Transcript Chapter 1
Chapter Outline Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Chapter 10 Preventing Cardiovascular Disease Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Cardiovascular diseases Any disease that affects the heart and the blood vessels Examples Coronary heart disease Peripheral vascular disease Congenital heart disease Rheumatic heart disease Atherosclerosis, strokes High blood pressure Congestive heart failure Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Cardiovascular diseases About 20% of the U.S. population has some form of cardiovascular disease 1 in 3 men and 1 in 10 women will develop a major cardiovascular problem before age 60 In the year 2000, 40% of all deaths in the U.S. were attributable to heart and blood vessel disease Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Heart disease About 1.1 million people in the U.S. have heart attacks each year—500,000 of them die as a result More than half of these deaths occur within 1 hour of the onset of symptoms, before the person reaches a hospital Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Cardiovascular diseases Although heart and blood vessel disease is still the number one health problem in the U.S., the incidence declined by 32% between 1960 and 2000 Health education: More people now are aware of the risk factors for cardiovascular disease and are changing their lifestyle to lower their own risk Hoeger & Hoeger. All slides © Wadsworth Publishing. Figure 10.2 Incidence of cardiovascular disease in the United States for selected years: 1900– 2000 Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Critical thinking What are your feelings about your own risk for diseases of the cardiovascular system? Is this something that you need to concern yourself with at this point in your life? Why or why not? Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Coronary heart disease (CHD) The major form of cardiovascular disease In CHD the arteries that supply the heart with oxygen and nutrients are narrowed by fatty deposits such as cholesterol and triglycerides Narrowing of the coronary arteries diminishes blood supply to the heart muscle, which can precipitate a heart attack Hoeger & Hoeger. All slides © Wadsworth Publishing. Figure 10.3 The heart and it’s blood vessels Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Coronary heart disease Single leading cause of death in U.S., accounting for 20% of all deaths and half of all cardiovascular deaths More than half of the people who died suddenly from CHD had no previous symptoms 80% of deaths from CHD in people under age 65 occur during the first heart attack The risk of death is greater in the least educated segment of the population Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Coronary heart disease Almost all risk factors are preventable and reversible The individual can reduce risk by participating in a healthy lifestyle program Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Major CHD risk factors Physical inactivity Abnormal electrocardiogram Abnormal cholesterol profile Elevated triglycerides Elevated homocysteine C-reactive protein Diabetes Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Major CHD risk factors High blood pressure Excessive body fat Smoking Tension and stress Personal and family history Age Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Physical inactivity Improving cardiorespiratory endurance through increased physical activity reduces the overall risk for heart disease Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Regular physical activity Daily physical activity and a regular aerobic exercise program help control most heart disease risk factors Increases cardiorespiratory endurance Decreases and controls blood pressure Reduces body fat Lowers blood lipids (cholesterol and triglycerides) Improves HDL cholesterol Helps control diabetes Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Regular physical activity Daily physical activity and a regular aerobic exercise program help control most heart disease risk factors Increases and maintains good heart function, sometimes improving certain ECG abnormalities Motivates toward smoking cessation Alleviates tension and stress Counteracts a personal history of heart disease Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention “ Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Physical activity and exercise Based on the overwhelming amount of scientific data in this area, evidence of the benefits of aerobic exercise in reducing heart disease is far too impressive to be ignored.” Hoeger & Hoeger. All slides © Wadsworth Publishing. The electrocardiogram or ECG provides a record of the electrical impulses that stimulate the heart to contract Figure 10.4 Normal electrocardiogram Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Stress electrocardiogram Also known as a graded exercise stress test or a maximal exercise tolerance test A stress ECG reveals the tolerance of the heart to increased physical activity Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Stress ECG guidelines Men over age 45 and women over age 55 A total cholesterol level above 200 mg/dl or an HDL cholesterol below 35 mg/dl Hypertensive and diabetic patients Cigarette smokers People with an abnormal resting ECG Hoeger & Hoeger. All slides © Wadsworth Publishing. Individuals with a family history of CHD, syncope, or sudden death before age 60 All individuals with symptoms of chest discomfort, dysrhythmias (abnormal heartbeat), syncope, or chronotropic incompetence (heart rate that increases slowly during exercise and never reaches maximum) Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Abnormal cholesterol profile Blood lipids are carried in the bloodstream by molecules of protein known as High density lipoproteins (HDLs) Low density lipoproteins (LDLs) Very low density lipoproteins (VLDLs) Chylomicrons Hoeger & Hoeger. All slides © Wadsworth Publishing. Figure 10.7 The atherosclerotic process Curtesey American Heart Association. © AHA Hoeger & Hoeger. All slides © Wadsworth Publishing. Table 10.3 Cholesterol guidelines Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Key term High-density lipoproteins (HDLs): Cholesterol transporting molecules in the blood (“good” cholesterol) that help clear cholesterol from the blood Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Key term Low-density lipoproteins (LDLs): Cholesterol transporting molecules in the blood (“bad” cholesterol) that tend to increase blood cholesterol Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors HDL-cholesterol HDL-cholesterol acts as a "scavenger," removing cholesterol from the body and preventing plaque from forming in the arteries The strength of HDL is in the protein molecules found in their coatings When HDL comes in contact with cholesterol filled cells, these protein molecules attach to the cells and take their cholesterol Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors HDL-cholesterol For the most part, HDL-cholesterol is determined genetically Generally, women have higher levels than men The female hormone estrogen tends to raise HDL, so premenopausal women have a much lower incidence of heart disease Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Ways to increase HDL-cholesterol Habitual aerobic exercise (> 6 METs, 3 times/week for 20 min/session) Weight loss (if necessary) Niacin supplementation Quitting smoking Increasing consumption of beta carotene Drug therapy Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors LDL-cholesterol Tends to release cholesterol, which then may penetrate the lining of the arteries and speed up the process of atherosclerosis Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Ways to lower LDL-cholesterol Loss of body fat (if necessary) Dietary changes Drug therapy Participation in a regular aerobic exercise program Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors LDL-cholesterol It is better to lower LDL-cholesterol without medication, as drugs can cause muscle and joint pain and alter liver enzyme levels People with heart disease must often take cholesterol-lowering medication, but it is best if medication is combined with lifestyle changes to augment the cholesterol-lowering effect Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Ways to lower LDL-cholesterol Choose a diet low in fat, saturated fat, and cholesterol Saturated fat should be replaced with monounsaturated and polyunsaturated fats because the latter tend to decrease LDLcholesterol Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Ways to lower LDL-cholesterol Total daily fiber intake should be 25 to 38 grams per day, including a minimum of 10 grams of soluble fiber Total fat consumption must be less than 30% of total daily caloric intake Saturated fat consumption should be under 7% of the total daily caloric intake Average cholesterol consumption should be much lower than 200 mg per day Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Diet & cholesterol A drawback of very low fat diets (less than 25% fat) is that they tend to lower HDL-cholesterol and increase triglycerides If HDL-cholesterol is already low, monounsaturated and polyunsaturated fats should be added to the diet Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Ways to lower LDL-cholesterol Consume 25 grams of soy protein a day Consume red meats fewer than three times per week, and no organ meats (liver, kidneys) Eat fish instead of red meat Do not eat commercially baked foods Avoid foods that contain transfatty acids, hydrogenated fat, or partially hydrogenated vegetable oil Drink low fat milk (1% or less) and choose low fat dairy products Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Ways to lower LDL-cholesterol Limit egg consumption to less than 3 eggs per week Bake, broil, grill, poach, or steam food instead of frying Refrigerate cooked meat before adding to other dishes; remove fat hardened in the refrigerator before mixing meat with other foods Avoid fatty sauces made with butter, cream, or cheese Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Cholesterol-lowering medications There are now very effective medications to treat elevated cholesterol and triglycerides Most notable are the statins group, which can lower cholesterol by up to 60% in 2 to 3 months Statins Slow down cholesterol production and increase the liver's ability to remove blood cholesterol Decrease triglycerides and produce a small increase in HDL levels Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Triglycerides Also known as free fatty acids In combination with cholesterol, triglycerides speed up the formation of plaque in arteries Triglycerides are carried in the bloodstream primarily by very low density lipoproteins (VLDLs) and chylomicrons Hoeger & Hoeger. All slides © Wadsworth Publishing. Table 10.5 Triglycerides guidelines Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Triglycerides Found in Poultry skin Lunch meats Shellfish Manufactured mainly in the liver, from refined sugars, starches, and alcohol Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Ways to lower triglycerides Cut down on high-triglyceride foods Decrease overall fat consumption Quit smoking Reduce weight (if necessary) Participate in aerobic exercise Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Critical thinking Are you aware of your blood lipid profile? If not, what keeps you from having a blood chemistry test done? What are the benefits of having it done now as opposed to later in life? Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Homocysteine Clinical data indicates that many heart attack and stroke victims have normal cholesterol levels A high concentration of the amino acid homocysteine in the blood is thought to enhance plaque formation and subsequent blockage of arteries Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Homocysteine Homocysteine is an intermediate amino acid in the interconversion of two other amino acids: methionine and cysteine This interconversion requires the B vitamin folate (folic acid) and vitamins B6 and B12 Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Homocysteine A large number of people have high blood levels of homocysteine due to a Genetic inability to metabolize homocysteine Deficiency in the vitamins required for its conversion Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Homocysteine Five servings of fruits and vegetables daily can provide sufficient levels of folate and vitamin B6 to remove and clear homocysteine from blood Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Homocysteine Vitamin B12 is found primarily in animal flesh and animal products Vitamin B12 deficiency is rarely a problem (1 cup of milk or an egg provides the daily requirement) The body recycles most of this vitamin, thus, a deficiency takes years to develop Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors C-reactive protein (CRP) Scientists are looking at inflammation as a major risk factor for heart attacks Low-grade inflammation can occur in a variety of places throughout the body For years it has been known that Inflammation plays a role in CHD Inflammation hidden deep in the body is a common trigger of heart attacks, even when cholesterol levels are normal or low and arterial plaque is minimal Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors C-reactive protein (CRP) A protein whose blood levels increase with inflammation Physicians have turned to CRP to evaluate ongoing inflammation in the body People with elevated CRP are more prone to cardiovascular events The risk of a heart attack is even higher in people with both elevated CRP and cholesterol, resulting in an almost 9-fold increase in risk Hoeger & Hoeger. All slides © Wadsworth Publishing. The hs-CRP (for high-sensitivity CRP) test is used to measure inflammation in the blood vessels Hoeger & Hoeger. All slides © Wadsworth Publishing. Table 10.6 Figure 10.8 Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors C-reactive protein (CRP) Levels decrease with statin drugs Also helpful are exercise, weight loss, proper nutrition, and aspirin Omega-3 fatty acids inhibit proteins that cause inflammation Excessive intake of alcohol and high protein diets increase CRP Aspirin therapy may also help control inflammation Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Diabetes mellitus A condition in which blood glucose is unable to enter the cells because The pancreas totally stops producing insulin The pancreas does not produce enough to meet the body's needs The cells develop insulin resistance The role of insulin is to "unlock" the cell to escort glucose into the cell Diabetes affects more than 16 million people in the U S. Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Diabetes People with chronically elevated blood glucose levels may have problems metabolizing fats, which can make them more susceptible to Atherosclerosis, coronary heart disease, heart attacks, high blood pressure, and strokes Diabetics also have lower HDL cholesterol and higher triglyceride levels Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Diabetes An 8-hour fasting blood glucose level above 126 mg/dl on two separate tests confirms a diagnosis of diabetes A level of 126 or higher should be brought to the attention of a physician Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Key terms Type I Diabetes: Insulin-dependent diabetes (IDDM) Also called juvenile diabetes The pancreas produces little or no insulin Type II Diabetes: Non-insulin-dependent diabetes (NIDDM) The pancreas either does not produce sufficient insulin or it produces adequate amounts but cells become insulin-resistant Accounts for 90% to 95% of all diabetes cases Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Diabetes Although diabetes has a genetic predisposition, type II is related to Overeating, obesity, and lack of physical activity Once limited primarily to overweight adults Now accounts for almost half of new cases in children More than 80% of all type II diabetics are overweight or have a history of excessive weight In most cases, type II can be corrected through Diet, weight loss, and regular exercise Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Diabetes Both moderate and vigorous physical activity are associated with increased insulin sensitivity and decreased risk for diabetes The key to increase and maintain proper insulin sensitivity is regularity of the exercise program Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Diabetes A healthy diet is beneficial High in complex carbohydrates and water-soluble fibers (found in fruits, vegetables, oats, and beans) Low in saturated fat and sugar Aggressive weight loss, especially if combined with exercise, often allows diabetic patients to normalize blood sugar level without the use of medication Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Syndrome X As cells resist insulin's action, the pancreas releases even more insulin in an attempt to keep blood glucose from rising A chronic rise in insulin appears to trigger a series of abnormalities referred to as syndrome X or metabolic syndrome These abnormal conditions include Low HDL-cholesterol, high triglycerides, an increased blood clotting mechanism, and high blood pressure Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Syndrome X Syndrome X patients should distribute daily caloric intake so that 45% of the calories are derived from carbohydrates (primarily low-glycemic) 40% from fat (30% to 35% mono- and polyunsaturated fats, and 5% to 10% saturated fat) 15% from protein Syndrome X patients also benefit from Weight loss (if overweight) Exercise Smoking cessation Hoeger & Hoeger. All slides © Wadsworth Publishing. QuickTime™ and a Sorenson Video decompressor are needed to see this picture. Dietary guidelines Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Key terms Blood pressure: A measure of the force exerted against the walls of the vessels by the blood flowing through them Systolic blood pressure: Pressure exerted by the blood against the walls of the arteries during the forceful contraction (systole) of the heart; higher of the two numbers in blood pressure readings Hoeger & Hoeger. All slides © Wadsworth Publishing. Diastolic blood pressure: Pressure exerted by the blood against the walls of the arteries during the relaxation phase (diastole) of the heart; lower of the two numbers in blood pressure readings Hypertension: Chronically elevated blood pressure Hypotension: Low blood pressure Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors High blood pressure The “silent killer” A blood pressure above 140/90 mm Hg Approximately 20% of Americans are hypertensive High blood pressure is a risk factor for CHD, congestive heart failure, strokes, kidney failure, and osteoporosis Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Blood pressure guidelines Rating Systolic Diastolic Optimal 120 80 Normal 121–129 81–84 High Normal 130–139 85–89 Stage 1 Hypertension 140–159 90–99 Stage 2 Hypertension 160–179 100–109 Stage 3 Hypertension 180 110 Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Critical thinking Do you know what your most recent blood pressure reading was, and did you know at the time what the numbers meant? How would you react if your doctor instructed you to take blood pressure medication? Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors High blood pressure treatment Increase physical activity Follow recommended dietary guidelines to reduce blood pressure Lose weight if above recommended body weight Practice stress management Do not smoke cigarettes or use tobacco Consider drug therapy Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Hypertension & exercise Hypertensive people who are physically active have a lower risk of mortality from all causes than inactive individuals with normal blood pressure The death rates for unfit individuals with low systolic blood pressure are much higher than in highly fit people with high systolic blood pressure Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Effects of aerobic exercise on blood pressure An individual can expect exercise-induced reductions of approximately 3 to 5 mm Hg in resting systolic and diastolic blood pressures (both through aerobic exercise and strength training) Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Exercise and high blood pressure treatment Moderate-intensity aerobic exercise program 50% intensity 30 to 45 minutes 5 to 7 times per week Moderate-resistance strength-training program 8 to 12 exercises 1 to 3 sets of 12 to 15 repetitions to near fatigue 2 times per week Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Hypertension & diet Eat less salt and sodium-containing foods Consume more potassium-rich foods Such as potatoes, bananas, orange juice, cantaloupe, tomatoes, and beans Do not consume more than 2 alcoholic beverages a day if you are a man, 1 if you are a woman Follow the dietary approach to stop hypertension (DASH) Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Dietary approach to stop hypertension (DASH) 7 or 8 daily servings of grains, bread, cereal, or pasta 8 to 10 daily servings of fruits and vegetables 2 or 3 daily servings of nonfat/low-fat dairy products 2 or less daily servings of meat, poultry, or fish (less than 3 ounces per serving) 4 or 5 servings per week of beans, peas, nuts, or seeds Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors High blood pressure medication Antihypertensive drugs often are the first choice of treatment Antihypertensive drugs produce many side effects Lethargy, sleepiness, sexual difficulties, higher blood cholesterol and glucose levels, lower potassium levels, elevated uric acid levels Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Excessive body fat (obesity) Recognized as an independent risk factor for CHD Risks attributed to obesity, however, often are caused by other risk factors that usually accompany excessive body fat Risk factors such as high blood lipids, hypertension, and diabetes usually improve with increased physical activity Overweight people who are physically active may not be at increased risk for premature death Hoeger & Hoeger. All slides © Wadsworth Publishing. QuickTime™ and a Sorenson Video decompressor are needed to see this picture. Weight management Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Smoking More than 47 million adults and 3.5 million adolescents in the U.S. smoke cigarettes Smoking causes between 435,000 and 440,000 annual deaths in the U.S. In relation to CHD Smoking speeds up the process of atherosclerosis Causes a threefold increase in the risk of sudden death following a myocardial infarction Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Smoking Increases heart rate Raises blood pressure Irritates the heart, increasing the risk of fatal cardiac arrhythmias Decreases HDL-cholesterol Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Tension & stress People who are not able to relax have a constant low-level strain on the cardiovascular system that could manifest itself in heart disease Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Tension & stress Individuals who are under a lot of stress and do not cope well need to take measures to counteract the effects of stress One way is to identify the sources of stress and learn how to cope with them Take control: Examine and act upon the things that are most important, ignore less meaningful details Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Personal history Individuals who have had cardiovascular problems are at higher risk for disease than those who have never had a problem People with such history should control other risk factors as much as they can Most risk factors are reversible, so they can greatly decrease the risk for future problems Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Family history Genetic predisposition toward heart disease has been clearly demonstrated All other factors being equal, a person with blood relatives who now have or have had heart disease run a greater risk than someone with no such history In some cases, there is no way of knowing whether a person has a true genetic predisposition or if it is poor lifestyle habits that led to the problem Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Critical thinking Do you have any relatives that have suffered from cardiovascular disease? If so, what steps are you taking to prevent a cardiovascular event in your life? Is there something you can do to help others in your family do the same? Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Age Age is a risk factor because of the higher incidence of heart disease in older people This tendency may be induced partly by other factors stemming from changes in lifestyle as we get older Less physical activity, poor nutrition, obesity Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Age Although the aging process cannot be stopped, it certainly can be slowed down Physiological versus chronological age is important in preventing disease Some individuals in their 60s or older have the body of a 20year-old 20-year-olds often are in such poor condition that they almost seem to have the body of 60-year-olds Risk factor management and positive lifestyle habits are the best means of slowing down aging Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Gum disease Oral bacteria that builds up with dental plaque can enter the blood stream and contribute to inflammation and blood vessel plaque formation, increase blood clots, and thus increase heart attack risk Daily flossing for 1 to 2 minutes is the best way to prevent gum disease Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Snoring Loud snoring has been linked to cardiovascular disease People who snore heavily may suffer from sleep apnea, in which the throat closes for a brief moment, causing breathing to stop In one study, individuals who snored heavily tripled their risk of a heart attack and quadrupled the risk of a stroke Hoeger & Hoeger. All slides © Wadsworth Publishing. Cardiovascular Disease Prevention Coronary Heart Disease Major CHD Risk Factors Other CHD Risk Factors Aspirin Aspirin therapy is recommended to prevent heart disease A daily aspirin dose of 81 mg (equivalent of a baby aspirin) can prevent or dissolve clots that cause heart attacks or strokes The incidence of a nonfatal heart attack is decreased by about 32% with daily aspirin use Hoeger & Hoeger. All slides © Wadsworth Publishing. End of Chapter Hoeger & Hoeger. All slides © Wadsworth Publishing.