✔ Cardiovascular-disease etiology and pathogenesis
Отзывы Cardiovascular-disease etiology and pathogenesis
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Cardiovascular disease: Etiology and pathogenesis
Cardiovascular diseases (CVD) represent one of the main causes of morbidity and mortality in industrialized countries. Their origin (Etiology), and development mechanisms (pathogenesis) are complex and include a variety of factors.
Etiology
The causes of cardiovascular diseases can be classified into modifiable and non-modifiable risk factors under share.
Among the non-modifiable factors:
Genetic Disposition: Familial clustering of certain diseases, such as hypercholesterolemia or hypertension has a genetic component.
Age: With increasing age increases the risk for atherosclerosis and other cardiovascular diseases significantly.
Sex: men are affected in General, the earlier, and more frequently from coronary heart disease than women; after Menopause, the risk in women approaches that of men.
The modifiable risk factors include:
Hypertension: high blood pressure strains the heart and blood vessels and promotes atherosclerosis.
Dyslipidemia: Elevated levels of LDL cholesterol and low HDL‑cholesterol levels are strongly associated with the development of atherosclerosis.
Tobacco use: Smoking endothelial damage, promotes thrombus formation and increases the heart rate and blood pressure.
Diabetes mellitus: hyperglycemia leads to vascular damage and increases the risk for cardiovascular events significantly.
Overweight and obesity: in Particular Central obesity, is associated with an increased risk for hypertension, Diabetes and dyslipidemia.
Lack of exercise: Lack of physical activity promotes Obesity and deterioration of the cardiovascular Fitness.
Diet: A diet with a high content of saturated fatty acids, salt and sugar to the cardiovascular risk increases.
Stress: Chronic psychosocial Stress can lead, via neuroendocrine mechanisms in the pathogenesis of CVD.
Pathogenesis
The Central pathological process of many cardiovascular diseases is atherosclerosis — a chronic inflammation of the vessel wall. Your course can be described as follows:
Endothelial injury: risk factors (e.g., hypertension, hyperglycemia, Smoking) there is damage to the vascular endothelium. This leads to increased permeability and Expression of adhesion molecules.
Lipid storage: LDL particles to penetrate into the intimal layer of the arterial wall and are oxidized.
Inflammatory response: monocytes adhere to the damaged Endothelial cells, migrate into the vessel wall and differentiate to macrophages. This phagocytize ox‑LDL, and become foam cells, the key component of fatty streaks.
Glättmuszelproliferation: Glättmuszellen migrate from the Media into the Intima, proliferate and produce extracellular matrix, which leads to the formation of a fibrotic Plaque.
Plaque instability In advanced Plaques necrosis foci, Calcinations, and a thin cover layer are formed. These vulnerable Plaques are prone to cracking.
Thrombus formation: the Case of cracking or Erosion of the Plaque it comes to the activation of platelets and the formation of a Thrombus that occludes the artery partially or completely. This is the most common cause of acute coronary events such as myocardial infarction or unstable Angina pectoris.
In addition to atherosclerosis, other pathogenetic mechanisms play a role:
Left heart burden of hypertension: Chronic elevated peripheral resistance, leads to left ventricular hypertrophy, and later of heart failure.
Myocardial fibrosis: By Ischemia or inflammatory processes repeated connective tissue replaces functional myocardium.
Rhythm disorders: Structural and electrical remodeling processes in the myocardium promote arrhythmias.
Summary
The cardiovascular diseases are caused by the interaction of genetic and environmental factors. Its pathogenesis is based in many cases on the development and Progression of atherosclerosis, which is characterized by a cascade of endothelial, inflammatory and thrombotic processes. The understanding of these mechanisms is essential for the development of preventive and therapeutic approaches.
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