Download Cardiovascular Disease

Chapter 15
Cardiovascular
Disease:
Reducing Your Risk
Lecture Outline
Copyright © 2010 Pearson Education, Inc.
written by Bridget Melton, Georgia Southern University
Objectives
• Discuss the incidence, prevalence, and outcomes
of cardiovascular disease.
• Describe the anatomy and physiology of the heart
and circulatory system and the importance of
healthy heart function.
• Review major types of cardiovascular disease,
controllable and uncontrollable risk factors, methods
of prevention, and current strategies for diagnosis
and treatment.
Copyright © 2010 Pearson Education, Inc.
Activity Break: Health Family Tree
• Create a family tree that includes each person’s
cause of death and his or her major health condition,
if any.
• Take 5 to 10 minutes to begin your family tree.
• We will discuss as a group the diseases you
recognize.
• Continue adding to your health family tree this
week by talking to your relatives.
Copyright © 2010 Pearson Education, Inc.
Total Cardiovascular Disease Death
Rates by State, Age Adjusted
Copyright © 2010 Pearson Education, Inc.
An Epidemiological Overview
• Cardiovascular disease (CVD) is the leading cause
of death in the United States.
• In 2005, CVD accounted for approximately 37
percent of all deaths.
• CVD has been the number-one killer in the United
States since 1900, except during the 1918 influenza
pandemic.
• More than 2,400 Americans die from CVD each day.
• Among women, 1 in 2.6 are deaths from CVD.
Copyright © 2010 Pearson Education, Inc.
Prevalence of Cardiovascular Disease in
U.S. Adults Aged 20 and Older by Age
and Sex
Copyright © 2010 Pearson Education, Inc.
ABC News Video: Heart Disease in America
| Heart Disease in America
Discussion Questions
1. What preventive measures can be taken to avoid
a heart attack?
2. What effect does a celebrity death from a certain
illness have on how members of the public
address their own health?
Copyright © 2010 Pearson Education, Inc.
Understanding the Cardiovascular System
• Cardiovascular system includes the heart, arteries,
arterioles, capillaries, venules, and veins.
• The heart
• Muscular, four-chambered pump
• Contracts 100,000 times per day
• Two upper chambers: atria
• Two lower chambers: ventricles
• Tricuspid, pulmonary, mitral, and aortic valves
Copyright © 2010 Pearson Education, Inc.
Anatomy of the Heart
Copyright © 2010 Pearson Education, Inc.
Heart Function
• Right Atrium (pulmonary side)
• Deoxygenated blood enters the right atrium.
• Blood moves into the right ventricle.
• Right ventricle
• Pumps blood through the pulmonary artery to the
lungs
Copyright © 2010 Pearson Education, Inc.
Heart Function (cont.)
• Left Atrium (systemic side)
• Oxygenated blood enters the left atrium from lungs.
• Blood is forced into the left ventricle.
• Left ventricle
• Pumps blood through the aorta to all body parts
Copyright © 2010 Pearson Education, Inc.
Types of Cardiovascular Disease
• Atherosclerosis
• Coronary heart disease (CHD)
• Chest pain (angina pectoris)
• Irregular heartbeat (arrhythmia)
• Congestive heart failure (CHF)
• Congenital and rheumatic heart disease
• Stroke
Copyright © 2010 Pearson Education, Inc.
Percentage Breakdown of Deaths from
Cardiovascular Disease in the United States
Copyright © 2010 Pearson Education, Inc.
Atherosclerosis
• Characterized by deposits of fatty substances,
cholesterol, cellular waste products, calcium, and
fibrin in the inner lining of the artery
• Hyperlipidemia
• Abnormally high blood lipid level
• Plaque
• Buildup of deposits in the arteries
Copyright © 2010 Pearson Education, Inc.
Atherosclerosis (cont.)
Copyright © 2010 Pearson Education, Inc.
Coronary Heart Disease
• Myocardial infarction (MI), or heart attack
• Blood supplied to the heart is disrupted.
• Coronary thrombosis
• Blood clot in the coronary artery
• Embolus
• The blood clot is dislodged and moves through
the circulatory system.
• Collateral circulation
• If blockage to the heart is minor, blood flow is
rerouted.
Copyright © 2010 Pearson Education, Inc.
Angina Pectoris
• Ischemia
• Reduction of the heart’s blood and oxygen supply
• The more serious the oxygen deprivation, the
more severe the pain.
• Nitroglycerin
• Drug used to relax (dilate) the veins
• Beta blockers control potential overactivity of the
heart muscle.
Copyright © 2010 Pearson Education, Inc.
Arrythmias
• Irregularities in heart rhythm
• Tachycardia is a racing heart in the absence of
exercise or anxiety.
• Bradycardia is an abnormally slow heart beat.
• Fibrillation is a sporadic heart beat with a
quivering pattern.
Copyright © 2010 Pearson Education, Inc.
Congestive Heart Failure
• Damaged or overworked heart muscle is unable to
keep blood circulating normally.
• Affects over 5 million Americans
• Damage to heart muscle may result from rheumatic
fever, pneumonia, heart attack, or other
cardiovascular problem.
• Lack of proper circulation may allow blood to
accumulate in the vessels of the legs, ankles, or
lungs.
• Diuretics relieve fluid accumulation.
Copyright © 2010 Pearson Education, Inc.
Congenital and Rheumatic Heart Disease
• Congenital heart disease affects 1 out of 125
children.
• May be due to hereditary factors, maternal diseases,
or chemical intake (alcohol) during fetal
development
• Rheumatic heart disease results from rheumatic
fever, which affects connective tissue.
Copyright © 2010 Pearson Education, Inc.
Stroke
• Occurs when the blood supply to the brain is
interrupted
• Thrombus is a blood clot.
• Embolus is a free-flowing clot.
• Aneurysm is a bulging or burst blood vessel.
• Transient ischemic attack (TIA) is a brief interruption
of blood supply that causes temporary impairment.
Copyright © 2010 Pearson Education, Inc.
Blood Vessel Disorders that Can Lead to
Stroke
Copyright © 2010 Pearson Education, Inc.
Activity Break: CVD Risk Factors
• Get into groups of four to five students.
• Assign a note taker and a runner.
• When your group has the answer, run it up to me.
• List four nonmodifiable risk factors for CVD.
• List four modifiable risk factors for CVD.
Copyright © 2010 Pearson Education, Inc.
Reducing Your Risk for Cardiovascular Diseases
• Risks you cannot control
• Heredity
• Age
• Gender
• Race
Copyright © 2010 Pearson Education, Inc.
Reducing Your Risk for Cardiovascular Diseases
(cont.)
• Risks you can control
• Avoid tobacco.
• Cut back on saturated fat and cholesterol.
• Maintain a healthy weight.
• Modify dietary habits.
• Exercise regularly.
• Control diabetes.
• Control blood pressure.
• Systolic is the first number.
• Diastolic is the second number.
• Manage stress.
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Cholesterol and Triglycerides
Two major types of cholesterol
• LDL, or low-density lipoprotein, is “bad” cholesterol
that builds up on artery walls.
• HDL, or high-density lipoprotein, is “good”
cholesterol that helps protect the body by removing
cholesterol from artery walls and transporting it to
the liver for elimination.
• Triglycerides are a common fat produced by your
body.
• They do not cause arteries to thicken, but may
speed the process.
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Modify Dietary Habits
Overweight people are more likely to develop heart
disease and stroke.
Heart health can be improved by good dietary habits.
• Consume 5 to10 milligrams of fiber per day.
• Consume approximately 2 grams of plant sterols per
day (found in fruits, vegetables, nuts, seeds, cereals,
legumes, and vegetable oils).
• Limit your salt intake.
Copyright © 2010 Pearson Education, Inc.
The DASH Eating Plan
Copyright © 2010 Pearson Education, Inc.
Control Your Blood Pressure
• Hypertension is sustained high blood pressure.
• Called the “silent killer” because it has no
symptoms
• Greater risk for CVD
• Formula for blood pressure: systolic over diastolic
• Systolic pressure is pressure applied to artery
walls as the heart contracts.
• Diastolic pressure is pressure applied to the
artery walls during relaxation phase.
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
Combined Risks: Metabolic Syndrome
Metabolic syndrome is a group of obesity-related risk
factors that increase the risk of heart disease and
diabetes.
• Indicated by three or more of the following:
• Abdominal obesity (40-inch waist in men;
35-inch waist in women)
• Elevated blood fat
• Low levels of HDL
• Elevated blood pressure
• Elevated fasting glucose greater than 100 mg/dL
• High levels of C-reactive proteins (inflammation)
Copyright © 2010 Pearson Education, Inc.
Risks You Cannot Control
• Race: African Americans are at a 45 percent greater
risk for hypertension and heart disease.
• Heredity: Cautionary medical factors seem to have a
genetic link.
• Age: 75 percent of all heart attacks affect people
over age 65.
• Gender: Men are at a greater risk for cardiovascular
disease until around age 60. After menopause,
women are at increase for cardiovascular disease.
Copyright © 2010 Pearson Education, Inc.
Deaths from Cardiovascular Disease in
the United States by Gender and Race
Copyright © 2010 Pearson Education, Inc.
Women and Cardiovascular Disease
• In 2004, CVD killed:
• 405,780 men
• 450,250 women
• Estrogen
• Once estrogen production stops, risk for CVD death
increases.
Copyright © 2010 Pearson Education, Inc.
Women and Cardiovascular Disease (cont.)
• Diagnostic and therapeutic differences
• Delay in diagnosing possible heart attack
• Complexity in interpreting chest pain in women
• Less aggressive treatment of female heart attack
victims
• Smaller coronary arteries in women
• Gender bias in CVD research—most CVD research
has been conducted on male subjects.
Copyright © 2010 Pearson Education, Inc.
Copyright © 2010 Pearson Education, Inc.
New Weapons against Heart Disease
• Techniques for diagnosing heart disease
• Electrocardiogram (ECG)
• Angiography
• Positron emission tomography (PET)
• Single-photon emission computed tomography
(SPECT)
• Radionuclide imaging
• Magnetic resonance imaging (MRI)
• Ultrafast computed tomography (CT)
• Digital subtraction angiography (DSA)
Copyright © 2010 Pearson Education, Inc.
Angioplasty versus Bypass Surgery
• Angioplasty involves threading a thin catheter
through the blocked arteries. The catheter has a
balloon on the tip, which is inflated to flatten the fatty
deposits against the wall of the artery.
• Coronary bypass surgery takes a blood vessel from
another site and implants it to bypass blocked
arteries and transport blood.
Copyright © 2010 Pearson Education, Inc.
Aspirin for Heart Disease?
• Research shows that 80 milligrams of aspirin daily
or every other day is beneficial to heart patients
due to its blood-thinning properties.
• Some side effects of aspirin include gastrointestinal
intolerance and a tendency for difficulty with blood
clotting.
• Aspirin should be taken only under the advice of
your physician.
Copyright © 2010 Pearson Education, Inc.
Thrombolysis
• If a heart attack victim reaches an emergency room
and is diagnosed quickly, thrombolysis can be
performed.
• Thrombolysis involves injecting an agent such as
tissue plasminogen activator (TPA) to dissolve the
clot and restore some blood flow.
Copyright © 2010 Pearson Education, Inc.
Cardiac Rehabilitation
• Every year, 1 million people survive heart attacks.
• Cardiac rehabilitation exercise training increases
stamina and strength, and promotes recovery.
Copyright © 2010 Pearson Education, Inc.
Personal Advocacy and Heart-Smart Behaviors
• Know your rights as a patient.
• Find out about informed consent procedures, living
wills, durable power of attorney, organ donation, and
other legal issues before you become sick.
• Ask about alternative procedures.
• Remain with your loved one as a personal advocate.
• Check the credentials of health care providers.
• Be considerate of your care provider.
• Be patient with the patient.
Copyright © 2010 Pearson Education, Inc.