1. Cardiovascular Disease

3. Caused by Atherosclerosis  Blocked artery By plaque Arteriosclerosis  “Hardening of the arteries”

4. Coronary Artery Disease Plaque buildup in arteries of the heart No outward symptoms Can produce a myocardial infarction  Heart attack  Due to blocked artery

5. Declining death rates in cardiovascular disease Due to:  Better diet  Reduction in cigarette smoking  Improved emergency care

6. Stroke Third most frequent cause of death Blocked artery in the brain Common stroke  Blocked artery Hemorrhagic stroke  Burst blood vessel

7. Framingham Heart Study Risk factors for heart disease  Cigarette smoking  High cholesterol  Hypertension  Sedentary lifestyle  Obesity

8. Framingham Heart Study LDL - Low-density lipoprotein  Positively related to cardiovascular disease  “L” = Lousy High-density lipoprotein  Protection against heart disease

9. Physical risk factors

10. Hypertension (High Blood Pressure) Best predictor of heart attack and stroke Reducing it is difficult because No visible symptoms To reduce it: Lose weight Reduce salt Better diet Fruits, vegetable, whole grain, low-fat dairy Regular physical activity

11. Cholesterol Total cholesterol  = LDL + HDL + Triglycerides Ratio Total cholesterol to HDL e.g. 4.5:1 Lower is better

12. Periodontal (gum) disease & CVD Chronic inflammation = increased risk of CVD Anti-inflammatory drugs (aspirin) Lowers risk of heart attack

13. Behavioral risk factors Smoking Diet Social support Anger Hostility Optimistic bias

14. Smoking Leading behavioral risk factor in CV death Less smoking = lower cardiovascular death

15. Diet Fruits, vegetables & fish reduce heart attack (CVD) risk

16. Social support Single, divorced, or widowed men = most at risk of CVD Marriage & social support help

17. Anger Anger increased risk of heart attack (CVD)

18. Hostility Cynical hostility = especially harmful to CV health

19. Optimistic bias “It won’t happen to me.”

20. Effect of nonfatal heart attack on sex Fear of having sex Not justified