Atherosclerosis

Lucky Resa Santoso

121 0211 036

FAKULTAS KEDOKTERAN
UNIVERSITAS PEMBANGUNAN NASIONAL VETERAN JAKARTA

 Atherosclerosisisatypeof
arteriosclerosis.Atherosclerosiscauses
arteriestonarrow,weakenandbeless
flexible.It'sthetermfortheprocessof
fattybuildupintheinnerliningofanartery.
Thebuildupthatresultsiscalledplaque
andreducestheamountofbloodand
oxygenthatisdeliveredtovitalorgans.

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

PublishedonbehalfoftheEuropeanSocietyofCardiology.Allrightsreserved.TheAuthor
2010.Forpermissionspleaseemail:journals.permissions@oxfordjournals.org.

PRIMARYAND
SECONDARY
PREVENTIONOFCHD

Primary prevention: persons without established CHD

Scope of primary prevention
PrimarypreventionaimstopreventnewonsetCHD.
Theessentialapproachtoprimarypreventionistoreduce
riskfactorsforCHD.

WaitinguntiladiagnosisofCHDismadebeforebeginning
riskfactorreductionwillmisstheopportunitytoprevent
CHDinpeoplewhosefirstpresentationissuddencardiac
deathordisability.

Primary prevention with lifestyle changes

1) Basis for lifestyle recommendations for primaryprevention
AbroadbaseofevidencesupportsrecommendationsforlifestylechangesforLDLloweringtherapyinprimaryprevention.
2) Dietary clinical trials of cholesterol lowering
Asizablenumberofclinicaltrialshavebeencarriedouttotestwhetherlowering
serumcholesterollevelswithdietarymodificationwillreduceriskforCHD.
3) Linkage of public health approach and clinical approach in primary prevention
Astrongcaseexistsfortheefficacyandsafetyofprimarypreventionthrough
lifestylechanges.Primarypreventioneffortsextendtobothpublichealthand
clinicalarenas.Theessentialchangesinlifehabitsincludesmokingavoidanceor
cessation,modifyingintakesoffoodsandnutrients,weightcontrol,andphysical
activity.

Effectiveness of LDL-lowering drugs in primary prevention

Clinicaltrialsofcholesterol-loweringdrugssupporttheefficacyofclinical
primarypreventioninhigherriskpersons.Intheerabeforestatindrugs,
severalprimarypreventiontrialsofcholesterolloweringwerecarriedout
withdrugintervention.
Theavailabilityofmoreefficaciouscholesterol-loweringdrugs(statins)
madeitpossibletodefinitivelytestwhetherLDLloweringwouldreduce
CHDrisk.

Secondary prevention: persons with CHD

Secondary prevention of recurrent CHD
PersonswithestablishedCHDareatveryhighriskforrecurrentCHD.Agrowing
bodyofevidenceindicatesthatLDL-loweringtherapyreducesrecurrentcoronary
eventsinpersonswithexistingCHD.

Bibliography
PathophysiologyofHeartDisease
LeonardS.Lilly
National Heart, Lung, and Blood Institute - National Institutes of Health
Detection,Evaluation,andTreatmentofHighBloodCholesterolinAdults
(AdultTreatmentPanelIII)
OxfordJournals|Medicine|EuropeanHeartJournal|Atherosclerosis
http://www.oxfordjournals.org/our_journals/eurheartj/cardio_image_ban
k/atherosclerosis.html
AmericanHeartAssociationWatch,LearnandLive:Interactive
CardiovascularLibrary
http://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=athero