Cardiovascular Health Chapter 11

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

Blood Pressure Classification Category Systolic (mm Hg) Diastolic Normal Below 120 and Below 80 Prehypertension 120–139 or 80–89 Hypertension Stage 1 Stage 2 140–159 160 and above 90-99 100 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 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 200–239 240 or more HDL cholesterol (mg/dl) Less than 40 Low (undesirable) 60 or more High (desirable)

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 Can’t 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

Possible Risk Factors Under Study C-reactive protein Homocysteine Lipoprotein(a) Small, dense LDL particles Infectious agents

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)

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

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

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).

Diagnosis and Treatment for Heart Disease Exercise stress test MRI, echocardiogram, angiogram Treatment Lifestyle changes (diet and exercise) Low-dose aspirin therapy Prescription medications Balloon angioplasty Coronary bypass surgery

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

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

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

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

Reducing Your Risk of CVD Do Less Don’t use tobacco in any form. Avoid exposure to environmental tobacco smoke. Limit consumption of cholesterol, added sugars and refined carbohydrates. Avoid excessive alcohol consumption – no more than one drink per day for women and two drinks per day for men. Limit consumption of salt to no more than 2300 mg of sodium per day. Avoid excess stress, anger, and hostility. Do more Eat a diet rich in fruits, vegetables, whole grains, and low-fat or fat-free dairy products. Eat several servings of high-fiber foods each day. Eat 2 or more servings of fish each week. Choose unsaturated fats rather than saturated and trans fats. Be physically active and do aerobic exercise and strength training on a regular basis. Achieve and maintain a health weight.

Cardiovascular Health Chapter 11 end