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Blood clotting

When blood vessel walls are damaged a blood clot is likely to form.
Platelets come into contact with vessel wall and change from flat discs to spheres
with long thin projections.
This change causes them to stick to the exposed collagen in the wall and each other
and from a temporary platelet plug.
Contact between the platelets and damaged tissues (collagen fibres) allows the
platelets to break open in large numbers which release substances to form a clot.
(SEROTONIN causes the blood vessel to constrict minimizing the blood loss to the
damaged area)
THROMBOPLASTIN is an enzyme thats sets a progress in cascade of events that
leads to clot formation.
Thromboplastin along with Ca2+ and vitamin K catalyses the conversion of a protein,
prothrombin to an enzyme, thrombin which in turn acts on another soluble plasma
protein, fibrinogen to convert into an insoluble substance called fibrin.
This forms a fibre mesh at the cut area trapping the red blood cells and platelets
forming a blood clot.
Special proteins in the structure of platelets contract, making the clot tighter and
tougher.

Some times this blood clotting mechanism can occur at the wrong place such as
arteries that get damaged due to high blood pressure. This forms the clot at the
damaged area resulting in the blockage of arteries.

Aneurysms can also form which are a buildup of blood behind a narrowed part of an
artery. At the point of an aneurysm, there is typically a bulge. The wall of the blood
vessel or organ is weakened and may rupture.
What is atherosclerosis?
Atherosclerosis can lead to coronary heart disease and strokes. It does this by blocking
an artery with fatty deposits.
Stages of atherosclerosis:
Endothelium becomes damaged (e.g. due to high blood pressure, or
cigarette smoke)
Damage causes inflammatory response. White blood cells move
into the artery wall, they accumulate chemicals from the blood
(cholesterol)
A deposit then builds up called an atheroma
Calcium salts and fibrous tissue build up at site and form a hard
swelling (plaque)
This makes the artery lose some of its elasticity (hardens)
It also causes the artery to narrow
This makes it difficult for the heart to pump blood around the body
and results in high blood pressure
Positive feedback builds up as the increased blood pressure
makes it more likely that more plaques will form.

Describe the factors that increase the risk of CVDs (genetic, age, diet,
gender, high blood pressure, smoking and inactivity)

HIGH BLOOD PRESSURE:

Elevated blood pressure is also known as hypertension. It is considered to be one of


the most common factors of cardiovascular diseases as it increases the likelihood of
atherosclerosis. Blood pressure is the hydrostatic force of attraction of the blood
against the walls of a blood vessel. Pressure in artery is more than in veins. During
ventricular systole the pressure in the arteries is at the highest known as systolic
pressure. During diastole, the pressure in the arteries is at the lowest known as
diastolic pressure.

Any factor that causes arteries or arterioles to constrict can lead to an elevated
blood pressure. These factors might be release of hormones such as adrenaline or
high salt diet or loss of elasticity of artery due to ageing. This high blood pressure
can lead to atherosclerosis.

if the blood pressure in the capillary is raised above normal then more fluid comes
out of the capillary and into the tissues surrounding causing edema which causes
swelling.

AGE:

As you get older the arteries become less elastic and narrower which can lead to
raised blood pressure leading to atherosclerosis which cause heart disease.

GENDER:

The females below the age of 50 have lower chances of CVDs because of their
menstrual cycle. The oestrogen, that is the female hormone appears to reduce the
build-up of plaque which gives women some protection against CVDs than men until
menopause when the oestrogen levels falls.

GENES:

Studies show that there is a genetic tendency in some families and in some ethnic
groups to develop CVDs. The genetic tendency varies- there may be more likelihood
of arteries being damaged or hypertension that leads to atherosclerosis or may be
the cholesterol mechanism may be faulty.

SMOKING:

One of the major risks of CVDs. Nicotine is a chemical found in cigarette smoke, it
stimulates the production of the hormone adrenaline which increases the heart rate
also constricting the arteries and arterioles raising the blood pressure.

Many chemicals in smoke can irritate the lining of arteries, triggering


atherosclerosis.

CO from the smoke binds with haemoglobin instead of oxygen resulting in reduced
amounts of oxygen supply to the body cells. Any narrowing of the artery as a result
of atherosclerosis will reduce the blood supply to the heart and the brain further
reducing the blood supply to brain and the heart. This will result in an increased
heart rate as body reacts to provide enough oxygen for cells.

INACTIVITY:
Moderate exercise prevents high blood pressure and can help to lower it, reducing
risks of CVDs. It also maintains a persons weight as well as raise HDL levels in the
blood without affecting LDL levels.

OBESITY:

BMI is the method of classifying body weight relative to a persons height.

BMI = body mass (in kg) / height (in m2)

Obesity increase the risk of coronary heart diseases as well as stroke. The more the
fat you carry around your belly the more at risk you are. This is because belly fat
raises the levels od LDLs in the blood whereas HDLs levels to fall that you know can
create devastating effects.