1. Chapter Ten Enhancing Your Cardiovascular Health
Health Ch 10
10/27/09

2. Cardiovascular Disease
Pertaining to the heart (cardio) and the blood vessels (vasculara)
Estimated Prevalence of Major Cardiovascular Diseases
Hypertension 72,000,000
Coronary heart disease 15,800,000
Stroke 5,700,000
Congestive heart failure 5,200,000
Congenital heart disease 1,300,000

3. The Vascular System Blood 45% Red Blood Cells (carry Ox)
Refers to the blood vessels
Arteries carry blood away from the heart
Arterioles are smaller-diameter extensions of arteries
Veins carry blood back into the heart
Venules are smaller-diameter extensions of veins
Capillaries
Smallest extensions of the vascular system
Site of exchange of oxygen, food, and waste
Blood % Red Blood Cells (carry Ox)
0.7 White Blood Cells
2 % Platelets (assist clotting)

4. Deaths from Cardiovascular Disease
Figure 10-1 Deaths from Cardiovascular Disease 4

5. The Heart Four-chambered pump Size of a fist Function: Location:
Creates pressure to circulate blood throughout the body
Location:
Left center of the thorax (between lungs)
Signal sends impulses from brain to the heart
Electrocardiograph (ECG or EKG) measures the cardiac electrical functioning

6. Circulation through the Heart
Figure 10-2 Circulation through the Heart 6

7. Blood Functions of the circulatory system
Transportation of nutrients, oxygen, waste products
Regulation of water content of cells
Regulation of body temperature
Buffering of ph level
Prevention of blood loss
Protection against toxins and microorganisms by circulating antibodies within the bloodstream
Average person has 5 quarts of blood

8. Risk Factors That Cannot Be Changed
Increasing age
Most people who die from heart disease are age 65 and older
Male gender
Before age 55, men have a greater risk of heart disease than women do
After menopause, women’s rates of heart disease increase
Heredity
Family history
Race/ethnicity negros have higher risk factors for CVD and hypertension

9. Risk Factors That Can Be Changed
Major Risk Factors: The “Big Six”
Tobacco smoke
Physical inactivity
Abnormal blood cholesterol levels
High blood pressure
Diabetes mellitus
Obesity and overweight
Contributing Risk Factor
Individual responses to stress
Type A personality = risk factor
Image source: Getty Images 9

10. Risk Factors That Can Be Changed
Tobacco smoke
Increases risk of heart attack, sudden cardiac death
Affects nonsmokers exposed to environmental tobacco smoke
Quitting leads to a reduced risk of heart disease
Physical inactivity
Exercise strengthens the heart muscle, maintains healthy blood vessels
Lowers cholesterol levels
Encourages weight loss and retention of lean muscle mass
Moderates stress
Image source: BananaStock/PunchStock 10

11. Risk Factors That Can Be Changed
Abnormal Blood Cholesterol Levels
Classification of Total Cholesterol, Triglycerides, LDL, and HDL
Normal or Desirable
Borderline-High
High
Total cholesterol
< 200
≥ 240
Triglycerides
< 150
≥ 200
LDL cholesterol
< 130
≥ 160
Low
Normal
High (Desirable)
HDL cholesterol
< 40
40-59
≥ 60

12. Risk Factors That Can Be Changed
High blood pressure
Damages heart and blood vessels
Diabetes mellitus
Increases risk of heart and blood vessel disease
Linked to abnormal levels of cholesterol and other blood fats
Obesity and overweight
Abdominal obesity is especially risky

13. Metabolic Syndrome Risk factors often appear in a group
Criteria for Metabolic Syndrome
Elevated waist circumference muse 38 in
Men: ≥ 40 inches
Women: ≥ 35 inches
Elevated triglycerides muse 300*
≥ 150 mg/dL
Reduced HDL cholesterol muse 38 *
Men: < 40 mg/dL
Women: < 50 mg/dL
Elevated blood pressure muse 120 /77
≥ 130/85 mmHg
Elevated fasting glucose muse 80 mg/dL
≥ 100 mg/dL

14. Forms of Cardiovascular Disease
Coronary heart disease
Hypertension
Stroke
Congenital heart disease
Rheumatic heart disease
Congestive heart failure
Diseases of the arteries
Arrhythmias

15. Coronary Heart Disease
Damage to vessels that supply blood to the heart muscle
Atherosclerosis: Buildup of plaque on the inner walls of arteries
Myocardial infarction (heart attack): Death of part of the heart muscle
Biomarkers
Homocysteine
High sensitivity C-reactive protein
If hs-CRP level is lower than 1.0 mg/L, a person has a low risk of developing cardiovascular disease.
If hs-CRP is between 1.0 and 3.0 mg/L, a person has an average risk.
If hs-CRP is higher than 3.0 mg/L, a person is at high risk.

16. Progression of Atherosclerosis
Figure 10-3 Progression of Atherosclerosis 16

17. Cholesterol and Lipoproteins
Low-density lipoprotein (LDL)
“Bad” cholesterol
High-density lipoprotein (HDL)
“Good” cholesterol
To improve cholesterol levels:
Reduce saturated fat intake
Reduce cholesterol intake
Reduce caloric intake to control weight
Take a Statin drug (lipitor, zocor)

18. Coronary Heart Disease
Angina pectoris: Chest pain with stress or exertion
Symptoms of a heart attack include chest pain, shortness of breath, nausea, lightheadedness, back or jaw pain
Emergency treatment: CPR and AEDs
Diagnosis
Blood tests
Vital signs
Electrocardiogram, echocardiogram
Coronary arteriography
PET, EBCT, and MRI
Nuclear medicine
Image source: Keith Brofsky/Getty Images 18

19. Coronary Heart Disease
Surgical treatments
Coronary artery bypass surgery
Provides alternative routes for blood to take around points of blockage
Percutaneous coronary intervention
A slender balloon-tipped tube is used to flatten plaque and widen an artery
Heart transplant
Nonsurgical treatments
Medications, including aspirin (prevents platelet sticking) Statin Drugs

20. Percutaneous Coronary Intervention
Figure 10-4 Percutaneous Coronary Intervention 20

21. Hypertension Symptoms: “Silent killer” (no symptoms)
Screening: Regular checks of resting blood pressure
Effects: Heart attacks, strokes, kidney failure, eye damage
Classification
Blood pressure (mm Hg)
Normal
Prehypertension
Hypertension
Systolic (top number)
Less than 120
140 or higher
Diastolic (bottom number)
Less than 80
80-89
90 or higher

22. Hypertension Prevention and treatment Weight reduction
Physical activity
Moderation in alcohol use
DASH eating plans
Salt restriction
Stress reduction
Medication (lisonopril, B-blockers)

23. Stroke Blockage of vessel to the brain Types of stroke
Cerebrovascular occlusions
Cerebral hemorrhage
Cerebral aneurysm
Warning sign: Transient ischemic attack (TIA)
Diagnosis
Computerized axial tomography (CT) scan
Magnetic resonance imaging (MRI) scan
Treatment
Clot dissolving drugs
Cell-rebuilding drugs

24. Causes of Stroke
Figure 10-5 Causes of Stroke 24

25. Congenital Heart Disease
Abnormalities present at birth
Caused by environmental factors or illness
Types
Valve damage
Holes in the walls of the septum
Blood vessel transportation
Underdevelopment of left side of the heart
Treatment
Surgery may be performed to repair malformations

26. Rheumatic Heart Disease
Chronic damage to the heart (especially the valves)
Result of streptococcal infection in the heart
Complication of rheumatic fever
Damage tends to occur in valves of the heart
Diagnosis: X-rays, echocardiogram
Treatment: Surgery

27. Congestive Heart Failure
Inability of the heart to pump out all the blood that returns to it
Fluid accumulates in veins, lungs, and kidneys
Caused by heart damage from other causes
Treatment
Rest
Proper diet
Modified daily activities
Use of appropriate drugs

28. Diseases of the Arteries
Peripheral artery disease (PAD)
Blood vessel disease involving changes to the arteries and arterioles in the extremities
Causes
Cigarette smoking
Obesity
High-fat diet
Sedentary occupations
Treatment
Blood vessel surgery
Medication
Modified lifestyle

29. Arrhythmias
Irregular beating pattern of the heart caused by disruption of the normal sequence of electrical activity in the heart
Can result in loss of consciousness or even death
Diagnosis: EKG
Treatment: Medication to control heart rate
Heart patterns
Bradycardia: Fewer than 60 beats/minute at rest
Tachycardia: More than 100 beats/minute at rest

30. CVD Prevention Avoid tobacco Choose a healthy diet
Be physically active
Control body weight
Manage stress
Get regular screenings
Image source: The McGraw-Hill Companies, Inc./Ken Karp, photographer 30

32. Chapter Ten: Enhancing Your Cardiovascular Health