Yolo

Atherosclerosis

* Thickening and loss of elasticity of arterial walls

* Hardening of the arteries

* Greatest morbidity and mortality of all human diseases via

* Narrowing

* Weakening

* Three Patterns

* Dominant Pattern: Affects elastic (aorta, carotid, iliac) and large to medium sized muscular arteries (coronary, popliteal)

* Medial Calcific Sclerosis: Calcium buildup in arteries

* Scan calcium deposits in arterial walls

* Arteriolosclerosis: Small arteries and arterioles (hypertension and DM)

* Non-Modifiable Risk Factors

* Age: Dominant Influence

* Beings in the young, but does not precipitate organ injury until later in life

* Gender

* Men more prone than women, but age 60-70 about equal frequency

* Family History: Genetic Differences

* Familial clusters of risk factors

* Modifiable Risk Factors (Potentially Controllable)

* Hyperlipidemia

* Hypertension

* Cigarette Smoking

* Diabetes Mellitus

* Elevated Homocysteine

* Factors that affect hemostasis and thrombosis (clotting of circulation system)

* Infections: Herpes Virus; Chlamydia, Pneumoniae

* Obesity, Sedentary Lifestyle, Stress

Inflammation and atherosclerosis

* Immune cells dominate early lesions

* Immune effector molecules accelerate lesion progression

* Activation of inflammation elicits acute coronary syndromes

* Inflammation Vasodilation Send in T-Cells, Macrophages (WBCs), Platelets

* Atherosclerosis is an inflammatory disease in which immune mechanism interact with metabolic risk factors to initiate, propagate and activate lesions in the arterial wall

The Numbers

* CAD causes 38% of all deaths in N.A.

* Most comment cause of death in men <65

* Second most among women

Early lesion. Modified lipoproteins and “foam cell” formation

Oxidized Fat Macrophage Foam...