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• If atherosclerolsis occurs in arms or legs, called peripheral vascular disease 
• If atherosclerosis occurs in the heart, called coronary artery disease
• If atherosclerosis occurs in the brain, called cerebrovascular disease
• causes of atherosclerosis include increased blood lipid levels, inflammation, type of lipid elevated
• Hyperlipidemia - lipids are increased
• Hypercholesterolemia - cholesterol is increased
• Hypertriglyceridemia - triglycerides are increased 
• atherosclerosis tends to affect men earlier than women, as cholesterol is used more for reproductive hormones in women than men, less available cholesterol to contribute to atherosclerosis in women
• After menopause, risk of atherosclerosis becomes equal 
• atherosclerosis starts with fatty streaks which are deposits of esterified cholesterol; receptors for lipoproteins will cause their absorption
• atherosclerosis can start because of injury to the endothelium (interior of vasculature)
• receptors for LDL and VLDL will cause their absorption in atherosclerosis
• diseases which cause injury to vascular endothelium that can cause atherosclerosis include periodontal disease and inflammatory diseases that can damage inside of blood vessels
• progression of atherosclerosis with injured endothelium

  1. Endothelium is activate
  2. Vasoconstriction
  3. Platelet aggregation
  4. LDL brings lipids, so new membrane can form (lipid insudation)
  5. Some LDL is oxidized and absorbed by macrophages

  • Macrophages (foam cells) then enter vessel wall
  • In many cases, lumen of artery narrows 
  • When artery narrows enough, blockage can be created by either clots or more lipid deposits 
• • Subendothelial state - where lots of lipid accumulate as there are receptors for LDL, VLDL, etc 
• bruh

  A) positive

  B) negative

  
• • Negative modeling tends to be susceptible to blood clots 
• • Unstable lesion - rupture of fat deposit and may causes damage
• • Positive remodeling is still unstable as only a single fibrous layer separates fat from blood vessel
• treatment of atherosclerosis include change in lifestyle and use of drugs/supplements
• Change in lifestyle - avoid fatty foods and regular exercise 
• Exercise will use up lipids for energy, reducing number, less likely for them to clog arteries; increases HDL
• statins inhibit activity of HMG-CoA reductase - HMG-CoA is changed to mevalonate via HMG-CoA reductase
• side effects of statins:

  • small percentages have gotten liver damage (start with lower dose and do weekly liver function tests)
  • Muscle pain or cramping - stop taking meds