Atherosclerosis: Risk Factors and Development (Nursing)

00:01 So what are some other risk factors for atherosclerosis? Well, high blood pressure.

00:06 Remember, the biggest risk for atherosclerosis, for the hardening of the vessels, is cardiovascular events like an MI or a stroke.

00:15 You end up with something breaking off and clotting off an important vessel.

00:18 So I'm not perfusing my heart muscle or perfusing my brain.

00:23 High blood pressure puts me at an increased risk for one of those events.

00:27 Smoking is another one, really hard habit to quit.

00:31 If you or your patients are smokers, that's a challenge to help someone walk through the process of stopping smoking.

00:38 Now, the third one you're already familiar with, right? That elevated LDL cholesterol.

00:42 Remember, that's the one we most want to control, is the LDL level we want to get lower.

00:49 We want to increase the HDL or the good cholesterol.

00:53 So when you're working with your patients, or even thinking through your own personal health, controlling blood pressure, stopping smoking or making sure you don't start, and lowering the LDL cholesterol are great ways to lower your risk factors for atherosclerosis.

01:10 So we keep throwing that word around, and it's a hard one to say, isn't it? It's a tongue twister. But we've got a graphic here to show you kind of what happens.

01:18 Now look at the graphic. You see the artery.

01:21 The endothelium is that lining inside the artery, and you've also got smooth muscle.

01:27 Now, the yellowish, kind of, goopy stuff there, those are lipids and calcium, and just comecellular debris, kind of, the extra trash that's in there.

01:36 So you can see that it's starting to build up in people.

01:39 That's a hardening or a narrowing of the artery that's caused up by a buildup of plaque.

01:45 Well, what's plaque? That's that yellow stuff right there; lipids and calcium and that cellular debris.

01:52 So when someone has atherosclerosis, they have this buildup of this kind of plaque-y, trashy stuff in their vessels.

02:00 It makes them stiffer and prone to things breaking off and lodging in further areas down the pipeline, and you end up having something like an MI, a heart attack, or a stroke.

02:12 Okay, so, you already knew that atherosclerosis is not a good thing, right? You knew you didn't want it, but we want you to be very clear, this is what we're trying to avoid by taking statins because we want less of the plaque buildup and statins can help us get to that goal.

02:29 Less plaque buildup means vessels that are able to move better.

02:33 They're not as stiff, and they're not as narrowed from a buildup of plaque.

02:38 So, how does atherosclerosis happen? Let's look at it step by step.

02:43 On the right hand side, you see at the very top what a normal artery looks like.

02:47 See, it's open, it's wide, it's clear, there's nothing there.

02:51 Then you have like an early injury to the endothelium.

02:54 Remember, that's the lining of that vessel.

02:57 Then it starts to build up and you can see in that third picture, you've got atherosclerosis.

03:02 All that trash and debris and lipids are starting to become this mass that's narrowing how much the blood has room to move through.

03:11 Now, the bottom one is complete blockage, okay? So, this is a very sad story.

03:17 When you start with a normal artery, you end up with a complete blockage, then you have an area of occlusion. Look at the picture of the heart there.

03:24 You see that black area? That's to represent tissue death.

03:28 Because when the blood supply is cut off to tissue, then you have muscle damage and death if we can't resolve that quickly.

03:36 So, atherosclerosis is this gradual process of hardening and narrowing of the arteries.

03:42 Now, before you get too depressed, look, it's a process.

03:45 So we can intervene at any point and help ourselves or help our patients become healthier, and lower their risk of a heart attack or a stroke just by intervening with dietary and medications.

03:59 So, it's this chronic inflammatory process, which is actually a good thing, right? We've got time to make a difference.

04:06 So you have damage to the endothelium, see that? Early injury.

04:10 Then you have atherosclerosis, that building up of that plaque, and what we want to avoid is that build up and a complete blockage.

04:19 So that's the process of atherosclerosis. How we end up with a -- starting from a normal artery, all the way down to an event like a heart attack or an MI.

04:29 See, those LDLs, remember, those are the bad cholesterol, remember? When we have that damage to the endothelium, the LDLs cross that damaged endothelium into the wall of the artery.

04:41 So in overtime, that cholesterol becomes part of that plaque, right, that atherosclerosis.

04:47 So then the circulation is compromised because it's got less area to pump through and you have the increased risk for stroke or MI.