Term
| what is the first stage of atherosclerotic progression? |
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Definition
| 1) unaffected artery w/thin intimal layer & smooth luminal surface |
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Term
| what is the second stage of atherosclerotic progression? |
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Definition
| 2) early lesions - fatty streaks in the intima that attract monocytes and stimulate a cellular immune response |
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Term
| what is the third stage of atherosclerotic progression? |
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Definition
| 3) advanced lesions - cholesterol, calcium crystals, and cellular debris accumulate w/in the intima which starts bulging into the arterial lumen |
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Term
| what is the fourth stage of atherosclerotic progression? |
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Definition
| 4) thrombus formation (can build on lesion or move downstream) - clotting factors and platelets activated by contact with lesions |
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Term
| what nutrients are protective in stage 3 atherosclerosis? |
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Definition
| high fiber, anti-oxidants (vit E from fruits/veggies), folate, +/-vit K, and decreased trans fats and saturated fats |
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Term
| what can be protective nutritionally in pts w/stage 4 atherosclerosis? |
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Definition
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Term
| what are atherogenic lipoproteins? |
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Definition
| LDL, VLDL remnants, chylomicron remnants |
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Term
| what are non-atherogenic lipoproteins? |
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Definition
| HDL, VLDL, and chylomicrons |
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Term
| what are good ranges in a lipid profile? |
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Definition
| total cholesterol <200, triglycerides <150, LDL <100, and HDL >40 |
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Term
| what is metabolic syndrome? |
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Definition
| low HDL, high LDL, HTN, insulin resistance and visceral obesity |
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Term
| why do alcoholics suffer from fatty livers? |
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Definition
| impaired liver function causes VLDL to stay in the liver |
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Term
| what is the half life of the different lipoproteins? |
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Definition
| chylomicrons: w/in minutes, VLDL: min-hrs, LDL: days to weeks (especially problematic w/oxidized LDLs) |
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Term
| what are some factors that influence serum LDL concentrations? |
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Definition
| genetics, body weight, diet and exercise |
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Term
| how do genetics influence serum LDL concentrations? |
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Definition
| the Apo E4 gene increases risk of heart disease, atherosclerosis and CV while Apo E2 decreases the risk and is more protective. overall level of LDL receptors in the liver can help reduce total cholesterol |
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Term
| how do reduced body weight and exercise affect atherosclerotic risk? |
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Definition
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Term
| what are LDL increasing dietary factors? |
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Definition
| myristic acid (C14) and palmitic acid (C16) - carbon 14 & 16 FAs respectively which are found in milk fat and meat. trans and saturated fats and partially hydrogenated oil. |
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Term
| what are LDL level neutral or (slightly increasing) dietary factors? |
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Definition
| monounsaturated FAs (olive oil, oleic acid, palmitoleic) and stearic acid - an 18C that mildly raises cholesterol |
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Term
| what are LDL decreasing dietary factors? |
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Definition
| PUFAs (omega 3, 6 FAs, EPAs, DHAs, fish/walnuts/flax seed) and soluble fibers |
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Term
| why are excessive copper/iron stores considered a risk factor for CV disease development? |
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Definition
| promotion of free radical formation which is not only an atherosclerotic risk factor - but also for CA and alzheimer's disease |
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Term
| what dietary change is most likely to lower LDL cholesterol concentration? |
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Definition
| decreasing consumption of trans FAs |
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Term
| is there a difference between a stroke and heart attack in terms of etiology? |
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Definition
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Term
| what is the most likely effect of lowering cholesterol intake on a pt w/a currently high cholesterol level? |
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Definition
| the LDL receptor number in the liver will increase and the LDL concetration will decrease |
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Term
| how does high intake of dietary cholesterol affect HMG-CoA reductase? |
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Definition
| HMG-CoA reductase is the rate-limiting enzyme in cholesterol synthesis and in situations w/high levels of cholesterol HMG-CoA reductase is inhibited by negative feedback |
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Term
| what factors influence HDL levels? |
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Definition
| exercise increases HDL levels, women have 20% more HDL before menopaude, moderate alcohol consumption increases HDL, and reduced body weight inceases HDL levels |
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Term
| what is increase in risk of CV disease w/HDL loss? |
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Definition
| there is a 2-3% increase in CV disease risk w/a decrease of 1 g/dL if HDL concentration |
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Term
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Definition
| a polyphenol with potent anti-oxidant properties found in grapes and grape seeds |
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Term
| for a pt w/a total cholesterol of 250, LDL of 175, HDL of 35 and triglycerides at 210 what are good measures to take in tx? |
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Definition
| weight loss, reduce sat/trans fat intake, and increase physical activity. (don't need to start rx or fish oil b/c no hx of stroke or MI) |
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Term
| what is a good diet for prevention of atherosclerosis? |
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Definition
| reduced/limted salt, reduced/limited sugar, increases PUFAs, decreased sat/trans fats, 2 servings fish per week, 4 servings of fruit/veggies daily, 6 servings of fiber/whole grains daily |
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