Transcript Cardiovascular Health and Other Diseases

Cardiovascular Health
Chapter 11
Test Your Knowledge
1.
2.
3.
Women are about as likely to die of cardiovascular
disease as they are to die of breast cancer? True or
False
How much earlier, on average, do sedentary people
develop heart disease compared with people who
exercise?
6 months, 2 years, 6 years
Which of the following foods would be a good choice
for promoting heart health?
1.
2.
3.
Tofu
Salmon
Bananas
Answers
1. False. CVD kills far more. Among American
women, about 1 in 2 deaths is due to CVD
and about 1 in 30 is due to breast cancer.
2. 6 years. Both endurance exercise and
strength training significantly improve
cardiovascular health.
3. ALL THREE! Soy protein (tofu), foods with
omega-3 fatty acids (salmon) and foods high
in potassium and low in sodium (bananas) all
improve cardiovascular health.
Cardiovascular Health
 Cardiovascular disease (CVD) is a disease of the heart and blood
vessels.
 CVD is the leading cause of death in the U.S.
 CVD claims one life every 37 seconds, about 2400 Americans
each day.
 CVD is largely a result of our way of life.
 CVD is the results from high-fat diets, an overweight, sedentary
lifestyle, smoking, poor stress management, HTN,
hypercholesteremia and lack of knowledge of the signs and
symptoms of CVD or denial of symptoms.
 More than one out of every 5 Americans suffers from some form of
CVD.
 Most body functions and body tissues rely on the cardiovascular
system – heart, blood, and blood vessels.
Cardiovascular Disease
Risk Factors
 Risk Factors are genetic tendencies or learned behaviors
that increase the chances of disease. The more risk
factors a person has, the greater the likelihood of
developing the disease.
 MAJOR RISK FACTORS THAT CAN’T BE CHANGED
 Heredity – Children of parents with CVD are more likely to develop
it themselves. It is not your destiny, but you may have to work
harder to prevent it.
 Being Male –CVD is the leading killer of both men and women in
the U.S. but men face a greater risk of heart attack than women,
especially earlier in life. Estrogen production may offer
premenopausal women some protection against CVD.
 Age – The risk of heart attack increases significantly after age 65.
Over 70% of all heart attack victims are over age 65.
 Race/Ethnicity – Death rates from heart disease vary among the
ethnic groups. African Americans have a much higher rate of HTN,
heart disease and stroke than other groups. Asian Americans
historically have had lower rates of CVD than white Americans.
Risk Factors
 Major Risk Factors That Can Be Changed
 Cigarette/Tobacco Use – About 1 in 5 deaths from CVD
can be contributed to smoking. 1 ppd = 2 times the risk of
CAD. 2 or more ppd = 3x the risk.
 Women who smoke and use contraceptives have 39 times more
risk of heart attack and 22 times more likely to have a stroke than
women who do not smoke and take contraceptives.
 When smokers have heart attacks they are 2-4 times more likely
than nonsmokers to die from them.
 Smoking damages the linings of the arteries, decreases HDL’s,
raises LDL’s and triglycerides, increases HR and BP and causes
platelets to be stickier.
 Carbon monoxide in smoke displaces oxygen in the blood,
reducing the amount of oxygen available to the heart.
Risk Factors That Can Be Changed
Blood Pressure – It is the force exerted against the
walls of the arteries. High blood pressure
(hypertension) = sustained abnormally high blood
pressure
 Systole = pressure when heart contracts
 Diastole = pressure when heart relaxes
 High blood pressure strains the heart, damages the
arteries, and increases risk of heart attack, stroke,
kidney failure, and blindness
 Reduce with regular exercise, healthy diet (reduced
salt, increased potassium and fiber), and moderation
of alcohol intake
Blood Pressure Classification
Category
Normal
Prehypertension
Hypertension
Stage 1
Stage 2
Systolic
(mm Hg)
Diastolic
(mm Hg)
Below 120
and
Below 80
120–139
or
80–89
140–159
160 and above
or
or
90-99
100 and above
Risk Factors That Can Be Changed
Cholesterol – Refers to the fatty substance that circulates the blood
stream and is an important component for cell membranes, sex
hormones, nerves. Excess cholesterol can clog arteries and ↑ risk for
CVD.
~ Any body who has a liver produces cholesterol! Also obtained
through the foods we eat.
~Cholesterol is carried in protein-lipid packages called lipoproteins,
the shuttles that carry cholesterol to and from the liver through the
circulatory system.
Low-density lipoprotein (LDL) = unhealthy (“bad”) cholesterol; excess
amounts are deposited in artery walls
High-density lipoprotein (HDL) = healthy (“good”) cholesterol; shuttle
unused cholesterol back to the liver for recycling
 Levels can be improved by quitting smoking, exercising, and improving
diet (less saturated and trans fat, more fruits, vegetables, fiber, and whole
grains)
Cholesterol Testing should begin at the age of 20!
Cholesterol Guidelines
LDL cholesterol (mg/dl)
Less than 100
Optimal
100–129
Near optimal/above optimal
130–159
Borderline high
160-189
High
190 or more
Very high
Total cholesterol (mg/dl)
Less than 200
Desirable
200–239
Borderline high
240 or more
High
HDL cholesterol (mg/dl)
Less than 40
Low (undesirable)
60 or more
High (desirable)
Figure 11.1 Travels with Cholesterol
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Risk Factors That Can Be Changed
~Physical Inactivity – Is a major modifiable risk factor
for CHD. Exercise is the closest “magic bullet” against
heart disease.
 25% of the population do not perform any physical activity
 60% of the population do not get the recommended amount of
exercise
 As little as 3 hours/week of walking reduces the risk
~ Obesity – In 1998, obesity was declared a major risk factor
for heart disease. Greater than 30% are above the
recommended weight.
+ Obesity is also a risk factor for HTN, Diabetes and high
cholesterol. Fat distribution is also an important factor (apple).
Risk Factors That Can Be Changed
 Diabetes – A metabolic disorder where the body is
unable to regulate the level of glucose (sugar) in the
blood. Elevated blood sugar levels damage the lining
of the arteries, making them more vulnerable to
atherosclerosis.
 Type II diabetes can be prevented or delayed by eating a
healthy diet, exercise and maintaining a healthy body weight.
 Exercise helps to lower the risk of diabetes as it helps to
control weight and enhances the cellular sensitivity to insulin.
Contributing Risk Factors
 Triglycerides – Greater
than 190 mg/dl tends to
increase blood thickness
resulting in sluggish blood
flow which makes it more
difficult in delivering
oxygen and nutrients to
the heart.
Triglycerides
(mg/dl)
Less than
150
Normal
150–199
Borderline
high
200–499
High
500 or more
Very high
Possible Risk Factors Under Study
 Metabolic syndrome, also known as syndrome X or insulin
resistance syndrome
 Abdominal obesity (waist circumference)
 Greater than 40 inches in men
 Greater than 35 inches in women
 High blood pressure (130/85 or higher)
 High triglycerides (150 mg/dl or higher)
 Low HDL cholesterol
 Below 40 mg/dl in men
 Below 50 mg/dl in women
 Insulin resistance (glucose of 110 mg/dl or higher)
 Homocysteine – It is an amino acid that is derived from food. It
functions to manufacture protein to build and maintain body tissues. It
is carried in the blood and normally broken down. But when this does
not occur, levels rise and it is a risk for CVD. It damages the lining of
the arteries. Levels can be controlled with diet. B vitamins, folate,
especially important to break down homocysteine
Women and CVD
 Women underestimate their CVD risk
 Nearly 1 in 2 women dies from CVD
 About 1 in 30 women dies from breast cancer
 Women are protected from CVD at younger ages
by natural estrogen
 After menopause, women are more likely than
men to die after a heart attack
 Women are more likely to have a heart attack
without chest pain
African Americans and
CVD
 Blacks have higher rates of hypertension
and stroke
 Genetic, biological, and lifestyle factors
may play a role
 Lifestyle changes can reduce risk, as can
medical treatment
Types of Cardiovascular Diseases
Atherosclerosis:
 Arteries are narrowed by deposits of fat,
cholesterol, and other substances called
plaques
 Once narrowed by a plaque, an artery is
vulnerable to blockage by blood clots
 Blockage in the coronary arteries (coronary
heart disease) can lead to a heart attack
 Blockage in the brain can cause a stroke
Atherosclerosis
Heart Disease and Heart Attacks
 Heart attack (myocardial infarction) = Damage to,
or death of, heart muscle, sometimes resulting
in a failure of the heart to deliver enough blood
to the body; myocardial infarction.
 Angina pectoris (chest pain) = A condition in
which the heart muscle does not receive enough
blood, causing severe pain in the chest and
often in the left arm and shoulder.
 Arrhythmia = An irregularity in the force or
rhythm of the heartbeat.
 Sudden cardiac death = A nontraumatic,
unexpected death from sudden cardiac arrest,
most often due to arrhythmia (in association
with underlying heart disease).
Heart Disease
 Peripheral Vascular Disease – Disease of the
peripheral vessels. The lack of proper
circulation (caused by blockages in arteries
that feed the legs) may cause fluids to pool in
the extremities. Symptoms include leg pain,
cramping, numbness, tingling, coldness and
loss of hair to the affected limbs. The disease
process may be extensive before the person is
symptomatic, as the heart and brain are more
sensitive to a decreased blood flow as
compared to the extremities.
Heart Attack
Symptoms of heart attack require
immediate action.
Signs and Symptoms of a
Heart Attack
~Uncomfortable
pressure, fullness,
squeezing, or pain in
the center of the chest
that lasts longer than 2
minutes.
~Pain that spreads to
the shoulders, arms,
back , stomach or neck.
~Severe pain,
dizziness, fainting,
sweating, nausea, or
shortness of breath can
occur.
Blood Supply to the Heart
Diagnosis and Treatment for
Heart Disease
 Diagnosis
 Exercise stress test
 MRI, echocardiogram, angiogram
 Treatment
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Lifestyle changes (diet and exercise)
Low-dose aspirin therapy
Prescription medications
Balloon angioplasty
Coronary bypass surgery
Treatment of Heart Disease
Surgery is one
possible treatment
for heart disease.
Stroke (Brain Attack)
 Stroke = An impeded blood supply to some
part of the brain resulting in the destruction of
brain cells
 Ischemic stroke = caused by blood clot that
blocks as artery
 Hemorrhagic stroke = caused by ruptured
blood vessel
 Strokes may cause paralysis, walking
disability, speech impairment, or memory loss
 Treatment may include clot-dissolving and
antihypertensive drugs
Stroke Warning Signs
 Sudden numbness or weakness of the face,
arm, or leg, especially one side of the body
 Sudden confusion, trouble speaking or
understanding
 Sudden trouble walking, dizziness, or loss of
balance or coordination
 Sudden severe headache with no known
cause
IF YOU OR SOMEONE WITH YOU HAS ONE
OR MORE OF THESE SIGNS – CALL 911
Congestive Heart Failure
 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
 Caused by high blood pressure, heart
attack, atherosclerosis, birth defects,
rheumatic fever
Ways to Reduce Your Heart Attack
Risk
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Quit Smoking
Know and manage your blood cholesterol level
Maintain a healthy body weight
Exercise regularly
Healthy Eating Plan
Mild-to-moderate alcohol consumption
Know and manage your blood pressure
Handle stress and anger effectively
OSTEOPOROSIS
 It is a disease characterized by low bone density, structural
deterioration of bone tissue which increases the risk of fractures
and bone fragility.
 Sometimes called the “silent disease”, as often there are no
symptoms as the bone density ↓.
 Childhood and teen years is when new bone develops more
quickly than old bone is reabsorbed.
 Peak bone mass at about age 30. After age 30, bone loss
exceeds bone formation.
 Seems to affect mostly women – 80% are post menopausal.
 History of excessive alcohol use or smoking ↑ risk.
 Regular physical activity reduces the risk, especially
weight-bearing exercise and weight training.
Risk Factors
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Age
Small, thin boned
Women
Possible genetic factors
Post-menopausal Caucasian and Asian
Poor diets-especially with Ca and Vita-D
Physical inactivity
Alcohol use
Smoking
Prevention
 Get regular physical activity!!
 Get adequate Ca and Vita-D intake
 Limit caffeine and phosphate containing
sodas
 Avoid prolonged hi-protein diets
 HRT at menopause may help
Figure 11.4 Strategies for Reducing Your Risk of
Cardiovascular Disease
34
Making excuses does not take
talent. Only those who
persevere find the reward at the
end of the day.