Transcript Blood Pressure

An Invitation to Health
Chapter 14
Keeping Your Heart Healthy
Dr. Lana Zinger
©2004 Wadsworth Publishing Co.
The Healthy Heart
The Healthy Heart
Chambers of the Heart
Left Atrium
Receives oxygenated
blood from the lungs.
Left Ventricle
Pumps blood rich in
oxygen through the aorta
to the arteries to nourish
the body systems.
Right Atrium
Receives blood
through the
superior and
inferior vena cava.
Right Ventricle
Pumps blood in need of
oxygen to the lungs.
The Path Of Blood Flow
Death Rates for Cardiovascular Disease in the
United States, 1940 & 2000
Activity
Reduction in body weight.
Reduction in blood pressure.
Reduction of LDL and total cholesterol.
Increase in HDL cholesterol.
Increased insulin sensitivity.
American Heart Association, American
College of Sports Medicine and the CDC
30 minutes or more of moderate-intensity
physical activity on most, if not all, days of
the week.
Institute of Medicine
60 minutes of daily physical activity to
counter the obesity epidemic.
Heart Healthy Nutrition
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Plenty of fruits and vegetables.
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Cholesterol Lowering Foods:
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Oats, barley, soy protein, and nuts.
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Fish 2 times a week (AHA).
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Insufficient Evidence to Recommend For or
Against the Use of:
Supplements of vitamin A, C, or E.
 Multivitamins with folic acid.
 Antioxidant combinations.
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The Lifestyle Syndrome
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Definition: A cluster of conditions and diseases
that result from:
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Consuming too many calories.
Ingesting too much saturated fat, sodium, and alcohol.
Not burning up enough calories.
Smoking or being exposed to tobacco smoke.
Consequences:
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Hypertension, metabolic syndrome, obesity, high
cholesterol, cardiovascular disease, cancer, osteoarthritis,
depression, sexual dysfunction, and diabetes mellitus.
Risk Factors for Cardiovascular Disease
Factors You Can Control Factors You Can’t Control
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Physical Inactivity
Tobacco
Obesity
Blood Fats
Metabolic Syndrome
Diabetes Mellitus
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Heredity
Race and Ethnicity
Age
Gender
Bacterial Infection
Tobacco and Heart Disease
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Smoking is the single most significant risk factor for
CV disease and peripheral vascular disease.
Each year smoking causes 250,000+ deaths from
cardiovascular disease.
Active vs. passive smoking.
How Smoking Damages The Heart:
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Nicotine overstimulates the heart.
Carbon monoxide reduce the oxygen supply to the heart.
Tars and other smoke residues increase the risk of cholesterol
build-up in the arteries.
Smoking increases blood clotting.
Smoking causes irreversible damage to the arteries.
Measurement of Blood Pressure
Blood Pressure
Definition: A measure of the force exerted against the walls of
the vessels by the blood flowing through them.
Systolic Blood Pressure
Pressure exerted by blood
against walls of the arteries
during forceful contraction
of the heart.
Diastolic Blood Pressure
Pressure exerted by blood
against the walls of the
arteries during
relaxation of the heart.
Sphygmomanometer &
Stethoscope
What Is a Healthy Blood Pressure?
115/75 mm Hg
HEALTHY READING
120-139/80-90 mm Hg
PREHYPERTENSION
140-159/90-99 mm Hg
160+/100+ mm Hg
HYPERTENSION
Consequences of High Blood Pressure
Understanding Blood Lipids
Low Density
Lipoprotein
(LDL)
Fatty substances produced by the liver that carry
cholesterol to arterial walls; “bad” cholesterol.
High Density
Lipoprotein
(HDL)
Fatty substance that picks up cholesterol in the bloo
stream and returns it to the liver; “good” cholestero
Very Low Density
Lipoprotein
(VLDL)
Triglycerides
The largest of the lipoproteins which allow
cholesterol to circulate in the bloodstream.
Fats that flow through the blood after meals and
have been linked to increased risk of coronary
artery disease.
Metabolic Syndrome
Syndrome X or Insulin-Resistant Syndrome
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Definition: A cluster of medical abnormalities that
increases the risk of heart disease and diabetes.
Probable Causes: Genetics, lack of exercise, and
overeating.
Diagnostic Criteria:
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Waist Circumference: Men > 40 inches; Women >35
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Triglycerides: >150 mg/dL.
High-Density Lipoproteins: Men <40 mg/dl; Women <50
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inches.
mg/dl.
Blood Pressure:130 mm Hg (systole)/85 mm Hg (diastole).
Fasting Blood Sugar: >110 mg/dl.
Preventing Hypertension
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Lifestyle Changes
 Losing
weight.
 Regular exercise.
 Dietary Approaches To Stop Hypertension
(DASH Diet).
 Restriction of daily sodium intake.
Serum Cholesterol Guidelines
Amount
Rating
Total Cholesterol
<200 mg/dl
200-239 mg/dl
>240 mg/dl
Desirable
Borderline High
High Risk
LDL Cholesterol
Less than 100 mg/dl
100-129 mg/dl
130-159 mg/dl
160-189 mg/dl
190+ mg/dl
Optimal
Near Optimal
Borderline High
High
Very High
HDL cholesterol
>45 mg/dl
36-44 mg/dl
<35 mg/dl
Desirable
Borderline High
High Risk
Lowering Cholesterol
Therapeutic Life
Changes (TLC)
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Dietary changes
Weight management
Physical activity
Medications
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Statins
Bile Acid Sequestrants
Nicotinic acid (niacin)
Fibrates
Novel Risk Factors for Heart Disease
C-Reactive Protein (CRP)
Fibrinogen
Homocysteine
Lipoprotein (a)
Lipoprotein Particle
Size and Density
Development of Atherosclerosis
Fatty Streaks Develop on the Arterial Walls at Injury Spots
Growth and Hardening of Fatty Streaks
Plaque Formation (well developed by age 30)
Narrowing and Loss of Elasticity of the Arteries
Restriction of Blood Flow to the Heart or Brain
Limited Oxygen Delivery to the Heart or Brain
Blood Pressure Elevation
Blood Clot Formation and Thrombosis
Angina, Heart Attack and/or Stroke
The
Atherosclerotic
Process
Unclogging The Arteries
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Cholesterol-lowering drugs
Low-fat diet
Dean Ornish Diet (without
medications)
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Very low-fat diet (8% of
total daily calories)
Moderate exercise for 1
hour three times per
week.
Stress counseling.
One hour of yoga,
meditation, breathing, and
progressive relaxation per
day.
Factors That Trigger
Coronary Artery Spasms
Clumping of
Platelets
Increased
Calcium
Flow
Smoking
Stress
Acute Myocardial Infarction
Heart Attack
Definition: A condition that occurs when blood
supply to the heart muscle is cut off and the tissue
dies.
Crushing or heavy Chest pain that spreads Heartburn symptoms
discomfort or pain to the shoulders, neck,
accompanied by
jaw or arms
in the chest
nausea and vomiting
Sweating
Lightheadedness,
dizziness or
fainting
Treatments That Save Hearts
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Clot-dissolving drugs
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Thrombolytic
Platelet receptor blocker
Early administration
of appropriate
medications.
Intravenous nitroglycerin
Beta-blockers
Angioplasty
Arrythmias
Irregular Heart Beat
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Bradycardia:
Heart rate of fewer than 60 beats per minute.
Tachycardia:
 Heart rate of more than 100 beats per minute.
Potential Causes:
 Atherosclerosis, hypertension, mineral imbalance, alcohol,
tobacco, cocaine, or other drugs.
Symptoms:
 Fatigue, lightheadedness, loss of consciousness, death,
and organ damage.
Diagnosis:
 Electrocardiogram.
Treatment:
 Medications and/or pacemakers.
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Other Crises Of The Heart
Mitral-Valve Prolapse
Congenital
Defects
Congestive
Heart Failure
Rheumatic Fever
Heart Savers
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Diagnostic Tests
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Electrocardiogram (ECG, EKG)
Thallium scintigraphy
Coronary angiography
Treatments
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Aspirin therapy
Medications
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Diuretics, beta-blockers, calcium channel blockers, angiotensinconverting enzyme inhibitors (ACE).
Surgical Procedures
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Coronary bypasspercutaneous transluminal coronary angioplasty,
heart transplant, and left-ventricular-assist devices (LVADs).
Stroke
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Definition
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Statistics
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Strokes are the 3rd leading cause of death in the U.S.
Worldwide stroke are the second leading cause of death.
Types
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When the blood supply to a portion of the brain is blocked.
Also called a cerebrovascular accident.
Ischemic stroke vs. hemorrhagic stroke vs. transient ischemic
attacks.
Causes
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Cerebral thrombosis, cerebral embolism, head injury and
bursting of an aneurysm.
Warning Signs of a Stroke
Sudden numbness or weakness of the face, arm, or
leg – particularly on one side of the body.
Sudden confusion, difficulty in speech or
understanding.
Sudden trouble seeing out of one or both eyes.
Sudden trouble walking, dizziness, loss of balance or
coordination.
A sudden severe headache of unknown cause.
Risk Factors for Strokes
Gender
Race
Age
Hypertension
High Red Blood Cell Count
Heart Disease
Blood Fats
Diabetes Mellitus
Prevention and Treatment for Strokes
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A baby aspirin a day keeps strokes away.
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Surgery
Carotid endartectomy
 Brain angioplasty
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Medications
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Thrombolytic drugs
Tissue-type plasminogen activator (tPa)
 Heparinoids
 Nimodipine
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Heart-Smart Strategies For Life
Don’t smoke
Watch your weight
Cut down on saturated fat and cholesterol
Get moving
Lower your stress levels
Know your family history
Get your blood pressure checked regularly
Tame your temper
Get a lipoprotein profile
Take appropriate medications