Atherosclerosis: Risk Factors (Nursing)

00:00 Okay now we're looking at non- modifiable risk factors.

00:04 This is an important section for you and I to remember because this is where we can help patients become healthier.

00:12 So don't look at this like, "Hmmm, just a victim, nothing I can do if I have this risk factor" No, no - it's a clue.

00:20 It's letting you know if you have this non-modifiable risk factor, meaning there's not a thing you can do to change it then it just helps you be aware that this is an area you need to be extra sharp and on guard for.

00:33 So I'm gonna give you several non-modifiable risk factors.

00:37 As a nurse, you're going to know these populations have increased risk.

00:41 As an educator as a nurse, you're going to make sure the patients are aware of this and know that it's really important that they make some healthy lifestyle changes.

00:50 First one is ethnicity.

00:53 Now certain ethnic groups have a higher risk or incidence of atherosclerosis.

00:58 The African, or african descendant, and hispanic, or latino, ethnicities are at an increased risk of developing atherosclerosis, correlated to the higher incidence rates of diabetes mellitus and hypertension in both populations.

01:11 If a patient or you has a family history of atherosclerosis, pay attention because that means that you also have likely a higher risk for atherosclerosis.

01:23 Now as we age and what your sex is, that means that you have a higher likelihood of having atheroscleoris.

01:30 So I'm worried about a higher-level atherosclerosis in a 70- year old than I am the average 20 year old.

01:36 Okay so there's the first three.

01:38 Now what's important about these? They're non- modifiable but it doesn't make you or your patients a victim.

01:45 They're just heads-up signals to let you know, you need to be really be aware of making healthier lifestyle changes.

01:51 So ethnicity, family history and as we age and your gender.

01:57 Now high blood pressure is something we can do about.

02:00 So we've got nine modifiable risk factors, let's get down to business.

02:06 These are things that if we can help the patient understand that they're empowered to make a difference in these, they can change this, won't be easy.

02:15 We may ask someone to make some really difficult choices but that's our job to help them make small changes toward better health.

02:23 Alright, high blood pressure.

02:24 So obviously, your risk for atherosclerosis, high blood pressure make everything worse, right? That pressure is gonna be really intense if the vessels are already kind of the narrowed.

02:35 This is gonna be problematic.

02:37 Next one, ugh this one starts meddling in people's business.

02:42 If the patient is a smoker, it might be kind of awkward for them to have a conversation with you about this because yeah, yeah, yeah they know, they know there's risk, they know, they know.

02:52 But this really powerful drug, nicotine uhh man it's so difficult but it's not impossible to stop.

03:01 So this is something that you want to have an open conversation with your patient.

03:05 See where they are on the issue and we'll give you some ideas and strategies on how you help people make big lifestyle changes but for now let's focus on the nine factors So you've got high blood pressure, smoking.

03:18 We think now if you're used, if you have elevated LDL cholesterol that put you at an increased risk for atherosclerosis so we'll wanna control that.

03:25 Obesity and what types of food you're eating also play a role.

03:30 Physical inactivity, so if a patient tends to be sedentary, that increases the risk for atherosclerosis.

03:36 And stress or substance abuse.

03:39 Okay, so we're six factors in.

03:42 Pause for just a minute and see how many of those original three that we started with you can recall.

03:51 Okay, good.

03:52 Sometimes when we're going through a list, it's hard to stay focused, you almost want to check out.

03:59 Do what it takes to keep your brain in there.

04:01 Number them as we go through them, do something that engages with these list so it helps it stick in your mind.

04:07 Now some additional risk factors, these are the last three: We'll talk about diabetes.

04:13 Anybody with diabetes 1 or 2 has a higher level of risk for cardiovascular events and atherosclerosis.

04:21 So we'll watch them very closely that's what we want, to watch all these other risk factors including keeping tight blood sugar control.

04:30 So the tighter the control we can keep on a patients blood sugar through their diet, exercise and medications as appropriate, they're gonna have a lower risk for atherosclerosis.

04:41 That's why it's important for blood sugar to keep within a normal range.

04:46 Now elevated homocysteine levels, that maybe something you're not familiar with but that's an additional risk factor.

04:53 Last one is C-reactive protein.

04:57 Now is that something you're familiar with? Well that's a marker or an indicator of inflammation.

05:03 Now based on what we've talked about, why do we want to minimize inflammation? Right, because that was an important piece of the puzzle.

05:11 When you have the damage to the endothelial lining, then you have the responders, right, those fatty things and inflammatory mediators.

05:19 Right, so if a patient has elevated c-reactive protein, we see that they've got extra inflammation going on in their body, that puts them at an even higher risk.