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Friday, September 27, 2019

How may genetic and epigenetic phenomena influence cardiovascular risk Essay - 1

How may genetic and epigenetic phenomena influence cardiovascular risk by altering the pathophysiology of plasma lipoproteins - Essay Example An important risk factor for the development of cardiovascular diseases is dyslipidemia, whereby the plasma concentrations of different lipoprotein fractions, in particular, HDL and LDL, are deviated from the norm (Hegele, 2009, p. 111). Since approximately half of the variations in the plasma levels of HDL and LDL cholesterol are heritable (Kathiresan, et al., 2008, p. 1241), it is postulated that genetic influences play a significant role in the determination of plasma lipoprotein levels, especially HDL and LDL, which in turn are strongly correlated with the risk of cardiovascular disease and outcomes. Similarly, recent literature has also unveiled several epigenetic mechanisms whereby concentrations of different lipoproteins are altered. This paper discusses the relationship between the levels of different lipoproteins found in the human bloodstream and the risk for cardiovascular diseases. Moreover, the focus of this paper is to elucidate how genetic and epigenetic phenomena infl uence cardiovascular risk by altering the pathophysiology of plasma lipoproteins. The relationship between plasma lipoproteins and the risk for cardiovascular diseases: As discussed previously, CVDs are the leading preventable cause of death globally. It has been found that these diseases account for approximately 50% of the deaths in the developed world and are the most common cause of death in both developed and underdeveloped countries (Ebesunun, Agbedana, Taylor, & Oladapo, 2008, p. 282). In the United States alone, cardiovascular diseases have been shown to claim almost 1 million lives each year (Eichner, Dunn, Perveen, Thompson, Stewart, & Stroehla, 2002, p. 490). The domain of cardiovascular diseases encompasses various ailments such as hypertension, coronary artery disease, arrhythmias, cerebrovascular diseases such as stroke and peripheral arterial disease (Brunzell, et al., 2008, p. 811; Eichner, Dunn, Perveen, Thompson, Stewart, & Stroehla, 2002, p. 490). There are severa l established risk factors for cardiovascular diseases, both modifiable and non-modifiable, including and not limited to age, sex, smoking, diabetes, hypertension, obesity (in particular, central obesity) and dyslipidemia (Rizzo & Berneis, 2006, p. 1; Ordovas, 2009, p. 1509). Dyslipidemia, which is defined as an alteration in the plasma levels of lipids and lipoproteins, is an important risk factor for CVD (Hegele, 2009, p. 111). Lipoproteins are transporter macromolecules that are present in the human bloodstream and tend to serve the function of transporting insoluble plasma lipids, including cholesterol and triglycerides in the bloodstream (Hegele, 2009, p. 109). There are several different types of lipoproteins present in the plasma, which have been classified according to their density, particle size and the substances that they transport (Hegele, 2009, p. 110). Several studies have revealed that the most important determinants of cardiovascular risk are the levels of two impor tant lipoproteins, viz. HDL and LDL and alterations in the levels of these lipoproteins can lead to several pathologies. While elevated LDL is found to increase CVD risk, elevated levels of HDL are found to confer protection against the likelihood of developing CVD. For example, it has been found that a 1mmol/l reduction in the plasma levels of LDL cholesterol leads to a 21% decline in the risk for

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