Cardiovascular Disease Awareness Quiz

Questions and Answers

What was the trend in total cardiovascular (CV) deaths in Australia between 1990 and 2013?

Increased by 50%

Increased by 5%

Remained unchanged

Decreased by 50% (correct)

What has occurred in regions where age-adjusted declines in CV disease did not happen?

Massive increase in CV disease burden (correct)

Significant decrease in CV disease burden

Only a slight increase in CV disease burden

No change in CV disease burden

Which of the following is indicated as a risk factor for cardiovascular disease?

Lack of physical activity (correct)

Diet high in fruits and vegetables

High HDL cholesterol levels

Low blood pressure

What does the lifetime risk of coronary disease in individuals with a 50% reduction of LDL cholesterol due to PCSK9 loss of function represent?

50% reduction Signup and view all the answers

What is one limitation of risk stratification mentioned in the content?

It cannot identify absolute risk Signup and view all the answers

What is a common drug target in the lipid pathways for treatment of high cholesterol?

Bile acid sequestrants Signup and view all the answers

Which outcome does the identification of risk factors aim to achieve in cardiovascular disease management?

Early intervention and prevention of complications Signup and view all the answers

Which aspect of cardiovascular disease does absolute risk stratification help to determine?

Long-term personal health outcomes Signup and view all the answers

What is the primary effect of statins on lipid levels?

Lowers LDL and lowers TG Signup and view all the answers

Which drug is known to raise HDL while lowering TG?

Fibrates Signup and view all the answers

Which of the following treatments is considered to lower LDL but may raise TG?

Bile acid sequestrants Signup and view all the answers

What is the primary action of PCSK9 inhibitors?

Lower LDL and Lp(a) Signup and view all the answers

Which of the following lipid-lowering drugs is less common and specifically lowers triglycerides?

Nicotinic acid Signup and view all the answers

In individuals with a 50% reduction of LDL due to loss of function in PCSK9, what is the reduction in their lifetime risk of coronary disease?

50% Signup and view all the answers

Which two factors are considered modifiable environmental factors that decrease cardiovascular risk?

Exercise and fruit intake Signup and view all the answers

What percentage of population attributable risk is explained by the nine risk factors identified?

90% Signup and view all the answers

Which risk category is associated with a high risk as per the Framingham risk score?

High risk if total cholesterol exceeds 7.5 mmol/L Signup and view all the answers

Which factor does NOT increase cardiovascular risk among modifiable factors?

Regular exercise Signup and view all the answers

What does the Framingham risk score evaluate?

Blood pressure and cholesterol levels Signup and view all the answers

What does coronary artery calcium predict?

Coronary events Signup and view all the answers

Which condition is NOT considered a high-risk factor by the Framingham risk score?

Moderate exercise habits Signup and view all the answers

What effect does Lp(a) have on cardiovascular health?

Increases risk of myocardial infarction Signup and view all the answers

How much can Lp(a) be lowered by PCSK9 antibodies?

30-40% Signup and view all the answers

What method of blood pressure measurement is considered more predictive?

Home BP monitoring Signup and view all the answers

What is a key strategy for managing blood pressure in patients?

Combined low doses of medications are more efficacious Signup and view all the answers

What is the recommended treatment threshold for blood pressure in most patients?

120/80 Signup and view all the answers

Which major protein is associated with High-Density Lipoprotein (HDL)?

apoA-I Signup and view all the answers

Which lipid is primarily associated with Low-Density Lipoprotein (LDL)?

Cholesteryl Ester (CE) Signup and view all the answers

What is the function of Niemann-Pick C1 Like 1 Protein in relation to cholesterol?

It facilitates cholesterol absorption in the intestines. Signup and view all the answers

Which of the following is a bile-acid sequestrant?

Cholestyramine Signup and view all the answers

Which lipid lowering drug acts by inhibiting PCSK9?

Proprotein convertase subtilisin/kexin type 9 inhibitors Signup and view all the answers

Which lipoprotein is primarily composed of the major protein apoB100?

Intermediate-Density Lipoprotein (IDL) Signup and view all the answers

What is the role of bile acids in cholesterol metabolism?

Acting as emulsifiers in the intestinal lumen Signup and view all the answers

Which of the following is a feature of Chylomicrons?

Primary carrier of dietary lipids Signup and view all the answers

Which type of lipid is found predominantly in Very-Low-Density Lipoprotein (VLDL)?

Triglycerides (TG) Signup and view all the answers

Which mechanism does Statins primarily use to lower cholesterol levels?

Inhibition of cholesterol biosynthesis Signup and view all the answers

Study Notes

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Learning Outcomes

Understand risk factors for cardiovascular (CV) disease - identification, severity, complications.
Comprehend risk stratification, including the concept of absolute risk and its limitations.
Explore lipid pathways and drug targets, covering established drugs and emerging therapies.
Learn about the management of high blood pressure and diabetes in relation to CV disease.

Burden of Cardiovascular Disease

Total CV deaths in Australia increased by 5% from 1990 to 2013 despite a 50% decrease in age-adjusted rates.
Population growth and aging have contributed to an overall increase in CV disease burden.
Regions such as South East Asia experienced significant increases in CV disease without age-adjusted rate declines.

Lifetime Risk and LDL Cholesterol

In individuals with a 50% reduction of LDL cholesterol due to PCSK9 mutation, the lifetime risk of coronary disease is reduced by 80%.
Genetic factors combined with environmental influences contribute to lifetime CVD risk.

Modifiable Environmental Factors

Increased CV risk factors include smoking, diabetes, hypertension, abdominal obesity, and psychosocial stress.
Protective factors include regular intake of fruits and vegetables, moderate alcohol consumption, and exercise.
Nine risk factors identify 90% of the population-attributable risk for CV disease.

Quantifying Absolute Risk (Framingham Risk Score)

FRS considers factors like blood pressure, age, sex, smoking status, lipid levels, and diabetes to assess CV disease risk.
High risk is indicated by scores greater than 15% over five years; intermediate risk ranges from 10-15%.

Coronary-Artery Calcium and Risk Prediction

Coronary artery calcium levels contribute to predicting coronary events and help stratify risk alongside the Framingham Risk Score.

Lipoprotein Nomenclature and Composition

Major apoproteins include apoB48 (chylomicrons), apoB100 (VLDL, IDL, LDL), and apoA-I (HDL).
Lipid compositions differ among various lipoproteins, such as triglycerides in VLDL and cholesterol esters in LDL and HDL.

Overview of Cholesterol Transport

Cholesterol transport involves several mechanisms, including absorption in the intestines.
NPC1 is critical for intestinal cholesterol absorption.

Drugs for Lowering Lipids

Statins effectively lower LDL cholesterol by 30-50% and triglycerides.
Ezetimibe and fibrates also lower LDL but to a lesser extent.
Emerging therapies include PCSK9 inhibitors, which significantly lower LDL levels.
Less commonly used drugs include bile acid sequestrants and nicotinic acid.

Total Cholesterol and Risk of Coronary Heart Disease (CHD)

Risk assessment is vital for determining the benefit of statin therapy.
The number needed to treat (NNT) varies based on baseline risk profiles.

Lp(a) and Myocardial Infarction

Elevated lipoprotein(a) correlates with increased risk of myocardial infarction and aortic stenosis.
Standard agents to lower Lp(a) are not effective, though PCSK9 antibodies can reduce levels significantly.

Contemporary Issues in Blood Pressure Management

Ambulatory BP readings provide better predictive value for risk than office-based measurements.
Low-dose combination therapies demonstrate greater efficacy compared to high-dose monotherapy.
Guidelines recommend individualized treatment goals for BP, with a general target of 120/80 mmHg for most patients.

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Description

Test your understanding of cardiovascular disease risk factors, management, and current trends. This quiz explores lipid pathways, drug targets, and the burden of cardiovascular disease in Australia. Enhance your knowledge on how high blood pressure and diabetes relate to CV health.