1. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Chapter 11 Cardiovascular Health

2. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Cardiovascular Disease Age-Adjusted Rates* of Death from Heart Disease, by Race and Sex --- United States, 1979--2006 † * Per 100,000 standard population. † Data for 2006 are preliminary.

4. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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

5. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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 CVD can be reduced with regular exercise, healthy diet (reduced salt, increased potassium and fiber), and moderation of alcohol intake

6. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Blood Pressure Classification Category Systolic (mm Hg) Diastolic (mm Hg) NormalBelow 120andBelow 80 Prehypertension120–139or80–89 Hypertension Stage 1 Stage 2 140–159 160 and above or 90-99 100 and above

7. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Blood Pressure Source: Centers for Disease Control and Prevention

8. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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)

9. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Cholesterol Guidelines LDL cholesterol (mg/dl) Less than 100Optimal 100–129Near optimal/above optimal 130–159Borderline high 160-189High 190 or moreVery high Total cholesterol (mg/dl) Less than 200Desirable 200–239Borderline high 240 or moreHigh HDL cholesterol (mg/dl) Less than 40Low (undesirable) 60 or moreHigh (desirable)

10. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Travels with Cholesterol

11. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Cholesterol Checked Among Americans Source: Centers for Disease Control and Prevention

12. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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

13. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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 150Normal 150–199Borderline high 200–499High 500 or moreVery high

14. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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

15. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Major CVD Risk Factors That Cannot 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

16. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Annual Incidence of Heart Attack

17. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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

18. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Major Forms of Cardiovascular Disease Hypertension (a risk factor and a form of CVD) Atherosclerosis Heart disease and heart attacks Stroke Congestive heart failure

19. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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

20. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Atherosclerosis

21. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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).

22. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Heart Attack Symptoms of heart attack require immediate action.

23. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Diagnosis and Treatment for Heart Disease Diagnosis –Exercise stress test –MRI, echocardiogram, angiogram Treatment –Lifestyle changes (diet and exercise) –Low-dose aspirin therapy –Prescription medications –Balloon angioplasty –Coronary bypass surgery Video: http://www.youtube.com/watch?v=S9AqBd4RExkVideo: http://www.youtube.com/watch?v=veP5R-pzJVk&NR=1 Video: http://www.youtube.com/watch?v=3Nf6Q2skGOM&feature=related Video: http://www.youtube.com/watch?v=kY 5gKdFWT3k&feature=related

24. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved.

25. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Video: http://www.youtube.com/watch?v=3Nf 6Q2skGOM http://www.youtube.com/watch?v=3Nf 6Q2skGOM

26. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Treatment of Heart Disease Surgery is one possible treatment for heart disease.

27. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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

28. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Types of Stroke

29. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Stroke

30. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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 (delayed complication of upper respiratory streptococcus infection)

31. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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 http://www.nhlbi.nih.gov/health/public/heart/hb p/dash/new_dash.pdf

32. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. 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 sphygmomanometer

33. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Reducing Your Risk of CVD

34. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Mitral Valve Mitral valve prolapse is the most common cause of heart murmur. When the ventricles contract, the redundant leaflets prolapse (flop backwards) into the left atrium, sometimes allowing leakage of blood through the valve opening (mitral regurgitation).

35. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 1 © 2007 McGraw-Hill Higher Education. All rights reserved. Wellness Worksheet Assignment Wellness Worksheets can be accessed online at www.mhhe.com/fahey8ewww.mhhe.com/fahey8e 1.From the website above, click on “student edition” at the bottom left column. 2.Click on “wellness worksheets” 3.Click on “126 Wellness Worksheets are available online” in the middle of the page. 4.Click on “89: Facts About Cardiovascular Disease” and complete the worksheet. 5.Print out the completed worksheet and submit on Monday, September 19 th

36. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11 ©2007 McGraw-Hill Higher Education. All rights reserved. Reminders Study guide for Exam I will be posted on instructor’s website. Review for Exam I on Monday, September 19 th Exam I (Chapters 1, 2, 3 and 11) on Wednesday, September 21 st Please bring a pencil and Scantron 882-E for Exam I