorta, renal, endocrine, neurological
- >Narrowing of renal artery cause hypertension due to the impair circulation of blood to the kidney, causing kidney to produce renin and angiotensin (hormones)
- >these hormones along with aldosterone cause constriction and incresed stiffness in peripheral arteries throughout the body resulting in hypertension.
Problem associated with hypertension
Hypertension can lead to:
- Myocardial infactions ( heart attack)
- Cerebrovascular accidents
- Renal disease
Age and hypertension
- >Bp rises with age
- >more common in young, middle male adulthood
- >more common in women aged 55+
- >Age related changes is dud to loss of tissue elasticity, stiffness of myocardium, increased peripheral resistance, decreased renal function, decreased renin response to sodium and water reduction
Glucose, Nicotine and hypertension
Nicotine causes vasoconstricion, carbon monoxide damages the lining of vessels
Abnormalities of glucose/insulin impairs vasodilation ( dilation of vessels)
Treatment for hypertension
Medications- ace inhabitors, beta blockers, diuretic, calcium channel blockers
Coronary artery disease (CAD)
- >major cause of illness/death
- >CAD begins when plaques are deposited within a coronary artery causing tiny clot to form which can obstruct flow of blood to heart muscle.
- >signs/symptoms include:
- chest pain - from inadequate blood flow to heart
- heart attack - sudden total blockage of coronary artery
- Sudden death - fatal disturbance of heart rhythm
- >Common symptom of heart disease
- >described as unpleasant feeling or discomfort, tightness on chest
- >Lasts a few minutes and can be relieved by rest or medication (glyceryl trinitrate - GTN)
- >may develop without knowing
- >Complet blockage of blood flow to part of heart muscle causes permanent damage to heart muscle
- >Pain last more than 15mins and cannot be relieved my mediacation ( GTN)
Nitrate is commonly used to treat angina. Nitrate relax the blood vessels, opening them wider so blood can flow more freely.
What cause Angina?
- >Fatty deposits build up under the lining of coronary arteries causing arteries to become narrowed and reducing blood flow to heart
- >pain (angina) occurs due to insufficient blood flow
- >usually felt across centre of chest sometime both shoulders, neck, jaw, down arms and hands
- > brought on by exertion, emotion, after heavy meal, cold weather, resting or at night time.
Coronary antioplasty (artery opening)
- > A procedure used to widen the narrowing in a coronary artery using special balloon.
- > narrowing is caused by build-up of plaque in the walls of arteries
Prevention of Cardiovascular disease
- >By doing cardio vascular risk assessment and promoting lifestyle changes to reduce risks.
- > people with diabetes, renal disease, genetic lipid disorders are highly at risk
fasting blood test
- Ratio is a good indicator of coronary heart disease
- The higher the ration the higher the risk of CVD
- LDL accounts for 60-70% of cholesterol
- HDL accounts for 30%
Measure of weight and truncal obesity
BMI- weight and height
- Waist circumference
- Men- > 102cm
Use national heart foundation cardiovascular risk tables
aims to reduced risk by 15%
Quit smoking (ABC smoking cessation)
Medications that help reduce CVD risks
Blood pressure lowering medications