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Prevalence of Cardiovascular Disease by Race

Prevalence of Cardiovascular Disease by Race. American Heart Association. Prevalence of Cardiovascular Disease. American Heart Association. Clinical Lesion. Fatty Steaks. Clean Artery. Fibrous Plaque. NATURAL HISTORY OF ATHEROSCLEROSIS. Lumen. Subendothelial Space. Anti-Adhesion

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Prevalence of Cardiovascular Disease by Race

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  1. Prevalence of Cardiovascular Disease by Race American Heart Association

  2. Prevalence of Cardiovascular Disease American Heart Association

  3. Clinical Lesion Fatty Steaks Clean Artery Fibrous Plaque NATURAL HISTORY OF ATHEROSCLEROSIS

  4. Lumen Subendothelial Space

  5. Anti-Adhesion Anti-Coagulation Fibrinolysis Blood Flow Insulin Acetylcholine Lumen ↑NO PI-3 kinase eNOS NADPH Nitric Oxide L-arginine O2 NO BH4 ↑NO Subendothelial Space Vasodilation

  6. Anti-Adhesion Anti-Coagulation Fibrinolysis Blood Flow Insulin Acetylcholine Oxidative Stress Lumen ↑NO PI-3 kinase O2- eNOS NADPH L-arginine O2 NO BH4 ONOO- ↑NO Subendothelial Space Vasodilation

  7. Anti-Adhesion Anti-Coagulation Fibrinolysis Blood Flow Insulin Acetylcholine Oxidative Stress ↓NO PI-3 kinase O2- eNOS NADPH L-arginine O2 NO BH4 ONOO- ↓NO Subendothelial Space Vasodilation

  8. Anti-Adhesion Anti-Coagulation Fibrinolysis Blood Flow Insulin Acetylcholine Oxidative Stress ↓NO PI-3 kinase O2- eNOS NADPH L-arginine O2 NO BH4 ONOO- ↓NO Subendothelial Space Vasoconstriction

  9. Anti-Adhesion Anti-Coagulation Fibrinolysis Blood Flow Insulin Acetylcholine Oxidative Stress ↓NO PI-3 kinase O2- eNOS NADPH L-arginine O2 NO O2- BH4 ONOO- ↓NO Subendothelial Space Vasoconstriction

  10. ENDOTHELIAL FUNCTION VASODILATION

  11. VASODILATION

  12. Shear Stress eNOS Oxygen L-Arginine NADPH Nitric Oxide Cofactors VASODILATION PI-3-Kinase

  13. Shear Stress ↓Ca++ eNOS cGMP Oxygen L-Arginine NADPH Nitric Oxide NO Cofactors VASODILATION i PI-3-Kinase

  14. Pre ARTERIAL HEALTH Flow-Mediated Dilation

  15. Post Pre 4.1 mm 4.7 mm ARTERIAL HEALTH Pre Flow-Mediated Dilation = 8%

  16. Faulx, et al, American Heart Journal 145:943-951, 2003 Iiyama, et al. American Heart Journal 132:779-782, 1996 Hashimoto, et al. International Journal of Obesity: RelarMetabDisord 22:477-484, 1998. Caballero, A.E., Obesity Research 11:1278-1289, 2003. Celermajer,et al. J Am CollCardiol 24:471-476, 1994.

  17. Apparently Healthy Hasimoto, et al. Circulation 92:3431-3435, 1995.

  18. Children Woo, et al, International Journal of Obesity 28:852-857, 2004

  19. Aging Celermajer,et al. J Am Coll Cardiol 24:471-476, 1994.

  20. Overweight & Obesity Hashimoto, et al. International Journal of Obesity: Relar Metab Disord 22:477-484, 1998.

  21. Hypertension Iiyama, et al. American Heart Journal 132:779-782, 1996

  22. Diabetes Caballero, A.E., Obesity Research 11:1278-1289, 2003.

  23. Anti-Adhesion Anti-Coagulation Fibrinolysis Blood Flow Insulin Resistance Acetylcholine Lumen ↑NO PI-3 kinase eNOS NADPH L-arginine O2 NO BH4 ↑NO Subendothelial Space Vasodilation

  24. Anti-Adhesion Anti-Coagulation Fibrinolysis Blood Flow Insulin Acetylcholine Lumen ↓NO PI-3 kinase eNOS NADPH L-arginine O2 NO BH4 ↑NO Subendothelial Space Vasodilation

  25. Anti-Adhesion Anti-Coagulation Fibrinolysis Blood Flow Insulin Acetylcholine Lumen ↓NO PI-3 kinase eNOS NADPH L-arginine O2 NO BH4 ↓NO Subendothelial Space Vasoconstriction

  26. Endothelial Function of Smokers Celemajer, D, et al Circulation 88:2149-2155, 1999

  27. Endothelial Function of Smokers Celemajer, D, et al Circulation 88:2149-2155, 1999

  28. OXIDATIVE STRESS IN OBESITY Davi, et al. JAMA 288:2008-2014, 2002

  29. OXIDATIVE STRESS FOLLOWING MAXIMAL EXERCISE Vincent, et al. Med Sci Sport Sci, 37:213-219, 2005.

  30. Triglyceride Storage Triglyceride Release Adipocyte Resistin Leptin TNF - α Agiotensin Adiponectin Plasminogen activator inhibitor

  31. Exercise

  32. Tsai, et al. Clinical Science 106:315-319, 2004 Anderson, et al, Atherosclerosis 154:475-483, 2001 Ceriello, et al, Circulation 106:1211-1218, 2002

  33. ↑FFA Β Oxidation TCA Cycle ↑Electron Donors NAD+ ↑ NADH+H+ ↑ O2- ↑FADH2 FAD Complex I e- Complex IV e- Complex II Q- Complex III e- e- Electron Transport Chain

  34. EXERCISE IMPROVES ENDOTHELIAL FUNCTION Hamby et al, Diabetes Care 26:2119-2125, 2003 Watts, et al, Journal Pediatrics 144:620-625, 2004 Walsh, et al, JAP 95:20-25, 2003

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