Cardiovascular Disease Prevalence by Race and the Natural History of Atherosclerosis

The American Heart Association reports on the prevalence of Cardiovascular Disease and its connection to race. "Clean Arteries," "Fatty Steaks," "Fibrous Plaque," and "Clinical Lesions" are stages in the natural history of Atherosclerosis.

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About Cardiovascular Disease Prevalence by Race and the Natural History of Atherosclerosis

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1. Prevalence of Cardiovascular Disease by Race American Heart Association

5. Prevalence of Cardiovascular Disease American Heart Association

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

10. Lumen Subendothelial Space

11. NO L-arginine O 2 NADPH Lumen NO NO Subendothelial Space eNOS BH 4 PI-3 kinase Blood Flow Insulin Acetylcholine Anti-Adhesion Anti-Coagulation Fibrinolysis Vasodilation Nitric Oxide

12. NO L-arginine O 2 NADPH Lumen NO NO Subendothelial Space eNOS BH 4 PI-3 kinase Blood Flow Insulin Acetylcholine Anti-Adhesion Anti-Coagulation Fibrinolysis Vasodilation Oxidative Stress Oxidative Stress O 2 - ONOO -

13. NO L-arginine O 2 NADPH NO Subendothelial Space eNOS BH 4 PI-3 kinase Blood Flow Insulin Acetylcholine Anti-Adhesion Anti-Coagulation Fibrinolysis Vasodilation Oxidative Stress Oxidative Stress O 2 - NO ONOO -

14. NO L-arginine O 2 NADPH NO Subendothelial Space eNOS BH 4 PI-3 kinase Blood Flow Insulin Acetylcholine Anti-Adhesion Anti-Coagulation Fibrinolysis Vasoconstriction Oxidative Stress Oxidative Stress O 2 - NO ONOO -

15. NO L-arginine O 2 NADPH NO Subendothelial Space eNOS BH 4 PI-3 kinase Blood Flow Insulin Acetylcholine Anti-Adhesion Anti-Coagulation Fibrinolysis Vasoconstriction Oxidative Stress Oxidative Stress O 2 - NO ONOO - O 2 -

20. ENDOTHELIAL FUNCTION ENDOTHELIAL FUNCTION VASODILATION VASODILATION

21. VASODILATION VASODILATION

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

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

24. ARTERIAL HEALTH ARTERIAL HEALTH Flow-Mediated Dilation Flow-Mediated Dilation Pre

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

26. 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: Relar Metab D isord 22:477-484, 1998. Caballero, A.E., Obesity Research 11:1278-1289, 2003. Celermajer,et al. J Am Coll Cardiol 24:471-476, 1994. 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: Relar Metab D isord 22:477-484, 1998. Caballero, A.E., Obesity Research 11:1278-1289, 2003. Celermajer,et al. J Am Coll Cardiol 24:471-476, 1994.

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

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

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

30. Hashimoto, et al. International Journal of Obesity: Relar Metab D isord 22:477-484, 1998. Hashimoto, et al. International Journal of Obesity: Relar Metab D isord 22:477-484, 1998. Overweight & Obesity Overweight & Obesity

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

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

33. NO L-arginine O 2 NADPH Lumen NO NO Subendothelial Space eNOS BH 4 PI-3 kinase Blood Flow Insulin Resistance Acetylcholine Anti-Adhesion Anti-Coagulation Fibrinolysis Vasodilation

34. NO L-arginine O 2 NADPH Lumen Subendothelial Space eNOS BH 4 PI-3 kinase Blood Flow Insulin Acetylcholine NO Anti-Adhesion Anti-Coagulation Fibrinolysis NO Vasodilation

35. NO L-arginine O 2 NADPH Lumen Subendothelial Space eNOS BH 4 PI-3 kinase Blood Flow Insulin Acetylcholine NO NO Anti-Adhesion Anti-Coagulation Fibrinolysis Vasoconstriction

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

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

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

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

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

43. Exercise Exercise

46. 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 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

49. Oxidation Electron Donors Electron Transport Chain FADH 2 O 2 - TCA Cycle FFA NADH+H + NAD + e - Complex I Complex III Complex II Complex IV Q - e - e - e - FAD

50. 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 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 EXERCISE IMPROVES ENDOTHELIAL FUNCTION EXERCISE IMPROVES ENDOTHELIAL FUNCTION

51. NITRIC OXIDE NITRIC OXIDE i Eight weeks of training in healthy adults Maeda, et al. Life Sciences 69:1005-1016, 2001 Maeda, et al. Life Sciences 69:1005-1016, 2001

56. Padilla, et al., European Journal of Applied Physiology, 98:256-262, 2006 Padilla, et al., European Journal of Applied Physiology, 98:256-262, 2006

57. Johnson, B. et al. ACTIVE vs. INACTIVE ACTIVE vs. INACTIVE

58. Johnson, B. et al. ACTIVE vs. INACTIVE ACTIVE vs. INACTIVE

59. Johnson, B. et al. ACTIVE vs. INACTIVE ACTIVE vs. INACTIVE

60. Johnson, B. et al. ACTIVE vs. INACTIVE ACTIVE vs. INACTIVE

61. Johnson, B. et al. ACTIVE vs. INACTIVE ACTIVE vs. INACTIVE

62. Harris, et al, Obesity, 2008 Harris, et al, Obesity, 2008 Active & Inactive Overweight Men Active & Inactive Overweight Men FMD Response FMD Response Treadmill Exercise Treadmill Exercise

63. Oxidative Source Oxidative Stress ( 8 PG F2alpha) Endothelial Function Single Physical Activity Session Single Physical Activity Session NO bioavailability Blood Flow Anti- inflammatory Myokine ( IL-6) Inflammatory Stress ( TNF-alpha) Antioxidant Defense ( SOD) Insulin Resistance Visceral Fat ( TNF-alpha) Systemic Inflammation ( CRP) Habitual Physical Activity Habitual Physical Activity Insulin Resistance