1. Cardiovascular Health
Chapter 11

2. Cardiovascular Disease
Cardiovascular disease (CVD) = disease of the heart and blood vessels
CVD is the leading cause of death among Americans
Some CVD risk factors are controllable; others are not
There are many things individuals can do to reduce their risk of CVD

3. Major CVD Risk Factors That Can Be Changed
Tobacco use and exposure to ETS
Causes about 1 in 5 deaths from CVD
Damages artery linings
Reduces HDL
Raises LDL and triglycerides
Causes platelets to stick together
Raises heart rate and blood pressure
Displaces oxygen in the blood
Increases the rate of the accumulation of fatty deposits in arteries

4. Major CVD Risk Factors That Can Be Changed
High blood pressure (hypertension) = sustained abnormally high blood pressure
Systole = pressure when heart contracts
Diastole = pressure when heart relaxes
High blood pressure strains the heart, damages the arteries, and increases risk of heart attack, stroke, kidney failure, and blindness
Reduce with regular exercise, healthy diet (reduced salt, increased potassium and fiber), and moderation of alcohol intake

5. Blood Pressure Classification
Category
Systolic
(mm Hg)
Diastolic
Normal
Below 120
and
Below 80
Prehypertension
120–139 or
80–89
Hypertension
Stage 1
Stage 2
140–159
160 and above
90-99
100 and above

6. Major CVD Risk Factors That Can Be Changed
Unhealthy Cholesterol Levels
Low-density lipoprotein (LDL) = unhealthy (“bad”) cholesterol; excess amounts are deposited in artery walls
High-density lipoprotein (HDL) = healthy (“good”) cholesterol; shuttle unused cholesterol back to the liver for recycling
Levels can be improved by quitting smoking, exercising, and improving diet (less saturated and trans fat, more fruits, vegetables, fiber, and whole grains)

7. Cholesterol Guidelines
LDL cholesterol (mg/dl)
Less than 100
Optimal
100–129
Near optimal/above optimal
130–159
Borderline high
High
190 or more
Very high
Total cholesterol (mg/dl)
Less than 200
Desirable
200–239
240 or more
HDL cholesterol (mg/dl)
Less than 40
Low (undesirable)
60 or more
High (desirable)

8. Major CVD Risk Factors That Can Be Changed
Physical inactivity
Exercise decreases blood pressure and resting heart rate, improves cholesterol, improves the condition of blood vessels, and helps prevent obesity and diabetes
Obesity
Strains the heart, especially excess fat in the torso
Diabetes
Increases CVD risk even when controlled

9. Contributing CVD Risk Factors That Can Be Changed
High triglyceride levels
Lower with exercise, healthy diet, quitting smoking, reducing alcohol intake
Triglycerides (mg/dl)
Less than 150
Normal
150–199
Borderline high
200–499
High
500 or more
Very high

10. Contributing CVD Risk Factors That Can Be Changed
Psychological and social factors
Stress
Chronic hostility and anger
Suppressing psychological distress
Depression and anxiety
Social isolation
Low socioeconomic status
Alcohol and drug use

11. Major CVD Risk Factors That Can’t Be Changed
Family history/heredity
Multiple genes contribute to CVD risk
Aging
CVD risk goes up with age
Being male
Men face a higher risk, especially earlier in life
Ethnicity
African Americans have higher rates of hypertension and stroke

12. Possible Risk Factors Under Study
C-reactive protein
Homocysteine
Lipoprotein(a)
Small, dense LDL particles
Infectious agents

13. Possible Risk Factors Under Study
Metabolic syndrome, also known as syndrome X or insulin resistance syndrome
Abdominal obesity (waist circumference)
Greater than 40 inches in men
Greater than 35 inches in women
High blood pressure (130/85 or higher)
High triglycerides (150 mg/dl or higher)
Low HDL cholesterol
Below 40 mg/dl in men
Below 50 mg/dl in women
Insulin resistance (glucose of 110 mg/dl or higher)

14. Women and CVD Women underestimate their CVD risk
Nearly 1 in 2 women dies from CVD
About 1 in 30 women dies from breast cancer
Women are protected from CVD at younger ages by natural estrogen
After menopause, women are more likely than men to die after a heart attack
Women are more likely to have a heart attack without chest pain

15. African Americans and CVD
Blacks have higher rates of hypertension and stroke
Genetic, biological, and lifestyle factors may play a role
Lifestyle changes can reduce risk, as can medical treatment

16. Major Forms of Cardiovascular Disease
Hypertension (a risk factor and a form of CVD)
Atherosclerosis
Heart disease and heart attacks
Stroke
Congestive heart failure

17. Atherosclerosis
Atherosclerosis: Arteries are narrowed by deposits of fat, cholesterol, and other substances called plaques
Once narrowed by a plaque, an artery is vulnerable to blockage by blood clots
Blockage in the coronary arteries (coronary heart disease) can lead to a heart attack
Blockage in the brain can cause a stroke

18. Heart Disease and Heart Attacks
Heart attack = Damage to, or death of, heart muscle, sometimes resulting in a failure of the heart to deliver enough blood to the body; myocardial infarction.
Angina pectoris = A condition in which the heart muscle does not receive enough blood, causing severe pain in the chest and often in the left arm and shoulder.
Arrhythmia = An irregularity in the force or rhythm of the heartbeat.
Sudden cardiac death = A nontraumatic, unexpected death from sudden cardiac arrest, most often due to arrhythmia (in association with underlying heart disease).

19. Diagnosis and Treatment for Heart Disease
Exercise stress test
MRI, echocardiogram, angiogram
Treatment
Lifestyle changes (diet and exercise)
Low-dose aspirin therapy
Prescription medications
Balloon angioplasty
Coronary bypass surgery

20. Stroke
Stroke = An impeded blood supply to some part of the brain resulting in the destruction of brain cells
Ischemic stroke = caused by stroke
Hemorrhagic stroke = caused by ruptured blood vessel
Strokes may cause paralysis, walking disability, speech impairment, or memory loss
Treatment may include clot-dissolving and antihypertensive drugs

21. Congestive Heart Failure
Congestive heart failure = condition resulting from the heart’s inability to pump out all the blood that returns to it
Blood backs up in the veins leading to the heart, causing an accumulation of fluid in various parts of the body
Caused by high blood pressure, heart attack, atherosclerosis, birth defects, rheumatic fever

22. Protecting Yourself Against Cardiovascular Disease
Eat heart-healthy
Decrease fat and cholesterol intake
Especially limit saturated and trans fats
Increase fiber intake
Alcohol intake—moderate, if at all
DASH (Dietary Approaches to Stop Hypertension)
Exercise regularly
Avoid tobacco

23. Protecting Yourself Against Cardiovascular Disease (cont’d)
Know and manage your blood pressure
Know and manage your cholesterol levels
Develop ways to handle stress and anger
Know your risk factors

24. Reducing Your Risk of CVD
Do Less
Don’t use tobacco in any form.
Avoid exposure to environmental tobacco smoke.
Limit consumption of cholesterol, added sugars and refined carbohydrates.
Avoid excessive alcohol consumption – no more than one drink per day for women and two drinks per day for men.
Limit consumption of salt to no more than 2300 mg of sodium per day.
Avoid excess stress, anger, and hostility.
Do more
Eat a diet rich in fruits, vegetables, whole grains, and low-fat or fat-free dairy products.
Eat several servings of high-fiber foods each day.
Eat 2 or more servings of fish each week.
Choose unsaturated fats rather than saturated and trans fats.
Be physically active and do aerobic exercise and strength training on a regular basis.
Achieve and maintain a health weight.

25. Cardiovascular Health
Chapter 11
end