Chapter 13 CARDIOVASCULAR DISEASE (CVD) · HEART DISEASE STARTS IN CHILDHOOD •Childhood risk...
Transcript of Chapter 13 CARDIOVASCULAR DISEASE (CVD) · HEART DISEASE STARTS IN CHILDHOOD •Childhood risk...
Professor Betty C. Jung
CARDIOVASCULAR DISEASE (CVD)
Chapter 13
ATHEROSCLEROSIS: THE PROCESS OF CARDIOVASCULAR DISEASE
Professor Betty C. Jung
RISK FACTORS THAT CANNOT BE CHANGED
• Heredity
• CVD has genetic component; high cholesterol levels, blood clotting and obesity
• Aging
• Over the age of 65
• Being male
• Men have higher risk earlier in life
Gender, Ethnicity & CVD
• Hormone Replacement Treatment (HRT) increases women’s risk for heart disease
• 1/3 die from HD, 1/34 from breast cancer
• African-Americans are at greatest risk for CVD
• Should treat high blood pressure at 130/80
• Greater salt sensitivity
• Latino populations Diabetes variation
• Higher among Mexican Americans and Puerto Ricans
• Lower in Cuban Americans
RISK FACTORS YOU CAN CHANGE
Professor Betty C. Jung
HEART DISEASE STARTS IN CHILDHOOD
• Childhood risk factors for cardiovascular events leading to hospitalization
• BMI: 10% rise -- > 20% higher risk
• Systolic BP: 10% rise -- > 40% higher risk
• Serum cholesterol: 10% rise -- > 16% higher risk
• Adolescent smoking -- > 77% higher risk (Quit/don't smoke!)
• Source: Childhood cholesterol, blood pressure, weight and smoking
predict adult heart disease
https://www.sciencedaily.com/releases/2019/09/190901100612.htm
Professor Betty C. Jung
CHARACTERISTICS OF METABOLIC SYNDROME
A person having three or more factors listed here is diagnosed with
metabolic syndrome.
FACTOR CRITERIA
Large waistline
(abdominal obesity)
35 or more inches (88 cm) for women
40 or more inches (102 cm) for men
High triglyceride level 150 mg/dl or higher
Or taking medication to treat high triglycerides
Low HDL level Less than 50 mg/dl for women
Less than 40 mg/dl for men
Or taking medication to treat low HDL
High blood pressure 130/85 mm Hg or higher (one or both numbers)
Or taking medication to treat high blood pressure
High fasting blood sugar 100 mg/dl or higher
Or taking medication to treat high blood sugar
SOURCE: Adapted from National Heart, Lung, and Blood Institute. 2015. How Is Metabolic
Syndrome Diagnosed? (http://www.nhlbi.nih.gov/health/health-
topics/topics/ms/diagnosis).
A person having three or more factors listed here
is diagnosed with metabolic syndrome.
OTHER FACTORS YOU CAN CHANGE
• Insulin Resistance- weight
gain=>less active, muscle, fat
and live less sensitive to
insulin, pancreas must work
harder.
• Inflammation – C-Reactive
Protein (CRP) released ->
elevated risk for heart attack
and stroke.
• Alcohol & Drugs
• Psychological & Social
Factors:
• Stress
• Chronic hostility & anger
• Suppressing psychological
distress
• Depression
• Anxiety
• Social isolation
• Low socioeconomic status
Professor Betty C. Jung
WHAT’S YOUR LIFE PURPOSE?
• People who didn't have a strong life purpose — which was defined
as "a self-organizing life aim that stimulates goals" — were more
likely to die than those who did, and specifically more likely to die
of cardiovascular diseases.
• Strong life purpose was associated with reduced risk of mortality
and cardiovascular events, such as heart attacks or stroke.
• What's Your Purpose? Finding A Sense Of Meaning In Life Is
Linked To Health (5/25/2019)
• https://www.npr.org/sections/health-
shots/2019/05/25/726695968/whats-your-purpose-finding-a-
sense-of-meaning-in-life-is-linked-to-health
Professor Betty C. Jung
SMOKING & HEART DISEASE
• According to a new study, fathers-to-be who smoke may place
their offspring at an increased risk of congenital heart defects.
• Risk of congenital heart defects was much greater in men who
smoke than in woman smokers. The associated risk of
congenital heart defects increased by 74% for men smoking,
124% for passive smoking in women, and 25% for women
smoking (all compared to no exposure).
• (https://www.zmescience.com/medicine/fathers-smoke-baby-
health-3525623 3/25/19)
Professor Betty C. Jung
ALCOHOL & HEART HEALTH
• “…any exposure to alcohol has a negative impact upon heart
health”
• “Reducing the amount of alcoholic beverages consumed,
even for light-to-moderate drinkers, may improve
cardiovascular health, including a reduced risk of coronary
heart disease, lower body mass index and blood pressure,
according to a new multi-center study. The latest findings call
into question previous studies which suggest that consuming
light-to-moderate amounts of alcohol may have a protective
effect on cardiovascular health.” (University of Pennsylvania
School of Medicine)
• Drinking alcohol provides no heart health benefit, new study shows
http://www.sciencedaily.com/releases/2014/07/140710151947.htm (7/2014)
Professor Betty C. Jung
TOBACCO
• 1 in 5 deaths from CVD is a smoker
• Smokers have 2 to 3 times higher
risk of death from a heart attack,
than non-smokers
• Damages the lining of arteries
• Reduces HDLs
• Raises triglycerides and LDLs
• Nicotine increases blood pressure
• CO displaces O2
• Causes platelets to become sticky and increases blood thickness
• Speeds the development of fatty deposits in the arteries
Professor Betty C. Jung
http://farm5.static.flickr.com/4022/4655619987_
efdd3182bc_b.jpg
Professor Betty C. Jung
CHOLESTEROL• Fatty wax substance in the
blood
• Cell membranes
• Sex hormones
• Vitamin D
• Lung coating
• Nerve protective sheath
• Excessive – clogs arteries
• Low-density lipoproteins (LDL) [LOUSY]
• Moves cholesterol from liver to the organs
• High-density lipoproteins (HDL) [HEALTHY]
• Moves unused back to liver
• Removes cholesterol from blood vessels (protects against atherosclerosis)
• Ideal: High (healthy) HDL, Low (lousy) LDL
http://www.healthspablog.org/wp-
content/uploads/2011/03/High-cholesterol-puts-1-of-5-
teens-at-risk-of-heart-disease.jpg
BLOOD PRESSURE CLASSIFICATION FOR HEALTHY ADULTS
CATEGORY aSYSTOLIC
(mm Hg) and/or
DIASTOLIC
(mm Hg)
Normal b below 120 and below 80
Elevated 120 to 129 and below 80
Hypertension c stage
1130 to 139 or 80 to 89
Hypertension stage 2 at least 140 or at least 90
a When systolic and diastolic pressures fall into different categories, the higher category
should be used to classify blood pressure status.
b The risk of death from heart attack and stroke begins to rise when blood pressure is
above 115/75.
c Based on the average of two or more readings taken at different physician visits. In
people older than 50, systolic blood pressure greater than 140 mm Hg is a much more
significant CVD risk factor than diastolic blood pressure.
SOURCE: Whelton, P. K. et al. 2017. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology S0735–1097(17): 41519–1.
LOWERING BP NATURALLY
Professor Betty C. Jung
http://blogs.webmd.com/heart-disease/2017/02/how-to-lower-your-blood-pressure-without-meds.html
Put all these together and you can realize anywhere from a 20 to 55 mmHg drop on your own. That’s the same kind of result you’d get from being on a bunch of medications!
PHYSICAL INACTIVITY
Professor Betty C. Jung
http://www.brainyweightloss.com/images/why-should-
people-exercise.jpg
• 40–60 million Americans are so
sedentary that they are at high
risk for developing CVD
• Exercise reduces risk by:
• Controlling blood pressure
and resting heart rate
• Increasing HDLs
• Maintaining weight
• Improving the condition of
blood vessels
• Preventing or controlling
diabetes
OBESITY
Professor Betty C. Jung
http://www.nature.com/nature/journal/v454/n720
3/images/nature07206-f1.2.jpg;
• The risk of death from CVD is two to
three times more likely in obese
people (BMI > 30)
• Strongly associated with:
• Hypertension
• High cholesterol
• Insulin resistance
• Diabetes
• Inactivity
• Increasing age
• Hypertrophy
• Congestive heart failure
DIABETES & HEART DISEASE
Professor Betty C. Junghttp://mms.businesswire.com/bwapps/mediaserver/View
Media?mgid=312094&vid=5&download=1
HEART ATTACK
• Women can have different
symptoms
• http://simplybeautifulhealthyliving.blogspot.com/2012/07/sy
mptoms-and-signs-of-heart-attack.html
• Helping a Heart Attack Victim
• Aspirin (325 mg) helpful – anti-clotting
• Most die within 2 hours from initial symptoms
• Cardiopulmonary resuscitation (CPR)
Professor Betty C. Jung
HEART DISEASE IN WOMEN
Professor Betty C. Jung
PCI & CABG
• Percutaneous Coronary
Intervention• Coronary Artery Bypass
Graft
Professor Betty C. Jung
STROKE (BRAIN ATTACK)
Professor Betty C. Jung
780,000 Americans suffer strokes each year2 million brain cells die per minute during a stroke.Interruption of the blood supply or any area of the brain prevents the nerve cells from functioning in some cases causing death.
Ischemic stroke (Clot) 90% Thrombotic Stroke Embolic Stroke
Hemorrhagic stroke (Bleed) 10%
Clot-dissolving drugs should be given only for Ischemic Strokes
Professor Betty C. Junghttps://www.stroke.nih.gov/materials/needtoknow.htm?utm_campaign=%2B%20Health&utm_content=104561810&utm_medium=social&utm_source=twitter&hss_channel=tw-14074515
Professor Betty C. Jung
http://www.stroke.org/redesign/core/img/stroke_infographic_web.jpg
BEING HEART HEALTHY
Professor Betty C. Junghttp://angelmedflight.files.wordpress.com/2012/02/simple-
7_mid.png?w=230&h=266
STRATEGIES FOR REDUCING YOUR RISK OF CARDIOVASCULAR DISEASE
Do More
• Eat a diet rich in fruits, vegetables, whole grains, and low-
fat or fat-free dairy products. Eat five to nine servings of
fruits and vegetables each day.
• Eat several servings of high-fiber foods each day.
• Eat two or more servings of fish per week; try a few
servings of nuts and soy foods each week.
• Choose unsaturated fats rather than saturated and trans
fats.
• Be physically active; do both aerobic exercise and
strength training on a regular basis.
• Achieve and maintain a healthy weight.
• Develop effective strategies for handling stress and
anger. Nurture old friendships and family ties, and
make new friends; pay attention to your spiritual
side.
• Obtain recommended screening tests and follow your
physician’s recommendations.
Do Less
• Don’t use tobacco in any form: cigarettes, spit tobacco,
cigars and pipes, bidis and clove cigarettes.
• Limit consumption of trans fats and saturated fats.
• Limit consumption of salt to no more than 2300 mg of
sodium per day (1500 mg if you have or are at high risk for
hypertension).
• Avoid exposure to environmental tobacco
smoke.
• Avoid excessive alcohol consumption—
no more than one drink per day for
women and two drinks per day
for men.
• Limit consumption of added
sugars and refined
carbohydrates
• Avoid excess stress,
anger, and hostility.
© Rubberball/Getty Images; © Vladyslav Starozhylov/Alamy
Professor Betty C. Jung
CARDIOVASCULAR DISEASE
Chapter 13