Chapter 13 CARDIOVASCULAR DISEASE (CVD) · HEART DISEASE STARTS IN CHILDHOOD •Childhood risk factors for cardiovascular events leading to hospitalization •BMI: 10% rise -- > 20%

Professor Betty C. Jung

CARDIOVASCULAR DISEASE (CVD)

Chapter 13

ATHEROSCLEROSIS: THE PROCESS OF CARDIOVASCULAR DISEASE


RISK FACTORS THAT CANNOT BE CHANGED

• Heredity

• CVD has genetic component; high cholesterol levels, blood clotting and obesity

• Aging

• Over the age of 65

• Being male

• Men have higher risk earlier in life

Gender, Ethnicity & CVD

• Hormone Replacement Treatment (HRT) increases women’s risk for heart disease

• 1/3 die from HD, 1/34 from breast cancer

• African-Americans are at greatest risk for CVD

• Should treat high blood pressure at 130/80

• Greater salt sensitivity

• Latino populations Diabetes variation

• Higher among Mexican Americans and Puerto Ricans

• Lower in Cuban Americans

RISK FACTORS YOU CAN CHANGE


HEART DISEASE STARTS IN CHILDHOOD

• Childhood risk factors for cardiovascular events leading to hospitalization

• BMI: 10% rise -- > 20% higher risk

• Systolic BP: 10% rise -- > 40% higher risk

• Serum cholesterol: 10% rise -- > 16% higher risk

• Adolescent smoking -- > 77% higher risk (Quit/don't smoke!)

• Source: Childhood cholesterol, blood pressure, weight and smoking

predict adult heart disease

https://www.sciencedaily.com/releases/2019/09/190901100612.htm


CHARACTERISTICS OF METABOLIC SYNDROME

A person having three or more factors listed here is diagnosed with

metabolic syndrome.

FACTOR CRITERIA

Large waistline

(abdominal obesity)

35 or more inches (88 cm) for women

40 or more inches (102 cm) for men

High triglyceride level 150 mg/dl or higher

Or taking medication to treat high triglycerides

Low HDL level Less than 50 mg/dl for women

Less than 40 mg/dl for men

Or taking medication to treat low HDL

High blood pressure 130/85 mm Hg or higher (one or both numbers)

Or taking medication to treat high blood pressure

High fasting blood sugar 100 mg/dl or higher

Or taking medication to treat high blood sugar

SOURCE: Adapted from National Heart, Lung, and Blood Institute. 2015. How Is Metabolic

Syndrome Diagnosed? (http://www.nhlbi.nih.gov/health/health-

topics/topics/ms/diagnosis).

A person having three or more factors listed here

is diagnosed with metabolic syndrome.

OTHER FACTORS YOU CAN CHANGE

• Insulin Resistance- weight

gain=>less active, muscle, fat

and live less sensitive to

insulin, pancreas must work

harder.

• Inflammation – C-Reactive

Protein (CRP) released ->

elevated risk for heart attack

and stroke.

• Alcohol & Drugs

• Psychological & Social

Factors:

• Stress

• Chronic hostility & anger

• Suppressing psychological

distress

• Depression

• Anxiety

• Social isolation

• Low socioeconomic status


WHAT’S YOUR LIFE PURPOSE?

• People who didn't have a strong life purpose — which was defined

as "a self-organizing life aim that stimulates goals" — were more

likely to die than those who did, and specifically more likely to die

of cardiovascular diseases.

• Strong life purpose was associated with reduced risk of mortality

and cardiovascular events, such as heart attacks or stroke.

• What's Your Purpose? Finding A Sense Of Meaning In Life Is

Linked To Health (5/25/2019)

• https://www.npr.org/sections/health-

shots/2019/05/25/726695968/whats-your-purpose-finding-a-

sense-of-meaning-in-life-is-linked-to-health


https://www.npr.org/sections/health-shots/2019/05/25/726695968/whats-your-purpose-finding-a-sense-of-meaning-in-life-is-linked-to-health

SMOKING & HEART DISEASE

• According to a new study, fathers-to-be who smoke may place

their offspring at an increased risk of congenital heart defects.

• Risk of congenital heart defects was much greater in men who

smoke than in woman smokers. The associated risk of

congenital heart defects increased by 74% for men smoking,

124% for passive smoking in women, and 25% for women

smoking (all compared to no exposure).

• (https://www.zmescience.com/medicine/fathers-smoke-baby-

health-3525623 3/25/19)


https://www.zmescience.com/medicine/fathers-smoke-baby-health-3525623

ALCOHOL & HEART HEALTH

• “…any exposure to alcohol has a negative impact upon heart

health”

• “Reducing the amount of alcoholic beverages consumed,

even for light-to-moderate drinkers, may improve

cardiovascular health, including a reduced risk of coronary

heart disease, lower body mass index and blood pressure,

according to a new multi-center study. The latest findings call

into question previous studies which suggest that consuming

light-to-moderate amounts of alcohol may have a protective

effect on cardiovascular health.” (University of Pennsylvania

School of Medicine)

• Drinking alcohol provides no heart health benefit, new study shows

http://www.sciencedaily.com/releases/2014/07/140710151947.htm (7/2014)


http://www.sciencedaily.com/releases/2014/07/140710151947.htm

TOBACCO

• 1 in 5 deaths from CVD is a smoker

• Smokers have 2 to 3 times higher

risk of death from a heart attack,

than non-smokers

• Damages the lining of arteries

• Reduces HDLs

• Raises triglycerides and LDLs

• Nicotine increases blood pressure

• CO displaces O2

• Causes platelets to become sticky and increases blood thickness

• Speeds the development of fatty deposits in the arteries


http://farm5.static.flickr.com/4022/4655619987_

efdd3182bc_b.jpg


CHOLESTEROL• Fatty wax substance in the

blood

• Cell membranes

• Sex hormones

• Vitamin D

• Lung coating

• Nerve protective sheath

• Excessive – clogs arteries

• Low-density lipoproteins (LDL) [LOUSY]

• Moves cholesterol from liver to the organs

• High-density lipoproteins (HDL) [HEALTHY]

• Moves unused back to liver

• Removes cholesterol from blood vessels (protects against atherosclerosis)

• Ideal: High (healthy) HDL, Low (lousy) LDL

http://www.healthspablog.org/wp-

content/uploads/2011/03/High-cholesterol-puts-1-of-5-

teens-at-risk-of-heart-disease.jpg

BLOOD PRESSURE CLASSIFICATION FOR HEALTHY ADULTS

CATEGORY aSYSTOLIC

(mm Hg) and/or

DIASTOLIC

(mm Hg)

Normal b below 120 and below 80

Elevated 120 to 129 and below 80

Hypertension c stage

1130 to 139 or 80 to 89

Hypertension stage 2 at least 140 or at least 90

a When systolic and diastolic pressures fall into different categories, the higher category

should be used to classify blood pressure status.

b The risk of death from heart attack and stroke begins to rise when blood pressure is

above 115/75.

c Based on the average of two or more readings taken at different physician visits. In

people older than 50, systolic blood pressure greater than 140 mm Hg is a much more

significant CVD risk factor than diastolic blood pressure.

SOURCE: Whelton, P. K. et al. 2017. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology S0735–1097(17): 41519–1.

LOWERING BP NATURALLY


http://blogs.webmd.com/heart-disease/2017/02/how-to-lower-your-blood-pressure-without-meds.html

Put all these together and you can realize anywhere from a 20 to 55 mmHg drop on your own. That’s the same kind of result you’d get from being on a bunch of medications!

PHYSICAL INACTIVITY


http://www.brainyweightloss.com/images/why-should-

people-exercise.jpg

• 40–60 million Americans are so

sedentary that they are at high

risk for developing CVD

• Exercise reduces risk by:

• Controlling blood pressure

and resting heart rate

• Increasing HDLs

• Maintaining weight

• Improving the condition of

blood vessels

• Preventing or controlling

diabetes

http://www.brainyweightloss.com/images/why-should-people-exercise.jpg

OBESITY


http://www.nature.com/nature/journal/v454/n720

3/images/nature07206-f1.2.jpg;

• The risk of death from CVD is two to

three times more likely in obese

people (BMI > 30)

• Strongly associated with:

• Hypertension

• High cholesterol

• Insulin resistance

• Diabetes

• Inactivity

• Increasing age

• Hypertrophy

• Congestive heart failure

http://www.nature.com/nature/journal/v454/n7203/images/nature07206-f1.2.jpg

DIABETES & HEART DISEASE

Professor Betty C. Junghttp://mms.businesswire.com/bwapps/mediaserver/View

Media?mgid=312094&vid=5&download=1

HEART ATTACK

• Women can have different

symptoms

• http://simplybeautifulhealthyliving.blogspot.com/2012/07/sy

mptoms-and-signs-of-heart-attack.html

• Helping a Heart Attack Victim

• Aspirin (325 mg) helpful – anti-clotting

• Most die within 2 hours from initial symptoms

• Cardiopulmonary resuscitation (CPR)


HEART DISEASE IN WOMEN


PCI & CABG

• Percutaneous Coronary

Intervention• Coronary Artery Bypass

Graft


STROKE (BRAIN ATTACK)


780,000 Americans suffer strokes each year2 million brain cells die per minute during a stroke.Interruption of the blood supply or any area of the brain prevents the nerve cells from functioning in some cases causing death.

Ischemic stroke (Clot) 90% Thrombotic Stroke Embolic Stroke

Hemorrhagic stroke (Bleed) 10%

Clot-dissolving drugs should be given only for Ischemic Strokes

Professor Betty C. Junghttps://www.stroke.nih.gov/materials/needtoknow.htm?utm_campaign=%2B%20Health&utm_content=104561810&utm_medium=social&utm_source=twitter&hss_channel=tw-14074515

https://www.stroke.nih.gov/materials/needtoknow.htm?utm_campaign=%2B Health&utm_content=104561810&utm_medium=social&utm_source=twitter&hss_channel=tw-14074515


http://www.stroke.org/redesign/core/img/stroke_infographic_web.jpg

BEING HEART HEALTHY

Professor Betty C. Junghttp://angelmedflight.files.wordpress.com/2012/02/simple-

7_mid.png?w=230&h=266

STRATEGIES FOR REDUCING YOUR RISK OF CARDIOVASCULAR DISEASE

Do More

• Eat a diet rich in fruits, vegetables, whole grains, and low-

fat or fat-free dairy products. Eat five to nine servings of

fruits and vegetables each day.

• Eat several servings of high-fiber foods each day.

• Eat two or more servings of fish per week; try a few

servings of nuts and soy foods each week.

• Choose unsaturated fats rather than saturated and trans

fats.

• Be physically active; do both aerobic exercise and

strength training on a regular basis.

• Achieve and maintain a healthy weight.

• Develop effective strategies for handling stress and

anger. Nurture old friendships and family ties, and

make new friends; pay attention to your spiritual

side.

• Obtain recommended screening tests and follow your

physician’s recommendations.

Do Less

• Don’t use tobacco in any form: cigarettes, spit tobacco,

cigars and pipes, bidis and clove cigarettes.

• Limit consumption of trans fats and saturated fats.

• Limit consumption of salt to no more than 2300 mg of

sodium per day (1500 mg if you have or are at high risk for

hypertension).

• Avoid exposure to environmental tobacco

smoke.

• Avoid excessive alcohol consumption—

no more than one drink per day for

women and two drinks per day

for men.

• Limit consumption of added

sugars and refined

carbohydrates

• Avoid excess stress,

anger, and hostility.

© Rubberball/Getty Images; © Vladyslav Starozhylov/Alamy


CARDIOVASCULAR DISEASE

Chapter 13

Documents

Chapter 13 CARDIOVASCULAR DISEASE (CVD) · HEART DISEASE STARTS IN CHILDHOOD •Childhood risk factors for cardiovascular events leading to hospitalization •BMI: 10% rise -- > 20%