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Chapter Ten
Enhancing Your Cardiovascular
Health
Health Ch 10
10/27/09
Cardiovascular Disease
 Cardiovascular
• Pertaining to the heart (cardio) and the blood
vessels (vasculara)
Estimated Prevalence of Major Cardiovascular Diseases
 Hypertension
72,000,000
 Coronary heart disease
15,800,000
 Stroke
5,700,000
 Congestive heart failure
5,200,000
 Congenital heart disease
1,300,000
© 2009 McGraw-Hill Higher Education. All rights reserved.
The Vascular System
 Refers to the blood vessels
 Arteries carry blood away from the heart
• Arterioles are smaller-diameter extensions of arteries
 Veins carry blood back into the heart
• Venules are smaller-diameter extensions of veins
 Capillaries
• Smallest extensions of the vascular system
• Site of exchange of oxygen, food, and waste
• Blood
45% Red Blood Cells (carry Ox)
»
0.7 White Blood Cells
2 % Platelets (assist clotting)
»
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Deaths from Cardiovascular Disease
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The Heart
 Four-chambered pump
 Size of a fist
 Function:
• Creates pressure to circulate blood throughout the
body
 Location:
• Left center of the thorax (between lungs)
 Signal sends impulses from brain to the heart
 Electrocardiograph (ECG or EKG) measures the
cardiac electrical functioning
© 2009 McGraw-Hill Higher Education. All rights reserved.
Circulation through the Heart
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Blood
 Functions of the circulatory system
•
•
•
•
•
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Transportation of nutrients, oxygen, waste products
Regulation of water content of cells
Regulation of body temperature
Buffering of ph level
Prevention of blood loss
Protection against toxins and microorganisms by
circulating antibodies within the bloodstream
 Average person has 5 quarts of blood
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Cannot Be Changed
 Increasing age
• Most people who die from heart disease are age 65
and older
 Male gender
• Before age 55, men have a greater risk of heart
disease than women do
• After menopause, women’s rates of heart disease
increase
 Heredity
• Family history
• Race/ethnicity
negros have higher risk factors for CVD and
hypertension
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Can Be Changed
 Major Risk Factors: The “Big Six”
• Tobacco smoke
• Physical inactivity
• Abnormal blood cholesterol levels
• High blood pressure
• Diabetes mellitus
• Obesity and overweight
 Contributing Risk Factor
• Individual responses to stress
•
Type A personality = risk factor
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Can Be Changed
1. Tobacco smoke



Increases risk of heart attack, sudden
cardiac death
Affects nonsmokers exposed to
environmental tobacco smoke
Quitting leads to a reduced risk of heart
disease
2. Physical inactivity




Exercise strengthens the heart muscle,
maintains healthy blood vessels
Lowers cholesterol levels
Encourages weight loss and retention of
lean muscle mass
Moderates stress
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Can Be Changed
3. Abnormal Blood Cholesterol Levels
Classification of Total Cholesterol, Triglycerides, LDL, and HDL
Normal or
Desirable
BorderlineHigh
High
Total
cholesterol
< 200
200-239
≥ 240
Triglycerides
< 150
150-199
≥ 200
LDL
cholesterol
< 130
130-159
≥ 160
Low
Normal
High
(Desirable)
< 40
40-59
≥ 60
HDL
cholesterol
© 2009 McGraw-Hill Higher Education. All rights reserved.
Risk Factors That Can Be Changed
4. High blood pressure
 Damages heart and blood vessels
5. Diabetes mellitus
 Increases risk of heart and blood vessel
disease
 Linked to abnormal levels of cholesterol and
other blood fats
6. Obesity and overweight
 Abdominal obesity is especially risky
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Metabolic Syndrome
 Risk factors often appear in a group
Criteria for Metabolic Syndrome
• Elevated waist circumference
muse 38 in
• Men: ≥ 40 inches
• Women: ≥ 35 inches
• Elevated triglycerides
muse 300*
• ≥ 150 mg/dL
• Reduced HDL cholesterol
muse 38 *
• Men: < 40 mg/dL
• Women: < 50 mg/dL
• Elevated blood pressure
muse 120 /77
• ≥ 130/85 mmHg
• Elevated fasting glucose
• ≥ 100 mg/dL
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muse 80 mg/dL
Forms of Cardiovascular Disease
 Coronary heart disease
 Hypertension
 Stroke
 Congenital heart disease
 Rheumatic heart disease
 Congestive heart failure
 Diseases of the arteries
 Arrhythmias
© 2009 McGraw-Hill Higher Education. All rights reserved.
Coronary Heart Disease
 Damage to vessels that supply blood to the
heart muscle
 Atherosclerosis: Buildup of plaque on the
inner walls of arteries
 Myocardial infarction (heart attack): Death of
part of the heart muscle
 Biomarkers
• Homocysteine
• High sensitivity C-reactive protein
If hs-CRP level is lower than 1.0 mg/L, a person has a low risk of developing cardiovascular disease.
If hs-CRP is between 1.0 and 3.0 mg/L, a person has an average risk.
If hs-CRP is higher than 3.0 mg/L, a person is at high risk.
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Progression of Atherosclerosis
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Cholesterol and Lipoproteins
 Low-density lipoprotein (LDL)
• “Bad” cholesterol
 High-density lipoprotein (HDL)
• “Good” cholesterol
 To improve cholesterol levels:
• Reduce saturated fat intake
• Reduce cholesterol intake
• Reduce caloric intake to control weight
• Take a Statin drug (lipitor, zocor)
© 2009 McGraw-Hill Higher Education. All rights reserved.
Coronary Heart Disease
 Angina pectoris: Chest pain with stress or exertion
 Symptoms of a heart attack include chest pain,
shortness of breath, nausea, lightheadedness, back or
jaw pain
Emergency treatment: CPR and AEDs
 Diagnosis
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•
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Blood tests
Vital signs
Electrocardiogram, echocardiogram
Coronary arteriography
PET, EBCT, and MRI
Nuclear medicine
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Coronary Heart Disease
 Surgical treatments
• Coronary artery bypass surgery
• Provides alternative routes for blood to take around
points of blockage
• Percutaneous coronary intervention
• A slender balloon-tipped tube is used to flatten
plaque and widen an artery
• Heart transplant
 Nonsurgical treatments
• Medications, including aspirin (prevents platelet
sticking).
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Statin Drugs
Percutaneous Coronary Intervention
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Hypertension
 Symptoms: “Silent killer” (no symptoms)
 Screening: Regular checks of resting blood pressure
 Effects: Heart attacks, strokes, kidney failure, eye damage
Classification
Blood pressure
(mm Hg)
Normal
Prehypertension
Hypertension
Systolic (top
number)
Less than 120
120-139
140 or higher
Diastolic
(bottom
number)
Less than 80
80-89
90 or higher
© 2009 McGraw-Hill Higher Education. All rights reserved.
Hypertension
 Prevention and treatment
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•
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Weight reduction
Physical activity
Moderation in alcohol use
DASH eating plans
Salt restriction
Stress reduction
Medication (lisonopril, B-blockers)
© 2009 McGraw-Hill Higher Education. All rights reserved.
Stroke
 Blockage of vessel to the brain
 Types of stroke
• Cerebrovascular occlusions
• Cerebral hemorrhage
• Cerebral aneurysm
 Warning sign: Transient ischemic attack (TIA)
 Diagnosis
• Computerized axial tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
 Treatment
• Clot dissolving drugs
• Cell-rebuilding drugs
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Causes of Stroke
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Congenital Heart Disease
 Abnormalities present at birth
• Caused by environmental factors or illness
 Types
• Valve damage
• Holes in the walls of the septum
• Blood vessel transportation
• Underdevelopment of left side of the heart
 Treatment
• Surgery may be performed to repair malformations
© 2009 McGraw-Hill Higher Education. All rights reserved.
Rheumatic Heart Disease
 Chronic damage to the heart (especially
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


the valves)
Result of streptococcal infection in the
heart
• Complication of rheumatic fever
Damage tends to occur in valves of the
heart
Diagnosis: X-rays, echocardiogram
Treatment: Surgery
© 2009 McGraw-Hill Higher Education. All rights reserved.
Congestive Heart Failure
 Inability of the heart to pump out all the blood
that returns to it
• Fluid accumulates in veins, lungs, and kidneys
 Caused by heart damage from other causes
 Treatment
• Rest
• Proper diet
• Modified daily activities
• Use of appropriate drugs
© 2009 McGraw-Hill Higher Education. All rights reserved.
Diseases of the Arteries
Peripheral artery disease (PAD)
 Blood vessel disease involving changes to the
arteries and arterioles in the extremities
 Causes
• Cigarette smoking
• Obesity
• High-fat diet
• Sedentary occupations
 Treatment
• Blood vessel surgery
• Medication
• Modified lifestyle
© 2009 McGraw-Hill Higher Education. All rights reserved.
Arrhythmias
 Irregular beating pattern of the heart caused by


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disruption of the normal sequence of electrical activity
in the heart
Can result in loss of consciousness or even death
Diagnosis: EKG
Treatment: Medication to control heart rate
Heart patterns
• Bradycardia: Fewer than 60 beats/minute at rest
• Tachycardia: More than 100 beats/minute at rest
© 2009 McGraw-Hill Higher Education. All rights reserved.
CVD Prevention
 Avoid tobacco
 Choose a healthy diet
 Be physically active
 Control body weight
 Manage stress
 Get regular screenings
© 2009 McGraw-Hill Higher Education. All rights reserved.
© 2009 McGraw-Hill Higher Education. All rights reserved.
Chapter Ten:
Enhancing Your Cardiovascular Health