MOOC/SPOC Summary Module 1
Describe the main forms of cardiovascular disease.
18 million deaths (1/3rd)
Major cause of morbidity as well
ICD-11 provides categorization of diseases:
- Circulatory system = 11
- Respiratory system = 12
- Disease of nervous system = 8
- Endocrine disorders = 5
There are four main types:
- coronary heart disease
- stroke
- peripheral arterial disease
- aortic disease
Describe the main types of diabetes.
Diabetes: major disorder that is characterized by high blood
glucose levels, hyperglycaemia. Due to hormone insulin. Both
cardiovascular disease and chronic kidney disease.
Diabetes Mellitus Type 1
Auto immune disorder. No insulin production at all due
to destruction of B-cells of pancreas. No lifestyle
prevention. Maybe breastfeeding could help. Sudden
onset, in children.
Diabetes Mellitus Type 2
Not enough insulin or cannot effectively use it. This process
develops over time, assisted by poor diet and exercise. Belly
fat is a strong predictor. Incidence in younger subjects due
to bad habits.
, Macrovascular problems, caused by damage of large blood
vessels. Could lead to myocardial infarction, stroke, or other
CV problems.
Microvascular problems, small vessels affected, can result to
blindness.
Medical treatment is needed, together with lifestyle
changes.
Diabetes Mellitus Type 3
Mentioned way less than T2DM and T1DM, as it doesn’t
affect blood sugar. But it does affect brain functionality.
Therefore, Alzheimer’s Disease is often called T3DM. Insulin
receptors in the brain lose sensitivity for insulin.
Explain which diseases are part of the
cardiometabolic cluster.
- Coronary heart disease
Dominant type of CVD, in Westernized countries. High
blood levels of LDL-c “bad cholesterol” can form fatty
streaks in the arteries. Development of plaques is called
atherosclerosis.
Macrophages attach to damaged cell wall and ingest LDL,
causing foam cell formation. Macrophage foam makes
plaques grow further, causing also an inflammatory
response. Fibrous tissue is added to plaque.
Calcium deposition in the plaque, stiffening arteries.
Rupture of plaque will form blood clot or thrombus, that
could block artery and stop oxygen supply.
- Heart attacks
, This happening in myocardial artery causes loss of
function of heart muscle, and eventual cardia arrest. Due
to heart arrythmia or ventricular fibrillation.
- Diabetes type 2
- Ischemic stroke
Infarction happening in the brain instead of the coronary
arteries.
Blood clot blocking brain artery Ischemic stroke
Thrombus from system Embolic stroke
Bleeding in brain Haemorrhagic stroke
Small ischemic stroke TIA (warning for real stroke)
- Peripheral artery disease
Narrowed arteries, causing pain in legs when walking.
- Kidney disease
Gradual loss of function over time, end-stage kidney
failure, requires dialysis or transplantation.
One third of diabetic patients develop kidney failure later
in life.
Understand why the different diseases in the
cardiometabolic cluster are linked.
Similar cardiometabolic problems like:
- insulin resistance
- Low grade inflammation
- Abnormal cholesterol (and other blood lipid) levels
- High blood pressure
- Vessel dysfunction
- Ischemic stroke
- Diabetes
- Kidney disease
Use the International Classification of Diseases (ICD)
coding system to retrieve the different types of
cardiometabolic diseases.
, ICD-10 category 9 is circulatory system related disease
Describe the main non-modifiable risk factors for
cardiometabolic diseases.
Less than 10% is predicted by genes
Bad habits are more important, thus modifiable risk factor.
Prevention paradox: population treatment to reduce large
numbers at low risk
Non-modifiable is genes, age, gender and race.
Understand the difference between a risk factor and a
risk marker.
Risk factor: More risk factors, higher risk on development of a
disease. These include non-modifiable (age, gender) risk factors,
which you cannot do something about. Modifiable risk factors can
be changed (smoker, non-smoker). High cholesterol (lipoproteins),
high blood pressure (health policy measures in low-risk groups).
High cholesterol is more of a risk factor for CHD than it is for
stroke. How?
Risk marker: can be a marker that is unrelated to the causal
pathway (e.g., C-reactive protein) and therefore a bad target for
prevention.
Describe the main underlying pathophysiological
processes for cardiometabolic diseases.
Accumulation of fat inside the arteries and blood clots both affect
blood flow. These can also damage the brain.
Blood cholesterol, mainly the subtype of LDL-cholesterol, plays
an important role in the pathogenesis of coronary heart disease
via the process of atherosclerosis, even at old age. The risk of
stroke is more strongly determined by high blood pressure
than by high LDL-cholesterol. The reason why blood cholesterol is
Describe the main forms of cardiovascular disease.
18 million deaths (1/3rd)
Major cause of morbidity as well
ICD-11 provides categorization of diseases:
- Circulatory system = 11
- Respiratory system = 12
- Disease of nervous system = 8
- Endocrine disorders = 5
There are four main types:
- coronary heart disease
- stroke
- peripheral arterial disease
- aortic disease
Describe the main types of diabetes.
Diabetes: major disorder that is characterized by high blood
glucose levels, hyperglycaemia. Due to hormone insulin. Both
cardiovascular disease and chronic kidney disease.
Diabetes Mellitus Type 1
Auto immune disorder. No insulin production at all due
to destruction of B-cells of pancreas. No lifestyle
prevention. Maybe breastfeeding could help. Sudden
onset, in children.
Diabetes Mellitus Type 2
Not enough insulin or cannot effectively use it. This process
develops over time, assisted by poor diet and exercise. Belly
fat is a strong predictor. Incidence in younger subjects due
to bad habits.
, Macrovascular problems, caused by damage of large blood
vessels. Could lead to myocardial infarction, stroke, or other
CV problems.
Microvascular problems, small vessels affected, can result to
blindness.
Medical treatment is needed, together with lifestyle
changes.
Diabetes Mellitus Type 3
Mentioned way less than T2DM and T1DM, as it doesn’t
affect blood sugar. But it does affect brain functionality.
Therefore, Alzheimer’s Disease is often called T3DM. Insulin
receptors in the brain lose sensitivity for insulin.
Explain which diseases are part of the
cardiometabolic cluster.
- Coronary heart disease
Dominant type of CVD, in Westernized countries. High
blood levels of LDL-c “bad cholesterol” can form fatty
streaks in the arteries. Development of plaques is called
atherosclerosis.
Macrophages attach to damaged cell wall and ingest LDL,
causing foam cell formation. Macrophage foam makes
plaques grow further, causing also an inflammatory
response. Fibrous tissue is added to plaque.
Calcium deposition in the plaque, stiffening arteries.
Rupture of plaque will form blood clot or thrombus, that
could block artery and stop oxygen supply.
- Heart attacks
, This happening in myocardial artery causes loss of
function of heart muscle, and eventual cardia arrest. Due
to heart arrythmia or ventricular fibrillation.
- Diabetes type 2
- Ischemic stroke
Infarction happening in the brain instead of the coronary
arteries.
Blood clot blocking brain artery Ischemic stroke
Thrombus from system Embolic stroke
Bleeding in brain Haemorrhagic stroke
Small ischemic stroke TIA (warning for real stroke)
- Peripheral artery disease
Narrowed arteries, causing pain in legs when walking.
- Kidney disease
Gradual loss of function over time, end-stage kidney
failure, requires dialysis or transplantation.
One third of diabetic patients develop kidney failure later
in life.
Understand why the different diseases in the
cardiometabolic cluster are linked.
Similar cardiometabolic problems like:
- insulin resistance
- Low grade inflammation
- Abnormal cholesterol (and other blood lipid) levels
- High blood pressure
- Vessel dysfunction
- Ischemic stroke
- Diabetes
- Kidney disease
Use the International Classification of Diseases (ICD)
coding system to retrieve the different types of
cardiometabolic diseases.
, ICD-10 category 9 is circulatory system related disease
Describe the main non-modifiable risk factors for
cardiometabolic diseases.
Less than 10% is predicted by genes
Bad habits are more important, thus modifiable risk factor.
Prevention paradox: population treatment to reduce large
numbers at low risk
Non-modifiable is genes, age, gender and race.
Understand the difference between a risk factor and a
risk marker.
Risk factor: More risk factors, higher risk on development of a
disease. These include non-modifiable (age, gender) risk factors,
which you cannot do something about. Modifiable risk factors can
be changed (smoker, non-smoker). High cholesterol (lipoproteins),
high blood pressure (health policy measures in low-risk groups).
High cholesterol is more of a risk factor for CHD than it is for
stroke. How?
Risk marker: can be a marker that is unrelated to the causal
pathway (e.g., C-reactive protein) and therefore a bad target for
prevention.
Describe the main underlying pathophysiological
processes for cardiometabolic diseases.
Accumulation of fat inside the arteries and blood clots both affect
blood flow. These can also damage the brain.
Blood cholesterol, mainly the subtype of LDL-cholesterol, plays
an important role in the pathogenesis of coronary heart disease
via the process of atherosclerosis, even at old age. The risk of
stroke is more strongly determined by high blood pressure
than by high LDL-cholesterol. The reason why blood cholesterol is
