Question

Deborah is 56 years old, smokes half a pack of cigarettes a day, and is overweight. Her friend wants her to come to a local women's fitness class she attends to once a week. She knows Deborah's dad had died an acute myocardial infarction when he was 56, and she fears, seeing Deborah's lifestyle, the same fate awaits her friend. What she did not know was that Deborah had also been to her doctor for her annual physical where she was told her LDLs were 180 mg/dL, HDLs were 36 mg/dL, and cholesterol was 239 mg/dL (Learning Objectives 3 and 4). 1. What are Deborah's known risk factors for coronary heart disease? 2. Deborah's doctor referred her to a dietician for strict dietary therapy, hoping the intervention would raise her HDL and lower her LDL and cholesterol levels. Why is diet modification necessary to control and moderate the lipids indicated? 3. Deborah's doctor also gave her pamphlets describing strategies to stop smoking and a list of exercise ideas she might want to try. How is smoking thought to contribute to atherosclerotic plaque formation? Why would exercise have a positive effect on Deborah's lipid profile? 4. Atherosclerosis is thought to be an inflammatory disorder. What is the role of macrophages in the formation of atherosclerotic plaques? What is the significance of elevated serum hs-CRP levels in at-risk individuals?

Answer 1

1. Deborah is a smoker, she is an overweight and 56-year-old lady. These three(smoker, overweight, age more than 40) are known as risk factors for coronary heart disease.

2. Deborah's doctor referred her to a dietician for diet therapy to raise HDL and lower LDL because diet plays a major role in increasing LDL.

Vegetables and fruits reduce saturated fat and increase unsaturated fat which ultimately decreases LDL(low-density lipoprotein ) and increases HDL(high-density lipoprotein).

By avoiding trans fat, fried food and eating more soluble fibers can also help to increase HDL.

3. Smoking is the greatest risk factor for atherosclerotic plaque because it damages the inner lining of blood vessels which facilitate the build-up of cholesterol and calcium and causes atherosclerotic plaque.

Exercise has a positive effect on Deborah's lipid profile because exercise reduces LDL(bad cholesterol) by an increase in the size of LDL particles and increases the label of HDL(good cholesterol).

4. Circulating macrophages get deposited in the damaged part of blood vessels and form foam cells. foam cells and fatty deposition later developed into atherosclerosis.

Serum hs- CRP level is elevated in risk individuals of cardiovascular diseases. It is a nonspecific marker of infection and inflammation.