Question

Discuss the pathologic mechanisms of atherosclerosis and come up with a list of all the specific pathologies (and clinical states) which you can.

Answer 1

the pathologic mechanisms of atherosclerosis are:

1. Hyperlipidemia:

• The cholesterol which is derived from lipoproteins form atherosclerotic plaques will form lesions of atherosclerosis

2. Hypertension:

• Systolic BP over 160 mm of Hg and diastolic pressure over 90mm of Hg leads to 5 times higher risk for atherosclerosis
• As per injury hypothesis, epithelial injury caused by high BP leads to plaque formation
• Hypertension leads to mechanical injury to the arterial wall which leads to atherosclerotic IHD and cerebrovascular disease

3. Smoking:

• There is a close association between smoking and atherosclerosis
• There will be reduced level of HDL in smokers and accumulation of carbon monoxide in blood that produces carbohy haemoglobin and hypoxia in arterial walls which favours for atherosclerosis
• Increased nicotine in blood leads to increased platelet adhesiveness, raised endothelial permeability which eventually increases the chances of atherosclerosis

4. Diabetes mellitus:

• Atherosclerosis develops early in the patients with insulin dependent and non insulin dependent DM
• Due to DM, there will be increased aggression of platelets, increased LDL and decreased HDL, it will trigger atherosclerosis