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© 2009 McGraw-Hill Higher Education. All rights reserved.
Chapter Nine Enhancing Your Cardiovascular Health
© 2009 McGraw-Hill Higher Education. All rights reserved.
Cardiovascular Disease Cardiovascular•Pertaining to the heart (cardio) and the blood
vessels (vasculara)
Estimated Prevalence of Major Cardiovascular Diseases Hypertension 72,000,000 Coronary heart disease 15,800,000 Stroke 5,700,000 Congestive heart failure 5,200,000 Congenital heart disease 1,300,000
© 2009 McGraw-Hill Higher Education. All rights reserved.
The Vascular System
Refers to the blood vessels Arteries carry blood away from the heart
• Arterioles are smaller-diameter extensions of arteries Veins carry blood back into the heart
• Venules are smaller-diameter extensions of veins Capillaries
• Smallest extensions of the vascular system• Site of exchange of oxygen, food, and waste
© 2009 McGraw-Hill Higher Education. All rights reserved.
Deaths from Cardiovascular Disease
© 2009 McGraw-Hill Higher Education. All rights reserved.
The Heart Four-chambered pump Size of a fist Function:
• Creates pressure to circulate blood throughout the body
Location:• Left center of the thorax (between lungs)
Signal sends impulses from brain to the heart Electrocardiograph (ECG or EKG) measures the
cardiac electrical functioning
© 2009 McGraw-Hill Higher Education. All rights reserved.
Circulation through the Heart
© 2009 McGraw-Hill Higher Education. All rights reserved.
Blood Functions of the circulatory system
• Transportation of nutrients, oxygen, waste products
• Regulation of water content of cells
• Regulation of body temperature
• Buffering of ph level
• Prevention of blood loss
• Protection against toxins and microorganisms by circulating antibodies within the bloodstream
Average person has 5 quarts of blood
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Cannot Be Changed
Increasing age• Most people who die from heart disease are age 65
and older Male gender
• Before age 55, men have a greater risk of heart disease than women do
• After menopause, women’s rates of heart disease increase
Heredity• Family history• Race/ethnicity
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Can Be Changed
Major Risk Factors: The “Big Six”• Tobacco smoke
• Physical inactivity
• Abnormal blood cholesterol levels
• High blood pressure
• Diabetes mellitus
• Obesity and overweight
Contributing Risk Factor• Individual responses to stress
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Can Be Changed1. Tobacco smoke
Increases risk of heart attack, sudden cardiac death
Affects nonsmokers exposed to environmental tobacco smoke
Quitting leads to a reduced risk of heart disease
2. Physical inactivity Exercise strengthens the heart muscle,
maintains healthy blood vessels Lowers cholesterol levels Encourages weight loss and retention of
lean muscle mass Moderates stress
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Can Be Changed
3. Abnormal Blood Cholesterol LevelsClassification of Total Cholesterol, Triglycerides, LDL, and HDL
Normal or Desirable
Borderline-High
High
Total cholesterol
< 200 200-239 ≥ 240
Triglycerides < 150 150-199 ≥ 200
LDL cholesterol
< 130 130-159 ≥ 160
Low Normal High (Desirable)
HDL cholesterol
< 40 40-59 ≥ 60
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Can Be Changed
4. High blood pressure Damages heart and blood vessels
5. Diabetes mellitus Increases risk of heart and blood vessel
disease Linked to abnormal levels of cholesterol and
other blood fats
6. Obesity and overweight Abdominal obesity is especially risky
© 2009 McGraw-Hill Higher Education. All rights reserved.
Metabolic Syndrome Risk factors often appear in a group
Criteria for Metabolic Syndrome• Elevated waist circumference
• Men: ≥ 40 inches• Women: ≥ 35 inches
• Elevated triglycerides• ≥ 150 mg/dL
• Reduced HDL cholesterol• Men: < 40 mg/dL• Women: < 50 mg/dL
• Elevated blood pressure• ≥ 130/85 mmHg
• Elevated fasting glucose • ≥ 100 mg/dL
© 2009 McGraw-Hill Higher Education. All rights reserved.
Forms of Cardiovascular Disease
Coronary heart disease Hypertension Stroke Congenital heart disease Rheumatic heart disease Congestive heart failure Diseases of the arteries Arrhythmias
© 2009 McGraw-Hill Higher Education. All rights reserved.
Coronary Heart Disease
Damage to vessels that supply blood to the heart muscle
Atherosclerosis: Buildup of plaque on the inner walls of arteries
Myocardial infarction (heart attack): Death of part of the heart muscle
Biomarkers•Homocysteine•High sensitivity C-reactive protein
© 2009 McGraw-Hill Higher Education. All rights reserved.
Progression of Atherosclerosis
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Cholesterol and Lipoproteins Low-density lipoprotein (LDL)• “Bad” cholesterol
High-density lipoprotein (HDL)• “Good” cholesterol
To improve cholesterol levels:•Reduce saturated fat intake
•Reduce cholesterol intake
•Reduce caloric intake to control weight
© 2009 McGraw-Hill Higher Education. All rights reserved.
Coronary Heart Disease
Angina pectoris: Chest pain with stress or exertion Symptoms of a heart attack include chest pain,
shortness of breath, nausea, lightheadedness, back or jaw pain
Emergency treatment: CPR and AEDs
Diagnosis• Blood tests• Vital signs• Electrocardiogram, echocardiogram• Coronary arteriography• PET, EBCT, and MRI• Nuclear medicine
© 2009 McGraw-Hill Higher Education. All rights reserved.
Coronary Heart Disease Surgical treatments•Coronary artery bypass surgery
• Provides alternative routes for blood to take around points of blockage
•Percutaneous coronary intervention• A slender balloon-tipped tube is used to flatten
plaque and widen an artery
•Heart transplant Nonsurgical treatments•Medications, including aspirin
© 2009 McGraw-Hill Higher Education. All rights reserved.
Percutaneous Coronary Intervention
© 2009 McGraw-Hill Higher Education. All rights reserved.
Hypertension
Symptoms: “Silent killer” (no symptoms) Screening: Regular checks of resting blood pressure Effects: Heart attacks, strokes, kidney failure, eye damage
Classification
Blood pressure (mm Hg)
Normal Prehypertension Hypertension
Systolic (top number)
Less than 120 120-139 140 or higher
Diastolic (bottom number)
Less than 80 80-89 90 or higher
© 2009 McGraw-Hill Higher Education. All rights reserved.
Hypertension Prevention and treatment•Weight reduction
•Physical activity
•Moderation in alcohol use
•DASH eating plans
•Salt restriction
•Stress reduction
•Medication
© 2009 McGraw-Hill Higher Education. All rights reserved.
Stroke Blockage of vessel to the brain Types of stroke
• Cerebrovascular occlusions• Cerebral hemorrhage• Cerebral aneurysm
Warning sign: Transient ischemic attack (TIA) Diagnosis
• Computerized axial tomography (CT) scan• Magnetic resonance imaging (MRI) scan
Treatment• Clot dissolving drugs• Cell-rebuilding drugs
© 2009 McGraw-Hill Higher Education. All rights reserved.
Causes of Stroke
© 2009 McGraw-Hill Higher Education. All rights reserved.
Congenital Heart Disease Abnormalities present at birth
• Caused by environmental factors or illness
Types• Valve damage
• Holes in the walls of the septum
• Blood vessel transportation
• Underdevelopment of left side of the heart
Treatment• Surgery may be performed to repair malformations
© 2009 McGraw-Hill Higher Education. All rights reserved.
Rheumatic Heart Disease Chronic damage to the heart (especially
the valves) Result of streptococcal infection in the
heart•Complication of rheumatic fever
Damage tends to occur in valves of the heart
Diagnosis: X-rays, echocardiogram Treatment: Surgery
© 2009 McGraw-Hill Higher Education. All rights reserved.
Congestive Heart Failure Inability of the heart to pump out all the blood
that returns to it• Fluid accumulates in veins, lungs, and kidneys
Caused by heart damage from other causes Treatment
• Rest• Proper diet• Modified daily activities• Use of appropriate drugs
© 2009 McGraw-Hill Higher Education. All rights reserved.
Diseases of the Arteries
Peripheral artery disease (PAD) Blood vessel disease involving changes to the
arteries and arterioles in the extremities Causes
• Cigarette smoking• Obesity• High-fat diet• Sedentary occupations
Treatment• Blood vessel surgery• Medication• Modified lifestyle
© 2009 McGraw-Hill Higher Education. All rights reserved.
CVD Prevention Avoid tobacco Choose a healthy diet Be physically active Control body weight Manage stress Get regular screenings
© 2009 McGraw-Hill Higher Education. All rights reserved.
Chapter Nine: Enhancing Your Cardiovascular Health