Learning Objectives

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Learning Objectives
w Find out the major causes of chronic diseases
in the United States and how a lack of physical
activity contributes to these conditions.
w Learn how atherosclerosis, hypertension, and
coronary artery disease (CAD) develop and at what
age they begin.
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Learning Objectives
w Learn what blood pressure changes result from
endurance exercise training in moderately
hypertensive individuals.
w Review the value of cardiac rehabilitation in
treating a person who has suffered a heart attack.
w Find out if there is any risk of death with
endurance exercise training.
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1995 CAUSES OF DEATH IN THE U.S.
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DECLINE IN DEATHS
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Factors Contributing to Decline in Deaths
w Better and earlier diagnosis
w Better emergency and medical care
w Improved drugs for specific treatment
w Improved public awareness
w Increased use of preventive measures, including
lifestyle changes
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Cardiovascular Diseases
w Coronary artery disease (CAD)
w Hypertension and stroke
w Congestive heart failure
w Peripheral vascular disease
w Valvular, rheumatic, and congenital heart
disease
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Coronary Artery Disease
Atherosclerosisprogressive narrowing of arteries
due to build up of plaque
Coronary artery disease (CAD)atherosclerosis in
the coronary arteries
Ischemiadeficiency in blood to heart caused by
CAD
Myocardial infarctionheart attack due to ischemia
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Did You Know?
Atherosclerosis begins in infancy and progresses
at different rates, depending primarily on
heredity and lifestyle choices such as smoking
history, diet practices, physical activity, and
stress.
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Classification of Blood Pressure for Adults, Age
18 Years and Older
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Hypertension
w Is chronically elevated blood pressure
w Causes the heart to work harder
w Is uncommon in childhood but can appear during
midadolescence
w Places strain on arteries causing them to
become less elastic over time
w Affects about one in every four adult Americans
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Stroke
w Also called a cerebral vascular accident (CVA).
w Cerebral infarction refers to when blood flow
is blocked to one part of the brain due to a
blood clot or atherosclerosis.
w Cerebral hemorrhage refers to a rupture of a
blood vessel that diminishes blood flow beyond
the rupture.
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CEREBRAL INFARCTION AND HEMORRHAGE
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Congestive Heart Failure
w Heart muscle becomes too weak to meets oxygen
demands of the body
w Can result from damage to heart, hypertension,
atherosclerosis, and heart attack
w Blood backs up in veins causing edema
w Can progress to irreversible damage, thus
requiring a heart transplant
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AN ARTERY WALL
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DEVELOPMENT OF ATHEROSCLEROSIS
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Primary Risk Factors of CAD
w Cigarette smoking
w Hypertension
w Elevated blood lipids (cholesterol and
triglycerides)
w Physical inactivity
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Secondary Risk Factors of CAD
w Obesity
w Diabetes and high blood levels of insulin
w Family history of CAD
w Male gender
w Advanced age
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Did You Know?
The ratio of total cholesterol (Total-C) to
high-density-lipoprotein cholesterol (HDL-C) may
be the most accurate lipid index of risk for CAD.
Values of 5.0 and greater indicate increased risk
while values of 3.0 and lower represent low risk.
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Controllable Risk Factors for Hypertension
w Insulin resistance
w Obesity
w Diet
w Use of oral contraceptives
w Physical inactivity
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Uncontrollable Risk Factors for Hypertension
w Family history of hypertension
w Advanced age
w Race
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Did You Know?
It appears that hypertension, coronary artery
disease, obesity, and diabetes are linked through
the common pathway of insulin resistance.
Metabolic syndrome, syndrome x, and civilization
syndrome are terms used to describe this
interrelationship.
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AMERICANS AT INCREASED CAD RISK
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Did You Know?
Epidemiological evidence shows that physical
inactivity doubles the risk of CAD. Low-intensity
activity is sufficient to reduce the risk of this
disease.
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Aerobic Training Adaptations
w Produces larger coronary arteries
w Increases heart size
w Increases heart pumping capacity
w Improves circulation of blood to vessels
surrounding heart
w Reduces blood pressure in individuals with
moderate hypertension
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How Exercise Reduces Risk of Disease
w Improves the hearts contractility, work
capacity, and circulation
w Improves ratio of blood lipids
w Controls and prevents moderate hypertension
w Controls weight, reduces body fat, and
increases muscle mass
w Alleviates stress and decreases cigarette
smoking
w Reduces insulin resistance
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ARTERY COMPARISONS
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Key Points
Risk of Death During Exercise
w There is an increased risk of heart attack
during actual exercise however, over a 24-hour
period, those who exercise regularly have a
reduced risk of heart attack.
w Deaths during exercise are rare.
w In people over 35 most deaths during exercise
are caused by a cardiac arrhythmia due to
atherosclerosis.
w Deaths during exercise in people under age 35
are usually caused by hypertrophic
cardiomyopathy, congenital conditions, aortic
aneurysm, or myocarditis.
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HEART ATTACK RISK AND EXERCISE