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Chapter 15 Cardiovascular Health

Introduction : 

15-2 Introduction Cardiovascular Disease (CVD) Leading cause of death in the U.S. Affects nearly 81 million Americans Claims one life every 38 seconds About 2300 Americans every day CVD is largely due to our way of life

The Cardiovascular System : 

15-3 The Cardiovascular System Pulmonary circulation Blood to and from the lungs. Systemic circulation Left side of the heart pumps blood through the rest of the body. Path of blood flow: Venae Cavae Right Atrium Sinoatrial node (pacemaker) Right Ventricle Pulmonary Artery To the lungs Pulmonary Vein Left Atrium Left Ventricle Aorta

Parts of the Heartbeat : 

15-4 Parts of the Heartbeat Systole The heart’s contraction Diastole The period of relaxation

Cardiovascular System : 

15-6 Cardiovascular System Heart, blood vessels, hormones, enzymes and wastes The Blood Vessels Veins Carry blood to the heart Thin walls Arteries Carry blood away from the heart Thick elastic walls which expand and relax with the volume of blood Coronary artery Two large vessels that supply blood to the heart Capillaries One cell thick Venules Blood empties from the capillaries into the venules which connect to veins that return the blood back to the heart 150-pound person has about 5 quarts of blood, which circulates about once each minute

Risk Factors For Cardiovascular Disease : 

15-8 Risk Factors For Cardiovascular Disease Two categories of increased CVD risk Major Risk factors Contributing Risk Factors Controllable aspects of lifestyle that can be changed Major risk factors that can be changed American Heart Association identified six major risk factors Tobacco use High blood pressure High levels of cholesterol Physical inactivity Obesity Diabetes

Tobacco Use : 

15-9 Tobacco Use 1 in 5 deaths from CVD is a smoker Smokers have 2 to 3 times higher risk of death from a heart attack than non-smokers Damages the lining of arteries Reduces HDL’s Raises triglycerides and LDL’s Nicotine increases blood pressure CO displaces O2 Causes platelets to become sticky and increases blood thickness Speeds the development of fatty deposits in the arteries

High Blood Pressure : 

15-10 High Blood Pressure Hypertension Too much pressure against arterial walls Short periods of high blood pressure is normal but chronic high blood pressure is a health risk Atherosclerosis Heart has to work harder, weakens, enlarges, arteries narrow, scar and harden About 30% of adults have hypertension 37% of adults have prehypertension Test your blood pressure at least once every two years

Table 15-1 Blood pressure classification for healthy adults : 

15-11 Table 15-1 Blood pressure classification for healthy adults

High Blood Pressure : 

15-12 High Blood Pressure Tachycardia 100 or more beats per minute Compromises the ability of the heart to pump effectively Ventricles can not completely fill

Low Blood Pressure : 

15-13 Low Blood Pressure Bradychardia 60 or less beats per minute Poor circulation of the blood Lack of o2 throughout to body and brain

High Cholesterol : 

15-14 High Cholesterol Excessive cholesterol clogs the arteries Increased risk of CVD Good versus Bad Cholesterol Low –density lipoproteins (LDL) Shuttle cholesterol from the liver to the organs and tissues High-density lipoproteins (HDL) Shuttle unused cholesterol back to the liver for recycling By removing cholesterol from blood vessels, HDL helps protect against atherosclerosis Benefits of controlling cholesterol

Table 15.2 Cholesterol guidelines : 

15-15 Table 15.2 Cholesterol guidelines

Figure 15.1 Cholesterol in the body : 

Figure 15.1 Cholesterol in the body

Physical Inactivity : 

15-17 Physical Inactivity 40-60 million Americans are so sedentary that they are at high risk for developing CVD Exercise reduces risk by: Controlling blood pressure and resting heart rate Lowering LDL’s Increasing HDL’s Maintaining weight Improving the condition of blood vessels Preventing or controlling diabetes

Obesity : 

15-18 Obesity Risk of death from CVD is two to three times more likely in obese people (BMI > 30) Increase strain on the heart Strongly associated with: Hypertension High cholesterol Insulin resistance Diabetes Increasing age Endothelial cell dysfunction Coronary arteries constrict instead of dilating Inflammatory markers

Diabetes : 

15-19 Diabetes Doubles the risk of CVD for men Triples the risk of CVD for women Loss of 5-10 years of life Higher risk: Hypertension Obesity Unhealthy blood lipid levels Elevated blood glucose and insulin can damage the endothelial cells lining the arteries More vulnerable to atherosclerosis

Contributing Risk Factors That Can Be Changed : 

15-20 Contributing Risk Factors That Can Be Changed High Triglyceride Levels Reliable predictor of heart disease Psychological and Social factors Stress Chronic hostility and anger Suppressing psychological distress Depression Anxiety Social isolation Low socioeconomic status Alcohol and Drugs

Major Risk Factors That Can’t Be Changed : 

15-21 Major Risk Factors That Can’t Be Changed Heredity CVD has genetic component; high cholesterol levels, blood clotting and obesity Aging Over the age of 65 Being male Men have higher risk earlier in life Ethnicity African Americans have higher risk of hypertension; Hispanics greater risk of HBP and Angina; Asians have lower rates of CVD

Possible Risk Factors Currently Being Studied : 

15-22 Possible Risk Factors Currently Being Studied Inflammation and C-reactive protein (CRP) Insulin resistance and metabolic syndrome Homocysteine Amino acid circulating in the blood Infectious agents Chlamydia pneumoniae – flu-like respiratory infections Lipoprotein(a) – Lp(a) Strong genetic component LDL Particle size Particles differ in shape and size Blood viscosity and Iron Uric Acid Time of day and time of year More heart attacks and sudden death occur between 6:00AM and noon 50% more occur in winter months than in summer months

Major Forms of Cardiovascular Disease : 

15-23 Major Forms of Cardiovascular Disease Atherosclerosis - ateries narrowed by fatty deposits Starts during childhood fat. Coronary heart disease (CHD) Coronary artery disease (CAD) Peripheral arterial disease (PAD) Heart Attack – heart tissue is damaged and part of it may die from lack of blood Myocardial infarction (MI)

Table 15-5 Deaths from Acute Myocardial Infarction, 2007 : 

Table 15-5 Deaths from Acute Myocardial Infarction, 2007

Heart attack symptoms may include the following: : 

15-25 Heart attack symptoms may include the following: Chest pain or pressure Arm, neck, or jaw pain Difficulty breathing Excessive sweating Nausea and vomiting Loss of consciousness

Heart Disease and Heart Attack : 

15-27 Heart Disease and Heart Attack Angina – arteries narrowed by disease, under stress heart can not receive enough oxygen Angina pectoris Usually felt as an extreme tightness in the chest and heavy pressure behind the breastbone or in the shoulder, neck, arm, hand, or back Arrhythmias and sudden cardiac death – Electrical conduction system is disrupted

Helping a Heart Attack Victim : 

15-28 Helping a Heart Attack Victim Most deaths from a heart attack happen within 2 hours of initial symptoms Cardiopulmonary resuscitation (CPR) Know the main warning signs: discomfort in chest and other areas of the upper body, shortness of breath

Detecting and Treating Heart Disease : 

15-29 Detecting and Treating Heart Disease Electrocardiogram (ECG or EKG) Electron-beam computed tomography (EBCT) Echocardiograph – sound waves Magnetic Resonance Imaging (MRI) Nuclear myocardial perfusion imaging Positron Emission Tomography (PET) Angiogram Balloon Angioplasty Coronary Bypass Surgery

Stroke or Cerebrovascular Accident (CVA) : 

15-30 Stroke or Cerebrovascular Accident (CVA) 795,000 Americans suffer strokes each year 2 million brain cells die per minute during a stroke. Ischemic stroke – blockage in blood vessels Thrombotic stroke clot forms in a cerebral artery; hypertension Embolic Stroke - wandering blood clot Hemorrhagic stroke - blood vessel ruptures in the brain Intracerebral hemorrhage Subarachnoid hemorrhage Aneurysm

The Effects of a Stroke : 

15-32 The Effects of a Stroke Interruption of the blood supply to any area of the brain prevents the nerve cells from functioning, in some cases causing death Those who survive have some lasting disability Paralysis Walking disability Speech impairment Memory loss Changes in behavior

Detecting and Treating Stroke : 

15-33 Detecting and Treating Stroke Prompt recognition of symptoms Sudden numbness or weakness of face, arm, leg or one side of the body Loss of speech or difficulty speaking Dimming or loss of vision in one eye Unexplained dizziness in relation to other symptoms

Four simple ways to recognize a stroke : 

15-34 Four simple ways to recognize a stroke Ask the person to smile. Unevenness is a sign of a possible stroke. Ask the person to hold their limbs out. If only one limb can be moved or only one limb can be held still there is a stroke possibility. Trouble speaking may be a sign that a stroke has occurred. Decreased sensation, numbness or tingling in limbs can indicate stroke.

Detecting and Treating Stroke : 

15-35 Detecting and Treating Stroke Transient ischemic attack (TIA) Temporary stroke like symptoms. Computed tomography (CT) MRI Ultrasound Drugs Carotid endarterectomy surgery – plaque is removed from the artery Rehabilitation Physical therapy Speech and Language therapy Occupational therapy

Peripheral Arterial Disease : 

15-36 Peripheral Arterial Disease PAD – atherosclerosis in arteries of the limbs, which can limit or block the blood flow Patients typically also have coronary artery disease 8-12 million people in the U.S. have PAD Risk factors: Smoking Diabetes Hypertension High cholesterol Symptoms Claudication and rest pain

Congestive Heart Failure : 

15-37 Congestive Heart Failure Number of conditions High blood pressure Heart attack Atherosclerosis Alcoholism Viral infections Rheumatic fever Birth defects Pulmonary edema - Fluid accumulates in the lungs Heart can not maintain regular pumping rate; fluid backs up Controlled by: Reducing cardiac load Eliminating excess fluid Restriction of salt Drug therapy

Other Forms of Heart Disease : 

15-38 Other Forms of Heart Disease Congenital heart defects Malformation of the heart or major blood vessel Hypertrophic Cardiomyopathy (HCM) 1:500 people Most common cause of sudden death in athletes younger than 35 Murmur Rheumatic Heart Disease Streptococcal infections causes damage to the heart muscle and valves Strep throat needs to be treated; can cause heart disease if not treated Heart Valve Disorders Congenital heart defects and certain types of infections Mitral valve prolapse

Protecting Yourself Against CVD : 

15-39 Protecting Yourself Against CVD Eat heart-healthy Decrease Fat and Cholesterol Total fats less than 30% of total calories Low Saturated Fats Increase fiber intake Decrease sodium intake and increase potassium intake Moderate alcohol consumption

Other Dietary Factors : 

15-40 Other Dietary Factors Omega-3 fatty acids Plant stanols and sterols Folic acid Vitamins B-6 and B-12 Calcium Soy protein Healthy carbohydrates Total daily caloric intake DASH Dietary Approaches to Stop Hypertension

Protecting Yourself : 

15-41 Protecting Yourself Moderate physical activity Avoid Tobacco Know and manage your blood pressure Know and manage your cholesterol levels Develop effective means of controlling stress and anger

Slide 43: 

Chapter 15 Cardiovascular Health

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