Cardiovascular Health Objectives:

1
Cardiovascular Health Objectives

• Describe the incidence, prevalence and
• outcomes of Cardiovascular disease.
• Describe the basic anatomy and physiology of the
  heart.
• Describe coronary artery disease and its risk
  factors.
• Describe how to prevent and reverse heart disease.

2
An Epidemiological Overview of Cardiovascular
Disease, CVD

• CVD, accounts for 50 of all diseases and deaths
  in the U.S.
• More than 2,600 people die each day from CVD,
  945,000 deaths per year.
• Almost 150,000 die before the age of 65 yrs
• The death rate per 100,000 white men397
  African-Am 510 white women286 Af-Am women 397

3
An Epidemiological Overview of Cardiovascular
Disease, CVD

• Nearly 61 million Americans live with some kind
  of CVD.
• Nearly 13 million have a history of heart attack,
  chest pain, or both.
• CVD will permanently disable 19 of the U.S.
  labor force.
• The best line of defense is PREVENTION!

4
Anatomy and Physiology of the heart

• The heart is a pump for the blood.
• It beats 60-100 beats per minute, average 70-80.
• There are four chambers right atrium, left
  atrium, right ventricle, left ventricle.
• There are four valves tricuspid, mitral,
  pulmonic and aortic.

5
Heart structures

6
A and P contd

• The heart is self regulating.
• The coronary arteries supply blood to the heart.
• The vena cavae bring deoxygenated blood to the
  heart.
• The pulmonary artery takes deoxygenated blood
  from the right ventricle to the lungs for oxygen.

7
A and P contd

• The pulmonary veins bring oxygenated blood from
  the lungs to the left atrium.
• The aorta takes oxygenated blood to the body from
  the left ventricle.

8
Coronary Heart Disease

• Also known as Coronary Artery Disease
• The diagnosis is made when there is 60 occlusion
  of the coronary arteries.
• This may lead to a heart attack or myocardial
  infarction (MI).
• Heart Attacks or MIs produce irreversible injury
  and myocardial tissue damage.

9
Coronary Heart Disease cond

• The area of dead tissue can no longer function as
  an effective pump.
• Although most heart attacks occur after the age
  of 65 years, the dysfunction leading to them
  begins well before adolescence, sometimes as
  early as childhood

10
Risk Factors include

• Lifestyle inactivity, tobacco
• Environmental influences that increase ones
  susceptibility to disease.
• High blood pressure
• High blood fats
• Age, hereditary, and race
• Obesity
• Male gender

11
Major risk factors that can be controlled

• Cholesterol, smoking, and physical inactivity
• What is cholesterol?
• A steroid, wax type substance that is used for
  the building of nerve tissue
• Also used for the construction of cell walls
• It helps with the manufacturing of hormones and
  bile (for digestion and absorption of fats).

12
Some more facts on cholesterol

• Consumption should be limited to 200mg/day.
• Is manufactured by the liver, intestines and
  arterial walls
• As cholesterol levels rise, atherosclerotic
  plaque forms
• When an injury occurs on the arterial walls (by
  tobacco smoke, high blood pressure, elevated
  LDLs, diabetes, viral or bacterial infections)
  the lumen becomes smaller.

13
Another controllable risk factor Physical
Inactivity

• Behaviors established in childhood and teenage
  years carry into adulthood
• Only 50 pf 12-21 year olds participate in
  regular physical activity.
• The percentage of overweight children has doubled
  since 1980.
• 61 of overweight 5-10 year olds have one or more
  risk factors for cardiovascular disease, 27 have
  2 or more

14
Risk factor physical inactivity contd

• Endurance exercises can reduce systolic and
  diastolic pressures by 10 points with people with
  mild hypertension (above 120/80)
• Resistive or strength training does not seem to
  lower blood pressure unless it is accompanied by
  aerobic exercises.

15
Why does exercise lower blood pressure?

• Contributes to weight loss
• Aerobic exercise reduces resistance to blood flow
  in arteries, thus lowering the force required to
  circulate blood.

16
Risk factors contd Hypertension

• Weight management
• Alcohol (no more than 2oz/day)
• Salt restriction
• Exercise meditation
• Yoga
• biofeedback

17
Another risk factor Nicotine

• Increase LDLs and lowers HDLs
• Causes platelets to aggregate, increases arterial
  spasms
• Increases the oxygen requirement of cardiac
  muscle
• Constricts blood vessels
• Produces irregular heart rate

18
Nicotine contd

• Is the causative agent in 30 of heart disease
  deaths
• Increases blood viscosity
• Decreases oxygen carrying capacity of red blood
  vessels.
• Increases the oxygen requirement of the heart
  muscle.

19
Other possible risk factors (cutting edge kind
of info)

• Iron rich blood
• Homocystine-an amino acid, that is a building
  block for protein, yet if it is not broken down
  it can lead to a higher risk for heart disease.
• Lipoprotein- a bad cholesterol
• High sensitivity C-reactive protein, a test that
  indicates inflammation
• Fibrinogen-increases thickness of blood.

20
Preventing and reversing heart disease

• Besides everything we have discussed
• Dr. Dean Ornish showed that a program consisting
  of yoga, low fat diet, smoking cessation and
  support groups decrease atherosclerosis.

21
Treating coronary artery occlusion,balloon
angioplasty

• Balloon angioplasty
• Coronary stent-metallic tube
• Coronary bypass surgery

22
Coronary Artery Bypass

23
Coronary Stent-metallic tube

24
Summary on Heart Attacks

• 1/3 are silent, with no signs or symptoms
• Symptoms when present include chest pain
  radiating to the left side of the jaw, nausea
• Warning sign angina pectoris
• Diagnosis EKG, enzymes, clinical presentation

25
Other types of C VD

• Angina (pectoris)
• Arrhythmias
• Congenital rheumatic
• heart disease
• Stroke
• congestive
• heart failure

26
Summary on how to manage risk factors for CVD

• Avoid tobacco
• Cut down on cholesterol
• Maintain healthy weight
• Manage stress
• Exercise regularly
• Eat low fat, low salt diet
• Control blood pressure