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CARDIOVASCULAR HEALTH

CARDIOVASCULAR HEALTH. Causes of Death. Top three causes of death Heart disease Someone suffers a coronary event every 29 seconds in the US Someone dies from a coronary event every minute Cancer Infectious disease. Cost to Society. 274 billion per year on cardiovascular disease

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CARDIOVASCULAR HEALTH

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  1. CARDIOVASCULAR HEALTH

  2. Causes of Death Top three causes of death • Heart disease • Someone suffers a coronary event every 29 seconds in the US • Someone dies from a coronary event every minute • Cancer • Infectious disease

  3. Cost to Society • 274 billion per year on cardiovascular disease • 99 billion per year on alcohol related disease • 72 billion on smoking related diseases • 67 billion spend on drug abuse

  4. Physiology of the Heart • Four chambered pump • Size of a fist • Weighs about 1 pound • Creates pressure to circulate blood throughout the body • Located between the lungs, left of center in the thorax

  5. Blood flow through the heart • Deoxygenated blood from the inferior and superior vena cava empties into the right atrium • Continues past the tricuspid valve into the right ventricle • Leaves the right ventricle and heads toward the lungs to pick up oxygen and returns to the heart as oxygenated blood

  6. Blood flow through the heart • Oxygenated blood returns to the left side of the heart entering the left atrium • Flows past the mitral valve into the left ventricle • Leaves the left ventricle through the aorta out to the rest of the body

  7. Important features of the heart • Valves ensure that the blood flows in one direction • Left ventricle is more muscular then the other chambers • Septum divides the heart in half

  8. Electrical Stimulation of the Heart • Signal sends impulses from the brain to the heart • SA node (pacemaker of the heart) creates an electrical impulse that contracts the atria • AV node picks up the signal and sends it on to the ventricles • EKG picks up the electrical signals from the heart and is able to detect abnormalities in the conduction

  9. Function of the blood • Transportation of nutrients, oxygen, waste products and hormones • Regulation of water content for cells • Regulation of body temperature • Buffers to maintain pH level • Clotting capabilities • Protection against pathogens by circulating antibodies • Average person has 6 quarts of blood

  10. The Vascular System • Refers to the blood vessels • Arteries carry blood away from the heart • Veins carry blood back into the heart • Coronary arteries carry blood to the heart • Carotid arteries carry blood to the brain • Iliac and femoral arteries carry blood to the abdomen and legs

  11. Permanent Risk Factors for Heart Disease • Age – as you age, the greater the risk • Gender – men are more at risk then premenopausal women • Ethnicity –African Americans more at risk due to the increased rates of high blood pressure • Heredity – if you have a family history of CVD your risk is greater

  12. Cardiovascular Risk Factors That Can Be Changed • High cholesterol • High blood pressure • Inflammation • Physical inactivity • Smoking • Diabetes • Obesity • Diet • Periodontal disease

  13. Cholesterol • Cholesterol manufactured in the liver and small intestines • Needed for the production of sex hormones, cell membranes, bile salts and nerve fibers • Cholesterol attaches itself to lipoproteins

  14. Cholesterol • Two types of lipoproteins • LDL-low density lipids • Bad cholesterol • Average levels • Less the 100 is optimal • 100-129 is near optimal • 130 or higher is dangerous • New study indicates even lower levels of LDL may be necessary ie; 60-70 • Carries cholesterol to coronary arteries • Agitate arterial walls and form lesions that allow plaque buildup

  15. Cholesterol • HDL-high density lipids • Good cholesterol • Average level • Men – 40-50 • Women – 50-60 • Carries cholesterol away from arteries to the liver • Offer protection against heart disease • Pick up LDL and bring them to the liver for removal

  16. Cholesterol • Total cholesterol above 200 is high • Combines HDL and LDL • HDL above 60 is healthy, below 40 is dangerous • LDL below 130 is healthy , above 190 is dangerous

  17. Cholesterol Reduction • Exercise • Single most effective way to increase HDLs • Weight reduction • Diet • Limit saturated fats • Increase your intake of fatty fish • High fiber diet • Smoking • Moderate alcohol intake • Phenols in red wine • Genetic predisposition

  18. Blood Pressure • Pressure exerted on the walls of the arteries • Systolic • Highest pressure • Pressure exerted when left ventricle is contracting • Diastolic • Lowest pressure • Left ventricle is filling with blood • Normal range • 120/80 • 120/80 to 139/89 now is called pre-hypertension

  19. Hypertension (High Blood Pressure) • Decreased elasticity of blood vessels makes is more difficult for the heart to pump the blood and increases the blood pressure • Higher incidence in non-whites • 65 million Americans have hypertension • Approx 35% of the population

  20. Hypertension • Signs and symptoms • No signs initially, until the pressure becomes very high • Headache • Irritability • Dizziness • Blurred vision

  21. Hypertension • Medical problems associated with high blood pressure • Stroke • Coronary artery disease • Kidney failure • Blindness • Dementia • Heart failure

  22. Hypertension • Known as the “silent killer” • Symptoms only appear when the blood pressure is dangerously high • You must take you medications even if you feel fine

  23. Hypertension • Medications • Diuretics - to remove fluid • Vasodilators – to enlarge the size of the blood vessels • Side effects • Impotence • Fatigue • Muscle weakness

  24. Hypertension • Blood pressure reduction • Weight reduction • Exercise • Reduce salt intake • Diet high in fruits and vegetables

  25. Inflammation of Blood Vessels • Inflammation in the vessels causes the plaque to break free • May contribute to heart attacks • Measured by C reactive proteins (CRP) • Average reading of CRP is 1.5 • High levels come from chronic infections (gum disease), sedentary lifestyle, HTN • Normally produced by the body to fight infections and promote healing

  26. Physical Inactivity • Exercise is the single most effective way to increase your HDL levels • Exercise decreases your blood pressure • Exercise contributes to weight reduction • Exercise strengthens your heart muscle and increases the efficiency • Exercise can increase your longevity • Walked 30 min/day for five days/week live 1.3-1.5 years longer • Running 30 min/day (or equivalent) live 3.5-3.7 years longer

  27. Smoking • The most dangerous risk factor for heart disease • Increases your heart rate and constricts your blood vessels • Doubles the risk of heart attack for a person who smokes one pack per day

  28. Diabetes • More then 80% of people with diabetes die from cardiovascular disease • If not well controlled can contribute to high cholesterol levels • Can be managed through diet, exercise and medications

  29. Obesity • Increases the strain on the heart • Increases blood pressure • May trigger diabetes • Weight loss increases your HDL and lowers your LDL • Weight gain of 11-18 lbs in adult life had 25% increase in risk of MI, increase over 25 lbs increased risk of MI by 200-300%

  30. Diet • Limit saturated fats • Beef, ham, pork • Dairy products • Palm and coconut oils • Use more polyunsaturated fats • Corn oil • Safflower oil

  31. Diet • Increase fatty fish such as salmon, mackerel • High in omega 3 fatty acids • High fiber diet • Men who ate 29 gms of fiber/day (one cup bran cereal) 36% decreased risk of MI • Keep fat to 30% of diet • Americans eat 46% fat in diet

  32. Periodontal Disease • Chronic infections from gum disease increase the CRP levels • Toxins and bacteria enter your bloodstream causing inflammation of the vessels

  33. Types Of Heart Disease • CAD – coronary artery disease • Hypertension • Stroke • Congenital heart disease • Congestive heart disease • Rheumatic heart disease

  34. Coronary Artery Disease • Atherosclerosis – hardening of the arteries • Fatty deposits build up inside the vessels that slow the flow of blood or completely occlude it

  35. Coronary Artery Disease • Angina • Chest pain • Decreased blood supply to coronary arteries • Nitroglycerin

  36. Myocardial InfarctionHeart Attack • MIs are getting smaller secondary to better medications and active lifestyles • Men are 20% more likely to have MI on birthday • Higher incidence in winter versus summer • More likely on Monday • more likely to be fatal at night • Four times more likely if you are depressed • Weekend warriors at greater risk

  37. Myocardial Infarction • Women and heart attacks • First MI 10-20 years later then men, but 70% more likely to die • Women take one hour longer to get to the ED • Women do not exhibit classic symptoms of MI, tends to be a spasm, not a blockage of the coronary arteries • 30% less likely to get the proper medications

  38. Myocardial Infarction • Premenopausal women usually protected but 9000 women younger then 45 die each yr • More women die from heart attacks and strokes then breast cancer, 500,000 women vs 40,000/yr • Women on HRT have an increased chance of MI/stroke/blood clots • Doubles risk of MI during first year

  39. Myocardial InfarctionHeart Attack • Heart Attack or Myocardial Infarction (MI) • Death of the cardiac muscle secondary to a lack of oxygen • Cause is a blockage of the coronary arteries by a floating piece of plaque or eventual closure due to cholesterol • Extent of damage depends on the size of the artery affected

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