Answer to Question 1
As discussed in your Nutrition Matters about Nutrition and Cardiovascular Health, some risk factors for cardiovascular disease are nonmodifiable. Most likely, James has a genetic predisposition to high blood cholesterol that was unchanged by dietary or exercise modifications.
Answer to Question 2
A chronic elevated blood cholesterol level can lead to atherosclerosis. Atherosclerosis can lead to cardiovascular disease. The greater concentration of cholesterol floating in Jamess bloodstream would most likely hasten the accumulation of plaque within his arteries. The excessive plaque in Jamess bloodstream would narrow the passageway in which his blood circulates and lead to chronic hypertension. The high blood pressure would also damage small capillary sites such as the retina, kidney, and brain, perhaps leading to early blindness, kidney failure, and risk of stroke. In addition, according to our textbook, atherosclerosis is exacerbated by chronic inflammation due to the bodys response to a noxious (poisonous) stimulus, injury, or infection. It is the rare adolescent and young adult that does not encounter smoke, alcohol, athletic injuries, and some sort of infection, all risk factors that would further harm James. In addition, the American Heart Association and American Stroke Association address the concept of the influence of stress on risk of heart disease. James has learned at a young age that he has high blood cholesterol and must take a lifelong medication; this knowledge may cause some stress. Furthermore, because the life of an adolescent has many instances of stress (relationships, college, employment), James will need to learn effective coping mechanisms to minimize his stress level.