Chapter 11

Cardiovascular Health

Cardiovascular Disease

Cardiovascular disease (CVD) = disease of the heart and blood vessels

CVD is the leading cause of death among Americans

Some CVD risk factors are controllable; others are not

There are many things individuals can do to reduce their risk of CVD

Major CVD Risk Factors That Can Be Changed

Tobacco use and exposure to ETS› Causes about 1 in 5 deaths from CVD› Damages artery linings› Reduces HDL› Raises LDL and triglycerides › Causes platelets to stick together› Raises heart rate and blood pressure› Displaces oxygen in the blood› Increases the rate of the accumulation of

fatty deposits in arteries

Major CVD Risk Factors That Can Be Changed

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

CVD can be reduced with regular exercise, healthy diet (reduced salt, increased potassium and fiber), and moderation of alcohol intake

Blood Pressure Classification

CategorySystolic (mm Hg)

Diastolic (mm Hg)

Normal Below 120 and Below 80

Prehypertension

120–139 or 80–89

Hypertension Stage 1 Stage 2

140–159160 and above

oror

90-99100 and above

Major CVD Risk Factors That Can Be Changed

Unhealthy Cholesterol Levels› 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 GuidelinesLDL 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)

Travels with Cholesterol

Cholesterol Checked Among Americans

Source

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Major CVD Risk Factors That Can Be Changed

Physical inactivity› Exercise decreases blood pressure and resting

heart rate, improves cholesterol, improves the condition of blood vessels, and helps prevent obesity and diabetes

Obesity› Strains the heart, especially excess fat in the

torso Diabetes

› Increases CVD risk even when controlled

Contributing CVD Risk Factors That Can Be Changed

High triglyceride levels› Lower with exercise, healthy diet, quitting

smoking, reducing alcohol intake

Triglycerides (mg/dl)

Less than 150 Normal

150–199 Borderline high

200–499 High

500 or more Very high

Contributing CVD Risk Factors That Can Be Changed

Psychological and social factors› Stress› Chronic hostility and anger› Suppressing psychological distress› Depression and anxiety› Social isolation› Low socioeconomic status

Alcohol and drug use

Major CVD Risk Factors That Cannot Be Changed

Family history/heredity› Multiple genes contribute to CVD risk

Aging› CVD risk goes up with age

Being male› Men face a higher risk, especially earlier in life

Ethnicity› African Americans have higher rates of

hypertension and stroke

Annual Incidence of Heart Attack

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

Major Forms of Cardiovascular Disease

Hypertension (a risk factor and a form of CVD)

Atherosclerosis Heart disease and heart attacks Stroke Congestive heart failure

Atherosclerosis 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 = 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 = 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 AttackSymptoms of heart attack require immediate action.

Diagnosis and Treatment for Heart Disease Diagnosis

› Exercise stress test› MRI, echocardiogram, angiogram

Treatment› Lifestyle changes (diet and

exercise)› Low-dose aspirin therapy› Prescription medications› Balloon angioplasty› Coronary bypass surgery

Video: http://www.youtube.com/watch?v=kY5gKdFWT3k&feature=related

Video: http://www.youtube.com/watch?v=veP5R-pzJVk&NR=1

Video: http://www.youtube.com/watch?v=3Nf6Q2skGOM

Treatment of Heart Disease

Surgery is one possible treatment for heart disease.

Stroke Stroke = An impeded blood supply to some

part of the brain resulting in the destruction of brain cells› Ischemic stroke = caused by stroke› 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

Types of Stroke

Stroke

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 (delayed complication of upper respiratory streptococcus infection)

Protecting Yourself Against Cardiovascular Disease

Eat heart-healthy› Decrease fat and

cholesterol intake Especially limit saturated

and trans fats› Increase fiber intake› Alcohol intake—moderate, if

at all› DASH (Dietary Approaches

to Stop Hypertension) Exercise regularly Avoid tobacco http://www.nhlbi.nih.gov/health/public/

heart/hbp/dash/new_dash.pdf

Protecting Yourself Against Cardiovascular Disease (cont’d)

Know and manage your blood pressure Know and manage your cholesterol levels Develop ways to handle stress and anger Know your risk factors

sphygmomanometer

Reducing Your Risk of CVD

Mitral Valve

Mitral valve prolapse is the most common cause of heart murmur.

When the ventricles contract, the redundant leaflets prolapse (flop backwards) into the left atrium, sometimes allowing leakage of blood through the valve opening (mitral regurgitation).

Wellness Worksheet Assignment

Connect Chapter 11 Worksheet is due on Monday, October 1st, no later than 11:59PM.

Reminders Study guide for Exam I will be posted

on instructor’s website. Review for Exam I on Wednesday,

September 26th. Exam I (Chapters 1, 2, 3 and 11) on

Monday, October 1st. Please bring a pencil and Scantron 882-

E for Exam I on Exam day. As indicated in the course syllabus, no

late or make-up exams given