Ch 15 Preventing Cardiovascular Disease – Flashcards
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over _million Americans (_out of every_adults) suffer from one or more types of cardiovascular disease (CVD)
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-82.6 million -1 out of every 3 adults
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cardiovascular disease (CVD)
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-diseases of the heart and blood vessels
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cardiovascular disease (CVD) it has been the leading killer of US adults every year since _, except in_, when _
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-1900 -1918, when a pandemic flu killed more people
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We spend billions on research for prevention strategies, treatments, and cures, and we have the post sophisticated media warnings and educational programs telling us how to avoid risks. Nevertheless, Americans are _, even though the rates of mortality from cardiovascular disease (CVD)_
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-more obese and spending more on treatment of cardiovascular disease (CVD) than ever before, even though the rates of mortality from cardiovascular disease (CVD) continues to decline
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7 key risk factors for cardiovascular disease (CVD)
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-weight -smoking -cholesterol -hypertension -fasting glucose levels -poor diet -lack of physical activity
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only _% of US adults are free of risk factors in these seven areas and nearly _% score in the "poor" range with over 3 significant CVD risks
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-6% -40%
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your actions right now can predispose you to _
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premature problems, regardless of your age
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cardiovascular system
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-organ system, consisting of the heart and blood vessels, that transports nutrients, oxygen, hormones, metabolic wastes, and enzymes throughout the body -network of organs and vessels through which blood flows as it carries oxygen and nutrients to all parts of the body
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cardiovascular system includes: (6)
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-heart -arteries -arterioles (small arteries) -veins -venules (small veins) -capillaries (minute blood vessels )
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the hear is a _(made of what, how many chambers, size)
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-muscular -four-chambered pump -roughly the size of your fist
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The heart is a highly efficient, extremely flexible organ that contract _times each day and pumps the equivalent of _gallons of blood to all areas of the body
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-100,000 times each day -2,000 gallons of blood
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In a 70-year lifetime, an average human heart beats _billion times
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-2.5 billion times
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Under normal circumstances, the human body contains approx. _of blood, which transports_(what does)
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-6 quarts of blood -transports nutrients, oxygen, waste product, hormones, and enzymes throughout the body
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blood functions
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-transports nutrients, oxygen, waste product, hormones, and enzymes throughout the body -aids in regulating body temperature, cellular water levels, and acidity levels of body components -helps defend the body against toxins and harmful microorganisms
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an adequate_is essential to health and well-being
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blood supply
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The heart four chambers work together to _constantly throughout the body
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-circulate blood
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Name the four chambers of the heart
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-the two upper chambers of the heart are called atria -the two lower chambers of the heart are called ventricles
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atria
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-(singular atrium) -The heart's two upper chambers, which receive blood -are large collecting chambers that receive blood from the rest of the body
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ventricles
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-the heart's two lower chambers, which pump blood throughout the blood vessels -pump the blood out again
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_regulate the steady, rhythmic flow of blood between chambers and prevent _
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-small valves -prevent leakage or backflow between them
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Heart activity depends on a complex interaction _
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-complex interaction of biochemical, physical, and neurological signals
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Explain blood flow through the heart
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1. deoxygenated blood enters the right atrium from the superior and inferior vena cavae after having been circulating through the body 2. From the right atrium, blood moves to the right ventricle and is pumped through the pulmonary artery to the lungs, where it receives oxygen and discards carbon dioxide 3. Oxygenated blood from the lungs then returns through the pulmonary veins into the left atrium of the heart 4. Oxygenated blood from the left atrium moves into the left ventricle. The left ventricle pumps blood through the aorta to all body parts (into the rest of the body's blood vessels)
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Various types of blood vessels are required for different parts of this process, list them
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-arteries -arterioles -capillaries -veins -venules
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arteries
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-vessels that carry blood away from the heart to the other regions of the body
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what kind of blood arteries carry?
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-all arteries carry oxygenated blood, except for pulmonary arteries, which carry deoxygenated blood to the lungs, where the blood picks up oxygen and gives up carbon dioxide
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after the arteries branch off the heart, they branch into _, and then into _
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-smaller blood vessels called arterioles -into even smaller blood vessels known as capillaries
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arterioles
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branches of the arteries
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capillaries
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-minute blood vessels that branch out from the arterioles and venules -their thin walls permit exchange of oxygen, carbon dioxide, nutrients, and waste products among body cells
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capillaries have _(thickness) walls that permit the exchange of _
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-thin walls -exchange of oxygen, carbon dioxide, nutrients, and waste products with body cells
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carbon dioxide and other wastes are transported to_(2)through_(2)
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-lungs and kidneys -through veins and venules
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veins
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-vessels that transport waste and carry blood back to the heart form other regions of the body
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venules
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-branches of veins -small veins
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for the heart to function properly, the four chambers must_
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-four chambers must beat in an organized manner
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your heart beat is governed by_
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an electrical impulse that directs the heart muscle to move when the impulse travels across it, which results in a sequential contraction of the chambers
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this signal starts in _
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-a small bundle of highly specialized cells in the right atrium, called sinoatrial node (SA node)
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sinoatrial node (SA node)
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-Cluster of electric pulse-generating cells that serve as a natural pacemaker for the heart
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the SA node serves as _(role)
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-a natural pacemaker for the heart
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what people with a damaged SA node must do?
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-people with a damaged SA node must often have a mechanical pacemaker implanted to make the heart beat
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The average adult heart at rest beats _times per minute, although a well-conditioned heart may beat only _times per minute to achieve the same results
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-70 to 80 times per minute -50 to 60 times per minute
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what is an unhealthy beats per minute range?
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resting heart rate is routinely in the high 80s or 90s
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if your resting heart rate is routinely in the high 80s or 90s, what this may indicate? (3)
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-it may indicate that you are out of shape, carrying too much weight, or suffering from some underlying illness
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when overly stressed, a heart may beat _
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-when overly stressed, a heart may beat more than 200 times per minute
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a health heart functions_(2)
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a healthy heart functions more efficiently and is less likely to suffer damage from overwork
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scientific name for heart attack?
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acute myocardial infraction
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Cardiovascular disease (CVD) claims more lives each year than the next three leading causes of death combined:_, accounting for _% of all deaths in the US
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-cancer -chronic lower respiratory disease -accidents 32.8%
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more than _Americans die each day from Cardiovascular disease (CVD), an average of 1 death every _. There are nearly _death annually, nearly _% of all deaths in the US, for which Cardiovascular disease (CVD) is listed as an underlying or contributing cause. Many of these fatalities are _that causes death either_
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-2,200 -39 seconds -1.4 million -55% -sudden cardiac deaths that causes death either instantly or shortly after symptoms occur
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sudden cardiac deaths
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-Death occurs as a result of abrupt, profound loss of heart function (cardiac arrest)
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In terms of total deaths, Cardiovascular disease (CVD) has claimed the lives of more_(gender) every year since 1984. Only among those people ages 20 to 39 is Cardiovascular disease (CVD) significantly more prevalent among_
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-more women than men -men than it is among women
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women also have a higher life time prevalence of_
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stroke, having over 55,000 more strokes per year than men
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what ethnicity has the highest rates of Cardiovascular disease (CVD) deaths of any group in the United State? (include gender) how this compares to whites? why this group? (health condition)
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-African Americans have the highest rates of Cardiovascular disease (CVD) deaths of any group in the United States, which rates of nearly 302 per 100,000 for African American men and 201 per 100,000 people for African American women -In contrast, non-Hispanic white men and women have rates of nearly 236 and 150 deaths per 100,000 people, respectively -Overall, African Americans are 40% more likely to have high blood pressure and 10% less likely to have it under control than the rest of the population
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Among men age 20 to 39, 20.3% have _, a dangerous grouping of key risk factors for Cardiovascular disease (CVD). This compares to 15.6% of women in the 20 to 39 age group.
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Metabolic syndrome (MetS)
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why people fail to get medical attention if they have risk of CVD?
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-Of the million of Americans who currently live with one of the major categories of CVD, many lack health insurance and fail to receive appropriate screening and diagnostic tests -Others fail to recognize subtle symptoms until they result in a major cardiovascular event -Still others live in rural or remote areas where emergency transportation and care are not available
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what percent of people will die after their initial heart attack?
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-25% of men and 38% of women will die within 1 year after having an initial heart attack -The older the age at first heart attack, the greater the risk of dying
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The economic burden of cardiovascular disease on our society is huge:
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more than $297 billion in direct and indirect costs
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what are the direct and indirect costs of cardiovascular disease (CVD)?
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-direct costs of physicians and other professionals, hospital services, prescribed medication, and home health care, as well as lost productivity resulting from illness, disability and death, but not the cost of nursing home care
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As Americans live longer with chronic disease, costs will_
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costs will continue to increase, resulting in tremendous burden on the health care system
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While economic concerns are huge, the effects of cardiovascular disease (CVD) on_may be even greater
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-on patients, their families, communities, the health care system, and society may be even greater
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cardiovascular disease (CVD) is not uniquely American health problem, why?
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With an international trend toward obesity, more and more countries face epidemic cardiovascular disease (CVD) rates
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World Health Organization (WHO) estimates, cardiovascular disease (CVD) accounts for _% of all deaths globally
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30%
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Explain how cardiovascular disease (CVD) spread globally by income
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-Many have the mistaken idea that cardiovascular disease (CVD) is only a "developed" nation problem -Unfortunately,over 80% of the world's deaths from cardiovascular disease (CVD) occur in low- and middle-income countries, places where people have more risks and fewer options for prevention and treatment -People with cardiovascular disease (CVD) in these countries die at younger ages, often during their most productive years
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list the several types of cardiovascular disease (CVD) (8)
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-atherosclerosis -coronary heart disease (CHD) -stroke -hypertension -angina pectoris -arrhythmia -congestive heart failure (CHF) -congenital cardiovascular defects -coronary artery disease -Peripheral artery disease -rheumatic heart disease
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List in order the leading causes of death in the US
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1. Heart disease 2. cancer 3. stroke 4. chronic lower respiratory diseases
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many of these forms of cardiovascular disease (CVD) are potentially fatal. explain how
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-many can cause significant physical and psychological disability -death
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which is harder to measure death rates or short- and long-term psychological problems?
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-although death rates are relatively easy to calculate, the short- and long-term psychological problems that occur after a person has a heart attack are harder to measure -imagine wondering each time you exercise if your heart will fail you or fearing that sexual activity might cause another heart attack -getting a grip on the anxieties that follow a cardiac event can be challenging
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what is a key to taking healthy action regarding your cardiovascular disease (CVD)?
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knowing more about specific cardiovascular disease (CVD) risks and what you can do about them is key to taking healthy action
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atherosclerosis
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-condition characterized by deposits of fatty substance (plaque) on the inner lining of an artery
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explain the meaning of atherosclerosis by dividing the word
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-comes from Greek words athero (meaning gruel or past) and sclerosis (hardness)
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in atherosclerosis what deposits on the inner lining of an artery?
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-fatty substances, cholesterol, cellular wast products, calcium, and fibrin (a clotting material in the blood) build up in the inner lining of an artery
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what is a key factor in the process of building a plaque in atherosclerosis?
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hyperlipidemia
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hyperlipidemia
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an abnormally high blood lipid level
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plaque
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-buildup of deposits in the arteries
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hyperlipidemia is a condition that underlies many _and is believed to be the biggest contributor to _
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-it is a condition that underlies many cardiovascular health problems and is believed to be the biggest contributor to disease burden globally
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As plaque accumulates, what causes? (atherosclerosis)
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as plaque accumulates, vessel walls become narrow and may eventually block blood flow or cause vessels to rupture -the pressure builds within arteries just as pressure builds in the hose (when put thumb over the end) -if vessels are weakened and pressure persists, they may burst or the plaque itself may break away from the walls of the vessels and obstruct blood flow -in addition, fluctuation in the blood pressure levels within arteries can damage their internal walls, making it even more likely that plaque will stick to injured wall surfaces and accumulate
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atherosclerosis is often called _. why?
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-atherosclerosis is often called coronary artery disease (CAD) because of the damage to the body's main coronary arteries on the outer surface of the heart
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cardiovascular artery disease (CAD)
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-a narrowing or blockage of coronary arteries, usually caused by atherosclerotic plaque buildup
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what is the function of the main coronary arteries on the outer surface of the heart?
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-these are the arteries that provide blood supply to the heart muscle itself
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when a heart attack results?
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a heart attack results from blockage of the main coronary arteries on the outer surface of the heart that provide blood supply to the heart muscle itself
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atherosclerosis and other circulatory impairments also often _, a condition known as _
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atherosclerosis and other circulatory impairments also often reduce blood flow and limit the heart's blood and oxygen supply,, a condition known as ischemia
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ischemia
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reduced oxygen supply to a body part or organ
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coronary arteries (where located and function)
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coronary arteries are located on the exterior of the heart and supply blood and oxygen to the heart muscle itself
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in atherosclerosis, what happens to arteries?
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arteries become clogged by a buildup of plaque
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how atherosclerosis is related to heart attacks?
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when atherosclerosis occurs in coronary arteries, blood flow to the heart muscle is restricted and a heat attack may occur
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peripheral artery disease (PAD)
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-atherosclerosis occurring in the lower extremities, such as in the feet,calves, or legs, or in the arms
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when peripheral artery disease (PAD) occurs?
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-when atherosclerosis occurs in the upper or lower extremities, such as in the arms, feet, calves, or legs, and causes narrowing or complete blockage of arteries
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signs or symptoms of peripheral artery disease (PAD)
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-pain and aching in the legs, calves, or feet upon walking or exercise and is relieved by rest (known as intermittent claudication)
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two possible results of peripheral artery disease (PAD)
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-can be disabling at best and lead to fatalities at its worst
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how gender differs regarding peripheral artery disease (PAD) and treatment?
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-while both men and women develop peripheral artery disease (PAD) in equal numbers, research and treatment of women has lagged behind that of men
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in recent years, increased attention has been drawn to peripheral artery disease (PAD)'s role in_
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-subsequent blood clots and resultant heart attacks
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sometimes peripheral artery disease (PAD) in the arms can be caused by _
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-trauma -certain diseases -radiation therapy -repetitive motion syndrome -the combined risk of these factors and atherosclerosis
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what risks peripheral artery disease (PAD) gives to people? what factors are responsible for this damage?
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-damage to vessels and threats to health can be severe, with two- or three-times greater risk of stroke and heart attack among those who have peripheral artery disease (PAD) -four factors are responsible for this damage: inflammation, elevated levels of cholesterol and triglycerides in the blood, high blood pressure, and tobacco use
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of all the major cardiovascular diseases, what is the greatest killer? include diseases it causes
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of all the major cardiovascular diseases, coronary heart disease (CHD) is the greatest killer, accounting for nearly 1 in 6 deaths in the United States. Approx 785,000 new heart attacks and 470,000 recurrent attacks occur each year. 195,000 silent heart attacks
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coronary heart disease (CHD)
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-a narrowing of the small blood vessels that supply blood to the heart -build up of plaque in the lining of the arteries
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silent heart attacks
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-heart attacks that do not produce the usual signs or symptoms
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heart attack
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-other name myocardial infraction (MI) -a blockage of normal blood supply to an area in the heart -involves an area of the heart that suffers permanent damage because its normal blood supply has been blocked
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heart attack or myocardial infraction is often brought on by_
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-coronary thrombosis (clot) -atherosclerosis narrowing that blocks a coronary artery (artery supplying the heart muscle with blood)
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coronary thrombosis
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-a blood clot occurring in a coronary artery
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other name to clot
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thrombus
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thrombus
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-clot -blood clot attacked to a blood vessel's wall
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embolus
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-a blood clot that becomes dislodged from a blood vessel wall and moves through the circulatory system
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what happens whenever blood does not flow readily?
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-whenever blood does not flow readily, there is a corresponding decrease in oxygen flow to tissue below the blockage
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If the blockage of blood is extremely minor, how body adapts?
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-if the blockage is extremely minor, an otherwise healthy heart will adapt over time by enlarging existing blood vessels and growing new ones to reroute needed blood through other areas. This system is called collateral circulation
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collateral circulation
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-adaptation of the heart to partial damage accomplished by rerouting needed blood through unused or underused blood vessels while the damaged heart muscle heals
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collateral circulation is a form of _that allows an _to _
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-this system, called collateral circulation, is a form of self-preservation that allows an affected heart muscle to cope with damage
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what happens when a heart blockage is more severe?
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-when a heart blockage is more severe the body is unable to adapt on its own, and outside lifesaving support is critical
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what time following a heart attack is the most crucial period and why?
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-the hour following a heart attack is the most crucial period-with the events of the first hour after an attack being critical to survival
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_% of heart attack victims die within the first hour following the heart attack
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40%
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why women are more likely to have heart damage of heart attack and die than men of the same age?
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-women who suffer heart attacks under the age of 55 are not only less likely to have classic chest pain or pressure, but also they tend to delay going to the doctor -when they do seek medical attention, they often report more atypical symptoms, such as shortness of breath or pain in the neck, shoulder, arms, and stomach -Many women chalk up heart symptoms to stress, flu, or lack of exercise -Because of treatment delays, women are more likely to have heart damage and to die from a heart attack than men of the same age
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sign or symptom of heart attack more common in men
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-crushing or squeezing chest pain -pain radiating down arm, neck, or jaw -chest discomfort or pressure
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signs or symptoms of heart attack common in both men and women?
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-shortness of breath -nausea/vomiting -lightheartedness
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signs or symptoms of heart attack common in women?
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-women more likely to feel pressure than pain (chest discomfort/pain or pressure with shortness of breath) -shortness of breath without chest pain, discomfort in back, neck, or jaw in one or both arms -radiating pain in arms, shoulder, neck, haw, or back -unusual weakness -unusual fatigue, anxiety or weakness -sleep disturbances -indigestion, flulike symptoms -body hurt, ache in chest, both arms sore . Feel hot, clammy, and vomited -dizziness -abdominal pain
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for common signs or symptoms for both men and women see
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*see page 465 table 15.1*
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how can women tell if she is having a heart attack?
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-the real answer to this question of how to tell if a women is having a heart attack is this: let a doctor determine that -If you or someone you know has even a few of these symptoms, do not delay. Take an aspirin and then have someone drive you to health care facility for evaluation, or call 911 to get an ambulance
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what medicine to use if have symptoms or signs of heart attack? why? how will help?
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-if someone is feeling the symptoms or signs, crush or chew a full strength aspirin and swallow it with water -in addition of being a pain killer, aspiring has blood-thinning properties, so taking one can prevent fatal blood clots from forming
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what to do when a heart attack hits? tips. what to do in case of a heart attack
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People often miss the signs of a heart attack, or they wait too long to seek help, which can have deadly consequences. Knowing what to do in an emergency could save your life or somebody else's: -Keep a list of emergency rescue service numbers next to your telephone and in your pocket, wallet, or purse. Be aware of whether your local area has a 911 emergency service -Expect the person to deny the possibility of anything as serious as a heart attack, particularly if that person is young and appears to be in good health. If you are with someone who appears to be having a heart attack, do not take no for an answer; insist on taking prompt action -if you are with someone who suddenly collapses, perform cardiopulmonary resuscitation (CPR). see www.heart.org for information on the new chest-compression-only techniques recommended by the American Heart Association. If you are trained and willing, use conventional CPR methods
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Like heart muscle cells, brain cells must have_
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have a continuous and adequate supply of oxygen in order to survive
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stroke (other name and definition)
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-also called cerebrovascular accident -a condition occurring when the brain is damaged by disrupted blood supply -occurs when blood supply to the brain is interrupted
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two types of strokes
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-ischemic -hemorrhagic
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explain an ischemic stroke
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caused by plaque formation or a clot that reduces blood flow
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two ways to have a ischemic stroke caused by clots
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-a thrombus is a blood clot that forms inside a blood vessel and blocks the flow of blood at its origin. A thrombus in a cerebral artery can lead to an ischemic stroke -an embolus is a blood clot that breaks off from its point of formation and travels in the bloodstream until it lodges in a narrowed vessel and blocks blood flow. Emboli in brain blood vessels can cause ischemic stroke
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two types of hemorrhagic strokes
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-subarachnoid, in which a vessel on the brain's surface bursts -intracerebral, in which a vessel within the brain bursts
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when an hemorrhage occurs?
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-a hemorrhage occurs when a blood vessel bursts, allowing blood to flow into the surrounding tissue or between tissues
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explain hemorrhagic stroke
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-meaning a blood vessel weakens and either bulges or ruptures
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what is the most well known and most life-threatening of hemorrhagic strokes?
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aneurysm is the most well known and most life-threatening of the hemorrhagic strokes
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aneurysm
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-is the bulging of a weakened blood vessel wall -a weakened blood vessel that may bulge under pressure and, in severe cases, burst
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how aneurysm in brain can cause strokes? (what kind of stroke?)
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-an aneurysm in the brain can cause hemorrhagic strokes if they burst
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when any of the ischemic or hemorrhagic strokes happens, why the brain dies?
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when any of these events occur, oxygen deprivation kills brain cells
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what mild strokes can cause?
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some strokes are mild and cause only temporary dizziness or slight weakness or numbness
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what more serious strokes cause?
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-more serious interruptions in blood flow may impair speech, memory, or motor control
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other strokes affect the parts of the brain that_and kill within minutes
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other strokes affect the parts of the brain that regulate heart and lung function and kill within minutes
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According to the American Heart Association's latest statistics , every year more than _Americans suffer strokes,_of whom die as a result
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-7 million -136,000
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what is the leading risk factor for stroke?
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hypertension
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when men vs women have strokes? include overall percentage in US
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-men have more strokes in their younger years; women suffer more strokes in their later years, accounting for over 60% of strokes cases in the US
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strokes can cause _
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-disability -suffering -death
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strokes account for _deaths each year, surpassed only by_(2)
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-1 in 18 deaths -coronary heart disease (CHD) and cancer
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many strokes are preceded days, weeks, or months earlier by_ (what happens before a stroke?)
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-transient ischemic attacks (TIAs)
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transient ischemic attacks (TIAs)
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-brief interruption of the blood supply to the brain that causes only temporary impairment -often an indicator of impending major stroke
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symptoms or signs of transient ischemic attacks (TIAs)
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-dizziness, particularly when first rising in the morning -weakness -temporary paralysis or numbness in the face or other regions -temporary memory loss -blurred vision -nausea -headache -slurred speech or difficulty in speaking -other unusual physiological reactions -some people may experience unexpected falls or have blackouts; others may have no obvious symptoms
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transient ischemic attacks (TIAs) often indicate_
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indicate an impending major stroke
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The earlier a stroke is _the more effective the treatment will be
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The earlier a stroke is recognized and treatment started, the more effective the treatment will be
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what age stroke rates increased the most?
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-that strokes rates (between 1995 and 2007) increased the most (up a dramatic 51%) among young men age 15 to 34 -stroke rates rose among women in this age group, too, but at a slower rate of 17^during the same time frame -young men are at particularly elevated risk for stroke
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why stroke rates are high among young people? possible factors contributing to this. how stroke rates are changing for older adults?
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-although the growing prevalence of obesity, high-fat diets, increased sodium consumption, and sedentary lifestyle are mentioned as likely contributors, trends went in the opposite direction among older adults, with stroke rates dropping 25% in men aged 65 and older and down 28% among women in the same age group, -Better awareness of stroke risks among older adults and increased use of antihypertensive medicines are among the possible reasons for these declines -more research is needed to find out why young adults seem to be having more strokes
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tips on recognizing a stroke (signs or symptoms of stroke)
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-people often ignore, minimize, or misunderstand stroke symptoms. Starting treatment within just a few hours is crucial for the best recovery outcomes. So if you suspect someone is having a stroke, use the "Cincinnati Prepositional Stroke Scale" to clarify what may be happening. Many emergency medical teams have adopted this tool to evaluate patients. Anyone with 3 abnormal signs has an over 70% likelihood of stroke: 1. Facial droop: ask the person to smile. it is normal for both sides of the face to move equally, and it is abnormal if one side moves less easily 2. Arm Drift: Ask the person to raise both arms. It is normal if both arms move equally (or not at all). it is abnormal if one arm drifts or cannot be raised as high as the other 3. Speech: Have the patient restate a sentence such as, "You can't teach an old dog new tricks." It is normal if they say the sentence correctly, and it is abnormal if they use inappropriate words, slur, or cannot speak
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one of the greatest medical successes in recent years has been the_. explain how
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-decline in the death rate from strokes, which has dropped by over 1/3 in the US since 1980s and continues to fall -improved diagnostic procedures, better surgical options, clot-bursting drugs injected soon after a stroke has occurred, and acute care centers specializing in stroke treatment and rehabilitation have all been factors
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Unfortunately, like many victims of other forms of CVD, stroke survivors do_(how recover, how people are left after stroke, problems)
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-do not always make a full recovery -problems with speech, memory, swallowing, and activities of daily living and other consequences can persist, even with physical therapy and medications -depression is also an issue for many post-stroke survivors
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hypertension
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sustained elevated or high blood pressure
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hypertension is known as_. why?
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-silent killer because it often has few overt symptoms
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how prevalence of hypertension has changed? what age group is increasing in chances of having it?
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-hypertension prevalence has increased by over 30% in the past 10 years; today 1 in 3 adult Americans has a higher-than-optimal blood pressure, and the incidence among teens and young adults is on the rise
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Why should I care about hypertension? (age group mainly affected)
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-Hypertension is becoming more common among college students -You cannot tell whether you have it by how you feel or how you look in the mirror, bit it poses a major potential threat to your quality of life -Get your blood pressure checked. It is easy to do, and it could save your life
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what ethnic group has high prevalence of hypertension?
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-Prevalence of hypertension among African Americans is among the highest in the world
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high blood pressure is also 2 to 3 times more common in women who _than in women who do not
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-common in women who take oral contraceptives than in women who do not take them
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Blood pressure is measured by 2 numbers:
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-systolic blood pressure -diastolic blood pressure
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how you report blood pressure? include which number is which
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ex: 110/80 mm Hg, stated as "110 over 80 millimeters of mercury" -The top number is systolic blood pressure and the bottom number is diastolic blood pressure (systolic/diastolic) trick: S/D
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systolic blood pressure
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-the upper number in the fraction that measures blood pressure, indicating pressure on arterial walls when the heart contracts -refers to the pressure of blood in the arteries when the heart muscle contracts, sending blood to the rest of the body -When heart contracts, or beats, it sends a surge of blood through the vessels, increasing blood pressure. This is called systolic pressure.
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diastolic pressure
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-the lower number in the fraction that measures blood pressure, indicating pressure on arterial walls during the relaxation phase of heart activity -refers to the pressure of blood on the arteries when the heart muscle relaxes, as blood is reentering the heart chambers -When your heart relaxes between beats, your blood pressure decreases. This is called diastolic pressure.
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normal blood pressure varies depending on _(factors of blood pressure)
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-age, weight, and physical condition
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how both types of blood pressure change with age?
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-systolic blood pressure tends to increase with age, whereas diastolic blood pressure typically increases until age 55 and then declines
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how women and men are likely to develop high blood pressure? (include ages)
answer
-women are about as likely as men to develop high blood pressure during their lifetimes. -However, for people under 45 years old, the condition affects more men than women. -For people 65 and older, it affects more women than men
question
high blood pressure is usually diagnosed when _
answer
-systolic pressure is 140 or above.
question
what is the most common form of high blood pressure or hypertension in older Americans?
answer
isolated systolic hypertension (ISH)
question
isolated systolic hypertension (ISH)
answer
condition when only systolic pressure is high
question
list the blood pressure classifications
answer
-normal -prehypertension -hypertension stage 1 or stage 2
question
systolic reading and diastolic reading to have: Normal
answer
-systolic reading (mm Hg): less than 120 and -diastolic reading (mm Hg): less than 80
question
systolic reading and diastolic reading to have: prehypertension
answer
-systolic reading (mm Hg): 120-139 or -diastolic reading (mm Hg): 80-89
question
systolic reading and diastolic reading to have: hypertension stage 1
answer
-systolic reading (mm Hg): 140-159 or -diastolic reading (mm Hg): 90-99
question
systolic reading and diastolic reading to have: hypertension stage 2
answer
-systolic reading (mm Hg): greater than or equal to 160 or -diastolic reading (mm Hg): greater than or equal to 100
question
when reading blood pressure and trying to determine category, what happens if systolic and diastolic readings fall into different categories?
answer
-treatment is determined by the highest category
question
angina pectoris
answer
chest pain occurring as a result of reduced oxygen flow to the heart
question
why angina pectoris happens? in what results?
answer
-occurs when there is not enough oxygen to supply the heart muscle, resulting in chest pain or pressure
question
what percentage of people suffer of angina pectoris? (include ages and gender)
answer
-approx 2% of US population between the ages of 25 and 45 experience angina pectoris, with over 13% of men and nearly 11% women experiencing mild to moderate symptoms by the age of 65
question
symptoms or signs of angina pectoris
answer
-for some, the pain is similar to a mild case of indigestion -for others, the pain is crushing, with heart-attack-like symptoms that may require powerful medications to control
question
generally, the more_, the more severe the pain of angina pectoris
answer
-more serious the oxygen deprivation
question
although angina pectoris is not a _, it does indicate _
answer
-is not a heart attack -indicate underlying heart disease
question
how coronary heart disease related to heart attack? how differs from atherosclerosis? (teacher source)
answer
-Coronary heart disease is the build up of plaque in the lining of the arteries. If the flow of oxygen rich blood is reduced or blocked, that is called a heart attack. -The difference really comes down to where the plaque build up is. For Coronary heart disease (CHD) the plaque builds up inside the coronary arteries. (These arteries supply blood to your heart). For atherosclerosis, the plaque builds up in the arteries (general definition).
question
list drugs that are part of teh method of treating angina pectoris
answer
-nitroglycerin -calcium channel blockers -beta-blockers
question
what nitroglycerin does to help treating angina pectoris?
answer
-nitroglycerin can dilate veins and provide pain relief
question
what calcium channel blockers do to help treating angina pectoris?
answer
-can relieve cardiac spams and arrhythmias, lower blood pressure, and slow heart rate
question
what beta-blockers do to help treating angina pectoris?
answer
-beta-blockers, the other major type of drugs used to treat angina, control potential overactivity of the heart muscle
question
how mild cases of angina pectoris can be treated?
answer
mild cases may be treated simply with rest
question
arrhythmia
answer
-an irregularly in the heartbeat -an irregularity in the heart rhythm that occurs when the electrical impulses in your heart that coordinate heartbeat don't work properly
question
fibrillation
answer
-a sporadic, quivering pattern of heartbeat that results in extreme inefficiency in moving blood through the cardiovascular system
question
how arrhythmia and fibrillation are described as?
answer
-often described as a heart "fluttering" or racing, these irregularities send many people to the emergency room, only to find that they are fine
question
tachycardia
answer
-a person with a racing heart in the absence of exercise or anxiety may be experiencing tachycardia -medical term for abnormally fast heartbeat
question
bradycardia
answer
-on the other end of the continuum to tachycardia -abnormally slow heartbeat
question
what happens when heart goes into fibrillation? what are the consequences of not treating it?
answer
-when a heart goes into fibrillation, it beats in a sporadic, quivering pattern, resulting in extreme inefficiency in moving blood through the cardiovascular system -If untreated, fibrillation may be fatal
question
what two instances can cause arrhythmia that is no life-threatening?
answer
-in many instances, excessive caffeine or nicotine consumption can trigger an arrhythmia episode
question
what to do in sever cases of arrhythmia?
answer
-severe cases may require drug therapy or external electrical stimulus to prevent serious complications -when in doubt, it is always best to check with your doctor
question
heart failure
answer
-other name congestive heart failure (CHF) -an abnormal cardiovascular condition that reflects impaired cardiac pumping and blood flow -pooling blood leads to congestion in body tissues
question
when congestive heart failure (CHF) results and what are the consequences? what are other key additional symptoms or signs?
answer
-when the heart muscle is damaged and cannot pump enough blood to supply body tissues, fluids may begin to accumulate in various parts of the body, most notably, the lungs, feet, ankles, and legs -acute shortness of breath and fatigue are often key additional symptoms
question
congestive heart failure (CHF) is increasingly common, particularly among _
answer
-those with a history of other heart problems -nearly 6.6 million adults age 20 and over in the US have congestive heart failure (CHF)
question
can you die from a broken heart?
answer
-as first described in a 2005 article in the New England Journal of Medicine, researchers reported "broken heart syndrome," which has come to be known as stress cardiomyopathy. In this phenomenon, the heart is so stressed by traumatic emotional events that it receives a "concussion," a type of heart attack triggered by extreme, overwhelming stress, grief, horror, or anger. This is believed to affect 6% of women who have an apparent heart attack
question
underlying causes of congestive heart failure (CHF) include:
answer
-heart injury form uncontrolled high blood pressure -rheumatic fever -pneumonia -heart attack and damage to the heart -heart valve issues -general coronary artery diseases -certain prescription drugs such as NSAIDS and diabetes medication also increase risks, as do chronic drug and alcohol abuse -in some cases, the damage is due to cancer radiation or chemotherapy treatments
question
untreated, congestive heart failure (CHF)can be _
answer
-fatal
question
list drugs in treatment of congestive heart failure (CHF). explain each
answer
-diuretics ("water pills") to relieve fluid accumulation -drugs, such as digitalis, that increase the pumping action of the heart -drugs called vasodilators, which expand blood vessels and decrease resistance, allowing blood to flow more freely and making the heart's work easier
question
what are ways to reduce risks of congestive heart failure (CHF)?
answer
prevention of underlying CVD risks, such as reducing sodium intake and following a heart smart diet, are the best ways to reduce your risks of congestive heart failure (CHF)
question
congenital cardiovascular defect
answer
-cardiovascular problem that is present at birth
question
what congenital means?
answer
-congenital means the problem is present at birth
question
what is a relative minor form of congenital cardiovascular defect?
answer
-slight murmurs
question
murmurs
answer
-congenital cardiovascular defect -low-pitched sounds caused by turbulent blood flow through the heart -caused by valve irregularities that some children outgrow
question
about 25% of those born with congenital heart defects must undergo_
answer
-invasive procedures to correct problems within the first year of life
question
what are possible causes for congenital cardiovascular defects?
answer
-The underlying causes of these defects are unknown, but they may be related to hereditary factors; maternal diseases, such as rubella, that occurred during fetal development; or the mother's chemical intake (particularly alcohol or methamphetamines) during pregnancy
question
what disease may cause similar heart problems in children to those caused by congenital cardiovascular defect?
answer
-rheumatic heart disease
question
rheumatic heart disease
answer
-a heart disease caused by untreated streptococcal infection of the throat -it is attributed to rheumatic fever, an inflammatory disease caused by an unresolved streptococcal infection of the throat (strep throat)
question
how rheumatic fever can cause rheumatic heart disease?
answer
-over time, this strep infection can affect many connective tissues of the body, especially those of the heart, joints, brain, or skin -in some cases, this infection can lead to an immune response in which antibodies attack the heart as well as the bacteria
question
Many of the thousands of operations on _performed per year in the US are related to rheumatic heart disease
answer
-heart valves
question
list the factors related to a person's being at a higher risk for developing cardiovascular diseases (factors associated with increased risk of CVD development)
answer
-obesity and overweight -smoking and exposure to secondhand smoke -high levels of cholesterol and other lipids -physical inactivity -high blood pressure (hypertension) -diabetes mellitus -metabolic syndrome -genetics and family history
question
although selected factors increase risk specific to CVD, the combination of these and other risk factors appears also increase risk for _. these combined risks are referred as_
answer
-insulin resistance -type 2 diabetes -Alzheimer's disease -cardiometabolic risks
question
cardiometabolic risks
answer
-physical and biochemical changes that are risk factors for the development of cardiovascular disease and type 2 diabetes -refers to these combined risks, which indicate physical and biochemical changes that can lead to diseases
question
some risks result_(2 extremes)
answer
-some risks result from choices and behaviors and so are modifiable, whereas others are inherited or are intrinsic (such as your age and gender) and cannot be changed
question
Over the past decade, different health professionals have attempted to establish diagnostic cutoff points for a cluster of combined cardiometabolic risks, variably labeled as_
answer
-syndrome X, insulin resistance syndrome, and most recently, metabolic syndrome (MetS)
question
metabolic syndrome (MetS)
answer
-also called syndrome X -also called insulin resistance syndrome -a group of metabolic conditions occurring together that increase a person's risk of heart disease, stroke, and diabetes
question
metabolic syndrome is believed to increase the risk for _by as much as 3 times the normal rates
answer
-atherosclerotic heart disease
question
metabolic syndrome has captured international attention because over _(people have it)
answer
-over 20% of people age 20 to 39, 41% of people age 40 to 59, and nearly 52% of those over the age of 60 meet the criteria for MetS
question
what is the most commonly used criteria for metabolic syndrome?
answer
-national cholesterol education program's adult treatment panel (NCEP/ATPIII) is most commonly used
question
According to national cholesterol education program's adult treatment panel (NCEP/ATPIII) criteria, for diagnosis of metabolic syndrome a person would have 3 or more of the following risks: (sings or symptoms of metabolic syndrome)
answer
-abdominal obesity (waist measurement of more than 40 inches in men or 35 inches in women) -Elevated blood fat (triglycerides greater than 150) -low levels of HDL ("good") cholesterol (less than 40 in men and less than 50 in women) -Hypertension: elevated blood pressure greater than 135/85 mm Hg (systolic blood pressure greater than or equal to 130 mm Hg; diastolic blood pressure greater than or equal to 85 mm Hg) -Elevated fasting glucose greater than 100 mg/dL (a sign of insulin resistance or glucose intolerance) *Other professional groups may add high levels of C-reactive proteins as a part of the criteria for MetS
question
metabolic syndrome is a quick _
answer
-quick risk profile
question
high levels of C-reactive proteins in the blood may indicate_
answer
-high inflammatory processes in the body that increase CVD risks
question
the use of metabolic syndrome classification and other, similar terms has been important in highlighting the relationship between_. however, critics have indicated that it is impossible to tell_
answer
-highlighting the relationship between the number of risks a person possesses and that person's likelihood of developing CVD and diabetes -it is impossible to tell how important each of these factors is (either individually or in combination) or which ones should be prioritized when taking action to reduce risks -overall lifestyle changes targeting these factors are important
question
young adults are not _. when you begin accumulating risks in your life?
answer
-young adults are not invulnerable to cardiovascular risks -since the first moments of your life, you begin to accumulate increasing numbers of risks -behaviors you choose today and over the coming decades can actively reduce or promote your risk for cardiovascular disease (CVD)
question
list modifiable risks to cardiovascular disease (CVD risks) (what to do to decrease them)
answer
-avoid tobacco -cut back on saturated fat and cholesterol -strive for a heart-healthy diet -maintain a healthy weight -exercise regularly -control diabetes -control your blood pressure -manage stress
question
although smoking rates declined over 50% between 1965 and 2007, about _% of US adults age 18 and over are still regular smokers. In spite of massive campaigns to _
answer
-21% -campaigns to educate us about the dangers of smoking and increasing number of states and municipalities enacting "smoke free" zones and policies
question
tobacco remains the leading cause of _
answer
-tobacco remains the leading cause of preventable death in the US, accounting for 1 of every 5 deaths
question
likewise, how nonsmokers are affected by tobacco?
answer
-nonsmokers regularly exposed to secondhand smoke have a 25% to 30% increased risk of heart disease
question
how great a risk is smoking when it comes to CVD? (smoking as risk factor in CVD)
answer
-cigarette smokers are two to four times more likely to develop coronary heart disease than are nonsmokers -cigarette smoking doubles a person's risk of stroke -smokers are more than 10 times more likely than nonsmokers to develop peripheral vascular diseases
question
smoking is thought to damage the heart in several ways. list them (smoking as risk factor in CVD) how affect coronary arteries?
answer
-nicotine increases heart rate, blood pressure, and oxygen use by heart muscles, which over time forces the organ to work harder -chemicals in smoke may damage and inflame coronary arteries, allowing cholesterol and plaque to accumulate more easily and increasing blood pressure
question
what is the good news regarding stop smoking? (quitting smoking)
answer
-the good news is that if you stop smoking, your heart appears able to mend itself -a former smoker's risk of heart disease drop by 50% 1 year after quitting -between 5 to 15 years after quitting, the risk of stroke and CHD becomes similar to that of nonsmokers
question
why college-age students need to quit smoking?
answer
-studies show quitting by age 30 reduces chances of dying prematurely from tobacco-related diseases by more than 90%. -Those who already have been diagnosed with early stage lung cancer fare much better after quitting
question
cholesterol
answer
-is a type of soft, waxy fat-like substance found in your bloodstream and in your body cells
question
cholesterol plays an important role in _
answer
-important role in the production of cell membranes and hormones (estrogen and testosterone), and it helps process vitamin D
question
However, when levels of cholesterol in the blood get too high, your risk_(cholesterol as risk factor in CVD)
answer
-your risk for CVD increases
question
sources of cholesterol
answer
-much of your blood cholesterol level is predetermined: about 75% of it is produced by your body, and the rest comes from foods in your diet
question
the good news regarding cholesterol? (how decrease it)
answer
-the good news is that changing your diet can make real improvements in your overall cholesterol level, even if yours is naturally high
question
how diets that contribute to high cholesterol levels in blood can lead to increasing risk of CVD? (cholesterol as risk factor in CVD)
answer
-diets high in saturated fat and trans fats are known to raise cholesterol levels, send the body's blood-clotting system into high gear, and make the blood more viscous in just a few hours, thereby increasing the risk of heart attack or stroke
question
high levels of cholesterol in the blood contributes to _ (high cholesterol levels)
answer
-high levels of cholesterol in the blood contributes to atherosclerosis
question
types of cholesterol
answer
-low-density lipoproteins (LDL) -high-density lipoprotein (HDL)
question
low-density lipoproteins (LDL)
answer
referred to as "bad" cholesterol, is believed to build up on artery walls -compounds that transport cholesterol in the blood to the body's cells
question
high-density lipoprotein (HDL)
answer
-good cholesterol, appears to remove cholesterol from artery walls -compounds that facilitate the transport of cholesterol in the blood to the liver for metabolism and elimination from the body
question
in terms of LDL and HDL, how increase risk of CVD? (cholesterol as risk factor in CVD)
answer
-if LDL levels get too high or HDL levels too low, cholesterol will accumulate inside arteries and lead to cardiovascular problems
question
beside cholesterol, _are also gaining increasing attention as a key factor in CVD risk
answer
triglycerides
question
rol of triglycerides in body
answer
-when you consume extra calories, the body converts the extra to triglycerides, which are stored in fat cells -hormones release triglycerides throughout the day to provide energy
question
explain how triglyceride as risk factor in CVD. how these levels change as age?
answer
-high counts of blood triglycerides are often found in people who are obese and overweight and have high cholesterol levels,heart problems, or diabetes -as they age, particularly if they gain weight, people's triglyceride and cholesterol levels tend to rise
question
to prevent cholesterol and triglycerides risk associated with CVD, what test to take? at what age? gender?
answer
-it is recommended that a baseline cholesterol test (known as a lipid panel or lipid profile) be taken at age 20, with follow-ups every 5 tears -Men over the age of 35 and women over the age of 45 should have their lipid profile checked annually, with more frequent tests for those at high risk
question
for recommended levels of cholesterol and triglycerides see
answer
*table 15.3 page 471* includes: -total cholesterol level (lower numbers better) -HDL cholesterol level (higher numbers are better) -LDL cholesterol level (lower numbers are better) -Triglyceride level (lower numbers are better)
question
what is the best method of evaluating cholesterol-level risk? what HDL levels leads to increased risk of CVD?
answer
-is to examine the ratio of HDL to total cholesterol, or the percentage of HDL in total cholesterol -if the HDL level is lower than 35 mg/dL, the risk increases
question
a person with an at-risk ratio of HDL to total cholesterol can try to_. how? (solutions to triglyceride and cholesterol as risk factor in CVD
answer
-can try to lower LDL and raise HDL -Regular exercise and a healthy diet low in saturated fat continue to be the best methods of maintaining healthy ratios
question
how Americans are at lowering cholesterol and triglycerides?
answer
-in spite of all the education on the danger of high cholesterol and the importance of lowering dietary fat and cholesterol in diet, Americans continue to have higher-than-recommended levels
question
the drugs of diuretics can also be used for_
answer
-high blood pressure (hypertension) and CVD
question
the drugs of beta-blockers are also used for_
answer
-high blood pressure (hypertension) and heart disease
question
pharmaceutical treatments for CVD risk are on_
answer
the rise
question
name of diet that recommend reducing the risk of CVD? what organization made it? (solutions)
answer
-an overall dietary modifications recommendations, such as the DASH (Dietary Approaches to Stop Hypertension) eating plan form the National Heart, Lung, and Blood Institute
question
the guidelines of DASH (Dietary Approaches to Stop Hypertension) eating plan include the following dietary changes to reduce CVD risk: (3)
answer
-Consume 5 to 10 milligrams per day of soluble fiber from sources such as oat bran, fruits, vegetables, legumes, and psyllium seeds. Even this small dietary modification may result in a 5% drop in LDL levels -Consume about 2 grams per day of plant sterols, which are naturally present in small quantities in many fruits, vegetables, nuts, seeds, and other plant sources -Sterols are also used to enrich products such as Benecol and Take Control margarine. Intake of plant sterols can reduce LDL by another 5% -Eat less sodium. Excess sodium has been linked to high blood pressure, which can in turn affect CVD risk
question
plant sterols
answer
-essential components of plant membranes that, when consumed in diet, appear to help lower cholesterol levels
question
The DASH eating plan is found in_
answer
*page 472 figure 15.8*
question
The foods that you ear play a major role in your CVD risk. How foods can decrease risks?
answer
-while many foods can increase your risk, several have been shown to reduce your chances that cholesterol will be absorbed in the cells, reduce levels of LDL cholesterol, or enhance the protective effects of HDL cholesterol
question
what foods you should have in your diet to protect your heart and reduce risks of CVD?
answer
-Fish high in omega-3 fatty acids -olive oil -whole grains and fiber -plant sterols and stanols -nuts -green tea -red wine *for specific types of food and how help you to reduce risk of CVD see page 473*
question
body weight plays a role in_. why?
answer
-CVD -researchers are not sure whether high-fat, high-sugar, high-calorie diets are a direct risk for CVD or whether they invite risk by causing obesity, which strains the heart, forcing it to push blood through the many miles of capillaries that supply each pound of fat. A heart that has to continuously move blood through an overabundance of vessels may become damaged
question
what is the risk for overweight people? what these people can do to make a difference? how this applies to body distribution of fat?
answer
-overweight people are more likely to develop heart disease and stroke even if they have no other risk factors -If you are heavy, losing even 5 to 10 pounds can make a significant difference -this is especially true if your are an "apple" (thicker around your upper body and waits) rather than "pear" (thicker around your hips and thighs)
question
_is a definite risk for CVD. how can solve this?
answer
-inactivity -the good news is that you do not have to be an exercise fanatic to reduce your risk. -Even modest level of low-intensity physical activity (walking, gardening, housework, dancing) are beneficial if done regularly and over the long term
question
how exercise can reduce risks of CVD?
answer
-exercise can increase HDL, lower triglycerides, and reduce coronary risks in several ways
question
heart disease death rates among adults with _are 2 to 4 times higher than the rates for adults without it. At least 65% of people with_die of some form of heart disease or stroke
answer
-diabetes -diabetes
question
how people with diabetes have high risks of CVD?
answer
-because overweight people have a higher risk for diabetes, distinguishing between the effects of the two conditions is difficult -People with diabetes also tend to have elevated blood fat levels, increased atherosclerosis, and a tendency toward deterioration of small blood vessels, particularly in the eyes and extremities
question
how diabetic people can control much of their increased risk for CVD?
answer
-through a prescribed regimen of diet, exercise, and medication, they can control much of their increased risk for CVD -control diabetes
question
although blood pressure typically creeps up with aging, _changes can dramatically reduce risks
answer
-lifestyle changes
question
among the most beneficial actions you can take are: (lifestyle changes to control blood pressure and reduce risks of CVD)
answer
-lose weight -cutting back sodium in your diet -exercising more -reducing alcohol intake -quitting smoking -reducing your caffeine intake
question
what is the relationship between CVD risk and a person's stress level? (give examples)
answer
-stress may influence established risk factors. ex: people under stress may start smoking or smoke more than they otherwise would.
question
related to stress, a_, two key components of Type A behavior pattern, increase young adults' risk of developing high blood pressure. other related factors, such as_, did not appear to increase risk
answer
-impatience and hostility -competitiveness, depression, and anxiety
question
scientists have tended to agree that unresolved stress appears to increase risk for_(3). although the exact mechanism is unknown
answer
scientists have tended to agree that unresolved stress appears to increase risk for hypertension, heart disease, and stroke
question
newer studies indicate that chronic stress may result in 3 times the risk of _and that there is a link between_
answer
-hypertension, CHD, and sudden cardiac death -link between anxiety, depression, and negative cardiovascular effects
question
nonmodifiable risks (unfortunately not all risk factors for CVD can be prevented or controlled. The most important are the following)
answer
-race and ethnicity -heredity -age -gender
question
what race or ethnicity has the highest CVD risks and why? (nonmodifiable risk)
answer
-Although Caucasians tend to have more heart disease, African Americans are 40% more likely to have hypertension and 10% less likely to have it under control and have a stroke -The rate of high blood pressure in African Americans is among the highest in the world -CVD risks are also higher among Hispanic/Latino Americans -Importantly, racial and ethnic minorities have a significantly greater risk of dying from CVD-relateed diseases
question
what ethnicity or race has more deaths of heart disease? stroke?
answer
-Caucasians or whites have highest heart disease deaths (25.1%) -African Americans have the highest percentage of deaths of strokes (4.0%) followed closely by Native Americans/Alaskan Native (3.9%) *summary of the percentages of total deaths for various ethnic groups by heart disease and stroke. include white/Caucasian, African American, Asian/Pacific Islander. Hispanic, Native American/Alaskan Native*
question
explain nonmodifiable risk of CVD: heredity
answer
-a family history of heart disease increases risk of CVD significantly -genetic link: amount of cholesterol produce, tendencies to form plaque, and a host of other factors -If you have close relatives with CVD, your risk may be double that of others
question
Is heart disease hereditary?
answer
-if there is a history of CVD in your family or your racial or ethnic background indicates a propensity for CVD, it is all the more important for you to have regular blood pressure and blood cholesterol screenings and for you to avoid lifestyle risks, including tobacco use, physical inactivity, and poor nutrition
question
what is difficult with the hereditary portion of nonmodifiable risks of CVD?
answer
-The difficulty comes in sorting out genetic influences from the modifiable factors shared by family members, such as environment, stress, dietary habits, and so on
question
nutrigenetics
answer
-newer research has focused on studying the interactions between nutrition and genes -study the role that diet may play in increasing or decreasing risks among certain genetic profiles
question
explain the nonmodifiable risk of CVD: age
answer
-although cardiovascular disease can affect all ages, 75% of heart attacks occur in people over age 65. -Increasing age ups the risk for CVD for all
question
explain the nonmodifiable risk of CVD: Gender
answer
-men are at greater risk for CVD until about age 60, when women catch up and then surpass them -Otherwise healthy women under age 35 have a fairly low risk, although oral contraceptive use and smoking increase the risk -after menopause, or after estrogen levels are otherwise reduced (ex: because of hysterectomy) women's LDL levels tend to go up, which increases the chance for CVD
question
research suggest that _(sugar food) may reduce the risk of blood clots and improve blood flow in the brain
answer
research suggest that cocoa flavonols in chocolate may reduce the risk of blood clots and improve blood flow in the brain
question
list other risk factors that lead to increased risk of CVD (3)
answer
-inflammation and C-reactive protein -homocysteine levels -lipoportein(a)
question
many experts believe inflammation plays a major role in _development. how?
answer
-atherosclerosis development -it occurs when bacteria, trauma, toxins, or heat injure blood vessel walls, making them more prone to plaque formation
question
what have been linked to increased risk of inflammation? what is the greatest risk?
answer
-cigarette smoke, high blood pressure, high LDL cholesterol, diabetes, certain forms of arthritis, and exposure to toxins have all been linked to increased risk of inflammation -However, the greatest risk appears to be from certain infectious disease pathogens, most notably Chlamydia pneumoniae, a common cause of respiratory infections; Helicobacter pylori, a bacterium that causes ulcers; herpes simplex virus; and Cytomegalovirus, another herpes virus infecting most Americans before the age of 40
question
During inflammatory reaction, _tend to be present at high levels
answer
C-reactive proteins (CRPs)
question
presence of C-reactive proteins (CRPs) in the blood may signal elevated risk for_. how doctors can use this information?
answer
-angine pectoris and heart attack -doctors can test patients, and if CRP levels are high, action could be taken to prevent progression to a heart attack or other coronary event
question
homocysteine
answer
-an amino acid normally present in the blood
question
when homocysteine leads to increased risk of CVD? what specific types of CVD? why? (how similar to C-reactive proteins (CRPs))
answer
-high levels of homocysteine was a prelude to coronary heart disease, peripheral artery disease (PAD), and increased risk of stroke -scientists hypothesized that homocysteine works in much the same way as CRPs, inflaming the inner lining of the arterial walls and promoting fat deposits on the damaged walls and development of blood clots
question
high homocysteine levels are implicated in _(what other diseases)
answer
-declining cognitive functioning, Alzhemier's, and other condtiions
question
what was thought to reduce homocysteine levels in the body? what is the best thing to do?
answer
-When early studies indicated that folic acid and other B vitamins may help break down homocysteine in the body, food manufacturers responded by adding folic acids to a number of foods and touting the CVD benefits -However, the connection between homocysteine, folic acid, and cardiovascular disease is slowly unreaveling -Professional groups such as the American Heart Association do not currently recommend taking folic acid supplements to lower homocysteine levels and prevent CVD. Instead, they recommend a healthy diet as the best way to reduce risk
question
what should be a primary goal for CVD prevention?
answer
-excessive body weight increases the risk of developing CVD -Weight management should be a primary goal for CVD prevention
question
list the lipoproteins (blood lipids) that leads to increase CVD risk
answer
-lipoprotein-associated phospholipase A2 (Lp-PLA2) -Apolipoprotein B (apo B)
question
lipoprotein-associated phospholipase A2 (Lp-PLA2)
answer
-enzyme that circulates in the blood and attaches to LDL
question
lipoprotein-associated phospholipase A2 (Lp-PLA2) plays an important role in _, particularly in_(gender)
answer
-plaque accumulation and increased risk for stroke and coronary events -men
question
the higher the lipoprotein-associated phospholipase A2 (Lp-PLA2), the higher the_
answer
-the higher the risk of developing CVD
question
Apolipoprotein B (apo B)
answer
-a primary component of LDL that is essential for cholesterol delivery to cells
question
although the mechanism is unclear, some researchers believe that Apolipoprotein B (apo B) levels may be more important to heart disease risk than _
answer
-cholesterol or LDL levels
question
Is there anything I can do to improve my cholesterol level?
answer
-about 25% of your blood cholesterol level comes from foods you eat, and this is where you can make real improvements
question
what medications can do in general in treating cardiovascular disease?
answer
-medication can strengthen heart beat, control arrhythmias, remove fluids, reduee blood pressure, and improve heart function
question
list some medications to treat cardiovascular disease
answer
-statins -ACE inhibitors -beta-blockers
question
what statins medication do?
answer
-can be used to lower blood cholesterol levels
question
what ACE inhibitors medication can do?
answer
-ACE inhibitors can lower blood pressure by causing the muscles surrounding blood vessels to contract
question
what beta-blockers medication can do?
answer
-beta-blockers can reduce blood pressure by blocking the effects of the hormone epinephrine
question
what method is used to threat emergency cardiovascular disease (CVD)? how has been changed? why?
answer
-long-standing methods of cardiopulmonary resuscitation (CPR) have also changed recently to focus primarily on chest compression rather than mouth-to-mouth procedures -The thinking behind this is that people will be more likely to do CPR if the risk for exchange of body fluids is reduced, and any effort to save a person in trouble is better than inaction
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list technological techniques for diagnosis CVD
answer
-electrocardiogram -angiography -positron emission tomography scans -magnetic resonance imaging (MRI) -ultrafast computed tomography (CT) -coronary calcium score
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electrocardiogram (ECG)
answer
-a record of the electrical activity of the heart -may be measured during a stress test
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two tests used for diagnosis of CVD
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-stress test -nuclear stress test
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stress test
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-standard exercise on a stationary bike or treadmill with an electrocardiogram and no injections
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nuclear stress test
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-involves injecting a radioactive dye and taking images of the heart to reveal problems with blood flow
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although these test provide a good indicator of potential heart blockage or blood flow abnormalities, a more accurate method of testing for heart disease is _
answer
-angiography
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angiography (other name and definition)
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-also referred as cardiac catheterization -a technique for examining blockages in heart arteries
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what is done in angiography?
answer
-a needle-thin tube called a catheter is threaded through heart arteries, a dye is injected, and an X ray is taken to discover which areas are blocked
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a more recent end even more effective method of measuring heart activity is a _
answer
positron emission tomography (PET) scan
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positron emission tomography (PET) scan produces what kind of images?
answer
produces 3D images of the heart as blood flows through it
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magnetic resonance imaging (MRI)
answer
-involves using powerful magnets to look inside the boy -computer-generated pictures can show the heart muscle and help physicians identify damage from a heart attack, diagnose congenital heart defects, and evaluate disease of larger blood vessels such as the aorta
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ultrafast computed tomography (CT)
answer
-an especially fast form of heart X ray -can be used to evaluate bypass grafts, diagnose ventricular function, and identify other heart irregularities
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coronary calcium score
answer
-coronary calcium score is derived form another type of ultrafast CT used to diagnose levels of calcium in heart vessels -Calcium accumulations on vessel walls provide an indication of plaque formation and heart attack risks; however, some people will show some level of calcium accumulation
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list surgical options for CVD
answer
-coronary bypass surgery -angioplasty and newer forms of laser angioplasty -stents -atherectomy
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coronary bypass surgery
answer
-a surgical technique whereby a blood vessel taken from another part of the body is implanted to bypass a clogged coronary artery
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coronary bypass surgery has helped people who suffered from_
answer
-patients who suffered coronary blockages or heart attacks
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what is done in coronary artery bypass graft (CABG)?
answer
a blood vessel is taken from another site in the patient's body and implanted to "bypass" blocked coronary arteries and transport blood to heart tissue
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what veins or arteries are used for coronary artery bypass graft (CABG)?
answer
-saphenous vein in the leg -internal thoracic artery (ITA) in the chest
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how coronary bypass surgery can be done being minimally invasive?
answer
-increasing numbers of heart surgeries are done using a minimally invasive bypass surgery in which the chest is not cracked -the surgeon enters the body through a series of ports and performs the surgery with cameras
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angioplasty
answer
-sometimes called balloon angioplasty -a technique in which a catheter with a balloon at the tip is inserted into a clogged artery; The balloon is inflated to flatten the fatty deposits against artery walls (allowing blood to flow more freely), and a stent is typically inserted to keep the artery open
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benefits of angioplasty over bypass surgery?
answer
-angioplasty carries fewer risk and may be more efficient than bypass surgery in selected cases
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today many people with heart blockage undergo angioplasty and have a _inserted
answer
stent
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stent
answer
-a stainless steel, mesh-like tube that is inserted to prop open the artery
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although stents are highly effective, _may actually increase after the procedure, leading to another blockage. in about 30% of patients, the treated arteries become_. what is used to reduce risk?
answer
-inflammation and tissue growth in the area -clogged again within 6 months -newer stents are usually medicated to reduce this risk
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what some surgeons think regarding bypass and angioplasty?
answer
-nonetheless, some surgeons argue that given this high rate of recurrence, bypass may be a more effective treatment
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atherectomy
answer
-a procedure that removes plaque
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what drug can be used for heart attack prevention and reduction of harm form heart attack? what does? what people recommend and problems?
answer
-Aspirin has been touted for its blood-thinning qualities, although even its proponents recommend that only people of certain ages take it regular because of its possible side effects. Furthermore, once a patient has taken aspiring regularly for possible protection against CVD, stopping this regimen may, in fact, increase his or her risk
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when a coronary artery is blocked, how long time passes for damage?
answer
-When a coronary artery is blocked, the heart muscle does not die immediately -Time determines how much damage occurs, and prompt action is vital
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If a victim reaches an emergency room and is diagnosed fast enough of coronary artery that is blocked, what therapy can be used?
answer
-a form of clot-busting therapy called thrombolysis
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thrombolysis
answer
-injection of an agent (such as tissue plasminogen activator (tPA)) to dissolve clots and restore some blood flow, thereby reducing the amount of tissue that dies from ischemia -these drugs must be administered within 1 to 3 hours after a heart attack for best results
question
Every year, more than _Americans survive heart attacks. Over _more have unstable angina, approximately _have angioplasty, _have bypass procedures, _have diagnostic angiograms, nearly _receive implantable defibrillators, and nearly_have pacemakers implanted to keep their hearts working properly
answer
-1 million -7 million more have unstable angina -approx 1.43 million have angioplasty -448,000 have bypass procedures -1.2 million have diagnostic angiograms -nearly 100,000 receive implantable defibrillators -nearly 2oo,000 have pacemakers implanted to keep their heart working properly
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many patients leave the hospital with _
answer
varying degrees of heart failure and fear of future cardiac problems
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cardiac rehabilitation
answer
-includes exercise training and health education classes on good nutrition and CVD risk management -need doctor's prescription for these services
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why many people will not attend to cardiac rehabilitation program?
answer
-lack of insurance -lack of transportation -lack facilities close to their home -face other barriers -biggest deterrent is fear of having another attack due to exercise
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benefits of cardiac rehabilitation
answer
-increased stamina and strength and faster recovery -the benefits far outweigh the risk when these programs are run by certified health professionals
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People who suspect they have cardiovascular disease are often_. who helps to determine where to seek help like hospitals and centers?
answer
-overwhelmed and frightened -usually it is a son or daughter (particularly those in college and computer savvy) who is called to be a personal advocate, do the behind-the-scenes research, and help with decision making and follow-up
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staying_is an important part of staying healthy
answer
staying informed
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what actions will greatly enhance your chances of remaining CVD free?
answer
-good dietary habits -regular exercise -stress management -prompt attention to suspicious symptoms -other healthy behaviors
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action on both _levels can help address the challenge of CVD. include factors
answer
-community and individual levels -other factors that include risk include how much emphasis our health care system place on access to health care for all undeserved populations, education about risk, and other community-based interventions
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The American Heart Association recommends certain people with increased risk of heart attack or stroke take_
answer
-aspirin daily for its blood-thinning properties
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what are things that can help you recover from a cardiac event?
answer
-the path to recovery after a heart attack, stroke, or other cardiac problem can be a challenging one, possibly involving medication, physical therapy, and diet modifications -another important element is stress reduction. ex: having a pet is one way to focus on something other than your medical condition
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What is the biggest preventable risk factor of all? (biggest CVD risk)
answer
-smoke or smoking
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role of HDL?
answer
"good" HDL cholesterol acts like a vacuum cleaner removing plaque.
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Is the number one cause of death in the United States a) cancer or b) cardiovascular disease?
answer
The answer is A - Cardiovascular disease. Nearly 4 in every 10 American deaths is caused by it. The probability of dying from cardiovascular disease is twice as great as dying by cancer, the second leading cause.
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Is the human heart a) the size of a golf ball or b) the size of a fist?
answer
The answer is b - It is the size of a fist.
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Do a) veins or b) arteries carry blood from the heart to the body?
answer
The answer is A - arteries carry blood away from the heart, while veins carry deoxygenated blood back to it. Arteries branch into smaller arterioles and eventually into tiny capillaries.
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A person whose sinoatrial node is damaged a) must have a pacemaker implanted to control the heart rhythm or b) requires an angioplasty.
answer
The answer is A - This person requires a pacemaker because the sinoatrial node functions as a natural pacemaker and initiates the electrical impulses that enable the heart to beat. When it fails to do this, the heart must be helped artificially.
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The medical term for a "thickening" of arteries is a) atherosclerosis or b) angina pectoris.
answer
The answer is A - The condition is atherosclerosis, , also known as hardening of the arteries. Atherosclerosis is caused by a buildup of plaque (fats, cholesterol, fibrin, platelets and calcium) on the artery walls.
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Ischemia is a) a squeezing of heart tissue causing damage or b) a reduced oxygen supply to the heart?
answer
The answer is B - It is a reduction of oxygen to the heart, and the same condition can lead to a stroke.
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When one's heart races is he experiencing a) angina or b) tachycardia?
answer
The answer is B - Tachycardia, one of the arhythmias.
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Which will reduce your risk for CVD? Is it a) quitting smoking or b) increasing your triglyceride level?
answer
The answer is A - Smoking is the #1 risk factor for CVD.
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Patients with angina caused by arterial spasms may be treated with a) beta blockers or b) calcium channel blockers.
answer
The answer is B - calcium channel blockers, because calcium atoms passing through arteries can create spasms.
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Which is a possible stroke symptom? Is it a) visual hallucinations or b) vision dimness?
answer
The answer is B - vision dimness.
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Which ingredient in commercially-prepared baked foods can increase vulnerability to CVD? Is it a) saturated fats or b) transfats?
answer
The answer is B - trans fats are considered to be potentially even more damaging to the heart than saturated fats.
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Which of these risks for CVD can you control: a) your heredity or b) your cholesterol?
answer
The answer is B - cholesterol.
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Some of us find that our blood pressure responds to everyday tensions and if so, are we called a) cold reactors or b) hot reactors?
answer
The answer is B - hot reactors.
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Do African Americans a) have the same risk of surviving heart disease as white people or b) less of a chance?
answer
The answer is B- less of a chance.
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Are the signs of heart disease among women often neglected because a) heart disease among women is a new phenomenon or b) that doctors tend to view heart disease among men as a more serious problem?
answer
The answer is B.
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Is it true or false that strokes can be caused by aneurysms?
answer
The answer is true - Strokes can be caused by aneurysms.
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Streptococcal infections can lead to rheumatic fever, which in turn can cause rheumatic heart disease. True or False?
answer
The answer is true.
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Men have more heart attacks but women die more often from heart attacks. True or False?
answer
The answer is true.
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We can prevent heart disease if our levels of LDL cholesterol are high while our HDL cholesterol is low? True or False?
answer
The answer is false.
question
Taking 80 milligrams per day of low-dose aspirin may help prevent blood clotting. True or False?
answer
The answer is true.
question
at least _Americans die of sudden cardiac arrest each year
answer
400,000
question
what is happening to people with CVD problems and do a stress test? why? what Americans can do to prevent this?
answer
-people take stress test, pass them, and later have a massive heart attack -reason for this is the stress test only detect cholesterol build-up in the middle of the artery that impedes the blood supply. But when the artery wall is affected with cholesterol build-up and inflammation, this can lead to a sudden crack in the artery -ask doctor for inexpensive test, this protein that tracks with artery inflammation, which gives information well beyond what we can get with the stress test. These test can help find the hidden plaque inside the artery wall
question
where heart is located?
answer
located slightly left of center in your chest.
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what is the function of the division between the left and right side of the heart? (atrioventricular septum)
answer
The division protects oxygen-rich blood from mixing with oxygen-poor blood
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what comprises the cardiovascular system?
answer
your heart and blood vessels comprise your cardiovascular system
question
you heart pumps about _quarts of blood every minutes
answer
5 quarts of blood
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flow of blood through cardiovascular system
answer
Oxygen-poor blood, "blue blood," returns to the heart after circulating through your body. The right side of the heart, composed of the right atrium and ventricle, collects and pumps blood to the lungs through the pulmonary arteries. The lungs refresh the blood with a new supply of oxygen, making it turn red. Oxygen-rich blood, "red blood," then enters the left side of the heart, composed of the left atrium and ventricle, and is pumped through the aorta to the body to supply tissues with oxygen.
question
what are the four valves of heart? function?
answer
Four valves within your heart keep your blood moving the right way. The tricuspid, mitral, pulmonary and aortic valves work like gates on a fence. They open only one way and only when pushed on. Each valve opens and closes once per heartbeat — or about once every second.
question
systole
answer
contraction of heart
question
diastole
answer
relaxation of heart
question
explain flow of blood through heart using systole and diastole
answer
During systole, your ventricles contract, forcing blood into the vessels going to your lungs and body — much like ketchup being forced out of a squeeze bottle. The right ventricle contracts a little bit before the left ventricle does. Your ventricles then relax during diastole and are filled with blood coming from the upper chambers, the left and right atria. Then the cycle starts over again.
question
your heart is nourished by blood too. what does this function?
answer
Blood vessels called coronary arteries extend over the surface of your heart and branch into smaller capillaries.
question
what keeps the heart beating? how flow of electricity flows? function of this system?
answer
-Your heart also has electrical wiring, which keeps it beating. Electrical impulses begin high in the right atrium and travel through specialized pathways to the ventricles, delivering the signal to pump. -The conduction system keeps your heart beating in a coordinated and normal rhythm, which in turn keeps blood circulating.
question
2 ways to measure blood pressure
answer
-It's done with a blood pressure monitor. There are two main types: manual, also called aneroid, and automatic. Automatic equipment contains electronics that sense the pulse wave under an inflated arm cuff. Automatic equipment minimizes human error and is recommended if you have hearing or vision loss.
question
what does a person's cholesterol levels indicate?
answer
the formation of fatty substances, called plaque, which can clog arteries
question
strategies to decrease chances of heart attack (lower hypertension)
answer
-decrease sodium -increase levels of exercise -practicing stress management/ control
