Chapter 5. Women are about as likely to die of cardiovascular disease as they are to die of breast...
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Transcript of Chapter 5. Women are about as likely to die of cardiovascular disease as they are to die of breast...
TEST YOUR KNOWLEDGE
Women are about as likely to die of cardiovascular disease as they are to die of breast cancer. True or False?
FALSE. Cardiovascular disease kills far more. Among American women, nearly 1 in 3 deaths is due to CVD and about 1 in 30 is due to breast cancer. In addition, more women than men die each year from cardiovascular disease.
TEST YOUR KNOWLEDGE
On average, how much earlier does heart disease develop in people who don’t exercise regularly than in people who do?
a. 6 months b. 2 years c. 6 years
c. Both aerobic exercise ad strength training significantly improve cardiovascular health.
TEST YOUR KNOWLEDGE
Which of the following foods would be a good choice for promoting heart health?
a. whole grains b. salmon c. bananas
ALL THREE. Whole grains, foods with omega 3 fatty acids, and foods high in potassium and low in sodium all improve cardiovascular health.
RISK FACTORS FOR CARDIOVASCULAR DISEASE
Factors associated with an increased risk of developing CVC are grouped in two categories:
Major risk factors Contributing risk factors
Controllable aspects (diet, exercise habits, tobacco) Non – controllable aspects (age, sex, race, heredity)
MAJOR RISK FACTORS THAT CAN BE CHANGED
Tobacco use: smoking harms the cardiovascular system in several ways: Damages the lining of arteries Reduces the level of high density lipoproteins
(HDL) Raises the levels of triglycerides and low-
density lipoproteins (LDL) Nicotine increases blood pressure and heart
rate Carbon monoxide displaces oxygen in blood Causes platelets to stick together in the blood
stream, leading to clotting Speeds the development of fatty deposits in
arteries
Second hand smoking is as damaging as first hand.
MAJOR RISK FACTORS THAT CAN BE CHANGED
High blood pressure – hypertension
Blood pressure: force exerted by the blood on the vessel walls created by the pumping action of the heart.
High blood pressure results from increased output of blood by the heart increased resistance to blood flow in the arteries.
Constriction of smooth muscle surrounding the arteries
Atherosclerosis: clogging and narrowing of arteries.
High blood pressure is common and usually has no symptoms.
MAJOR RISK FACTORS THAT CAN BE CHANGED
Blood Pressure Classification for Healthy AdultsCategory Systolic
(mm Hg)Diastolic(mm Hg)
NormalPrehypertensionHypertension Stage 1 Stage 2
Below 120120 – 139
140 – 159160 and above
Below 8080 – 89
90 – 99100 and above
MAJOR RISK FACTORS THAT CAN BE CHANGED
Unhealthy cholesterol levels Cholesterol: fatty, wax like substance
that circulates through the bloodstream
Important component of cell membranes, sex hormones, vitamin D, the fluid that coats the lungs and the protective sheaths around nerves.
Excess cholesterol clogs arteries and increases the risk of CVD
MAJOR RISK FACTORS THAT CAN BE CHANGED
CHLOLESTEROL Produced in the
liver Carried in blood by
lipoproteins LDL shuttle
cholesterol from the liver to organs and tissues.
HDL shuttle unused cholesterol back to the liver for recycling.
MAJOR RISK FACTORS THAT CAN BE CHANGED
CHOLESTEROL GUIDELINES
Total cholesterol (mg/dl)
Less than 200200 – 239240 or more
DesirableBorderline highHigh
LDL cholesterol (mg/dl)
Less than 100100 – 129130 – 159190 or more
OptimalNear optimal /above optimalBorderline highHigh Very high
HDL Cholesterol (mg/dl)
Less than 4060 or more
Low (undesirable)High (desirable
Triglycerides (mg/dl)
Less than 150150 – 199200 – 499500 or more
NormalBorderline highHigh Very high
Blood cholesterol levels
MAJOR RISK FACTORS THAT CAN BE CHANGED
Improving cholesterol levels Reduce your LDL to healthy
levels Choose unsaturated fats Increase fiber intake Exercise regularly Eat more fruits, vegetables,
fish and whole grains
MAJOR RISK FACTORS THAT CAN BE CHANGED
Physical Activity Lowers CVD risk by
Helping decrease blood pressure and resting heart rate Increase HDL levels Maintain desirable weight Improve the condition of blood vessels Prevent or control diabetes.
MAJOR RISK FACTORS THAT CAN BE CHANGED
Obesity Risk of death from CVD is two to three
times higher in obese people
Distribution of body fat is significant Fat in the abdomen is more dangerous than fat
in the hips
MAJOR RISK FACTORS THAT CAN BE CHANGED
Diabetes Disorder in which the metabolism of glucose is disrupted causing a buildup of glucose in the bloodstream Can damage the lining of arteries, making them more vulnerable to
atherosclerosis
Other risk factors include: hypertension, obesity, unhealthy cholesterol and triglyceride levels, platelet and blood coagulation abnormalities.
CONTRIBUTING FACTORS
High triglyceride levels Triglycerides: blood fats that are absorbed
from food and manufactured by the body Factors involved:
Excess body fat Physical inactivity Cigarette smoking Type 2 diabetes Excess alcohol intake Very high carbohydrate diets Certain diseases and medications
CONTRIBUTING FACTORS
Psychological and social factors Chronic stress Chronic hostility and anger Lack of social support Suppressed psychological distress Depression and anxiety Social isolation Low socio-economical status
CONTRIBUTING FACTORS
Alcohol and drugs
Drinking too much alcohol raises blood pressure and can increase the risk of stroke and heart failure.
MAJOR RISK FACTORS THAT CAN’T BE CHANGED
Family History (Heredity) Multiple genes contribute to the
development of CVD and its risk factors People with an inheritance for CVD are
not destined to develop it, but they have to work to prevent it.
Aging About 50% of adult Americans that
develop CVD are over age 65 However, people in their 30s and 40s,
specially men can have heart attacks.
MAJOR RISK FACTORS THAT CAN’T BE CHANGED
Being male Men face greater risk of heart attack than women The incidence of stroke is higher for males than
females until age 65,
Ethnicity African Americans have higher rates of
hypertension, heart disease and stroke than other groups.
POSSIBLE RISK FACTORS CURRENTLY BEING STUDIED C-reactive protein (CRP)
Released into the body during inflammatory response May be released in arteries injured by smoking, cholesterol, infectious
agents.
Homocysteine Amino acid that may damage the lining of blood vessels Men generally have higher homocysteine levels than women Individuals with low levels of folic acid, vitamin B-12 and B-6 also have high
levels.
Lipoprotein (a) – Lp(a) Type of LDL that has a strong genetic component and is difficult to treat.
LDL pattern B LDL particles differ in size and density People with high proportion of small, dense LDL particles appear to have a
high risk for CVD
POSSIBLE RISK FACTORS CURRENTLY BEING STUDIED
Infectious agents Chlamydia pneumoniae, cytomegalovirus and Helicobacter pylory Infections may damage arteries and lead to chronic
inflammation.
Fibrinogen Involved in blood clotting
Metabolic syndrome – Insulin resistance syndrome Symptoms include abdominal obesity, high triglycerides, lo HDL
cholesterol, high blood pressure, and high blood glucose levels.
MAJOR FORMS OF CARDIOVASCULAR DISEASE
Artherosclerosis Arteries become narrowed by
deposits of fat, cholesterol and other substances.
Deposits called plaques accumulate on artery walls
Arteries lose their elasticity and ability to expand and contract
Blood flow becomes restricted Artery becomes vulnerable to
blockage by blood clots.
MAJOR FORMS OF CARDIOVASCULAR DISEASE
Heart Disease and Heart Attacks
Coronary Heart Disease (CHD): caused by the hardening of coronary arteries.
Heart attack – myocardial infarction (MI): damage or death of heart muscle.
Angina pectoris (chest pain): severe pain in the chest, left arm and shoulder due to a lack of oxygen in the heart’s muscle.
Arrhythmia: irregularity in the force or rhythm of the heartbeat.
Sudden cardiac death – cardiac arrest: caused by an arrhythmia called ventricular fibrillation that results in ineffective pumping of blood
MAJOR FORMS OF CARDIOVASCULAR DISEASE
HEART DISEASE AND HEART ATTACK
Symptoms Symptoms differ but include the following:
Extreme tightness in the chest and heavy pressure behind the breastbone or in the shoulder, neck, arm, hand or back.
Shortness of breath, weakness, unusual fatigue, cold sweat, dizziness and nausea.
Diagnosis Electrocardiogram – ECG or EKG Magnetic resonance imaging MRI Electron – beam computed tomography EBC Echocardiograms Angiograms
MAJOR FORMS OF CARDIOVASCULAR DISEASE
HEART DISEASE AND HEART ATTACK
Treatment Low fat diet, regular exercise, smoking
cessation Low dose aspirin Balloon angioplasty Coronary stents Coronary Bypass Surgery
MAJOR FORMS OF CARDIOVASCULAR DISEASE
Stroke – cerebrovascular accident (CVA) Occurs when the blood supply to the brain is cut off Caused by
A blood clot that blocks an artery ischemic stroke Ruptured blood vessel hemorrhagic stroke
A stroke may cause paralysis, walking disability, speech impairment or memory loss.
Treatment involves the use of clot dissolving and antihypertensive drugs.
MAJOR FORMS OF CARDIOVASCULAR DISEASE
Congestive Heart Failure Condition resulting from the heart’s inability to pump out
all the blood that returns to it. Blood backs up in the veins leading to the heart, causing an accumulation of fluid in various parts of the body, specially legs and ankles.
Causes High blood pressure Heart attack Atherosclerosis Viral infections Rheumatic fever Birth defects
Treatment Reducing the workload on the heart Modifying salt intake Using drugs to eliminate excess fluid
PROTECTING YOURSELF FROM CARDIOVASCULAR DISEASE
Eat a heart – healthy diet Reducing fat intake
no more than 30% (7%) Substituting unsaturated fat for saturated and
trans fats 1/3 from fats
Increasing intake of whole grains and fiber Fiber traps the bile acids the liver needs to manufacture
cholesterol and carries them to the large intestine. Slows the production of proteins that promote blood
clotting. Interfere with the absorption of dietary fat. Recommended 25 – 28 gr/day.
PROTECTING YOURSELF FROM CARDIOVASCULAR DISEASE
Eat a heart – healthy diet Reducing the intake of sodium and increasing the
intake of potassium Alcohol
Moderate alcohol consumption reduces the risk of CHD Dash (Dietary Approaches to Stop Hypertension
6-8 servings a day of grains and grain products 4-5 servings a day of vegetables 4-5 servings a day of fruits 2-3 servings a day of low-fat or nonfat dairy products 6 or fewer 1-ounce servings a day of meats, poultry, and fish 4-5 servings a week of nuts, seeds and legumes 2-3 servings a day of added fats, oils and salad dressings 5 or fewer servings a week of snacks and sweets.
PROTECTING YOURSELF FROM CARDIOVASCULAR DISEASE
Exercise regularly 30 – 60 minutes of moderate-intensity physical
activity each day
Avoid tobacco The number one risk factor for CVD that you can
control is smoking
Know and manage your blood pressure Have your blood pressure measured every 2 years
PROTECTING YOURSELF FROM CARDIOVASCULAR DISEASE
Know and manage your cholesterol levels Have a lipoprotein profile (cholesterol, HDL, LDL
and triglyceride) once every 5 years
Develop ways to handle stress and anger
Know your risk factors If you are at moderate to high risk for CVD,
consult a physician about taking small doses of aspirin.