 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

 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

 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

Category Systolic (mm Hg) Diastolic (mm Hg) NormalBelow 120andBelow 80 Prehypertension120–139or80–89 Hypertension Stage 1 Stage 2 140– and above or and above

 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)

LDL cholesterol (mg/dl) Less than 100Optimal 100–129Near optimal/above optimal 130–159Borderline high High 190 or moreVery high Total cholesterol (mg/dl) Less than 200Desirable 200–239Borderline high 240 or moreHigh HDL cholesterol (mg/dl) Less than 40Low (undesirable) 60 or moreHigh (desirable)

Source: Centers for Disease Control and Prevention

 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

 High triglyceride levels › Lower with exercise, healthy diet, quitting smoking, reducing alcohol intake Triglycerides (mg/dl) Less than 150Normal 150–199Borderline high 200–499High 500 or moreVery high

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

 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

 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

 Hypertension (a risk factor and a form of CVD)  Atherosclerosis  Heart disease and heart attacks  Stroke  Congestive heart failure

 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 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).

Symptoms of heart attack require immediate action.

 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: FWT3k&feature=related

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Surgery is one possible treatment for heart disease.

 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 = 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)

 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 rt/hbp/dash/new_dash.pdf

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

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).

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

 Study guide for Exam I will be posted on instructor’s website.  Review for Exam I on Wednesday, September 26 th.  Exam I (Chapters 1, 2, 3 and 11) on Monday, October 1 st.  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