3-10: Coronary Heart Disease (Part 2) Flashcards
Explain how depression predicts heart disease.
There is stronger association between depression and CHD than there is between smoking and CHD. Depression stimulates inflammatory processes, including the release of c-reactive proteins.
Cite experimental evidence that exercise can reduce the risk of CHD.
Healthy Type A men were assigned to either an aerobic exercise training group or a strength and flexibility training group. After 12 weeks, both groups showed declines in behavioral reactivity to stress. In addition, the aerobic exercise group showed lower heart rate, blood pressure, and oxygen, both during a challenging task and during recovery.
Describe the effects of relaxation training on stress response.
Relaxation does not reduce cardiovascular reactivity during stress but produces faster recovery afterwards. Learning to speak more softly and gently can change cardiovascular reactivity, as well.
Identify the factors that predict a delayed response to a heart attack.
Older patients and African-American heart attack victims appear to delay longer, as do patients who have consulted with a physician or engaged in self-treatment for their symptoms. Experiencing the attack during the daytime, as well as having a family member present, enhances delay, perhaps because the environment is more distracting under these circumstances. A history of angina or diabetes actually increases, rather than decreases, delay.
List the goals of cardiac rehabilitation.
Cardiac rehabilitation is defined as the active and progressive process by which individuals with CHD attain their optimal physical, medical, psychological, social, emotional, vocational, and economic status. The goals of rehabilitation are to produce relief from symptoms, to reduce the severity of the disease, to limit further progression of disease, and to promote psychological and social adjustment.
Discuss the effects of psychological factors in recovery from MI.
Psychological factors that aid in recovery from myocardial infarction (MI), or heart attack, are: self efficacy, a problem-focused coping style, optimism, and high self-esteem.
Describe the effects of beta-blockers, aspirin and statins.
Beta-blockers inhibit the effects of sympathetic nervous system arousal; unpleasant side effects include fatigue and impotence. Aspirin helps prevent blood clots by blocking an enzyme that cause platelets to aggregate; this reduces the risk of MI. Statins target LDL cholesterol and reduce the risk of a repeated heart attack.
Name the populations most at risk for stress after a diagnosis of CHD.
The populations most at-risk for stress after a diagnosis of CHD are: younger patients, female patients, and those with poor social support and high social conflict, and those with a negative coping style.
Identify the components of stress management.
The patient is taught how to recognize stressful events, how to avoid those stressful activities when possible, and what to do about stress when it happens, using relaxation and other techniques.
Cite evidence that stress management programs can help CHD patients.
Stress management programs produce a 34% reduction in mortality rates among CHD patients, a 29% reduction in the recurrence of MI, and improvements in blood pressure, cholesterol levels, and body weight, as well as changes in smoking, exercise, and eating habits.
Describe the beneficial effects of cholesterol reduction on CHD.
There is a two percent reduction in the risk of CHD for every one percent reduction in total cholesterol.
vigilant coping
Chronically searching the environment for potential threats, which has been associated with risk factors for heart disease.
vital exhaustion
A mental state characterized by extreme fatigue, a feeling of being dejected or defeated, and enhanced irritability to cardiovascular disease.
cardiac rehabilitation
An intervention program designed to help heart patients achieve their optimal physical, medical, psychological, social, emotional, vocational, and economic status after the diagnosis of heart disease or a heart attack.
cardiac invalidism
A psychological state that can result after a myocardial infarction or diagnosis of coronary heart disease, consisting of the perception that a patient’s abilities and capacities are lower than they actually are; both patients and their spouses are vulnerable to these misperceptions.
