1. The Healthy Heart
Figure 14.1

2. Chambers of the Heart Left Atrium Receives oxygenated
blood from the lungs.
Right Atrium
Receives blood
through the
superior and
inferior vena cava.
Left Ventricle
Pumps blood rich in
oxygen through the aorta
to the arteries to nourish
the body systems.
Right Ventricle
Pumps blood in need of
oxygen to the lungs.

3. Development of Atherosclerosis
Fatty Streaks Develop on the Arterial Walls at Injury Spots
Growth and Hardening of Fatty Streaks
Plaque Formation (well developed by age 30)
Narrowing and Loss of Elasticity of the Arteries
Restriction of Blood Flow to the Heart or Brain
Limited Oxygen Delivery to the Heart or Brain
Blood Pressure Elevation
Blood Clot Formation and Thrombosis
Angina, Heart Attack and/or Stroke
Atherosclerosis usually begins with the accumulation of soft fatty streaks along the inner arterial walls, esp at branch points
The initiating step in the process of atherosclerosis is some form of injury or inflammation of the arterial wall
High BP, high chol levels, cigarette smoking are potential sources of injury
Raised LDL chol levels are a sign of high heart attack risk b/c LDLs in the blood tend to deposit cholesterol in the arteries
Researchers now theorize that LDL cholesterol is damaging to the artery walls once it has been oxidized
Circulating LDL is more likely to settle along the linings of the artery walls after it first reacts with an unstable form of oxygen to become oxidized LDL cholesterol
Researchers believe that scavenger cells from the immune system (macrophages) ingest more and more of the oxidized LDL particles and eventually become foam cells
These foam cells eventually burst and deposit their accumulated cholesterol as debris in the arterial wall, leading to the development of fatty streaks
These fatty streaks gradually enlarge and become hardened with minerals forming plaques
Most people have well developed plaques by age 30
The progression of atherosclerosis in the coronary arteries may restrict blood flow to the heart muscle and limit the delivery of oxygen
A diet high in saturated fat is a major contributor to the development of plaques and the progression of atherosclerosis
Small, cell-like bodies in the blood, known as platelets, cause clots to form whenever they encounter injuries in blood vessels
Clots usually form and dissolve all the timein atherosclerosis, clots form faster than they dissolve b/c the platelets respond to plaques as they normally do to injury
A blood clot can stick to a plaque in an artery and gradually grow large enough to restrict or close off a blood vessel (thrombosis)
A clot may also break free from the artery wall and travel through the circulatory system until it lodges in a small artery and suddenly shuts off flow to the tissues fed by the artery
These actions rob the tissue of oxygen and nutrients and the tissue may eventually die
When arteries are narrowed by plaques or clots, blood flow is restricted, and the heart must generate more pressure to deliver blood to the tissuesthe higher blood pressure further damages artery walls and plaques and clots are more apt to form at the sites of injuries
Heart attack (coronary thrombosis)blocks blood flow through an artery that feeds the heart muscle
Stroke or cerebrovascular accident (cerebral thrombosis)blocks blood flow through an artery that feeds the brain

4. The Atherosclerotic Process
Figure 11.7

5. Blood Pressure the vessels by the blood flowing through them.
Definition: A measure of the force exerted against the walls of
the vessels by the blood flowing through them.
Systolic Blood Pressure
Pressure exerted by blood
against walls of the arteries
during forceful contraction
of the heart.
Diastolic Blood Pressure
Pressure exerted by blood against the walls of the arteries during
relaxation of the heart.
Sphygmomanometer &
Stethoscope

6. What Is a Healthy Blood Pressure?
115/75 mm Hg
HEALTHY READING
/80-90 mm Hg
PREHYPERTENSION
/90-99 mm Hg
160+/100+ mm Hg
HYPERTENSION

7. Preventing Hypertension
Lifestyle Changes
Losing weight.
Regular exercise.
Dietary Approaches To Stop Hypertension (DASH Diet).
Restriction of daily sodium intake.

8. Risk Factors for Cardiovascular Disease
Factors You Can Control
Physical Inactivity
Tobacco
Obesity
Blood Fats
Metabolic Syndrome
Diabetes Mellitus
Factors You Can’t Control
Heredity
Race and Ethnicity
Age
Gender
Bacterial Infection

9. Tobacco and Heart Disease
Smoking is the single most significant risk factor for CV disease and peripheral vascular disease.
Each year smoking causes 250,000+ deaths from cardiovascular disease.
Active vs. passive smoking.
How Smoking Damages The Heart:
Nicotine overstimulates the heart.
Carbon monoxide reduce the oxygen supply to the heart.
Tars and other smoke residues increase the risk of cholesterol build-up in the arteries.
Smoking increases blood clotting.
Smoking causes irreversible damage to the arteries.

10. Understanding Blood Lipids
Low Density Lipoproteins (LDL) - Fatty substances produced by the liver that carry cholesterol to arterial walls: “bad” cholesterol
High Density Lipoproteins (HDL) – Fatty substance that picks up cholesterol in the bloodstream and returns it to the liver; “good cholesterol
Triglycerides – Fats that flow through the blood after meals and have been linked to increased risk of coronary artery disease

11. Serum Cholesterol Guidelines
Amount
Rating
Total Cholesterol
<200 mg/dl
mg/dl
>240 mg/dl
Desirable
Borderline High
High Risk
LDL Cholesterol
Less than 100 mg/dl
mg/dl
mg/dl
mg/dl
190+ mg/dl
Optimal
Near Optimal
High
Very High
HDL cholesterol
>45 mg/dl
36-44 mg/dl
<35 mg/dl

12. The Lifestyle Syndrome
Definition: A cluster of conditions and diseases that result from:
Consuming too many calories.
Ingesting too much saturated fat, sodium, and alcohol.
Not burning up enough calories.
Smoking or being exposed to tobacco smoke.
Consequences:
Hypertension, metabolic syndrome, obesity, high cholesterol, cardiovascular disease, cancer, osteoarthritis, depression, sexual dysfunction, and diabetes mellitus.

13. Unclogging The Arteries
Cholesterol-lowering drugs
Low-fat diet
Dean Ornish Diet (without medications)
Very low-fat diet (8% of total daily calories)
Moderate exercise for 1 hour three times per week.
Stress counseling.
One hour of yoga, meditation, breathing, and progressive relaxation per day.

14. Heart-Smart Strategies For Life
Don’t smoke
Watch your weight
Cut down on saturated fat and cholesterol
Get moving
Lower your stress levels
Know your family history
Get your blood pressure checked regularly
Tame your temper
Get a lipoprotein profile
Take appropriate medications