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Cardiovascular Disease

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Mel VIzza

on 22 October 2012

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Transcript of Cardiovascular Disease

Melanie Vizzachero, Rachael Cocchia, Arielle Sheris, Miranda Thomas Cardiovascular Disease Describes a variety of diseases that affect the heart
Involves narrow or blocked blood vessels that can lead to heart attack, angina (chest pain), or stroke
Includes infections and other conditions that affect the heart’s muscle, valves, and/or beating rhythm What is Cardiovascular Disease? Improves overall cardiovascular function and quality of life
Lessens the symptoms of congestive heart failure (chest pain, lethargy, shortness of breath)
Reduces blood pressure
Reduces LDL and total cholesterol
Increases HDL cholesterol
Increases insulin sensitivity
Improves the abilities of the blood
vessels to dilate in response to
Improves oxygen transport
Perform ADL’s with greater ease
Decreases risk of heart attack and stroke Preventing and Treating Cardiovascular Disease Through Exercise Physical inactivity is a major risk factor for coronary heart disease
Studies have shown that patients who have heart problems, and even those who are at high risk for heart disease or failure, can benefit greatly from exercise
Exercise essentially gives the heart a muscle workout (since it is a muscle) overall making it stronger
It is noted that exercise helps to improve heart health by making the heart muscle stronger and larger.
This enables it to pump more blood throughout the body with each beat which essentially allows it to function efficiently and at it’s maximum potential
Exercise keeps the arteries elastic, which makes blood flow easier and helps maintain normal blood pressure
This reduces the risk of atherosclerosis and heart attack
One must adopt a healthy lifestyle in which one incorporates exercise into What Studies Show about Exercise Direct effect of sitting idle is the work performed by large skeletal muscles in legs, back and trunk come to a halt
Sitting for prolonged periods cause loss of opportunity for cumulative energy expenditure resulting from the thousands of intermittent muscular contractions throughout the 16-hour period that people are awake
This may have chronic effects on the propensity to become overweight
Insufficient information on inactivity to limit sitting time
Sitting and non-exercise physical activity can affect cellular processes for metabolic risk factors for coronary heart disease
People are at greater risk for cardiovascular disease if they keep a sedentary lifestyle
Bus drivers are at a twice greater risk for CVD than someone in a profession where less sitting is required
Risk for CVD mortality was 2.7-fold greater in high sitters relative to that in low sitters.
Studies have put inactivity on par with smoking as an increased risk to CVD Exercise can help prevent and treat cardiovascular disease
It is important to implement regular exercise routines
It is never too late to start!!! Conclusion What is Associated with Cardiovascular Disease? Heart Attack – Also known as myocardial infraction
Damage to an area of heart muscle that is deprived of oxygen due to blockage of a diseased coronary artery
Coronary Artery Disease – Hardening of the coronary arteries
Can cause chest pain or heart attack
Valvular Disease – Caused by abnormal narrowing of the cardiac valves and obstructed blood flow or by degeneration and blood regulation
Heart Murmur – Abnormal sound heard through a stethoscope over the region of the heart
Rheumatic Fever – Inflammatory disease that may develop after an infection with group A Streptococcus bacteria (strep throat or scarlet fever)
The disease can affect the heart, joints, skin and brain
Enlarged Heart – Can be caused by stress or medical conditions
Congestive Heart Failure – Failure of the heart to pump adequate amount of blood to tissues, resulting in an accumulation of blood returning to the heart from the veins
Accompanied by distension of the ventricles, edema, and shortness of breath
Cardiac Ectopy – Disturbance in cardiac rhythm
Hypertension – Elevation of blood pressure, especially diastolic blood pressure
Other – poor circulation, low blood pressure, heart failure, peripheral claudication Life became less strenuous
Most manual labor was either replaced or assisted by machinery
Automobiles, washing machines, elevators, and vacuum cleaners became commonplace
Modern conveniences made physical activity unnecessary The combination of a sedentary lifestyle and a poor diet led to an increase in clogged blood vessels, heart attacks, and strokes Diet was Affected as well History of Cardiovascular Disease in the United States (cc) image by nuonsolarteam on Flickr Cardiovascular Disease was rare before the 1900s Walking was the most common method of transportation
Laundry was done by hand
Farming land was worked physically
The use of manual labor prevailed
Most things were done without the use of electronics With the industrial revolution heart
disease became more prevalent Previously, high-fat treats had to be made by hand.
Machines were built to homogenize milk, process cheese, churn butter, and make ice cream
Fried foods, like potato chips, hamburgers, and french fries, became staples in many diets. Heart disease became common
The rate of heart disease increased so sharply between the 1940 and 1967 that the World Health Organization called it the world's most serious epidemic What is the Cost of Cardiovascular Disease? Money isn't the only cost... Heart disease is the leading cause of death for both men and women
Heart disease caused almost 25% of deaths (almost one in four)
Coronary heart disease is the most common type of heart disease
In 2008, 405,309 people died from coronary heart disease In 2010, coronary heart disease alone was projected to cost the United States $108.9 billion. This includes the cost of health care services, medications, and lost productivity The Good News is... The numbers are going down. BUT: Heart disease is still the number one killer in the United States 2009 Statistics •Number of deaths: 599,413
•Deaths per 100,000 population: 195.2
•Cause of death rank: 1 Prevalence of coronary heart disease among adults --- Behavioral Risk Factor Surveillance System, United States, 2010
By state, age-adjusted CHD prevalence in 2010 ranged from 3.7% in Hawaii and 3.8% in DC to 8.0% in West Virginia and 8.2% in Kentucky, with the greatest regional prevalence generally observed in the South
(Across the United States, death rates due to heart disease in 2008 were highest in Mississippi and lowest in Minnesota) In the United States, someone has a heart attack every 34 seconds. Each minute, someone in the United States dies from a heart disease related event Cardiovascular Disease and the Elderly An estimated 82.6 million American adults (more than 1 in 3) have 1 or more types of CVD Of these, 40.4 million are estimated to be older than 60 years of age Among those aged 60 - 79 years:
72.6% of men and 71.9% of women have CVD
Among those aged 80+ years:
80.1% of men and 86.7% of women have CVD The average life expectancy is about 77.9 years of age
Nearly 33% of CVD deaths occur in people before age 75 Conditions: Behaviors: Genetics: Risk Factors Blood cholesterol levels – Too much cholesterol (due to diet and processing rate) is deposited in the arteries, including heart arteries. This leads to the narrowing of arteries, heart disease, and other complications.
There are two types of cholesterol
HDL – “good cholesterol”
LDL – “bad cholesterol”
High blood pressure – Often no symptoms
Lowering blood pressure by changes in lifestyle or by medication can lower the risk of heart disease and heart attack
Diabetes Mellitus – The body does not make enough insulin and/or can't use its own insulin as well as it should. Sugar will then build up in the blood.
About 3/4 of people with diabetes die due to some form of heart or blood vessel disease Tobacco/Smoking – Increases the risk of heart disease and heart attack
Cigarette smoking promotes atherosclerosis and increases the levels of blood clotting factors, such as fibrinogen.
Nicotine raises blood pressure, and carbon monoxide reduces the amount of oxygen that blood can carry
Second hand smoke also increases the risk of cardiovascular disease
Diet – Diets high in saturated fats and cholesterol raise blood cholesterol levels and promote atherosclerosis
High salt or sodium in the diet causes raised blood pressure levels
Physical Inactivity – Related to development heart disease
Impacts other risk factors, including obesity, high blood pressure, high triglycerides, a low level of HDL, and diabetes
Regular physical activity can improve risk factor levels
Obesity – Excessive body fat
Linked to higher LDL and triglyceride levels and to lower HDL, high blood pressure, and diabetes
Alcohol – Excessive alcohol use leads to an increase in blood pressure, and increases the risk for heart disease
Also increases blood levels of triglycerides which contributes to atherosclerosis Heart disease can run in the family
Genetic factors likely play some role in high blood pressure, heart disease, and other vascular conditions
It is also likely that people with a family history of heart disease share common environments and risk factors that increase their risk
The risk for heart disease can increase even more when heredity is combined with unhealthy lifestyle choices, such as smoking cigarettes and eating a poor diet Average age of first heart attack is 64.5 years for men and 70.3 years for women About 81% of people who die of CHD are age 65 or older
Because women have heart attacks at older ages, they are more likely to die from them
For those aged 60–79 years - 22.8% of men and 13.9% of women have Coronary Heart Disease
For those aged 80+ years - 35.5% of men and 20.8% of women have Coronary Heart Disease Total costs for CVD in 2008 were $109.2 billion for patients 65 years of age and older. This is 36.7% of total
CVD costs Exercise Guidelines for Patients with Cardiovascular Disease Have a physician perform a stress test and prescribe an exercise program.
Make sure the client has taken their heart medication before each exercise session. Reduce physical exertion
Avoid exposure to extreme heat or cold
Mitigate emotional stress
Discourage consumption of
large meals before exercise Always check heart rate and blood pressure readings before, during, and after exercise.
Use RPE to assess exercise intensity level * Newly diagnosed patients who participate in a regular exercise program return to work sooner and report a higher quality of life

* Research has shown that heart attack patients who participate in a formal exercise program have their death rate reduced 20% to 25% Numbers of studies show benefits of moderate intensity physical activity for cardiovascular health
Moderate intensity 6 METS = 60-70% MAX HR
Examples of moderate intensity physical activities :
British Regional Heart Study (began in 1978)
Involved 7735 men (ages 40-59)
Men with and without pre-existing Coronary Heart Disease (CHD)
8 year follow up revealed:
men without pre-existing CHD who participated in moderate intensity physical activity, such as walking/cycling/recreational activity had a 50% reduction in risk for CHD compared to those who were inactive
Conclusively the British Regional Heart Study confirmed the health benefits of regular physical activity for middleaged men, and indicated that the activity does not need be vigorous but should be regular and current in order to reduce cardiovascular risk. Reported that walking among elderly men was highly associated with the reduced risk of CHD
2678 men (aged 71-93)
all participants were free of CHD
over a 2-4 year time period:
those who walked less than .25 miles/day 2X the risk of CHD than those who walked more than 1.5 miles/day Honolulu Heart Program Physical activity: the evidence of benefit in the prevention of coronary heart disease Class IV
(severe) Class III Class II Does not limit physical activity
Can perform any activity to completion
Greater than or equal to 7 METS Class I (Mild) Slight limitation on physical activity
Any activity requiring greater than or equal to 5 METS but no more than 7 METS Physical activity is greatly limited
Less than ordinary physical activity causes fatigue, dyspnea, and angina
Can perform any activity greater than or equal to 2 METS but no more than 5 METS Inability to perform any physical activity without discomfort NYHA Functional Classification System Exercise Testing EKG - Electrocardiogram
Exercise stress test
VO2 max test
Six minute walk test Study of Inactivity Inactivity vs. Sedentary Sitting too much and exercising too little are two different things
Sitting too much is a sedentary lifestyle
Exercising too little has earned the label inactive physiology
Inactive physiology is how the muscles and body work when youre not exercising
Non-exercise activity (ie: shopping, housework) falls under inactive physiology
Non-exercise activities can be beneficial
Slow movement raises the bodies energy expenditure 2.5-fold more than when sitting still
However, there is no substitute for actual exercise
However, there is no substitute for non-exercise activities
Non-exercise activities help keep the body moving and active
If someone works out the recommended amount of time but then sits for the rest of the week, the benefits of exercise are lost
Clarifying and giving exercise guidelines are important because it helps the public distinguish between exercise and non-exercise activity
Guidelines for aerobic exercise were clarified by the American College of Sports Medicine/American Heart Association
Very helpful, especially for older adults, so that people know when they're exercising
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