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TOPIC 11.docx

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University of Waterloo
HLTH 101
Glenn Ward

TOPIC 11: CARDIOVASCULAR AND RELATED DISORDERS 1. INTRODUCTION i) Impact  cardiovascular disorders are the leading cause mortality and morbidity in the 20th century, and again so far in the 21 century* o they are responsible for 30% of all deaths globally and roughly the same in Canada*  account for 10% of DALY’s in the developed world*  in Canada, a person dies from cardiovascular disease (CVD) every 7 minutes* o in 2006, this meant a total of 69,000 Canadian deaths o roughly equal between males and females  the economic costs of CVD to Canada are approximately 25 billion dollars per year* o this includes the cost of 175,000 hospitalizations per year o males 1.5X more likely to be hospitalized  the risk of CVD increases with age* - Developmental disease (happens over time) o 40% of deaths from the ages of 65 – 74 years is due to CVD o 60% of the deaths after age 85 ii) Trends  the incidence rate of CVD is increasing in the developing world*  at the same time, it is decreasing in the developed world, where the incidence of heart disease and stroke have declined:* o 70% since 1956 o 25% in the past 10 years alone iii) Specific Diseases and Conditions 1) ischemic heart disease*  the most common disease associated with CVD  partial blockage of coronary arteries o leads to reduced blood flow to heart muscle o if blockage severe, can lead to myocardial infarction (heart attack)  progression: a) ischemia (low blood flow) b) leads to anoxia (lack of oxygen in tissue — in this case, the heart tissue) c) leads to infarction (cell death) 2) cerebrovascular disease and stroke*  partial blockage of cerebral arteries  if severe, can lead to stroke 3) peripheral vascular disease*  partial blockage of peripheral arteries  usually affects legs 4) heart failure*  insult to heart muscle becomes so severe that heart can no longer pump sufficient blood to rest of body 5) rheumatic heart disease*  heart problems (usually involving the heart valves) caused by previous bacterial infection 2. PATHOLOGY  as described above, the primary clinical problems associated with CVD result from either of the following two problems: i. the blood vessels are not allowing adequate blood flow to specific tissues* ii. the heart is not pumping sufficient blood to meet the body’s demands for oxygen and nutrients* i) Progression of Cardiovascular Disease  CVD normally, but not always, follows the following progression 1) dyslipidemia* o often (but not always), the first change associated with CVD o denoted by changes in levels of lipids in either the tissues or plasma o the changes that often precede CVD are: a) increased triglyceride and low-density lipoprotein (LDL) production in the liver, which leads to:* b) increased triglyceride and low-density lipoprotein (LDL) levels in the blood o eventually, this leads to increased lipid uptake by endothelial cells lining the blood vessels, particular those lining the large and intermediate arteries* o the excess LDL is taken up and, in the endothelial cells, it forms crystals at the outer boundary of the intima (the layer of endothelial cells lining the lumen of the artery) where the endothelial c
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