BIOL1008 Lecture Notes - Lecture 18: Dyslipidemia, Claudication, Insulin Resistance
9 Jun 2018
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Lecture 18
Atherosclerosis
Disease of large and medium-sized arteries.
It causes
• plaques which cause vessel narrowing causing angina and claudication
• aneurysms which cause vessel rupture
• plaques can rupture causing thrombosis
Pathogenesis
It is a response to inflammation in the vessels that begins when the endothelium is damaged.
It is more common where blood flow is turbulent causing endothelial damage and decreased
NO production.
Risk factors for atherosclerosis:
• family history
• dyslipidemia
o Increased LDL, VLDL, decreased HDL
• Diabetes mellitus
• cigarette smoking
o smoke contains nicotine and other chemicals that are toxic to vascular
endothelium, increases platelet reactivity and [LDL]. It decreases [HDL].
• hypertension
• oxidative stressors
• systemic infection and inflammation
o a link between infection and atherosclerosis has been observed
Metabolic Syndrome is an important cause. It is associated with diabetes mellitus. Diabetes
increases inflammation and production of oxygen free radicals which directly injure the
endothelium.
Metabolic syndrome features
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2
1. abdominal obesity,
2. dyslipidemia, hypertension,
3. insulin resistance,
4. prothrombotic state,
5. proinflammatory state.
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Document Summary
It causes: plaques which cause vessel narrowing causing angina and claudication, aneurysms which cause vessel rupture, plaques can rupture causing thrombosis. It is a response to inflammation in the vessels that begins when the endothelium is damaged. It is more common where blood flow is turbulent causing endothelial damage and decreased. Risk factors for atherosclerosis: family history: dyslipidemia. Increased ldl, vldl, decreased hdl: diabetes mellitus, cigarette smoking, smoke contains nicotine and other chemicals that are toxic to vascular endothelium, increases platelet reactivity and [ldl]. It decreases [hdl]: hypertension, oxidative stressors, systemic infection and inflammation, a link between infection and atherosclerosis has been observed. Diabetes increases inflammation and production of oxygen free radicals which directly injure the endothelium. Metabolic syndrome features: abdominal obesity, dyslipidemia, hypertension, insulin resistance, prothrombotic state, proinflammatory state. Stages in atherosclerosis: intimal thickening, lipid uptake. Low-density lipoprotein (ldl) and very-low-density lipoprotein (vldl) also bind to endothelial cells and are oxidized in the subendothelium: fatty streak.
