1. Childe Hassam: “The South Ledges” Early 20 th Century American Impressionist: Note: light And color! (Very European…)

2. Preventing Heart Disease Chapter 12: 219-239

3. Cardiovascular Disease: #1 Killer in America (500K/Yr) Increased incidence since the “Industrial Revolution” What effect will the “Technology Revolution” Have? Epidemiology Population Studies to discover associations between disease/FACTORS

4. PRIMARY RISK FACTORS: HYPERTENSION HYPERTENSION HYPERLIPIDEMIA HYPERLIPIDEMIA TOBACCO USE TOBACCO USE PHYSICAL INACTIVITY PHYSICAL INACTIVITY All of These are Preventable “LIFESTYLE CHOICES”… All of These are Preventable “LIFESTYLE CHOICES”…

5. Secondary Risk Factors Family History (close relative <60) Age Gender Race Obesity Diabetes Tough to Modify, eh?

6. What is Atherosclerosis? In a Word…”Fatty” “Arteries” (ok, so two words…) Normal Atherosclerotic

7. Ouch!

8. Myocardial Infarction Complete blockage of blood All cells “downstream” will die without blood supply First symptom of Infarct?... SUDDEN DEATH (only 50% survive)

9. Primary Risk Factor #1: Hypertension >140 /90 CHRONICALLY Damages Blood Vessels CAD is 6X as great in hypertensives Incidence of stroke & heart/kidney failure is directly related to HTN Most causes of HTN are not known

10. Treatment Reduced Na+ diet (Na+ may constrict vessels & Incr. fluid volume) MODERATE exercise Body Fat reduction Reduce alcohol intake Drugs (diuretics, beta blockers, ACE inhibitors)

11. Hyperlipidemia Total Cholesterol: Protein Carriers: HDL / LDL Desirable TOTAL levels: < 200 mg/dl: Desirable 200-239:Borderline > 240 mg/dl:Very High

12. Low Density Lipoproteins (LDLs) “Bad” Cholesterol/Protein Complex Deposits Fat onto artery walls Linked to High Triglycerides (Associated with high fatty- sweet diet and glucose intolerance…more on that later)

13. High Density Lipoproteins (HDLs) “Good” Cholesterol/Protein Complex Carries Cholesterol to liver other organs for hormone synthesis etc. Activity, mono-unsaturated fats in diet may increase HDLs

14. HYPERLIPIDEMIA Desired Blood Lipid Levels: £ Total Cholesterol < 200 mg/dl £ LDL-C < 130 mg/dl £ HDL-C > 35 mg/dl £ Triglycerides < 130 A poor lipid profile will accelerate the atherogenic process.

15. Tobacco use (smoking, chew) Increases Blood Clotting activity Increases Blood Pressure Increases Heart Rate As if that’s not bad enough – Decreases O 2 Content of Blood Sounds like STRESS to me…

16. Physical Inactivity Independent Risk Factor! And Contributes to: Obesity Hypertension Hyperlipidemia (especially the worst kind) Diabetes

17. Percent of U.S. Population at Risk % BP 0 10 20 30 40 50 60 TCSmoke Inact

18. How do WSC Freshmen Rate? Based on Study by S.C. Glass & K.K. Glass 1995

19. Gender Characteristics Women Men Number Age Activity(1-5) T-C HDL-C LDL-C TC/HDL 203 19.91 + 3.57 3.42 + 1.30 169.08 + 32.68* 42.63 + 8.94 126.14+ 59.28* 4.14 + 1.23 268 20.15 + 4.04 3.22 + 1.61 175.09 + 30.10 49.49 + 10.94 112.82 + 53.25 3.70 + 1.07 * = p<.05

20. Smokers vs Non-Smokers Smokers Non Number Male Female Activity T-C HDL-C LDL-C * = p<.05 60 (15%) 28 (17%) 32 (14%) 2.67 + 1.4* 171.59 + 34.6 47.98 + 12.0 104.2 + 32.8 329 (85%) 139 (36%) 190 (49%) 3.43 + 1.5 172.15 + 31.6 46.61 + 10.7 101.21 + 27.1

21. HDL-Cholesterol by Gender Percent of Students Below Desirable (35 mg/dl) 13.8% Males 5% Females Average = 9.4%

22. Activity Level Distribution % Activity Level 0 5 10 15 20 25 30 35 12345

23. Most Frequently Listed Activities: Men 1.Basketball25.1 % 2.Wt. Lifting17.5 % 3.Jogging14.2 % 4.Racquetball5.9 % 5.Football5.2 % 6.Walking4.6 % 7.Golf4.6 % 8.Biking3.6 % 9.Baseball2.3 %

24. Most Frequently Listed Activities: Women 1.Walking19.3 % 2.Volleyball14.0 % 3.Jogging13.3 % 4.Biking9.5 % 5.Wt. Lifting8.8 % 6.Basketball7.3 % 7.Aerobics6.8 % 8.Racquetball4.0 % 9.Swimming3.5 %

25. Total Cholesterol by Activity Level mg/dl Activity Level

26. HDL by Activity Level mg/dl Activity Level

27. LDL by Activity Level mg/dl Activity Level

28. Lab Wednesday: Cardiovascular Risk Assessment and Blood Pressure Measurement Lab 12A: Pages 377-379 Lab 1A: Page 307