ATHEROSCLEROSIS

DEFENITION:
Atherosclerosis is often referred to as the hardening of the arteries by
means of the fatty mesh. Although this condition can occur in any arteries but
especially at the coronary arteries and abdominal aorta.
INCIDENCE:
The prevalence of the atherosclerosis is increases with the age above 55
yrs. The mens are more affected than women.
RISK FACTORS:
MODIFIABLE:
Elevated serum lipids.
Hypertension.
Tobacco use.
Physical inactivity.
Obesity.
Increased LDL and decreased HDL level.
NON - MODIFIABLE:
Age
Sex
Genetic factors.
Congenital abnormalities.
Ethnicity.
Race.
CONTRIBUTING:
Diabetes mellitus.
Physcological status.
Metabolic syndrome.( increased waist circumference )

 Homocysteine levels.
PATHOPHYSIOLOGY:
Due to the etiological factors
Decreased cardiac output
Decreased renal blood flow
Increases the CNS stimulation on the renal
Stimulate rennin secretion from the kidney
Activates the Angiotensin
Angiotensin - I
Angiotensin - II
Vasoconstriction
Increased the blood pressure

CLINICAL MANIFESTATIONS:

Ischemic heart diseases.

Angina pectoris.
Irreversible cardiac functions.
Dysponea.
Nausea.
Vomiting.
Weakness.

ASSESSMENT AND DIAGNOSIS:

History collection.
Physical examination.
12 lead ECG.
Blood urea nitrogen.
Serum glucose, potassium, chloride, carbon dioxide, calcium.
Serum lipid profile (total lipids, LDL, VLDL,LDL).
Blood glucose levels.

MANAGEMENT:
LIFE STYLE MODIFICATIONS:
Reduce the body weight by increases the physical activity.
Moderation of the alcohol consumption.
Avoidance of the smoking and the tobacco chewing.
NUTRITIONAL THERAPY:

Restriction of the sodium <2400 mg.

Restrict the cholesterol and the saturated fats up to 25-35%.
Maintain the adequate intake of the potassium.
Maintain the adequate intake of the protein up to 15%.

PHARMACOLOGICAL THERAPY:
Administration of the mentioned drugs.
HMG-CoA reducatase inhibitors fluvastatin, lovastatin.
Niacin niacin. Nicotinic acid.
fibric acid derivatives fenofibrate, gemfibrozil.
Bile- acid sequestrants choleystyramine, colestipol.
Cholesterol absorption inhibitor ezetimibe.
COMPLICATIONS:

Left ventricular hypertrophy.

Cardiac failure.
Ischemic stroke.
Retinal damage.
Nephrosclerosis.
Renal damage.