1. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings PowerPoint ® Lecture Slide Presentation prepared by Michael Hall Cardiovascular Disease: Reducing Your Risk

2. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Objectives  Discuss the incidence, prevalence, and outcomes of cardiovascular disease.  Describe the anatomy and physiology of the heart and circulatory system and the importance of healthy heart function.  Review major types of heart disease, factors that contribute to their development, diagnostic and treatment options and the importance of fundamental lifestyle modifications aimed at prevention.  Discuss controllable and uncontrollable risk factors for cardiovascular disease; your own risk profile, and determine the risk factors you can and cannot control.  Discuss methods of diagnosing and treating cardiovascular disease.

3. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings 2001 Total Cardiovascular Disease Rates by State and Gender, Age Adjusted Figure 15.1a

4. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings 2001 Total Cardiovascular Disease Rates by State and Gender, Age Adjusted (continued) Figure 15.1b

5. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings An Epidemiological Overview  Cardiovascular disease (CVD) is the leading cause of death in the U.S.  In 2005 CVD accounted for approximately 38 percent of all deaths  CVD has been the number one killer in the U.S. since 1900 except for 1918 (influenza)  More that 2,500 Americans die from CVD each day  Among women, 1 in 2.6 deaths from CVD

6. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Prevalence of Cardiovascular Diseases in American Men and Women, Ages 20 and Older Figure 15.2

7. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Death Rates for Cardiovascular Disease, Including CHD and Stroke for Selected Countries Figure 15.3

8. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings ABC News: Cardiovascular Disease Play Video Play Video | Cardiovascular Disease

9. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings ABC News: Cardiovascular Disease Discussion Questions:  How does inflammation account for nearly 85% of all heart attacks?  What test measures inflammation and how expensive is it?  Why have physicians been hesitate to order tests to measure inflammation?  What dietary changes are recommended to lower inflammation?

10. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Understanding The Cardiovascular System  Cardiovascular system includes: the heart, arteries, arterioles, capillaries, venules, and veins  The heart Muscular, four chambered pump Contracts 100,000 times per day Two upper chambers: atria Two lower chambers: ventricles Tricuspid, pulmonary, mitral, and aortic valves

11. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Heart Function  Deoxygenated blood enters the right atrium  From the right atrium blood moves to the right ventricle, pumped through the pulmonary artery to the lungs  Oxygen blood enters the left atrium  Blood from the left atrium is forced into the left ventricle  The left ventricle pumps blood through the aorta to various parts of the body

12. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Anatomy of the Heart Figure 15.4

13. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Types Of Cardiovascular Disease  Atherosclerosis  Coronary heart disease (CHD)  Chest pain (angina pectoris)  Irregular heartbeat (arrhythmia)  Congestive heart failure (CHF)  Congenital and rheumatic heart disease  Stroke

14. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Percentage Breakdown of Deaths from Cardiovascular Disease in the United States, 2001 Figure 15.5

15. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Artherosclerosis  Characterized by deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of the artery  Hyperlipidemia – abnormally high blood lipid level  Plaque – the buildup of deposits in the arteries

16. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Coronary Heart Disease  Myocardial infarction (MI) or heart attack – blood supplying the heart is disrupted  Coronary thrombosis – blood clot in the artery  Embolus – when the blood clot is dislodged and moves through the circulatory system  Collateral circulation - if blockage to the heart is minor, an alternative blood flow is selected

17. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Angina Pectoris  Ischemia – reduction of the heart’s blood and oxygen supply  The more serious the oxygen deprivation the more severe the pain  Nitroglycerin – drug used to relax (dilate) the veins  Beta blockers control potential overactivity of the heart muscle

18. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Arrythmias  An irregularity in heart rhythm  Tachycardia – racing heart in the absence of exercise or anxiety  Bradycardia – abnormally slow heartbeat  Fibrillation – heart beat is sporadic, quivering pattern

19. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Congestive Heart Failure (CHF)  Damaged or overworked heart muscle is unable to keep blood circulating normally  Affects over 5 million Americans  Damage to heart muscle may result from: rheumatic fever, pneumonia, heart attack, or other cardiovascular problem  Lack of proper circulation may allow blood to accumulate in the vessels of the legs, ankles, or lungs  Diuretics relieve fluid accumulation

20. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Congenital And Rheumatic Heart Disease  Congenital heart disease affects 1 out of 125 children born  May be due to hereditary factors, maternal diseases, or chemical intake (alcohol) during fetal development  Rheumatic heart disease results from rheumatic fever which affects connective tissue

21. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Stroke  Occurs when the blood supply to the brain is interrupted  Thrombus – blood clot  Embolus – free flowing clot  Aneurysm – bulging or burst blood vessel  Transient ischemic attack (TIA) – brief interruptions that cause temporary impairment

22. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Common Blood Vessel Disorders Figure 15.6

23. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Reducing Your Risk For Cardiovascular Diseases  Risks you can control Avoid tobacco Cut back on saturated fat and cholesterol Maintain a healthy weight Modify dietary habits Exercise regularly Control diabetes Control blood pressure Systolic – upper number Diastolic – lower number Manage stress

24. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Reducing Your Risk For Cardiovascular Diseases  Risks you cannot control Heredity Age Gender Race

25. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Classification of LDL, Total, and HDL Cholesterol (mg/dl) and Recommended Levels for Adults Table 15.1

26. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Women And Cardiovascular Disease  2003, CVD deaths 426,800 men 483,800 women  Estrogen Once estrogen production stops, risk for CVD death increases  Diagnostic and therapeutic differences Delay in diagnosing possible heart attack Complexity in interpreting chest pain in women Less aggressive treatment of female heart attack victims Smaller coronary arteries in women  Gender bias in CVD research – typically CVD research has been conducted on male subjects

27. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings New Weapons Against Heart Disease  Techniques for diagnosing heart disease Electrocardiogram (ECG) Angiography Positron emission tomography (PET) Single positron emission color tomography (SPECT) Radionuclide imaging Magnetic resonance imaging (MRI) Ultrafast CT Digital cardiac angiography (DSA)

28. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Angioplasty Versus Bypass Surgery  Angioplasty – a thin catheter is threaded through the blocked arteries. The catheter has a balloon on the tip which is inflated to flatten the fatty deposits against the wall of the artery  Coronary bypass surgery – a blood vessel is taken from another site and implanted to bypass blocked arteries and transport blood

29. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Aspirin For Heart Disease?  Research shows that 80 milligrams of aspirin every other day is beneficial to heart patients due to its blood thinning properties  Some side effects of aspirin: gastrointestinal intolerance and a tendency for difficulty with blood clotting  Should only be taken under the advice of your physician

30. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Thrombolysis  If victim reaches an emergency room and is diagnosed quickly, thrombolysis can be performed  Thrombolysis involves injecting an agent such as tissue plasminogen activator (TPA) to dissolve the clot and restore some blood flow

31. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Cardiac Rehabilitation  Every year, 1 million people survive heart attacks  Cardiac rehabilitation exercise training increases stamina and strength, and promotes recovery

32. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Personal Advocacy And Heart-Smart Behaviors  Know your rights as a patient  Find out about informed consent procedures, living wills, durable power of attorney, organ donation, and other legal issues BEFORE you become sick  Ask about alternative procedures  Remain with your loved one as a personal advocate  Monitor the actions of health care providers  Be considerate of your care provider  Be patient with the patient