Atheroscler osis By
May 14, 2015
AtherosclerosisAtherosclerosis
By
Suriya
By
Suriya
INTROINTRO…..…..
ARTERIOSCLEROSISARTERIOSCLEROSIS
• hardening or thickening of blood hardening or thickening of blood vesselvessel
• loss of elasticity of vessel wallloss of elasticity of vessel wall
Types of arteriosclerosisTypes of arteriosclerosis
• ArteriolosclerosisArteriolosclerosis
hyalinehyaline
hyperplastichyperplastic
• monckeberg’s medial calcific monckeberg’s medial calcific sclerosis sclerosis
• atherosclerosisatherosclerosis
AtherosclerosisAtherosclerosisGreek word Greek word
Athero-protruding, sclerosis-Athero-protruding, sclerosis-scarringscarring
Atherosclerosis-gruel/hardeningAtherosclerosis-gruel/hardening
Def: Def:
Intimal lesions – atheromasIntimal lesions – atheromas
Protrude into and obstruct vascular Protrude into and obstruct vascular lumens and weaken underlying medialumens and weaken underlying media
• Global in distributionGlobal in distribution
• Mortality - half of all deaths….Mortality - half of all deaths….
• Morbidity - higher than other disease Morbidity - higher than other disease in western worldin western world
• Increasing in developed and Increasing in developed and industrialized countriesindustrialized countries
Epidemiologic data………Epidemiologic data………
• 25% of deaths in USA is of MI25% of deaths in USA is of MI
• Mortality rate for IHD in USA is high(5 Mortality rate for IHD in USA is high(5 times of Japan)times of Japan)
• IHD-2IHD-2ndnd leading cause of death in Japan leading cause of death in Japan
• 1963-2000 1963-2000
↓ ↓ in 50% death rate due to IHDin 50% death rate due to IHD
↓ ↓ in 70% death rate due to strokein 70% death rate due to stroke
• In New Orleans In New Orleans
Postmortem findings of coronary Postmortem findings of coronary atherosclerosis in persons of age 25-atherosclerosis in persons of age 25-44 yrs in 1968-72 is comparatively 44 yrs in 1968-72 is comparatively less as in 1960-64 less as in 1960-64
Constitutional Constitutional
AgeAge
SexSex
Genetics Genetics
Family historyFamily history
AcquiredAcquired
HyperlipidemiaHyperlipidemia
HypertensionHypertension
DMDM
Cigarette smoking Cigarette smoking
CRPCRP
MAJORMAJOR
MINORMINOR
• ObesityObesity• Physical inactivityPhysical inactivity• StressStress• Postmenopausal estrogen deficiencyPostmenopausal estrogen deficiency• Diet Diet • AlcoholAlcohol• Lipoprotein aLipoprotein a• Coagulation factorsCoagulation factors• Infections Infections
AGEAGE
• Dominant influenceDominant influence
• 40-60 yrs of age-incidence of MI ↑ by 40-60 yrs of age-incidence of MI ↑ by 5 folds5 folds
SEXSEX
• Male Male
• Postmenopausal womenPostmenopausal women
• In elderly , both have equal riskIn elderly , both have equal risk
GENETICSGENETICS
• PolygenicPolygenic
• Familial diseases-HYT,DMFamilial diseases-HYT,DM
• Inborn metabolic errors-FamilialInborn metabolic errors-Familial
hyperlipidemiahyperlipidemia
HYPERLIPIDEMIAHYPERLIPIDEMIA
HypercholesterolemiaHypercholesterolemia
• High cholesterol diet & saturated fats High cholesterol diet & saturated fats - ↑ cholesterol level- ↑ cholesterol level
• Low cholesterol diet & Low cholesterol diet & polyunsaturated fats - ↓ cholesterol polyunsaturated fats - ↓ cholesterol levellevel
• Exercise & moderate consumption of Exercise & moderate consumption of ethanol - ↑ HDL levelethanol - ↑ HDL level
• Obesity & smoking - ↓ HDL levelObesity & smoking - ↓ HDL level
HypertensionHypertension
• ↑ ↑ risk of IHD by 60%risk of IHD by 60%
• HYT → LVH → IHDHYT → LVH → IHD
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