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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