Biomedical cell biology: atherosclerosis stroke

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  • Created by: Rosa
  • Created on: 16-04-13 17:40

BACKGROUND

Prevalence:

Cardiovascular/ cerebrovascular disease (CVD) primary cause of mortaility in developed countries. becoming more significant in developing such as middle east (20.4% prevalence) 

15 million suffer stroke worldwide each year. 5 million die, 5 million permanently diabled

High Blood pressure (HBP) contributes to 12.7 million (MOST IMPORTANT RISK FACTOR)

Europe - 1.1 million strok deaths. expected 1.5 million by 2025. costing 22 milion

increase with age affects 10,000 of every 100,000 over 80

developing countries incidence declining due to lower BP efforts, reduced smoking. however remains high

3rd leading cause of death in US (more than 140,000 per annum)

atherosclerosis and stroke:

atherosclerosis is often referred to as hardening of the arteries. athero (gruel/ paste) sclerosis (hardness)

the process which deposits the fatty substances, cholesterol, cellular waste products, calcium and other substances on the inner lining of an artery is called plaque

slow and complex which begins at childhood. may progress rapidly in 20s. others no threat until 50/60s.

atherosclerosis and stroke definition:

unstable plaques --> thrombosis --> break off

angina --> stable plaques--> can survive for many years inhaler dilates vessels

ischaemic stroke: lack of blood flow to brain

transient ischaemic attack (5x): transient episode of neurologic dysfunction caused by ischemia. Mini stroke. same underlying cause as normal stroke

Lacunar stroke: occlusion of one of the penetratingarteries that provides blood to the brain's deep structures 

Blood vessel affected:

  • carotid
  • cerebral

cerebral cortex most common

SEE IMAGE

future prevention system/ treatment:

CIPROTECT

ACHILES HEEL

(SEE IMAGE)

common in acient egyptians challenging the fact it may be a modern day disease due to unhealthy lifestyle. potential genetic predisposition.

risk factors of cerebrowascular disease: high blood pressure high cholesterol diabetes

modifiable:

tobacco smoke: coronary heart desiease 2-4 times that of smokers. powerful independant factor of sudden cardiac death for patients with coronary heart disease 2x risk of non-smokers

nicotine: decreased oxygen to heart, increased BP to heart, increased clotting, damage cells that line coronary arteries

high blood cholesterol: with tobacco smoke and HBP risk increases even more. also affected by age, sex heredity and diet

cholesterol carried through blood as lipoproteins: LDL (low-density) HDL (high-density)

High levels of LDL increase risk of heart attack and ischemic stroke. HDL reduces risk, carries away cholesterol from blood stream

triglyceride common fat in body, heart disease/ diabetes likely to be high. this with LDL speed up atherosclerosis.

macrophages engulf excess cholesterol then die and release it forming foam cells expanding the intimal core destabilising it.

treatment: diet/ statins. statins block enzyme in liver which creates cholesterol. Hydroxy-methylglutaryl-coenzymes A reductase (HMG-CoA reductase)

HBP: increase workload causing heart to thicken and become stiffer. Increase risk of stroke, heart attack, kidney failure and congestive heart failure

this with obesity, smoking, diabetes, high cholesterol increases risk of stoke, heart attack by several times

lifestyle (salt, excercise, alcohol)

medication:

  • ACE inhibitors (relax blood vessel)
  • calcium channel blockers (blocks calcium from entering heart and vessels)
  • beta (adrenergic) blockers (slow the heart rate down by blocking action of adrenaline…

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