Atherosclerosis Lucky Resa Santoso

121 0211 036

FAKULTAS KEDOKTERANUNIVERSITAS PEMBANGUNAN NASIONAL “VETERAN” JAKARTA

• Atherosclerosis is a type of arteriosclerosis. Atherosclerosis causes arteries to narrow, weaken and be less flexible. It's the term for the process of fatty buildup in the inner lining of an artery. The buildup that results is called plaque and reduces the amount of blood and oxygen that is delivered to vital organs.

Risk modifiers influence atherogenesis through effects on inflammation as reflected by biomarkers of the acute phase response.

Libby P , and Crea F Eur Heart J 2010;31:777-783

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2010. For permissions please email: journals.permissions@oxfordjournals.org.

PRIMARY AND SECONDARY

PREVENTION OF CHD

Primary prevention: persons without established CHD

Scope of primary prevention

Primary prevention aims to prevent new onset CHD.The essential approach to primary prevention is to reduce risk factors for CHD. Waiting until a diagnosis of CHD is made before beginning risk factor reduction will miss the opportunity to prevent CHD in people whose first presentation is sudden cardiac death or disability.

Primary prevention with lifestyle changes1) Basis for lifestyle recommendations for primarypreventionA broad base of evidence supports recommendations for lifestyle changes for LDL-lowering therapy in primary prevention.

2) Dietary clinical trials of cholesterol loweringA sizable number of clinical trials have been carried out to test whether lowering serum cholesterol levels with dietary modification will reduce risk for CHD.

3) Linkage of public health approach and clinical approach in primary preventionA strong case exists for the efficacy and safety of primary prevention through lifestyle changes. Primary prevention efforts extend to both public health andclinical arenas. The essential changes in life habits include smoking avoidance or cessation, modifying intakes of foods and nutrients, weight control, and physical activity.

Effectiveness of LDL-lowering drugs in primary prevention

Clinical trials of cholesterol-lowering drugs support the efficacy of clinical primary prevention in higher risk persons. In the era before statin drugs, several primary prevention trials of cholesterol lowering were carried out with drug intervention.

The availability of more efficacious cholesterol-lowering drugs (statins) made it possible to definitively test whether LDL lowering would reduceCHD risk.

Secondary prevention: persons with CHDSecondary prevention of recurrent CHDPersons with established CHD are at very high risk for recurrent CHD. A growing body of evidence indicates that LDL-lowering therapy reduces recurrent coronary events in persons with existing CHD.

Bibliography

Pathophysiology of Heart Disease

Leonard S. Lilly

National Heart, Lung, and Blood Institute - National Institutes of Health

Detection,Evaluation,and Treatment of High Blood Cholesterol in Adults

(Adult Treatment Panel III)

Oxford Journals | Medicine | European Heart Journal | Atherosclerosis

http://www.oxfordjournals.org/our_journals/eurheartj/cardio_image_bank/atherosclerosis.html

American Heart Association – Watch, Learn and Live: Interactive Cardiovascular Library

http://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=athero