Chapter Outline

IMPACT OF CARDIOVASCULAR DISEASE (CVD)

• Cardiovascular disease accounts for 41 percent of all deaths in the U.S.

• It is the number one killer, not cancer, accidents, or AIDS.

• Common forms of CVD include heart attack, stroke, high blood pressure, angina pectoris, irregular heartbeat, congestive heart failure, rheumatic heart disease, and congenital heart disease.

• Someone dies of CVD every 33 seconds in the U.S.

CORONARY HEART DISEASE (CHD)

• CHD is most commonly a result of atherosclerosis, a progressive condition in which plaque accumulates on the inner walls of coronary arteries.

• There are a variety of causes of atherosclerosis, many of which are related to unhealthy lifestyles (i.e., excessive dietary cholesterol and saturated fat leading to high blood cholesterol levels, high blood pressure, your reaction to emotional stress, using tobacco).

ANGINA PECTORIS

• Angina pectoris, or chest pain, is often brought on by sudden exertion when the blood flow to the heart is insufficient to meet its oxygen demand.

• It may be caused by atherosclerosis.

MYOCARDIAL INFARCTION

• The most prevalent form of CVD is myocardial infarction, or heart attack.

• It is caused when one or more of the coronary arteries is blocked atherosclerotic deposits.

• A deposit of plaque can suddenly break open, forming a blood clot that chokes off the supply of blood to the heart muscle.

STROKE (BRAIN ATTACK)

• A stroke occurs when blood flow to the brain is interrupted either by a blockage (ischemic stroke) or by a burst blood vessel (cerebral hemorrhage).

• It is caused primarily by atherosclerosis so a healthy lifestyle is a critical factor in reducing your risk.

RISK FACTORS

• These are conditions, situations, and behaviors that increase the likelihood that an undesirable outcome (injury, illness, or death) will occur.

PRIMARY RISK FACTORS

• These are linked directly to the development of CHD; they increase the possibility of having a heart attack.

• All primary risk factors for CHD are controllable.

• The five primary risk factors for CHD include:

Inactivity - linked to 250,000 deaths every year in the U.S.

High blood pressure, acceptable range = 90/60 to 139/89; 140/90 is considered hypertension.

High blood lipid level - total blood cholesterol should be less than 200 mg/dl

.Low-density lipoproteins (LDL) should be less than 130 mg/dl

.High-density lipoproteins should be 60 mg/dl or more

.Triglycerides should be below 200 mg/dl

Cigarette smoking

Obesity

SECONDARY RISK FACTORS

• These seven risk factors contribute to the development of CHD but not as directly as the primary risk factors.

• The controllable secondary risk factors include:

Stress

Emotional behavior

• The uncontrollable secondary risk factors include:

Age

Gender

Race

Positive family history

Diabetes mellitus - (The development of Type 2 diabetes is closely related to an unhealthy lifestyle)

• Blood glucose levels of 126 mg/dl indicates diabetes
• Blood glucose levels of 110-125 mg/dl may indicate insulin resistance and an increased risk of diabetes.

TREATMENT FOR BLOCKED ARTERIES

• When coronary arteries become blocked, usually the first treatments prescribed are diet modifications (low fat and sugar) and exercise therapy.

• The way you live, the choices you make, can have a profound impact on the health of your cardiorespiratory system.

DRUG THERAPY

• This involves drug treatment affecting the supply of oxygen to the heart muscle or the heart's demand for oxygen.

ANGIOPLASTY (or BALLOON ANGIOPLASTY)

• In this technique, obstructions in the coronary arteries are compressed by an inflated balloon resulting in the enlargement of the narrowed area. The balloon device is removed after the procedure.

• Stints (cylinders that prop the arteries open) reduces the risk of the arteries closing again.

CORONARY BYPASS SURGERY

• This is a surgical procedure in which doctors take a blood vessel from another part of the body (usually the leg) and use it to detour around a blockage in the coronary artery.

NEW TECHNIQUES

• Research is revealing new techniques that are showing great promise (i.e., enzyme therapy, laser beam treatment, vaccination, and insertion of a cancer gene).

THE FUTURE . . . FOCUS ON LIFESTYLE

• "An ounce of prevention is worth a pound of cure," will be the slogan for the twenty-first century.

• Heart disease prevention in our future will focus primarily on lifestyle changes and approaches that involve "mind and body" concepts.