Unit 14. Biochemical bases of cardiovascular diseases
Contents:
Properties and functions of the vascular endothelium Atherosclerosis and cardiovascular risk: biochemical markers in cardiovascular disease
fibrinogen
C-reactive protein
homocysteine. folic acid and vitamin B12. Most used.
Aspirin is used to treat cardiovascular disease.
Properties and functions of the vascular endothelium
Arteria Normal
The vascular endothelium is the innermost single cell layer of the
vessel that separates the blood from the vessel wall.
endothelial functions
It presents autocrine, paracrine and endocrine functions:
celulas musculares
Vasoconstriction / vasodilation
hemostasis, produces:
prothrombotics and antithrombotics
fibrinolytics and antifibrinolytics
It favors proliferation, cell migration, adherence and activation of leukocytes and acts in
inflammatory and immune processes.
Under normal circumstances, it has an antithrombotic effect by preventing blood from clotting and
shedding cells. Prostacyclin and NO act as vasodilators and as platelet aggregation inhibitors.
When endothelial damage occurs, vasodilators and
Danio endotelial
vasoconstrictors are activated. There is an increase in
vascular permeability, which allows infiltration of
Vasodilatadores Vasoconstrictores
lipoproteins, platelet aggregation and adhesion of
leukocytes that produce inflammatory cytokines.
Aumento de la permeabilidad vascular
Nitrous Oxide (NO)
No is a very powerful gaseous vasodilator. It is
LUMEN VASCULAR
produced by the enzyme endothelial NOsyntase
(eNOsfl. There are two forms of eNOs:
Constitutive eNOs: In the endothelium,
flow matters. Quickly releases small
CELULAENDOTELIAI
NO
amounts of NO.
ESPACIOEXTRACELULAR
Inducible eNOs: in smooth muscle and macrophages through the action of cytokines. Long-term large amounts of
NO
CELULA MUSCULAR VASCULAR
NO.
It prevents:
Adhesion of leukocytes and their arterial transmigration
Smooth muscle proliferation Platelet adhesion and aggregation
LDL oxidation
A decrease in NO leads to hypertension. The mechanism of action of nitrates in angina pectoris is an fcos
(antiHTAfl mechanism.
Atherosclerosis and cardiovascular risk: biochemical markers in cardiovascular disease
arteriosclerosis
It consists in the formation of a lipid plaque in the intimal arterial layer. As a result, the
vessel becomes narrowed or blocked. Acute myocardial infarction, stroke, or peripheral
vascular disease may occur. It progresses silently for decades. With age, plaques are
generated, the less we have, the less chance we have of contracting a disease.
Components of atherogenesis
Endothelial dysfunctions, lipid deposits and inflammatory reactions of the vessel wall occur, which
enable diagnosis, follow-up care and prognosis on the basis of biochemical parameters.
cardiovascular disease
Diseases of the heart and blood vessels
high blood pressure (hypertensionfl
Coronary heart disease (myocardial infarctionfl
Cerebrovascular disease (strokefl
peripheral vascular disease heart failure Rheumatic heart disease
Congenital heart defects
cardiomyopathies
epidemiology
World's leading causes of disability and premature death
Middle-aged and advanced stage symptoms Great advances in prevention
Highest morbidity and mortality worldwide
Deaths from CVD in both sexes
More than 80% occur in low- and middle-income countries, not in prevention programs
Most common cause: arteriosclerosis
cardiovascular risk factors
Increase the likelihood that a person will suffer from cardiovascular diseases in the future in a defined
period
Classic risk factors
Arterial hypertension
changes in lipid metabolism
diabetes
Family history of premature coronary artery disease Smoking
80% population risk and its control h