Chapter 15 - Cabrillo College Home Page

Chapter 15

Cardiovascular Disease:

Reducing Your Risk

Lecture Outline

Objectives

• Discuss the incidence, prevalence, and outcomesof 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.

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.

Total Cardiovascular Disease Death Rates by State, Age Adjusted

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.

Prevalence of Cardiovascular Disease in U.S. Adults Aged 20 and Older by Age and Sex

ABC News Video: 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?

| Heart Disease in America

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

Anatomy of the Heart

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

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

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

Percentage Breakdown of Deaths from Cardiovascular Disease in the United States

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

Atherosclerosis (cont.)

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.

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.

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.

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.

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.

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.

Blood Vessel Disorders that Can Lead to Stroke

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.

Reducing Your Risk for Cardiovascular Diseases

• Risks you cannot control

• Heredity

• Age

• Gender

• Race

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.

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.

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.

The DASH Eating Plan

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.

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)

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.

Deaths from Cardiovascular Disease in the United States by Gender and Race

Women and Cardiovascular Disease

• In 2004, CVD killed:

• 405,780 men

• 450,250 women

• Estrogen

• Once estrogen production stops, risk for CVD death increases.

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.

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)

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.

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.

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.

Cardiac Rehabilitation

• Every year, 1 million people survive heart attacks.

• Cardiac rehabilitation exercise training increases stamina and strength, and promotes recovery.

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.

Chapter 15 - Cabrillo College Home Page

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