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than woman by an overall ration of 4:1 ?40y, the ration 8:1 ?70y, the ration 1:1 24 Company Logo Modifiable risks ?Lowdensity lipoprotein cholesterol (dyslipidemia) ?Cigarette smoking ?Hypertension ?Diabetes mellitus ?Estrogen deficiency ?Inactivity ?Obesity 25 Company Logo Cholesterol levels —— lipoprotein ?LDL: lowdensity lipoprotein ?HDL: highdensity lipoprotein ?CM: chylomicron ?VLDL: verylowdensity lipoprotein 26 Company Logo ?LDL: carry cholesterol to arteries ?HDL: carry cholesterol back to liver ?most dangerous: lipoprotein(a), samll and density LDL ?in CAD patients, alwalys high LDLc, low HDLc 27 Company Logo 各組兔主動脈動脈粥樣硬化病變情況: 上條和中條:高膽固醇組; 下條:對照組 28 Company Logo Smoking Modifiable risks(2) ?Research demonstrates that smoking causes transient and reversible prothrombotic increases in fibrinogen levels and platelet adhesion, increased blood carboxyhemoglobin levels, reduced highdensity lipoprotein (HDL) cholesterol, and coronary artery vasoconstriction. 29 Company Logo Smoking ?smokers are twice as likely to develop atherosclerosis and coronary artery disease as are nonsmokers. 收縮壓和脈壓對冠心病危險性的聯(lián)合影響 The Framingham Hear Study; 入選者年齡 50歲 Stanley S, et al. Circulation 1999。 it can begin in childhood and progress throughout a person’s lifetime. 11 Company Logo Atherosclerosis ?Unstable atherosclerotic plaques may rupture, leading to the formation of a plateletrich thrombus that partially or pletely occludes the artery and causes acute ischemic symptoms.