Lecture 8 Cardiovascular Health 1 Lecture 8 1. Introduction 2. Cardiovascular Health 3. Stroke 4. Contributing Factors 1
Human Health: What s Killing Us? Health in America Health is the U.S Average life expectancy 1900 Men = 48 years Women = 51 years Average life expectancy 2017 Men = 75 years Women = 80 years 2
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Health in U.S. Premature deaths caused by lifestyle Poor diet, Lack of exercise, Smoking, Obesity Health in the U.S. 4
Health in the U.S. Health in the U.S. 5
Cardiovascular Health 11 Cardiovascular Disease Cardiovascular Disease (CVD) - any disease involving the heart and/or blood vessels CVD include heart attack, stroke, peripheral artery disease, congestive heart failure, and others 12 6
CVD the leading cause of death in the United States, accounting for one-third of all deaths 13 Heart Disease and Stroke account for 65.4% of deaths from CVD in the U.S. 14 7
Atherosclerosis The disease process underlying many forms of CVD is atherosclerosis A thickening or hardening of the arteries due to the buildup of fats and other substances 15 Atherosclerosis Starts with damage to the inner lining of vessels and the formation of a fatty streak(s) 16 8
Atherosclerosis Once an injury exists on the artery, white blood cells, collagen, and other proteins are formed, creating plaque (accumulation of debris in an artery wall) 17 Atherosclerosis Eventually the artery becomes blocked, or Plaque can break off and completely block artery elsewhere 18 9
Coronary Heart Disease Coronary Heart Disease (CHD) - atherosclerosis of the coronary arteries, which can result in a heart attack 19 Coronary Heart Disease CHD is the leading form of all cardiovascular diseases An estimated 16.3 million Americans are living with CHD Those who survive a heart attack are often left with damaged hearts and significantly altered lives, lead to CHF 10
Coronary Heart Disease Ischemia - insufficient supply of oxygen and nutrients to tissue, caused by narrowed or blocked arteries Angina - pain, pressure, heaviness, or tightness in the center of the chest caused by a narrowed coronary artery 21 Coronary Heart Disease Myocardial Infarction (Heart Attack!) - lack of blood flow to the heart muscle with resulting death of heart tissue 22 11
Coronary Heart Disease Coronary Thrombosis (also a heart attack) - blockage of a coronary artery by a blood clot that may cause sudden death 23 12
Copyright 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 25 Testing /Treatment for Heart Disease Diagnostic Testing Electrocardiogram (ECG or EKG) 26 13
Testing /Treatment for Heart Disease Diagnostic Testing Echocardiogram (sound waves) 27 Testing /Treatment for Heart Disease Diagnostic Testing Exercise Stress Test - involves doing brisk cardiovascular activity while your heart beat, blood pressure, and breathing are monitored. 28 14
Treatment: Angioplasty (balloon catheter) 29 Coronary Artery Bypass Grafting 30 15
Congestive Heart Failure Usually follows a severe heart attack Heart s pumping power is weaker than normal Chambers of the heart stretch to hold more blood, or heart muscle becomes thick and stiff (heart tries to compensate) Eventually the heart muscle weakens Person with this condition experiences difficulty breathing, shortness of breath, coughing, fatigue, and confusion. Fluid build up in lungs and extremities 31 Congestive Heart Failure 32 16
Arrhythmias and Sudden Cardiac Death Arrhythmia - irregular or disorganized heartbeat Ventricular Fibrillation - type of arrhythmia in which the ventricles contract rapidly and erratically, causing the heart to quiver or tremor rather than beat Sudden Cardiac Death - abrupt loss of heart function caused by an irregular or ineffective heartbeat 33 Stroke 34 17
Stroke A Stroke or Cerebrovascular Accident (CVA) - when blood flow to the brain or part of the brain is blocked Fourth leading cause of death in the United States; leading cause of severe, long-term disability 35 Stroke Ischemic Stroke - caused by blockage in a blood vessel in the brain (accounts for 87% of all strokes) 36 18
Stroke Hemorrhagic Stroke - caused by rupture of a blood vessel in the brain, with bleeding into brain tissue 37 Stroke Transient Ischemic Attacks (TIAs) ministrokes - periods of restricted blood supply that produce the same symptoms as a stroke 38 19
39 Management of Stroke Management medications can dissolve clot and restore blood flow to the brain If hemorrhagic, depends on the underlying cause of the bleed; sometimes surgery is necessary Rehabilitation, usually including physical therapy, an important component 40 20
Contributing Factors 41 Hypertension Hypertension - blood pressure that is forceful enough to damage artery walls the silent killer many people don t know they have it until its too late Untreated high blood pressure/hypertension: Can weaken and scar the arteries and make the heart work harder Can cause heart attacks, strokes, kidney disease, peripheral artery disease, and blindness 42 21
Hypertension Systolic Pressure Diastolic Pressure 43 Hypertension 44 22
Other Contributing Factors Triglyceride Levels fat in blood Levels in blood should be less than 150 to achieve desired levels Alcohol Intake Heavy drinking (more than 3 drinks/day) can damage the heart Light drinking (less than 2 drinks/day) can increase HDL levels, therefore protecting against heart disease and stroke risk Psychosocial Factors Personality, chronic stress, socioeconomic status, depression, and social support 45 Cholesterol 46 23
Noncontrollable Factors in Cardiovascular Health Age Gender Genetics and Family History Ethnicity and Race Postmenopausal Status 47 Major Controllable Factors in Cardiovascular Health Tobacco Use Blood Pressure Levels Cholesterol Levels Physical Activity BMI Blood Glucose Levels Diet 48 24
Areas of Interest for Future CVD Research Researchers are looking at how the following are associated with CVD: Low levels of vitamin D High blood levels of homocysteine (amino acid red meat) Metabolic syndrome (a set of conditions associated with CVD) Inflammation (body s response to protect itself) High levels of C-reactive protein in the blood Infections that may cause atherosclerotic plaques to break free Lower birth weight 49 Other Cardiovascular Diseases Heart Valve Disorders 50 25
Other Cardiovascular Diseases Congenital Heart Disease Structural defect at birth 51 Other Cardiovascular Diseases Peripheral Vascular Disease (PVD) - Atherosclerosis in the arms and legs 52 26
Other Cardiovascular Diseases Cardiomyopathy - Disease of the heart muscle 53 27