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Jawi, Motasim Mohammed T

University of British Columbia

Patients with high levels of lipoprotein(a) (Lp[a]) have an increased risk of ischemic heart disease. Persistently elevated resting heart rate (RHR) and arterial wall thickening, two common clinical manifestations in cardiovascular disease (CVD), are known determinants of myocardial ischemia as well as predictors of future cardiovascular events. The association of improved physical activity (PA) with these ischemic heart disease risk factors in patients with high Lp(a) levels is controversial. The overall objectives of this dissertation are to provide a comprehensive investigation of RHR and early structural atherosclerotic vascular changes in patients with high Lp(a) as well as the association of PA with these two parameters. The first objective of this dissertation is to raise awareness about the harmful effects of Lp(a) (Chapter 2). I described the association between RHR and PA in primary and secondary prevention patients enrolled in the Healthy Heart Program (HHP) prevention clinic (Chapter 3). The fourth chapter aimed to evaluate the relative significance of Lp(a) as a predictor of future CVD compared with selected established CVD risk factors (Chapter 4). I also assessed the association of improved PA and RHR in HHP patients with high Lp(a) levels (Chapter 5) and explored the potential beneficial impact of improved PA on early structural atherosclerotic vascular changes in healthy subjects enrolled in the Multicultural Community Health Assessment Trial (M-CHAT) trial (Chapter 6). I showed that participants who increased their PA could reduce their RHR significantly. I also showed that male sex, Lp(a), low-density lipoprotein (LDL-C), and non-high-density lipoprotein (HDL-C) were significant independent risk factors for CVD, in decreasing order of importance. Moreover, RHR, blood pressure, and the Framingham risk score decreased significantly in HHP patients with high Lp(a) levels who improved their PA over three years. Finally, I showed that improving daily PA associated with significantly better carotid artery intima-medial thickness and total plaque area compared to those in less active M-CHAT participants. This dissertation provides new knowledge on RHR and arterial early structural atherosclerotic vascular changes in patients with high Lp(a) and the potential associations between PA with these two ischemic heart disease risk factors in CVD patients.

Text

2023-11-30

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/80309

Experimental Medicine

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/