3-9: Coronary Heart Disease (Part 1) Flashcards
Indicate how inflammatory processes are related to cardiovascular disease.
Low-grade inflammation appears to be linked to many, if not, most cases of coronary heart disease (CHD). A strong predictor of CHD is the level of c-reactive protein in the bloodstream, which is produced in response to inflammation. Inflammation can promote damage to the walls of the blood vessels.
Identify common risk factors for CHD.
Risk factors for CHD include high blood pressure, diabetes, cigarette smoking, obesity, high serum cholesterol level, low levels of physical activity, exposure to air pollution, and metabolic syndrome.q
Explain how metabolic syndrome is diagnosed.
Metabolic syndrome is diagnosed when a person has three or more of the following problems: obesity centered around the waist; high blood pressure; low levels of HDL, the so called good cholesterol; difficulty metabolizing blood sugar, an indicator of risk for diabetes; and high levels of triglycerides, which are related to bad cholesterol.
Describe the relationship between cardiovascular reactivity and CHD.
Cardiovascular reactivity contributes to the development of coronary heart disease in part by damaging endothelial cells, which facilitates the deposit of lipids, increases inflammation, and ultimately contributes to the development of atherosclerotic lesions.
List the job factors that are related to an increased risk for CHD.
Research on CDH and the workplace reveals that several job factors are reliably related to increased risk: job strain, especially the combination of high work demands and low control; a discrepancy between one’s educational level and one’s occupation; low job security; little social support at work; and high work pressure.
Cite evidence that social instability is tied to higher rates of CHD.
Urban and industrialized countries have a higher incidence of CHD than do underdeveloped countries. Migrants have a higher incidence of CHD than do geographically stable individuals, and acculturation to western society is a risk factor for high blood pressure; distress associated with cultural change accounts for increases in risk factors for coronary heart disease. People who are occupationally, residentially, or socially mobile in a given culture have a higher frequency of coronary heart disease than do those who are less mobile.
Explain why women are protected at young ages from CHD, relative to men.
One reason may be their higher levels of high-density lipoprotein (HDL), which appear to be linked to estrogen levels in pre-menopausal women. Estrogen diminishes sympathetic nervous system arousal, which may add to the protective effect against heart disease seen in women; in response to stress, pre-menopausal women show smaller increases in blood pressure and cortisol levels than do men and older women.
Discuss the effectiveness of estrogen replacement therapy following menopause in reducing the risk of CHD in women.
The belief that estrogen replacement therapy following menopause would keep rates of CHD among women low has proven to be groundless; HRT may actually increase the risk for heart disease. Consequently, the relation of estrogen to heart disease remains unclear.
Compare the medical care received by men and women with CHD.
Women are less likely to receive counseling about heart disease than men or learn about the benefits of exercise, nutrition, and weight reduction in preventing heart disease. They are also significantly less likely to get risk factor interventions for heart disease. They are significantly less likely than men to receive and use drugs for the treatment of heart disease including aspirin, beta blockers, and lipid lowering agents, and they are significantly more likely not to be diagnosed or to be misdiagnosed.
Name three components of the Type A behavior pattern.
- Easily aroused hostility.
- A sense of time urgency.
- Competitiveness or achievement striving.
Describe the relationship between the Type A behavior pattern and CHD.
Type A behavior is only weekly predictive of CHD, although it predicts the risk of heart attack in those with CHD.
Discuss the relationship between hostility and CHD.
Hostility has been tied to higher levels of pro-inflammatory cytokines and to the metabolic syndrome.
Identify the child-rearing practices that seem to foster hostility:
The child-rearing practices that foster hostility are characterized by parental interference, punitiveness, lack of acceptance, conflict, and abuse.
Compare the effects of expressing vs. harboring hostility.
The expression of hostility is more reliably correlated with cardiovascular reactivity than is the state of anger.
Describe the role of catecholamines in CHD.
The rise and fall of catecholamine levels results in fluctuations in blood pressure that weaken blood vessels.
