CARDIOVASCULAR HEALTHChapter 5

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.