-PRIMARILY MYOCARDIAL INFARCTIONS (HEART ATTACKS)

-ONLY ONE OF MANY CVD'S

-LARGEST CAUSE OF DEATH IN AMERICAN MEN AND WOMEN

-NO DIFFERENT BETWEEN RACES

-48% OF MEN AND 63% OF WOMEN HAVE NO PREVIOUS SYMPTOMS BEFORE DYING OF A HEART ATTACK

-7 MILLION AMERICANS SUFFER FROM IT

-ONLY 20% OF HEART ATTACKS ARE PRECEDED BY LONG-STANDING ANGINA PECTORIS

-CAN BE HEMORRHAGIC OR ISCHEMIC (BLOOD LEAKS OR CLOTS AND STOPS BLOOD FROM GETTING TO VITAL AREAS)

-3RD LARGEST CAUSE OF DEATH(AFTER MI AND CANCER)

-STROKES ARE HIGHER IN AFRICAN AMERICAN MEN AND WOMEN THAN CAUCASIANS

-AKA HIGH BLOOD PRESSURE

-EXTREMELY COMMON 1/4 AMERICANS HAVE IT

-MOST PREVALENT CONDITION ALONG WITH OBESITY AND PHYSICAL INACTIVITY

-BP>140 (SYSTOLIC)AND/ OR>90(DIASTOLIC)

-1/3 DONT EVEN KNOW THEY HAVE IT

-MORE DEATHS FROM IT IN BLACKS THAN WHITES

-DEATH

-DISABILITY

-DOLLARS

-3 STEP PROCESS

-VERY COMPLICATED

-A HARDENING/THICKENING OF THE ARTERIES

-ENDOTHELIUM: INNERMOST

-INTIMA

-MEDIA

-ADVENTITIA

-LAYER BETWEEN THE ARTERIAL WALL AND THE BLOOD

-NORMALLY NOTHING STICKS TO IT

-SERVES AS A PERMEABLE BARRIER

-IN THE ARTERIAL WALL

-WHERE ALL THE ATHEROSCHLEROTIC THINGS OCCUR

-MEDIAL LAYER

-SITE OF SMOOTH MUSCLES

-NOT VERY INVOLVED WITH ATHEROSCHLEROSIS

-OUTERMOST LAYER

-NOT INVOLVED IN ATHEROSCHLEROSIS

FATTY STREAK

-AN INJURY OCCURS TO THE ENDOTHELIAL LAYER, USUALLY OCCURS AT A BEND IN THE ARTERY

-THE BEND CAUSES TURBULENT FLOW WHICH LEADS TO VULNERABILITY IN THE ARTERY

-SOME CVD RISH FACTORS CONTRIBUTE TO INJURY OF THE ENDOTHELIUM

-ENDOTHELIAL LAYER LEAKS LEAKS CHEMICALS SUCH AS LDL AND BECOMES TRAPPED

-MONOCYTES ENTER TO DIGEST MODIFIED LDL-C

-THESE FORM "FOAM CELLS*"

-FOAM CELLS LAY UNDER THE ENDOTHELIUM AND LOOK LIKE A "FATTY STREAK"

-SMOOTH MUSCLE CELLS MIGRATE TO THE FATTY CELLS FROM THE MEDIA TO THE INTIMA

-MANY PEOPLE HAVE THESE BUT IT MAY NOT LEAD TO FIBROUS PLAQUE

-A FIBROUS CAP FORMS OVER THE FATTY STREAK COMPOSED OF SMOOTH MUSCLE

-MAY ALSO HAVE DEAD CELLS, CONNECTIVE TISSUE, AND CALCIUM DEPOSITS

-DOESN'T CONTAIN MUCH LIPID BUT THE LAYER BELOW IT CONTAINS THE FOAM CELLS

-THE ENDOTHELIAL LAYER IS LOST IN THIS STAGE

-THIS ALLOWS CELLS TO ATTACH TO THE INSIDE WALLS OF THE BLOOD VESSEL

-CAUSES MORE SMOOTH MUSCLE TO MIGRATE FROM THE MEDIA TO THE INTIMA

-STARTS TO DECREASE THE OPEN AREA IN THE BLOOD VESSEL THROUGH WHICH BLOOD TRAVELS

-WHEN A FIBROUS PLAQUE HEMORRHAGES OR ULCERATES 

-CAN BE CAUSE BY THE FORCE OF BLOOD FLOW TURBULENCE, HEMORRHAGE WITHIN THE PLAQUE OR OTHER CHEMICAL REASONS

-THIS INCREASES PLATELET BINDING AND COAGULATION

EFFECT OF COMPLICATED LESION FORMATION

-MAY DISSOLVE ON ITS OWN

-MAY BECOME LARGER AND EXPAND THE LESION

-MAY BLOCK ARTERY AND CAUSE HEART ATTACK

-MAY TRAVEL AND GET STUCK ON ANOTHER PLAQUE OR TRAVEL FAR ENOUGH AND BLOCK AN ENTIRE ARTERY

-THERE MUST BE A STATISTICAL RELATIONSHIP

-MUST BE A POTENTIAL MECHANISM TO EXPLAIN RELATIONSHIP

WHAT ARE CVD RISK FACTORS

-HYPERTENSION

-DIABETES

-OBESITY

-DIET

-PHYSICAL INACTIVITY

-PHYSICAL FITNESS

-GENETICS

-RACE

-AGE

-GENDER

-SMOKING

-STRESS

-EXCESSIVE ALCOHOL CONSUMPTION

-HIGH CHOLESTEROL