Understanding the Cardiovascular System

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Understanding the Cardiovascular System
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A.D.A.M. Software

• Cardiovascular System
• Interactive Physiology CD

CDROM
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Cardiorespiratory System

• Cardiovascular System
• Respiratory System

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Sub-Components of the Cardiorespiratory System

• Heart
• Blood
• Blood Vessels
• Lungs

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Function of the Respiratory System

• Transport gases (O2 and CO2) to and from the
  lungs and body tissues.
• O2 is inhaled and transported, in blood, to the
  tissues.
• CO2, a by product of metabolism, is picked up at
  the tissue level and transported, in blood, back
  to the heart and lungs.

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Function of the Cardiovascular System

• Assist in gas transport.
• Deliver nutrients, hormones
• Remove waste products from the cells
• Assist in temperature regulation
• Assist in balancing body fluids and helps prevent
  dehydration

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Anatomical Considerations of the Heart

• Approximately the size of a closed fist
• Located in the mediastium of the chest cavity

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Systems of the Heart

• The heart functions to contract and propel blood
  through the two blood transport systems.
• Pulmonary system
• Systemic system

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Pulmonary System

• Within the pulmonary system blood is transported
  to and from the lungs.
• The right ventricle propels deoxygenated, carbon
  dioxide rich, blood to the lungs where carbon
  dioxide is released and oxygen is picked up.
• After gas exchange the blood returns to the left
  atrium of the heart.

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Systemic System

• Within the systemic system blood is propelled
  from the left ventricle to the body.
• Here blood is delivered to the working muscles
  where oxygen is utilized and the by product of
  metabolism, carbon dioxide, is picked up.
• After this gas exchange blood returns to the
  right atrium.

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Impact of Cardiovascular Disease

• Affects more than 60 million Americans each year
• Results in nearly 1 million deaths each year
• Cost nearly 275 billion

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Cardiovascular Disease

• Cardiovascular disease (CVD) is the number one
  cause of death in the United States.
• Most reported deaths are related to coronary
  artery disease

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Forms of Cardiovascular Disease

• Coronary artery disease (CAD or CVD)
• Hypertension (Chronic high blood pressure)
• Cerebral vascular accidents (strokes)
• Peripheral vascular disease
• Valvular heart disease
• Congenital heart disease
• Congestive heart failure

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Coronary Artery Disease

• Primary form of heart disease
• A disease involving waxy plaque build-up in the
  arteries

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Coronary Risk Factors

• Primary Risk Factors Factors that have been
  definitively associated with or directly cause
  coronary artery disease.
• Smoking, inactivity, hypertension
• Secondary Risk Factors Factors believed to
  contribute to or advance the severity of CAD.
• Gender, age

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Primary Risk Factors (Alterable)

• Smoking
• Hypertension (high blood pressure)
• High serum cholesterol
• Physical inactivity
• Diabetes mellitus
• Obesity

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Secondary Risk Factors

• Stress
• Age
• Gender (male vs. female)

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Smoking 1

• The single most important, preventable cause of
  illness and early death
• 400,000 related deaths per year, 50 billion
• Cancer, heart disease, respiratory diseases
  (emphysema)
• Cigarette smoking and passive smoke inhalation
  are highly related to CAD.

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Smoking 2

• Smokers have a 70 greater level of coronary risk
  than nonsmokers.
• Magnitude of risk is related to number of
  cigarettes smoked.
• Pipe, cigar, pot

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Secondary Smoke

• 53,000 annual deaths
• For each pack of cigarettes smoked, the non
  smoker, sharing the same air, will inhale the
  equivalent of 3 to 5 cigarettes.

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Smokeless Tobacco

• Chewing tobacco

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Actions of Cigarette Smoke on the Body

• Injures the inner lining of the arteries
• Increases the risk of blood clotting
• Increases the risk of mycardial infarction
• Lowers HDL cholesterol

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Major Components of Tobacco Smoke

• Carbon Monoxide reduces oxygen carrying capacity
  of red blood cells
• Nicotine
• stimulates various brain centers
• constricts vessels of the skin
• increases blood pressure and heart rate
• Tar carcinogenic (lung cancer and emphysema)

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Hypertension/Blood Pressure

• Blood Pressure The driving force that moves
  blood throughout the body. The pressure exerted
  by the blood on the walls of the arteries.
• Blood pressure is highest near the heart

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Blood Pressure 2

• Systolic Pressure The highest pressure occurs
  during heart contraction (ventricular
  contraction)
• Diastolic Pressure The lowest pressure occurs
  during heart relaxation (resting or refilling
  stage of the contraction)

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Normal Blood Pressure

• 120/80
• 120 is the systolic reading
• 80 is the diastolic reading
• NEVER 80/120

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Hypertension

• A silent killer
• 140/90 considered mild stage of hypertension
• Which is more problematic? a high systolic or
  high diastolic?
• Potentially leads to stroke

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Factors Affecting Blood Pressure

• Hypertensive medications
• Time of day
• Full bladder content
• Body Posture
• Recent intake of caffeine
• Nicotine
• Alcohol
• Recent strenuous activity

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Impact of Hypertension

• 25 or 50 million Americans are hypertensive
• 67 are not treated
• 1/2 are unaware of the complication

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Factors Contributing To Hypertension

• Age
• Race
• Sodium sensitivity
• Chronic alcohol abuse
• Sedentary living

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Factors Related To Hypertension That Lead to CVD

• Elevated serum cholesterol and lipids
• Obesity
• Diabetes mellitus
• Cigarette Smoking

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Cholesterol

• High density lipoproteins (HDL) (GOOD)
• May remove plaque from the arteries
• Aerobic activity will raise HDL level

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Cholesterol 2

• Low density lipoproteins (LDL) (BAD)
• enhances plaque build up in the arteries
• increases with a high saturated fat diet

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High Serum Cholesterol

• Cholesterol levels
• Desirable below 200
• Borderline high 200-239
• Risk for CVD 240 and above

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Understanding Cholesterol 2

• High-density lipoproteins (HDL) offer a
  protective effect against CAD.
• Low-density (LDL) and very-low-density
  lipoproteins (VLDL) are undesirable and are
  associated with increase risk of CAD.

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Understanding Cholesterol Ratios

• One of the best methods of determining CAD risk
  is to determine the ratios of total cholesterol
  (TC) to high-density lipoproteins (HDL).
• Having high HDL associated with low LDL decreases
  the risk of a CAD

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Controlling Cholesterol

• Avoid saturated fats
• fats from animal sources
• Avoid dietary cholesterol
• Exercise
• Limit red meats (fewer than 3 times per week)
• Avoid commercially baked goods (tropical oils)
• Use skim milk

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Controlling Cholesterol 3

• Plant foods do not contain cholesterol
• Eat fish 2-3 times per week
• Bake, broil, steam, microwave
• Remove excess fat (soup, chili)
• Is ground turkey better?

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Controlling Cholesterol 4

• Avoid fatty sauces (fettuccini Alf redo)
• Substitute in recipes
• Egg whites for eggs
• Applesauce for oil in cakes
• Salsa instead of butter for baked potatoes
• Maintain proper body weight
• High cholesterol may be genetic
• Medications may need to be prescribed

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Physical Inactivity

• Physical activity levels and CAD are strongly
  inversely related.
• Sedentary individuals have 2-3 times greater risk
  of CAD than active individuals.
• Sedentary individuals have twice the risk of
  fatal heart attacks.

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Physical Activity

• Physical activity is argumentably be the single
  best method of controlling or reducing CAD.
• Increases strength of the heart
• Helps to establish and maintain normal blood
  pressure.
• Helps to control obesity due to increase in
  caloric expenditure

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Physical Activity 2

• Raises HDL levels, while lowering LDL
• Helps to manage stress levels
• Increases coronary artery circulation
• Decreases resting heart rates

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Physical Activity 3

• Increases resting and exercising stroke volumes
• Lowers blood glucose levels, reducing risk of
  diabetes

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Types of Diabetes

• Type I insulin dependent or juvenile onset
• Type II maturity or adult onset, usually
  non-insulin dependent

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Diabetes Mellitus

• A condition in which glucose is unable to enter
  the cells
• A disease associated with problems in controlling
  blood glucose or blood sugar
• The disease results when the pancreas has
  problems producing insulin
• Insulin is the taxi that carries sugar from the
  blood to the cells

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Diabetes Mellitus Adult Onset

• The pancreas does not produce enough insulin or
  has just forgotten how
• Directly related to obesity

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Blood Sugar Levels

• Normal blood sugar levels 70-110
• Hyperglycemia
• High levels of blood sugar
• When sugar levels remain high, over time, it
  damages the walls of the vessels
• Leads to impairment of the circulatory system
• Affects functioning of most organs
• Problems healing (small cuts, amputations)
• Blindness

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Hypoglycemia

• Low levels of blood sugar
• May give sugar to the diabetic, protein
  recommended
• Some may experience hypoglycemia but are not
  diabetic

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Adult Onset 2

• An 20 increase in body weight doubles the
  chances of developing diabetes
• A diabetic male has twice the risk of CAD
• A diabetic female has three times the risk of CAD

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How To Avoid Adult Onset Diabetes

• Control cholesterol
• Control blood pressure
• Exercise regularly (aerobic)
• Exercise lowers blood sugar
• Diabetics must plan for meals, insulin
  injections, and exercise

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Obesity Fat Distribution

• Apples Android Obesity
• Fat distributed in upper body
• Higher risk of CAD
• Pears Gynoid Obesity
• Fat is distributed in the hips and legs

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Relationship of Obesity of Other Coronary Risk
Factors

• Obesity is related to
• High cholesterol
• Hypertension
• Elevated LDL levels
• Lower HDL levels
• Physical Inactivity
• Diabetes
• Obesity is also related to joint problems

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What Constitutes Obesity?

• Body fat percentages
• Men 25
• Women 30

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Other Diseases Associated With Obesity

• Stroke
• Renal disease
• Gallbladder disease
• Pulmonary disease

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Other Diseases 2

• Degenerative arthritis
• Some cancers
• Post menopausal obese women 5 times more likely
  to develop uterine cancer

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Stress A Secondary Risk Factor

• Unmanaged stress is related to CAD.
• Type A personality is related to CAD.
• The relationship between stress and CAD appears
  stronger in white, middle aged men than in women,
  blacks, Hispanics, and younger adults.

A
B
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Age Secondary Risk Factor

• Men over the age of 45 and women over the age of
  55 appear to have greater risk of CAD.
• CAD is related to menopausal women who do not
  take estrogen replacement therapy.

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Family History Primary or Secondary?

• Individuals with a family history of CAD are at
  greater risk.
• The risk is greater when the father or other
  first degree relative has experienced a MI or
  sudden death before the age of 55.

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Family History 2

• The risk is greater when the mother or another
  female family member has experienced a MI or
  sudden death before the age of 65.
• Individuals with family histories of diabetes,
  hypertension, are at a greater risk.

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Gender

• Men have a greater history of CAD earlier in
  life.
• CAD is a disease of equal opportunity

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Assignment

• Read Chapter 5
• Read Lab 5b (in-class lab)
• Quiz ???