Arteriosclerosis

·         thickening or hardening of the arterial wall

·         innermost layer undergoes a series of changes that ¯ the artery’s ability to change lumen size

·         Manifestations depend on

*         Vessel involved

*         Site of the lesion

*         Age of patient

*         Genetic makeup

*         Physiologic status of the individual

·         HTN develops if atherosclerosis ­ systemic vascular resistance (SVR)

·         Cerebral or myocardial ischemia is a life-threatening manifestation of atherosclerosis in vessels of the brain or heart

·         Assess BP in both arms

·         Palpate pulses – note differences

·         Palpate skin temperature in lower extremities

·         Assess cap refill prolonged > 3 seconds in young to middle aged adults; > 5 seconds in older adults

Serum Cholesterol (HDL+LDL+1/5 Triglyceride Level)

▪       Desirable – < 200 mg/dL

▪       Borderline High Risk – 200 – 239 mg/dL

▪       High Risk – 240 mg/dL and over

LDL-C

©        Levels indicate a persons risk for atherosclerosis

©        LDL’s deposit cholesterol in lining of vessels

©        HDL’s carry cholesterol away from the arteries to the liver, where the cholesterol can be processed into a harmless substance and excreted from the body

©        HDL cholesterol has been compared to "janitors" in the arteries – there are 5 subclasses of HDL seen with special electrophoresis

©        Desirable HDL–C   > 40 mg/dL men

   > 50 mg/dL women

©        Low HDL puts one at high risk for heart disease

©        High HDL ³ 60 mg/dL considered protective against CAD

Triglycerides:  lab ranges

▪       normal < 150 mg/dL

▪       150 – 190 mg/dL are borderline high

▪       Levels > 200 mg/dL are high

*         One of the acute phase proteins that inc. during systemic inflammation

▪       Inflammation is a common component to the development of lipid containing plaques

*         Level < 1 mg/dL considered low risk; level > 3 mg/dL ­ risk heart disease

*         Marker for CV events

*         CRP consistently > 10 may indicate other noncardiac causes of inflammation

*         Can decrease with ASA, exercise, statins

Therapeutic Lifestyle Changes (TLC)

Smoking Cessation

Exercise