Cardiovascular Disease (CVD) A general term for diseases of the heart and/or blood __________ _____% of all deaths annually 2,600 American deaths each day Average of 1 death every 33 seconds

Atherosclerosis (a type of CVD) The progressive narrowing and hardening of an artery due to build up of plaque.

Pathological Determinants of Atherosclerosis in Youth 2,876 subjects aged % had intimal lesions in aorta Subjects aged 15-19: 60% had coronary artery lesions Subjects aged 30-34: 70% of females and 80+% of males had coronary artery lesions JAMA 281:727, 1999

Pathological Determinants of Atherosclerosis in Youth Key Conclusions: 1. Atherosclerosis begins in youth 2. Fatty streaks & clinically raised lesions increased rapidly in prevalence and extent during ages 15 to The earlier the cardiovascular risk factors are modified the greater the potential for deferring the onset of heart disease 4. Primary prevention of atherosclerosis must begin in childhood or adolescence

Coronary Artery Disease – Atherosclerosis of coronary arteries

Non-Controllable Risk Factors of Coronary Artery Disease _________ Being male

Major Controllable Risk Factors for Coronary Heart Disease Tobacco use/Smoke High Blood Cholesterol High Blood Pressure Physical Inactivity _________________ ___________

Other Recognized Risk Factors High blood homocysteine level High blood iron level (males) Low flavonoid intake Inflammation

Tobacco Use/Smoke Damages inner lining of artery Stimulates platelets to clot Produces free radicals Decreases HDL levels Constricts vessels Reduces oxygen carrying capacity Increases heart rate

Blood Cholesterol - Risk LipidDesirableBorderlineHigh Total < LDL< HDL> <40 Trig.< Excessive LDL or inadequate HDL leads to deposition of cholesterol in artery

Blood Pressure Rating ClassificationSystolicDiastolic Optimal<120<80 _______________ Hypertension Damages inner lining of artery 2. Causes arteries to become rigid

Blood Pressure Systolic pressure: the pressure exerted against the walls of the artery during heart _______________ Diastolic pressure: the pressure exerted against the walls of the artery during the _______________ phase

Physical Inactivity Lower HDL levels Lack of stimulus for collateral circulation Lack of stimulus for endothelial function Loss of vessel elasticity Inhibited glucose metabolism No stimulus for myocardium strengthening Increased risk for high blood pressure

Obesity & Overweight Increased risk for high cholesterol levels Increased risk for elevated blood pressure Increased risk for type II diabetes

Diabetes Damages inner lining of artery Modification of LDL cholesterol