Cardiovascular Health

1. Cardiovascular Health Chapter 15

2. Introduction • Cardiovascular Disease (CVD) • Leading cause of death in the U.S> • Claims one life every 35 seconds • CVD is due to our way of life ©2008 McGraw-Hill Companies. All Rights Reserved.

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. • Total blood volume for a 150 pound person is about 5 quarts, which circulates once every minute ©2008 McGraw-Hill Companies. All Rights Reserved.

4. Cardiovascular System • Systole • The hearts contraction • Diastole. • The period of relaxation ©2008 McGraw-Hill Companies. All Rights Reserved.

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6. Cardiovascular System • Heart, blood vessels, hormones, enzymes and wastes. • Four chambers (size of a fist). • Upper chambers (Atriums). • Right atrium contains the sinus node • Lower chambers (Ventricles). • Vena cava. • Pulmonary Artery and vein. • Aorta. • Coronary Arteries and veins. • Veins • Capillaries ©2008 McGraw-Hill Companies. All Rights Reserved.

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9. Risk Factors For Cardiovascular Disease • Major Risk factors • Contributing Risk Factors • Four Major Risk Factors that can be changed. • Tobacco use. • High blood pressure. • High levels of cholesterol. • Physical inactivity. • Obesity. • Diabetes. ©2008 McGraw-Hill Companies. All Rights Reserved.

10. Tobacco Use • 1 in 5 deaths from CVD is a smoker • Smokers have 2-4 times higher risk of death from a heart attack, than non-smokers • Reduces HDL’s • CO displaces O2 • Causes platelets to become sticky and increases blood thickness ©2008 McGraw-Hill Companies. All Rights Reserved.

11. High Blood Pressure • Contributing factors • Hypertension • Too much pressure against arterial walls • Atherosclerosis • Heart has to work harder, weakens, enlarges, arteries narrow, scar and harden • See Table 15-1 for blood pressure classification for healthy adults ©2008 McGraw-Hill Companies. All Rights Reserved.

12. High Blood Pressure • Tachycardias. • 100 or more beats per minute. • Compromises the ability of the heart to pump effectively. • Ventricles can not completely fill. ©2008 McGraw-Hill Companies. All Rights Reserved.

13. Low Blood Pressure • Bradychardia • 60 or less beats per minute • Poor circulation of the blood • Lack of 02 throughout to body and brain ©2008 McGraw-Hill Companies. All Rights Reserved.

14. Cholesterol • LDL’s and HDL’s or good versus bad • Clogs the arteries • Increased risk of CVD • Recommended blood cholesterol levels see Table 15-2 • LDL’s - less than 120 mg/dl • HDL’s - greater than 60 mg/dl • Total cholesterol should be below 200 mg/dl • Levels over 240 mg/dl indicates high risk of CVD • Triglycerides – less than 150 mg/dl • Benefits of controlling cholesterol ©2008 McGraw-Hill Companies. All Rights Reserved.

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16. Physical Inactivity • Exercise reduces risk by: • Controlling Blood pressure • Lowering LDL’s • Increasing HDL’s • Maintaining weight • Helps prevent or control Diabetes ©2008 McGraw-Hill Companies. All Rights Reserved.

17. Obesity • More than 30% above recommended weight. • BMI equal to or greater than 30 • Increase strain on the heart. • Strongly associated with • Hypertension • High cholesterol • Insulin resistance • Diabetes physical inactivity • Increasing age • Endothelial cell dysfunction • Coronary arteries constrict instead of dilating • Inflammatory markers ©2008 McGraw-Hill Companies. All Rights Reserved.

18. Diabetes • Doubles the risk of CVD for men. • Triples the risk of CVD for women. • Loss of 5-10 years off your 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 ©2008 McGraw-Hill Companies. All Rights Reserved.

19. Contributing Risk Factors That Can Be Changed • High Triglyceride Levels • Psychological and Social factors • Chronic hostility and anger • Suppressing psychological distress • Depression • Anxiety • Social isolation • Low socioeconomic status ©2008 McGraw-Hill Companies. All Rights Reserved.

20. Major Risk Factors That Can’t Be Changed • Heredity - CVD has genetic component; high cholesterol levels, blood clotting and obesity • Age - Over the age of 65 • Sex - Men have higher risk earlier in life • Ethnicity - African Americans have higher risk of hypertension; Hispanics greater risk of HBP and Angina; Asians Lower rates of CVD ©2008 McGraw-Hill Companies. All Rights Reserved.

21. Possible Risk Factors Currently Being Studied • Inflammation and C-reactive protein • Insulin resistance and metabolic syndrome • Homocysteine • Infectious agents • Lipoprotein(a) • LDL Particle size. • Fibrinogen • Blood Viscosity and Iron • Uric Acid • Time of day and time of year ©2008 McGraw-Hill Companies. All Rights Reserved.

22. Major Forms of Cardiovascular Disease • Atherosclerosis - narrowed by fatty deposits. Starts during childhood fat. • Heart Attack - Coronary thrombosis, coronary occlusion or myocardial infarction. Vessels in the heart become blocked. • Angina – narrowed by disease, but under stress heart can not receive enough oxygen. • Arrhythmias and sudden cardiac death – Electrical conduction system is disrupted ©2008 McGraw-Hill Companies. All Rights Reserved.

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25. Helping a Heart Attack Victim • Most die within 2 hours from initial symptoms • Cardiopulmonary resuscitation (CPR) • Refer to Box “What to Do in Case of a Heart Attack, Cardiac Arrest, or Stroke”. ©2008 McGraw-Hill Companies. All Rights Reserved.

26. Detecting and Treating Heart Disease • Electrocardiogram (ECG or EKG) • Electron-beam computed tomography (EBCT) • Echocardiograph – sound waves • Magnetic Resonance Imaging (MRI) • Angiogram • Balloon Angioplasty • Coronary Bypass Surgery ©2008 McGraw-Hill Companies. All Rights Reserved.

27. Stroke or Cerebrovascular Accident (CVA) • 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 • Subarachnoid hemorrhage • Intracerebral hemorrhage • Aneurysm ©2008 McGraw-Hill Companies. All Rights Reserved.

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29. The Effects of a Stroke • 700,000 Americans per year • One-third die within a year • Those who survive have some lasting disability. • Paralysis • Walking disability • Speech impairment • Memory loss • Changes in behavior ©2008 McGraw-Hill Companies. All Rights Reserved.

30. 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 • Refer to “Signs of a Stroke” ©2008 McGraw-Hill Companies. All Rights Reserved.

31. 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 ©2008 McGraw-Hill Companies. All Rights Reserved.

32. Peripheral Arterial Disease • PAD – atherosclerosis in the leg (or arm) arteries, which can limit or block the blood flow. • Patient’s typically also have coronary artery disease. • 10 million people in the U.S. have PAD • Risk factors • Smoking • Diabetes • Hypertension • High cholesterol ©2008 McGraw-Hill Companies. All Rights Reserved.

33. Congested Heart Failure • Number of conditions • 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 ©2008 McGraw-Hill Companies. All Rights Reserved.

34. Other Forms of Heart Disease • Congenital heart disease • Malformation of the heart or major blood vessel • Hypertrophic Cardiomyopathy (HCM) • Most common cause of sudden death in athletes • Rheumatic Heart Disease • Streptococcal infections causes damage to the heart muscle and valves. • Strep throat needs to be treated, primary cause if not treated. • Heart Valve Disorders • Mitral valve prolapse ©2008 McGraw-Hill Companies. All Rights Reserved.

35. Protecting Yourself Against CVD • Eat heart-healthy • Decreased Fat and Cholesterol • Total Fats less than 30% of total calories • Low Saturated Fats • Increased Dietary Fiber • Decreased sodium intake and increased potassium intake • Moderation of Alcohol ©2008 McGraw-Hill Companies. All Rights Reserved.

36. Other Dietary Factors • Omega-3 fatty acids • Plant stanols and sterols • Folic acid • Vitamins B-6 and B-12 • Calcium • Soy protein • Healthy carbohydrates • DASH • Dietary Approaches to Stop Hypertension ©2008 McGraw-Hill Companies. All Rights Reserved.

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38. Protecting Yourself • Moderate physical activity • Avoid Tobacco • Know and manage your blood pressure (monitored once every two years) • Know and manage your Cholesterol levels • Effective means of controlling stress and anger ©2008 McGraw-Hill Companies. All Rights Reserved.

39. Cardiovascular Health Chapter 15