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Chapter 12 Cardiovascular Disease Reducing Your Risks NON-COMMUNICABLE DISEASES Degenerative Diseases: • diseases that significantly threaten health/wellness • chronic illness • lifestyle / genetic factors Cardiovascular Diseases Found in Heart and Blood Vessels 2000 • responsible for > 50% of all deaths in Canada • female deaths = male deaths • declined by 52% / males & 64% females ( 1950 – 1993) Blood Vessels • Arteries - large vessels • Arterioles - smaller • Capillaries - O2 / CO2 exchange, nutrients other stuff. • Venues • Veins RELATED TERMINOLOGY • Calcium Channel Blockers – reduce muscular contractions + reduce heart rate • Diuretics: drugs that increase the amount of urine produced + excreted • Beta Blockers – block some of the nervous impulses to the heart muscle / prevent over activity of the heart RELATED TERMINOLOGY • Occlusion: blockage of artery • Vasodilators: (Nitroglycerin) drugs that cause widening of blood vessel • Cyanosis: lack of oxygen, resulting in blueness of skin • Necrosis: tissue death • CPR: Cardio-Pulmonary Resuscitation Common Forms of Cardiovascular Diseases Angina Pectoris: (Ischemia) – chest pain • Blood flow not totally occluded • Insufficient to meet MVO2 (oxygen consumption of myocardial muscle) Arrhythmia: irregular heartbeat • Tachycardia and Fibrillation • Bradycardia (abnormally slow heart rate) Clogging the Pipes! Atherosclerosis • (fatty plaque buildup in arteries) – hardening of the arteries • deposits of fatty substances / cholesterol / cellular waste products / calcium / fibrin = plaque • can lead to a complete blockage Heart Attack! • Myocardial Infarction heart attack - occlusion is complete and muscle has permanent damage • Coronary thrombosis – blood clot • Collateral circulation – physiological response to adapt to the heart attack Stroke: a heart attack in the brain – cerebrovascular Thrombus (blood clot) / Embolus (wondering blood clot) / Aneurysm (blood vessel weakness) • Damage location of brain effected • Speech, memory, loss of motor control or death (location of heart and lung regulation) • Transient ischemic attacks ( mild stroke) indicator of a greater problem ? Heart Disease • Congestive Heart Failure weak / damaged heart – fluid build up = poor heart performance (heart chokes) • Congenital Heart Disease development of heart disease before birth (1 in 125 births) e.g. murmurs – valve irregularities Rheumatic Heart Disease: • childhood illness (predisposition) inflammatory disease / effects • connective tissues heart, joints, joints, brain & skin • streptococcal infection – (strep throat) – reduction in immune response RISK FACTORS OF CORONARY HEART DISEASE BIOLOGICAL FACTORS: cannot modify these factors Family history: • If grand-parents die of CHD before 60 - 3-6 times risk of CHD • Genetic predisposition for hypertension, obesity, and diabetes = increased incidence of CHD Sex • Males: greater risk / stress / lifestyle • Women before menopause CHD risks of • protective characteristic of estrogen on CHD • Women after menopause CHD risks of • 60yrs. women = 50yrs. male // late 70’s yr. = male • Hormone Replacement Therapies / reduce risks 12% to 25% / • Increase HDL and decrease LDL Women and Cardiovascular Disease • HA - Kills 9500 / year • Stroke - Kills 8500/year • Breast Cancer - kills 5000/year • Men have greater incidence but survive more often • Women lower incidence but survival rate is lower • Research has been MALE orientated Symptoms Men and women show different symptoms • men chest pain - first sign is MI • women - chest discomfort/not pain (angina) • severe abdominal pain / indigestion • physicians ignore condition Neglect of Symptoms Physicians: • may be gender-biased - not looking for heart disease • view male heart disease as a more severe problem in men • women decline major procedures more often then men Age………. • 80% of heart problems – 65yrs. more years of wear ‘n tear / lifestyle PHYSIOLOGICAL AND METABOLIC FACTORS: • Hypertension (High Blood Pressure) – 90% essential no specific cause / 10% secondary due to specific factors = kidney disease, obesity or tumors of the adrenal glands Blood Pressure • Sphygmomanometer: instrument measuring blood pressure • Systolic BP: pressure when the blood leaves the heart and enters the aorta • Diastolic BP: just before contraction of left ventricle (or when the heart is relaxing); peripheral resistance Hyperlipidemia • increased cholesterol levels + increased blood clotting potential – making blood sludgy in hours!! Diabetes: • prolonged effects of insulin / CAD • if overweight increased blood fat levels & atherosclerosis • tendency towards deterioration of small blood vessels • eyes and extremities Blood Pressures and What they Mean to You! Classification Systolic Diastolic Action Normal Below 130 below 85 Check Every Two Years High Normal 130 to 139 85 to 89 Check Every Year Mild Hypertension 140 to 159 90 to 99 Check in Two Months Moderate 160 to 179 100 to 109 See Physician in a Month Severe 180 and 110 and above See Physician Immediately Hypertension above Hypertension Obesity………... Obesity: • Is it the high fat / sugar / calorie diet or • heart strain by pumping blood through many more Km’s of extra blood vessels! LIFESTYLE FACTORS: • Smoking • Alcohol abuse • Stress • Physical Inactivity Diagnostic / Assessment Procedures: • ECG – Electrocardiogram – a record of the heart’s performance during stress testing • Angiography: a diagnosis procedure examines to blockages a catheter is inserted / dye released and X-ray Positron Emission Tomography (PET Scan): Positron Emission Tomography (PET Scan): • 3-D view of heart – radioactive tracer injected • scanner picks up emissions and provide image Radionuclide Imaging: • injected Radionuclides are injected and produce info. on chamber functioning/ blood flow to the heart / parts damaged Magnetic Resonance Imaging: (MRI or NMR) • powerful magnets produce computer-generated images of the aorta, heart, heart damage, and congenital defects Digital Cardiac Angiography: • computer-aided imaging / records pictures of heart & blood vessels How To Fix the Problem? Coronary Bypass Surgery: • procedure that reroutes the blood supply in a coronary artery after that artery was completely blocked Angioplasty: a balloon catheter is inserted into a blocked artery • 1% - die • 3 to 7% - blood vessel collapse spontaneously (need bypass) • 30% - clogged after 6 months Aspirin: • low dose (325mg) per day or every other day beneficial • gastrointestinal intolerance a common problem! Thrombolysis If person is diagnosed quickly then TPA (tissue plasminogen activator) can be used to dissolve some of the clot return some blood flow / save some of the heart muscle tissue / brain tissue Or be Preventative………... • Adopt health and lifestyle practices that will reduce the odds of developing CHD / CAD / Stroke / Diabetes • Nutritional Awareness • Active Lifestyle • Exercise • Stress Management • Weight Management