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Cardiovascular

Health
Chapter 11

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Cardiovascular Disease
Cardiovascular disease (CVD) =
disease of the heart and blood
vessels
CVD is the leading cause of death
among Americans
Some CVD risk factors are
controllable; others are not
There are many things individuals
can do to reduce their risk of CVD
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Cardiovascular Disease

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Major CVD Risk Factors That Can Be


Changed

Tobacco use and exposure to ETS

Causes about 1 in 5 deaths from CVD


Damages artery linings
Reduces HDL
Raises LDL and triglycerides
Causes platelets to stick together
Raises heart rate and blood pressure
Displaces oxygen in the blood
Increases the rate of the accumulation
of fatty deposits in arteries
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Major CVD Risk Factors That Can Be


Changed

High blood pressure (hypertension) =


sustained abnormally high blood pressure
Systole = pressure when heart contracts
Diastole = pressure when heart relaxes

High blood pressure strains the heart,


damages the arteries, and increases risk of
heart attack, stroke, kidney failure, and
blindness
Reduce with regular exercise, healthy diet
(reduced salt, increased potassium and
fiber), and moderation of alcohol intake
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Blood Pressure Classification


Category

Systolic
(mm Hg)

Normal

Below 120

and

Below 80

120139

or

8089

140159
160 and
above

or
or

90-99
100 and
above

Prehypertensio
n
Hypertension
Stage 1
Stage 2

Diastolic
(mm Hg)

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Blood Pressure

Source: Centers for Disease Control and Prevention


Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Major CVD Risk Factors That Can Be


Changed

Unhealthy Cholesterol Levels

Low-density lipoprotein (LDL) =


unhealthy (bad) cholesterol; excess
amounts are deposited in artery walls
High-density lipoprotein (HDL) = healthy
(good) cholesterol; shuttle unused
cholesterol back to the liver for recycling
Levels can be improved by quitting
smoking, exercising, and improving diet
(less saturated and trans fat, more fruits,
vegetables, fiber, and whole grains)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Cholesterol Guidelines
LDL cholesterol (mg/dl)
Less than 100

Optimal

100129

Near optimal/above optimal

130159

Borderline high

160-189

High

190 or more

Very high

Total cholesterol (mg/dl)


Less than 200

Desirable

200239

Borderline high

240 or more

High

HDL cholesterol (mg/dl)


Less than 40

Low (undesirable)

60 or more

High (desirable)

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Travels with Cholesterol

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Cholesterol Levels Among Americans

Source: Centers for Disease Control and Prevention


Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Major CVD Risk Factors That Can Be


Changed

Physical inactivity

Exercise decreases blood pressure and


resting heart rate, improves cholesterol,
improves the condition of blood vessels,
and helps prevent obesity and diabetes

Obesity
Strains the heart, especially excess fat
in the torso

Diabetes
Increases CVD risk even when controlled
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Contributing CVD Risk Factors That Can Be


Changed

High triglyceride levels

Lower with exercise, healthy diet, quitting


smoking, reducing alcohol intake
Triglycerides (mg/dl)
Less than 150

Normal

150199

Borderline high

200499

High

500 or more

Very high

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Contributing CVD Risk Factors That Can Be


Changed

Psychological and social factors

Stress
Chronic hostility and anger
Suppressing psychological distress
Depression and anxiety
Social isolation
Low socioeconomic status

Alcohol and drug use


Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Major CVD Risk Factors That Cant Be


Changed

Family history/heredity

Multiple genes contribute to CVD risk

Aging
CVD risk goes up with age

Being male
Men face a higher risk, especially earlier in
life

Ethnicity
African Americans have higher rates of
hypertension and stroke
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Annual Incidence of Heart Attack

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Possible Risk Factors Under Study


C-reactive protein
Homocysteine
Lipoprotein(a)
Small, dense LDL particles
Infectious agents

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Possible Risk Factors Under Study


Metabolic syndrome, also known as
syndrome X or insulin resistance
syndrome
Abdominal obesity (waist circumference)
Greater than 40 inches in men
Greater than 35 inches in women

High blood pressure (130/85 or higher)


High triglycerides (150 mg/dl or higher)
Low HDL cholesterol
Below 40 mg/dl in men
Below 50 mg/dl in women

Insulin resistance (glucose of 110 mg/dl or


higher)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Women and CVD


Women underestimate their CVD risk
Nearly 1 in 2 women dies from CVD
About 1 in 30 women dies from breast cancer

Women are protected from CVD at


younger ages by natural estrogen
After menopause, women are more likely
than men to die after a heart attack
Women are more likely to have a heart
attack without chest pain
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

African Americans and CVD


Blacks have higher rates of
hypertension and stroke
Genetic, biological, and lifestyle
factors may play a role
Lifestyle changes can reduce risk,
as can medical treatment

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Major Forms of
Cardiovascular Disease

Hypertension (a risk factor and a


form of CVD)
Atherosclerosis
Heart disease and heart attacks
Stroke
Congestive heart failure

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Atherosclerosis
Atherosclerosis: Arteries are narrowed
by deposits of fat, cholesterol, and
other substances called plaques
Once narrowed by a plaque, an artery
is vulnerable to blockage by blood
clots
Blockage in the coronary arteries
(coronary heart disease) can lead to a
heart attack
Blockage in the brain can cause a
stroke
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Atherosclerosis

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Heart Disease and Heart Attacks


Heart attack = Damage to, or death of, heart muscle,
sometimes resulting in a failure of the heart to deliver
enough blood to the body; myocardial infarction.
Angina pectoris = A condition in which the heart
muscle does not receive enough blood, causing severe
pain in the chest and often in the left arm and shoulder.
Arrhythmia = An irregularity in the force or rhythm of
the heartbeat.
Sudden cardiac death = A nontraumatic, unexpected
death from sudden cardiac arrest, most often due to
arrhythmia (in association with underlying heart
disease).

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Heart Attack
Symptoms of heart attack
require immediate action.

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Blood Supply to the Heart

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Diagnosis and Treatment for Heart Disease


Diagnosis
Exercise stress test
MRI, echocardiogram, angiogram

Treatment

Lifestyle changes (diet and exercise)


Low-dose aspirin therapy
Prescription medications
Balloon angioplasty
Coronary bypass surgery
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Diagnosis of Heart Disease

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Treatment of Heart Disease

Surgery is one
possible treatment
for heart disease.

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Stroke
Stroke = An impeded blood supply to
some part of the brain resulting in the
destruction of brain cells
Ischemic stroke = caused by stroke
Hemorrhagic stroke = caused by ruptured
blood vessel

Strokes may cause paralysis, walking


disability, speech impairment, or memory
loss
Treatment may include clot-dissolving
and antihypertensive drugs
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Types of Stroke

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Stroke

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Congestive Heart Failure


Congestive heart failure = condition
resulting from the hearts inability to
pump out all the blood that returns to
it
Blood backs up in the veins leading to
the heart, causing an accumulation of
fluid in various parts of the body
Caused by high blood pressure, heart
attack, atherosclerosis, birth defects,
rheumatic fever
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Protecting Yourself Against Cardiovascular


Disease
Eat heart-healthy

Decrease fat and cholesterol intake


Especially limit saturated and trans fats

Increase fiber intake


Alcohol intakemoderate, if at all
DASH (Dietary Approaches to Stop
Hypertension)

Exercise regularly
Avoid tobacco
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Protecting Yourself Against Cardiovascular


Disease (contd)
Know and manage your blood
pressure
Know and manage your cholesterol
levels
Develop ways to handle stress and
anger
Know your risk factors

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Reducing Your Risk of CVD

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Mitral Valve

Mitral valve
prolapse is the
most common
cause of heart
murmur

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.

Cardiovascular Health

Chapter 11

Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
2007 McGraw-Hill Higher Education. All rights reserved.