Download Preventing Cardiovascular Disease

Preventing Cardiovascular Disease
 Cardiovascular disease is the leading cause
of death in the U.S.— 42% of all deaths
 Approximately 1.5 million heart attacks
occur each year—500,000 are fatal
 About 50% of people who
have heart attacks wait
2 hours before seeking
medical attention
Circulation
 The primary function of
circulation is to provide a
constant supply of blood and
nutrients to cells while
removing their waste products
Blood is so important to the heart
that every muscle fiber is
supplied by at least one
capillary
Cardiovascular Disease (1)
 Coronary heart disease (coronary artery
disease; CAD) is diagnosed when any artery
is narrowed by 60% or more
 A myocardial infarction (heart attack; death
of the heart muscle) occurs when blood flow
to the heart muscle is disrupted
 Most heart attacks occur after age 65, but
the process begins as early as adolescence
Myocardial Infarction
 The medical term for heart attack is
myocardial infarction (MI)
 Up to one third of all heart attacks are
silent—without obvious signs or symptoms
 Silent ischemia, reduced blood flow, can
initiate heart attacks without warning
 Most heart attacks are obvious
Cardiovascular Disease (2)
 Heart disease is an acquired
disease that is preventable
 Americans as young as 18
have obstructions in their
coronary arteries caused by
atherosclerosis
 Atherosclerosis, characterized
by plaque beneath artery
linings, is responsible for 80%
of CAD deaths in the U.S.
Brain Attack (Stroke)
 Brain attacks are caused by a
thrombus or an embolus (70%
to 80%) or a cerebral
hemorrhage
 Brain cells die, causing loss of
function of some parts of the
body
 Brain attacks have the same risk
factors and prevention factors as
heart disease
Unchangeable Risk Factors for Heart
Disease (AHA)
 Age—80% of fatal heart attacks occur
after age 65
 Male gender—Heart disease is the leading
cause of death for both males and
females
» Females have a lower rate than males
» Rate is increasing among females, particularly
those who smoke and use oral contraceptives
 Heredity and Race—A tendency toward
heart disease appears to be hereditary
Changeable Risk Factors
Cholesterol (1)
 A certain amount of cholesterol
is necessary for good health
 The best way to lower serum
(blood) cholesterol is to reduce
intake of saturated fat
 Saturated fat increases the
liver’s production of cholesterol
Changeable Risk Factors
Cholesterol (2)
 Cholesterol is a steroid that does not dissolve
in blood, so it is transported to cells by
protein packages
 Low-density lipoproteins (LDL), the primary
transporters of cholesterol, are the most
capable of producing atherosclerosis
 People with low blood levels of LDL (less
than 100 mg/dl) rarely have heart attacks
Changeable Risk Factors
Blood Pressure (1)
 Blood pressure is the force exerted against
artery walls as blood travels through the
circulatory system
 High blood pressure (hypertension) has no
signs or symptoms
 High BP= 140/90 mmHg
Changeable Risk Factors
Blood Pressure (2)
 Long-term uncontrolled
hypertension increases the work
of the heart, causes it to
hypertrophy, and leads to
congestive heart failure
 Hypertension damages the
arteries, accelerates
atherosclerosis, and is the most
important risk factor for brain
attacks
Changeable Risk Factors
Tobacco
 Cigarette smoking may be the most harmful
of the preventable risk factors for chronic
illness and premature death
 These illnesses include chronic bronchitis,
emphysema, strokes, and 87% of all lung
cancers
 Passive smoking, inhaling the smoke of
others, causes the deaths of 38,000 to
43,000 nonsmokers annually
Changeable Risk Factors
Physical Inactivity
 Physical inactivity increases
the risk of coronary heart
disease by 1.5 to 2.4 times
 The greatest health benefits
are gained when people
expend 1500 to 2000 calories
(walk 15 to 20 miles) per
week
 Exercise for health does not
have to be as strenuous as
exercise for physical fitness
Changeable Risk Factors
Physical Inactivity
 Physical activity is any physical
movement that results in energy
expenditure—walking, mowing
the lawn, vacuuming
 “Every U.S. adult should
accumulate 30 minutes or more
of moderate intensity physical
activity on most, preferably all,
days of the week.” (ACSM/CDC
statement)
Changeable Risk Factors
Obesity
 Obesity contributes to about 300,000 deaths
per year
 Fat that accumulates in the upper half of the
body (central abdominal obesity) is
significantly more likely to contribute to
heart disease
 A 5% to 10% weight loss that is maintained
can significantly reduce the risk of heart
disease
Changeable Risk Factors
Diabetes Mellitus
 Diabetes is a metabolic disorder in which the
body cannot properly use sugar (glucose) as
fuel
 Type II (90% of all diabetes) occurs in older,
overweight, sedentary adults
 Diabetes increases the risk of coronary artery
disease 2 to 3 times in men and 3 to 7 times
in women
Changeable Risk Factors
Stress
 Stress elevates heart rate,
blood pressure, breathing
rate, and blood sugar
levels, activates the
immune response, and
causes other physiological
changes
 Chronic (long-term)
distress significantly
strains the body
Prevention of Heart Disease
Prevention includes:
 Regular exercise
 Optimal body weight
 Sound nutritional practices
 Nonuse of tobacco and other drugs
 Nonuse or moderate use of alcohol
 Dealing constructively with stress
 Periodic medical examinations
Diagnostic Techniques
 Medical examination and patient history
 Exercise stress tests
 Thallium treadmill test
 Echocardiography
 Cardiac catheterization
Medical Treatment
 Low-dose aspirin therapy
 Coronary artery bypass surgery
 Balloon angioplasty
 Coronary stent
 Artificial valves
 Left ventricular assist devices
 Heart transplants