The Genetic Aspect of Atherosclerosis

                Atherosclerosis is contributed to a healthy diet and adequate exercise, but family genetics can be the X factor.  The concern for this disease should not be secluded to only people that lack exercise or a healthy diet. A proper healthy diet low on fats and complimented with adequate exercise can reduce the probability of heart disease, but it does not eliminate the chances.

                Currently the London Olympics of 2012 is under the spotlight, but a great swimmer is not among them due to atherosclerosis. Certainly, everyone understands the strict diets and daily exercise routines that Olympic athletes undergo during training. The death of a Norwegian athlete swimmer, by the name of Alexander Dale Oen, came at almost a complete surprise.

                Alexander Dale Oen, born on May 21st 1985, was only age 26 on April 30th 2012 when he was found unconscious  in this hotel room in Arizona during his training camp in the USA.  After being brought to the hospital in Flagstaff Medical Center he was pronounced dead. A later autopsy found that he had suffered from a heart attack due to a chronic, coronary heart disease.  A more detailed autopsy reported that his left descending  artery was blocked by atherosclerotic plaque.  

                Alexander is Norway's first Olympic medalist. He won silver during the 2008 Beijing Olympics by coming second in the 100 meter breaststroke finals. Alexander is also had some notable achievements over his swimming career including gold at the 2008 European Championships and setting  a new Nordic record for the 100 meter breaststroke. 

A picture of Alexander Dale Oen:

                Unfortunately, he will not be participating in this year's Olympics. This goes to show that atherosclerosis genuinely is not discriminatory towards healthy individuals with top physical fitness compared to individuals of less physical fitness. Although a healthy diet and adequate exercise may help reduce the risks of a heart disease, the genes passed down by past generations can play a major factor.

A tribute to Alexander by his admirers:

                Genetics help map out our bodies are constructed from within. Scientists have found that there is a major gene that contributes to how our body stores certain fats. A proposed mechanism of lipid peroxides being stored is thought to be related to how genes recognize, oxidize, and produce an inflammatory response to lipids.

                A recent study published online on July 3, 2012 in the journal Cell Metabolism commented that they have identified a signaling pathway that may control both atherosclerosis and obesity.  Scientist from the Singapore Bioimaging Consortium and institute of Molecular and Cell Biology determined that mice deficient in the Wip1 gene were resilient against weight gain and atherosclerosis. This gene can potentially affect how lipids are stored and recognized in the body and help prevent many disease, including heart disease. The mice in this study were found that through the regulation of the Ataxia telangiectasia mutated gene and the signaling molecule mTor, the mice was able to resistant to weight gain and atherosclerosis. Whether, or not, this gene is applicable to humans yet is still unclear, but nevertheless, this is a leap forward in finding a potential treatment in the genetic aspect of atherosclerosis.

References:

·         http://circ.ahajournals.org/content/91/9/2488.full

·         http://en.wikipedia.org/wiki/Alexander_Dale_Oen

·         http://in.news.yahoo.com/mechanism-controls-both-obesity-atherosclerosis-identified-121155576.html

·         http://www.nbcolympics.com/news-blogs/swimming/norwegian-swimmer-alexander-dale-oen-died-of-heart-disease.html

Preventing Atherosclerosis with Basic Exercise

            Atherosclerosis is the hardening of arteries. As plaque builds up, it begins blocking blood flow. Clogged arteries may lead to potentially lethal consequences.  Exercise can potentially prevent atherosclerosis and reduce the likelihood of clogged arteries.  Exercise promotes nitric oxide production in the blood, that promotes circulation.

            The problem is: individuals lack the motivation, or time to commit to a regular basis exercise routine.  However, a brief cardiovascular exercise a few times a week can make a world of difference compare to that of no exercise. 

            Nevertheless, I understand that not everyone can put aside 30 minutes to 1 hour exclusively for time to exercise daily. But it is better to put in 10 to 15 minutes at least 2 or 3 times a week, the more the better, than it is to not do any exercise.

            Moreover, I completely sympathize with those individuals that have not exercise since their P.E. (physical education) classes back in their middle school.  It is always hard to take that first step and start up a routine.

             As an individual who has always struggled with my own weight, I understand how the first few days, or even the first week, is hard on the body when you begin exercising.  The body has a set point, or the level of activity it is accustomed.  Once the body is out of this comfort zone, it will feel tired at first since you are not used to the increased level of activity. However, after continued exercise and increased level of activity, the body will raise that set point to a higher level. Which is also why when the same person working out the same routine over a prolonged period of time will not receive the same effect after continued use. Instead they are required to do an extra few repetitions or increase the weights to further increase their effectiveness when they exercise.

            On a personal level, I started a program called Insanity. By no means am I paid to advertise their product, but I became of fan of it due my progress. Before I began the program I was at the peak of my highest body weight at 175 pounds at 5 feet 3 inches. We all have those days where our weight goes up and down so the numbers are subjective. The program is marketed 60 days of the Insanity. It is actually about 54 days excluding the one day a week day off, or 63 days total if you count everything. I managed to lose about 15-20 pounds along with 2-3 inches off my waist.  It was hard at first, but now it has become fun and even addictive.

            Conversely, I am not trying to advertise that you should run out there and grab an exercise program, it may not be right for you.  Everyone has their own level of fitness and should go on their own pace. If a long-term exercise program is not right for you, simply pick up a routine and stick to it.

Some basic exercise include:

Ø  Jogging

Ø  Swimming

Ø  Yoga

Ø  Walking

Ø  Jump Rope

Ø  Weight training

            In a study from the journal of "Experimental and Clinical Cardiology", researchers study on the effects of exercise on the development of atherosclerosis. Researchers have found that "mild to moderate exercise training protects against experimental atherosclerosis" in mice. Mice with exercise had a significant reduced risk of heart-relate disease than compared to mice with no exercise. Therefore, it is crucial to squeeze in any little bit or exercise you can before it is too late. Personally, I attempt to do a few push-ups before bed or when I wake up in case I have a busy day and forget to do a longer exercise during the day. Some exercise is always better than no exercise.

References:

1.      Froelicher VF. Animal studies of effect of chronic exercise on the heart and atherosclerosis: A review.Am Heart J. 1972;84:496–506. 

2.      Kramsch DM, Aspen AJ, Abramowitz BM, Kreimendahl T, Hood WB., Jr Reduction of coronary atherosclerosis by moderate conditioning exercise in monkeys on an atherogenic diet. N Engl J Med.1981;305:1483–9.

3.      Shephard RJ, Balady GJ. Exercise as cardiovascular therapy. Circulation. 1999;99:963–72. 

4.      Steinberg D, Parthasarathy S, Carew TE, Khoo JC, Witztum JL. Beyond cholesterol. Modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med. 1989;320:915–24. 

Signs and Symptoms of Atherosclerosis

                Cardiovascular disease continues to be the number one killing disease in America over tobacco or cancer. Many cases of cardiovascular disease, but not all, typically results from the hardening of arteries and the buildup of plaque, or atherosclerosis.  

                The hardening of arteries and the buildup of plaque is the result of constant wear and tear within the endothelial lining in blood vessels.

Arteries can experience wear and tear from:

Ø  Old age

Ø  Smoking

Ø  High blood pressure

Ø  High cholesterol

                These are typically the most common risk factors, but are not excluded to only these factors.  There can even be hereditary factors that are passed down from generation to generations from close relatives.

                Unfortunately, nearly every individual has some form of atherosclerosis, but the level of severity of plaque buildup may vary.

                In early stages, the inner layer of cells along the blood vessel are torn as a result of the risk factors mentioned above.  The body then uses cholesterol  along with other material to repair the walls. White blood cells that are responsible for digesting excess cholesterol  and other debris in the blood stream become trapped along the wall and becomes plaque. However, signs and symptoms do not appear until the buildup of plaque has become a significant hindrance to blood flow.

Signs and Symptoms include:

Ø  Pain or dizziness during exertion

Ø  Shortness of breath

Ø  Poor wound healing

Ø  Stroke, in severe cases

                These symptoms are caused by insufficient blood flow to regions of the body created by the blockage in the blood vessel from plaque buildup. Consider a toll booth on a bridge, regardless of how many cars there are on the road the speed of traffic is restricted at the toll booth. Similarly, the opening gap within the plaque buildup in the artery limits the speed of the blood flow. Platelets in the blood that are used to promote blood clog will be unable to reach an open wound as quickly and can even be caught up within the plaque.

                Since atherosclerosis can occur in just about any region of the body, it is often categorized by the region it is found.  

Regions where atherosclerosis is found are classified as:

Ø  Coronary artery disease - Located in the chest region.

Ø  Cerebrovascular disease - Located in the brain.

Ø  Peripheral artery disease - Located in the limbs, typically the legs.

However, how can an individual physically determine that atherosclerosis is occurring in their body?

                Although some techniques can be more riskier and have potential complications, other methods are more practical.

Methods used for testing for atherosclerosis:

Ø  Angiography - inserting a tube into the blood vessel and physically checking for regions of plaque buildup. This procedure is considered to be risky and is frequently reserved for serious cases of atherosclerosis.

Ø  Carotid Artery Ultrasound - an ultrasound test along the carotid arteries. This procedure is considered as risk free.

Ø  Electron beam computed tomography (EBCT) - A specialized CT scan that photographs the heart and uses a computer to measure the level of calcium presence.

                

Regardless of what level in severity of plaque buildup, it is always wise to be conscious of eating and exercise habits while being aware of any signs or symptoms of atherosclerosis. My personal opinion and advice is to get regular check-ups and minimize recreational drug consumption, or quit them altogether if you are not medically required to consume. 

References:

http://heart-disease.emedtv.com/atherosclerosis/atherosclerosis-p3.html

http://www.webmd.com/heart-disease/silent-symptoms-diagnosing-atherosclerosis?page=2

http://www.webmd.com/heart-disease/what-is-atherosclerosis?page=2

Atherosclerosis and Cholesterol

                Atherosclerosis is the buildup of plaque. Plaque may consists of cholesterol, platelets, and macrophages being trapped in a lesion along the epithelium of the arterial walls.

            Today's post we will focus on cholesterol. Not all cholesterol is bad. In fact, in all your cells in your body has cholesterol built within its lipid bilayer cell membrane.

            It is practically impossible to render your body free of cholesterol. So how do we counteract atherosclerosis with the topic of cholesterol?

            Cholesterol can be categorized as either low-density lipoprotein (LDL) or high-density lipoprotein (HDL). The cholesterol that is associated with plaque buildup is the LDL cholesterol. So you might be wondering, how can a common person understand the difference and how do we avoid it?

            There is a common phrase saying, "you are what you eat".  There is probably a book with this title, but by no means am I referencing that piece of text in this post. In short, your body is comprised of what you feed it.

            The best way to differentiate between food with LDL or HDL cholesterol can be fairly simple. Typically in meat, LDL is associated with red meat and HDL is associated with white meat. Red meat can be classified as beef, lamb, veal, and pork. While white meat can be classified as chicken or fish.

            However, this is not always the case. Pork for example, is red when raw, but white when cooked. Meanwhile, tuna is red when raw, but white when cooked. This can be confusing, but by nutritionist standards, any meat from a mammal is consider red meat.

            Nevertheless, regardless of what color the meat is when raw or cooked, the best way to distinguish meat with LDL or HDL cholesterol is to simply look at how much saturated fat is on the meat before its cooked. You know the juicy and flavorful white bits on the meat, yeah that stuff. The leaner the meat is, the less fat on the meat, the lower the level of LDL cholesterol in it.

Food to avoid that contains LDL cholesterol:

·         Eggs

·         Dairy

·         Meat

·         Animal products

·         Trans fats (typically in processed food)

·         Hydrogenated Oil

            Conversely, meats that are high in HDL cholesterol, such as fish, are filled with the good fats. The omega-3 fatty acids in salmon has now been referred to as the good cholesterol. 

Food that helps lower LDL cholesterol, while promoting HDL cholesterol:

·         Oatmeal

o   Soluble fiber that helps reduce cholesterol, also found in fruits and vegetables

·         Fish

o   Omega-3 fatty acids that help reduce blood pressure

·         Walnuts, almonds, and other nuts

o   Reduce blood cholesterol, while maintaining healthy blood vessels with polyunsaturated fatty acids

·         Olive oil

o   Antioxidants that lower LDL cholesterol

·         Food with added sterols or stanols

o   Orange juice or yogurt that has added sterol or stanols

Here is a clip that contains good tasting food that help lower cholesterol:

            Generally, it would be ideal to avoid all animal products and meat altogether, but that is not only unreasonable to certain individuals, but also potentially bad for individuals which rely on meat as a staple for nutrition. The best way to counteract atherosclerosis is to simply reduce fat consumption, but not necessarily avoid it altogether while maintaining a balanced diet through fruits and vegetables. 

References:

1.       Krauss R. M., Eckel R. H., Howard B., Appel L. J., Daniels S. R., Deckelbaum R. J., Erdman J. W., Jr, Kris-Etherton P., Goldberg I. J., et al. AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Stroke. 2000;31:2751-2766.

2.       Hu F. B. Plant-based foods and prevention of cardiovascular disease: an overview. Am. J. Clin. Nutr. 2003;78:544S-551S.

3.       Hoffmann I., Groeneveld M. J., Boeing H., Koebnick C., Golf S., Katz N., Leitzmann C. Giessen Wholesome Nutrition Study: relation between a health-conscious diet and blood lipids. Eur. J. Clin. Nutr. 2001;55:887-895.

4.       Key T. J., Fraser G. E., Thorogood M., Appleby P. N., Beral V., Reeves G., Burr M. L., Chang-Claude J., Frentzel-Beyme R, et al. Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies. Public Health Nutr. 1998;1:33-41.

5.       http://www.mayoclinic.com/health/cholesterol/CL00002

How atherosclerosis is affected by the brain and the nervous system.

                Atherosclerosis is the buildup of plaque along the arterial walls. As plaque accumulates, the gap within the lumen of the blood vessel becomes increasingly small. Just as a drain is clog, little material is able to pass through the clogged region.

                A clogged artery or vein can be a serious and life threatening scenario. When a blood vessel is clogged, oxygenated blood is unable to pass through to provide fresh oxygen to the tissues of the body.        

                Symptoms of dizziness, easy fatigue, and lapse in judgment can be signs of the lack of oxygen to the brain. Ever whether why boxing or sports movies have the coach or medical staff asking the person that just got knocked out, "How many fingers am I holding up?" When cells in the tissue of any part of the body lacks oxygen, they lose their effectiveness and functionality.  

                In the brain, the central and peripheral nervous system cooperates to help control your body. While the central nervous system consists of primarily the brain and spinal cord, the peripheral nervous system contains the cranial and spinal nerves.

                 In addition, the peripheral nervous system is further broken down into either somatic or autonomic nervous system. The somatic nervous system is responsible for controlling the physical movement of the body through skeletal muscles. Meanwhile, the autonomic nervous system is responsible for controlling everything else. Atherosclerosis is genuinely most influenced by the autonomic nervous system.

                The autonomic nervous system can be categorized into sympathetic and parasympathetic nervous system.  There is a common approach when defining which nervous system is in action when it is defined as either  "fight or flight" and "rest and digest".

                 The following video provides a clear insight about the brain and the nervous system:

                In basic terms, the nervous systems receives a signal, analyzes it and responds accordingly.  In a more detailed perspective, when the body needs to run away from a tiger the sympathetic nervous system will kick into fight or flight response and increase heart rate to allow more oxygenated blood to reach skeletal muscles and promote movement.  Meanwhile, the parasympathetic nervous system responsible for rest and digest will slow down and restrict blood flow sent towards the digestive tract.

                Conversely, if the individual is sitting down and eating lunch they will slow down their sympathetic nervous system and increase their parasympathetic nervous system.  Henceforth, when a blood vessel is clogged the autonomic nervous can influence the severity of slowing down blood flow.

                For instance, if a water hose is clogged, but is still able to slowly churn out water is then squeezed, then the already restricted water flow will cease to exist. The same scenario exists within blood vessels during high pressures created from stress or high heart rate. Unfortunately, individuals with high stress and hypertension will further increase their likelihood of having a stroke even with a less severe case of atherosclerosis.

                 Fortunately, bypass surgery exists for those with clogged arteries that are life threatening, but a more permanent solution should be developed to prevent atherosclerosis. Among the different types of medical treatments, awareness accompanied by a healthy diet and regular exercise will greatly reduce the buildup of plaque is the best solution. 

References:

1.       American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association;2000.

2.       Korczak DJ, Goldstein BI, Levitt AJ. Panic disorder, cardiac diagnosis and emergency department utilization in an epidemiologic community sample.Gen Hosp Psychiatry 2007;29:335–9.

3.       Chen YH, Tsai SY, Lee HC, Lin HC. Increased risk of acute myocardial infarction for patients with panic disorder: a nationwide population-based study. Psychosom Med 2009;71:798–804.

4.       Bystritsky A, Craske M, Maidenberg E, Vapnik T, Shapiro D. Ambulatory monitoring of panic patients during regular activity: a preliminary report. Biol Psychiatry 1995;38:684–9.

Update on Synthetic Blood Vessels

                Presently, a permanent solution to atherosclerosis does not exist. Although certain medications help alleviate the causation of the buildup of plaque in the arteries, extreme levels of blood clog may require a bypass surgery.  A bypass surgery typically consist of removing a healthy blood vessel from another part of the body and replacing the targeted severely clogged blood vessel.

                Bypass surgeries can be both dangerous and occasionally impossible because the patient lacks any usable healthy blood vessels to be extracted. Although there are several types of bypass surgery that may involve either stopping the heart, or not stopping the heart, both types of surgery are fairly successful by having a success rate of 95-98%. Gradually, technology will allow minimal invasive techniques that prevents a large incision of the chest and sternum.

In the following video clip, a brief animation explanation of bypass surgery is given.

                Bypass surgery is not always successful or even impractical for certain individuals. However, the theory of a synthetic blood vessel has been developed.  Individuals that do not possess any healthy blood vessels suitable for transplant  may soon experience a medication breakthrough that will allow synthetic blood vessels to permanently replace their damaged or severely clog blood vessels.

                Nevertheless, a medical breakthrough would not exist if the task is not hard solve. Currently, thousands of scientists around the world are trying to develop a synthetic blood vessel that may be suitable for implantation in a human. 

The problem of the synthetic blood vessel resides in:

1)      Can the synthetic blood vessel function exactly like an actual blood vessel?

2)      What material should the blood vessel be developed from?

i)        Would the body reject the synthetic blood vessel?

ii)       Is the material strong enough? elastic? pliable?

iii)     How long does it take to be produced?

3)      How would the synthetic blood vessel be created?

i)        Would it be grown in a culture within a Petri-dish within a laboratory?

ii)       Would it be printed through ink-jet printers?

4)      Will the new synthetic blood vessel permanently solve plaque buildup?

i)        Would the new blood vessel prevent atherosclerosis from reoccurring in the same region?

5)      Is a synthetic blood vessel practical?

i)        Will it be economically affordable?

ii)       How long will it take to be constructed?

The following video presents a research group in Germany attempting to develop artificial blood vessels that can be potentially used for human benefits.

                Although there is still plenty to learn about in the development of synthetic blood vessels, future research will allow bigger and better medical breakthroughs to be potentially discovered.  The current focus on synthetic blood vessel development revolve strongly on tissue synthesis from existing host cells that can be cultured in the laboratory through tissue engineering techniques. However, radical ideas using technologies that currently exist, such as the researchers from Germany have promising results. Researchers around the world are developing blood vessel prototypes that simply lack specific target characteristics of an authentic human blood vessel, but eventually they will be to synthesize a working blood vessel that may save the lives of thousands, or even millions around the world.

References:

1.      Amiel GE, et al. (2006) Engineering of blood vessels from acellular collagen matrices coated with human endothelial cells. Tissue Eng12:2355–2365.

2.      Kaushal S, et al. (2001) Functional small-diameter neovessels created using endothelial progenitor cells expanded ex vivo. Nat Med 7:1035–1040.

3.      McKee JA, Banik SS, Boyer MJ, Hamad NM, Lawson JH, Niklason LE, Counter CM. Human arteries engineered in vitro. EMBO Rep. 2003; 4: 633–638.

4.      Whittemore AD, Kent KC, Donaldson MC, Couch NP, Mannick JA. What is the proper role of polytetrafluoroethylene grafts in infrainguinal reconstruction? J Vasc Surg. 1989; 10: 299–305.

Introduction to Atherosclerosis and myself

Hi everyone,

                      My name is Raymond Wu and I am currently an undergraduate student at San Francisco State University currently majoring in biology with concentration in physiology. I enjoy learning about new scientific methods and the potential practicality in which they can be applied. Among them is the topic of atherosclerosis.

            Atherosclerosis is the thickening of arterial walls created by the buildup of plaque. Although this terminology may be new to some, it is the major cause of human related deaths in the United States. This disease even peaks over cancer and tobacco death rates. Atherosclerosis itself does not immediately kill its host, but is the leading cause of cardiovascular problems which develops gradually into a hazardous health problem. So why is this important? Simply because each and every single individual has this disease gradually building up despite how healthy you may appear, but is only a matter of time when it peaks the allowed blockage of your arteries and you can no longer send fresh oxygenate blood throughout your body. Then BAM! You are either having a stroke, or you probably do not know it because you are already dead.

            The purpose of this blog is to discuss the practicality of potential treatments of atherosclerosis. Currently I understand that although atherosclerosis is not curable, but rather only treatable.

Treatments include:

·         Medications that lower the arterial pressure by inducing changes in the heart with calcium-channel or beta blockers, and angiotension-converting enzyme inhibitors

·         Surgery which involve angioplasty and stent placement, endarterectomy, and bypass surgery.      

             

Potential treatments still under research:

·         Synthestic blood vessels

            I would like this blog to discuss the opinions of the best potential treatment, or a combination of treatments, for atherosclerosis. Personally, I prefer the idea of a synthetic blood vessel that may be transplanted into the affected area without having to perform a bypass surgery of removing a healthy blood vessel from another part of the body to replace the clogged one.

             If you agree with me about the synthetic blood vessel, what would be your opinion of the best material to be used to construct the vessel. The idea of embryonic stem cells from the actual patient that needs the vessel being used to synthesize their own blood vessel may probably reduce the chance of  the body rejecting the newly implanted tissue.

            What is your opinion on the subject matter?

References:

Aronow, W. S. (2011). Osteoporosis, osteopenia, and atherosclerotic vascular disease. Arch Med Sci. , 7(1), 21-26. doi: 10.5114/aoms.2011.20599

Butcher, M. J., & Galkina, E. V. (2012). Phenotypic and functional heterogeneity of macrophages and dendritic cell subsets in the healthy and atherosclerosis-prone aorta. Front Physiol, 3, doi: 10.3389/fphys.2012.00044

Li, J. (2011). Inflammation in coronary artery diseases.Chinese Medical Journal, 124(21), 3568-3575. Retrieved from http://www.cmj.org/Periodical/paperlist.asp?

Mercando, A.D., et al (2012):. Reduction in atherosclerotic events: a retrospective study in an outpatient cardiology practice. Arch Med Sci. . 8.1, 57-62. Retrieved from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309438/?tool=pubmed>.

Niessner, A., & Weyand, C. M. (2009). Dendritic cells in atherosclerotic disease. Clin Immunol, 134(1), doi: 10.1016/j.clim.2009.05.006

Twigg, M.W., K. Freestone, et al( 2012):. The LOX-1 Scavenger Receptor and Its Implications in the Treatment of Vascular Disease." Cardiol Res Pract.. 2012. Retrieved from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290926/?tool=pubmed>.

Widmaier, Eric P., et al (2011). Vander's Human Physiology: The Mechanisms of Body Function. 12th ed. New York: McGraw Hill, 2011. 414-16.

Zacharias, D. G., and et al. (2012). Humanin, a cytoprotective peptide, is expressed in carotid artherosclerotic plaques in humans. PLoS One, 7(2), Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273477/?tool=pubmed