CHAPTER 11 Flashcards
1
Q
What is atheroscleroisis?
A
slow, progressive hardening & narrowing of the arteries by plaques (deposits of fat, cholesterol, and other substances)
form of arteriosclerosis
2
Q
What is arteriosclerosis?
A
thickening & hardening of the arteries
3
Q
What are the main risk factors for atherosclerosis?
A
cigarette smoking physical inactivity high concentration of cholesterol in the blood high BP diabetes mellitus
4
Q
What is a stroke?
A
when blood supply to the brain is cut off
5
Q
What may be caused by a stroke?
A
paralysis
walking disability
speech impairment
memory loss
6
Q
What are the types of stroke?
A
Ischemic
Hemorrhagic
7
Q
What differentiates the types of stroke?
A
Ischemic: caused by a blood clot
Hemorrhagic: ruptured blood vessel
8
Q
What are the signs & symptoms of a stroke?
A
weakness trouble speaking vision problems headaches dizziness
9
Q
What are effective treatments of stroke?
A
prompt recognition of signs/symptoms
correct diagnosis of type of stroke
use clot-dissolving & antihypertensive drugs
10
Q
What is congestive heart failure?
A
condition resulting in the heart’s inability to pump out all of the blood that returns to it because the heart cannot maintain its regular pumping rate & force
fluids begin to back up in the body resulting in edema, usually in the legs & ankles, & sometimes in other parts of the body such as the lungs
11
Q
Which factors can damage a heart’s pumping mechanism?
A
High blood pressure Heart attack Atherosclerosis Rheumatic fever Birth defects
12
Q
What is rheumatic fever and does it cause congestive heart failure?
A
A disease, mainly of children, characterized by fever, inflammation, & pain in the joints.
Often damages the heart muscle resulting in rheumatic heart disease.
13
Q
What are the 6 major risk factors for CVD identified by the Canadian Heart Health Initiative & the Heart & Stroke Foundation of Canada that can be changed?
A
Tobacco Use High Blood Pressure Unhealthy Cholesterol Levels Physical Inactivity Obesity Diabetes
14
Q
What are all of the risk factors for CVD that can be changed?
A
High Triglyceride Levels
Psychological & Social Factors
15
Q
Are smokers at a greater risk of developing CVD than non-smokers?
A
yes
16
Q
Are non-smokers at risk of developing CVD when exposed frequently to high concentrations of environmental tobacco smoke (ETS), otherwise known as second-hand smoke?
A
yes
17
Q
How does smoking damage the cardiovascular system?
A
Damages the linings of arteries.
Reduces the concentration of HDL cholesterol in the blood.
Nicotine increases blood pressure & heart rate.
Carbon monoxide displaces oxygen in the blood.
Causes platelets to stick together in the blood, leading to clotting.
Speeds the development of fatty deposits in the arteries
18
Q
Is high blood pressure a risk factor for other forms of CVD?
A
yes
19
Q
What is high blood pressure often called because it usually has no symptoms?
A
silent killer
20
Q
What are the blood pressure classifications for healthy adults?
A
120/80
21
Q
Which blood pressure measurements would classify a person as being prehypertensive & hypertensive?
A
Prehypertensive: 120-140/80-90
Hypertensive: 140-160/90-100, 160+/100+
22
Q
Which conditions or CVDs have their risk increased by high blood pressure?
A
Heart attack Congestive heart failure Stroke Kidney failure Blindness
23
Q
Which lifestyle changes are recommended for prehypertensive & hypertensive individuals?
A
Weight reduction
Regular physical activity
A healthy diet
24
Q
What is the DASH diet?
A
Fruits Vegetables Whole grains Foods rich in potassium, calcium & fibre Diets rich in potassium & calcium may be helpful in preventing & treating hypertension. Foods low in sodium
25
What must be restricted in the diet by some individuals due to its association with high blood pressure?
alcohol
26
What is the adequate intake (AI) of sodium?
1500 mg/day
27
What is the tolerable upper intake level (UL) of sodium?
2300 mg/day
28
What is cholesterol?
fatty, waxlike substance that circulates through the bloodstream
29
What is the importance of cholesterol in the human body?
```
important component of:
Cell membranes,
Sex hormones,
Vitamin D,
The fluid that coats the lungs,
The protective sheaths around nerves
```
30
What problems are associated with unhealthy levels of cholesterol in the blood?
clogged arteries
| increased risk of CVD
31
Where does the majority of our cholesterol come from?
from the liver (80%)
32
What is a lipoprotein?
carriers or transporters of lipids (cholesterol, triglycerides, & phospholipids) in the human body
composed of different proportions of cholesterol, triglycerides, phospholipids, & protein
33
What is a chylomicron?
```
lipoproteins synthesized in the small intestine after the consumption of a meal.
transport exogenous (dietary) lipids from the small intestine into the blood to various tissues of the body such as adipose, muscle, & liver tissues
```
34
What is a very-low-density lipoprotein?
lipoproteins synthesized in the liver that transport endogenous (body) lipids to various tissues of the body
35
What is a low-density lipoprotein?
formed by the liver or through the breakdown of VLDLs in the blood.
transport cholesterol from the liver to the organs & tissues that require it.
are known as “bad” cholesterol because an amount beyond the body’s needs is deposited in the walls of blood vessels such as arteries & may be oxidized by free radicals resulting in inflammation & damage of the artery walls
36
What is a high-density lipoprotein?
formed mainly by the liver.
transport cholesterol from the body’s tissues back to the liver for recycling or excretion, &, as a result, are known as “good” cholesterol.
37
How can the LDL cholesterol concentration in the blood be reduced to healthy levels?
Choosing unsaturated fats instead of saturated & trans fats,
Increasing soluble fibre intake,
Eating more fruits, vegetables, & whole grains,
Consume food products containing plant stanols & plant sterols,
Consume soy protein,
Exercising regularly
38
How can the HDL cholesterol concentration in the blood be raised in order to reduce the risk of CVD?
Exercising regularly,
Losing weight if overweight,
Quitting smoking, &
Altering the amount & type of dietary fat consumed
39
What is thought to be the closest thing we have to a “magic bullet” against heart disease?
exercise
40
How does exercise lower the risk for CVD?
```
Decrease blood pressure,
Increase HDL levels,
Maintain desirable weight,
Improve the condition of the blood vessels, &
Prevent or control diabetes
```
41
What does excess body fat contribute to?
Hypertension,
Elevated cholesterol, &
Type 2 diabetes
42
What type of obesity is significantly associated with the narrowing of coronary arteries?
abdominal obesity
43
Which fasting blood glucose concentration classifies a person as having diabetes?
>=7.0
44
Are high triglyceride levels a reliable predictor of heart disease?
yes
45
Are there any other risk factors that make high triglyceride levels an even more reliable indicator of heart disease?
High LDL level
Low HDL level
Obesity
Diabetes
46
Which factors contribute to high triglyceride levels?
```
Excess body fat
Physical inactivity
Cigarette smoking
Type 2 diabetes
Excess alcohol intake
Very high carbohydrate diets
Certain diseases & medications
```
47
What are the psychological & social factors that contribute to the development of CVD?
```
stress
chronic hostillity/anger
supressed psychological distress
depression/anxiety
social isolation
low socioeconomic status
```
48
Can excessive stress contribute to CVD?
yes
49
Which 3 character traits of a “Type A” personality are associated with an increased risk of heart disease?
hostility, cynicism & anger
50
Is suppressing psychological distress associated with a higher rate of heart disease?
yes
51
What type of personality is characterized by the suppression of psychological distress?
Type D (distressed)
52
Are depression & anxiety linked or associated with an increased risk of CVD?
yes
53
Does a low socioeconomic status & low educational attainment increase the risk for CVD?
yes
54
What are the major risk factors for CVD that cannot be changed?
family history (heredity)
aging
being male
ethnicity
55
Does family history increase the risk to develop CVD?
yes
56
After what age does the risk of heart attack increase dramatically?
65 years
57
Do Canadian men show a greater prevalence of CVD risk factors than women?
yes
58
Do more Canadian men die from heart attacks & coronary artery diseases than women?
yes
59
After what age does CVD typically develop in women?
until after the age of 50
60
Why does CVD develop in women after the age of 50?
before menopause, estrogen plays a protective role by reducing CVD risk factors
61
Which ethnic groups have the highest rates of CVD?
caucasians
62
What other possible risk factors for CVD have been identified in recent years?
```
C-Reactive prtein
homocystein
Lipoprotein A
LDL Pattern B
Infectious Agents
Fibrinogen
Metabolic Syndrome
```
63
What is C - reactive protein?
substance released into the bloodstream during the inflammatory response
64
What is indicated by a high concentration of C-reactive protein in the blood?
substantially elevated risk of heart attack & stroke
65
Are there any other factors that increase the level of C-reactive protein in the blood?
smoking, high levels of total & LDL cholesterol, hypertension, infectious agents
66
What is homocysteine?
amino acid that may damage the lining of blood vessels
67
Are homocysteine levels generally higher in men than in women?
men
68
Which vitamins can lower the level of homocysteine in the blood if consumed in foods such as fruits, vegetables, & grains, & in supplements?
folate/folic acid
vitamin B12
vitamin B6
69
What is lipoprotein(a) & does it increase the risk for CVD?
specific type of LDL that at high levels in the blood has been identified as a possible risk factor for CHD
70
Is it difficult to treat a person with a high concentration of lipoprotein(a) in the blood?
yes, because they have a strong genetic component
71
What is LDL Pattern B & does it increase the risk for CVD?
condition characterized by a high proportion of small, dense LDL particles
yes, it increases the risk
72
Which infectious agents are possible risk factors for CVD?
Chlamydia pneumonia
Cytomegalovirus
Helicobacter pylori
73
What is fibrinogen?
protein involved with blood clotting
74
Are higher or lower concentrations of fibrinogen believed to be another marker for a higher risk of developing CVD?
higher levels
75
What is metabolic syndrome?
cluster of risk factors:
```
abdominal obesity,
high blood pressure,
high triglycerides,
low HDL cholesterol, &
high blood glucose levels
```
76
Does metabolic syndrome increase a person’s risk of developing CVD?
yes
77
What can be done to prevent CVD or protect against the development of CVD?
```
Eat Heart-Healthy
Exercise Regularly
Avoid Tobacco
Know & Manage Your Cholesterol Levels
Develop Ways to Handle Stress & Anger
Know Your Risk Factors
```
78
What are the Health Canada recommendations for total fat & saturated fat consumption?
<30% of total daily calories
| 10% of total daily calories
79
What are total fat & saturated fat recommendations for people with heart disease or high LDL levels?
25-35% total daily calories
| <7% total daily calories
80
What is daily recommended dietary cholesterol intake for Canadians?
<300mg/day
81
What is the suggested daily limit of cholesterol for people with heart disease or high LDL levels?
200mg/day
82
What are some of the advantages of incorporating adequate amounts of fibre into your diet?
traps bile acids to prevent cholesterol production
slows production of protein that promotes blood clotting
interferes with absorption of dietary fat
helps cut total food intake
83
What is the recommended limit for sodium intake in healthy adults?
2300 mg/day
84
What is the recommended limit for sodium intake in individuals that are middle-aged, older, or hypertensive?
1500 mg/day
85
What is the recommended limit for potassium intake in healthy adults?
4700 mg/day
86
What level of alcohol consumption may lower the risk of coronary heart disease (CHD) among men > 45 & women > 55?
men: not more than 2 drinks/day
women: not more than 1 drink/day
87
What does this level of alcohol consumption correspond to in terms of drinks per day?
moderate
88
What does the acronym DASH stand for?
Dietary Approaches to Stop Hypertension
89
What is the recommended exercise prescription (overload or dose) to significantly reduce your risk of CVD?
30-60 mins
90
What is the primary risk factor for CVD that you can control?
smoking
91
Does ETS increase your risk for CVD?
yes, by permanently increasing the rate of plaque formation
92
When should you have your blood pressure measured if you have or do not have CVD risk factors, or if you have hypertension?
once every 2 years
93
When should an adult aged 20 or more years have a lipoprotein profile done?
once every 5 years
94
Which factors affect your LDL goal?
```
Cigarette smoking,
High blood pressure,
Low HDL cholesterol,
Family history of Heart disease,
Age > 45 yrs for men,
Age > 55 yrs for women
```
95
How much aspirin should be taken per day if you are at moderate risk for CVD?
50-325 mg/day
96
What is the leading cause of cancer death for men & women combined in Canada?
Lung Cancer
97
What is the second leading cause of cancer death in Canada?
Colorectal Cancer
98
What is the third leading cause of cancer death in Canada?
Breast Cancer/Prostate Cancer
99
What are the major forms of cardiovascular disease?
atherosclerosis
HD & Heart Attacks
Stroke
Congestive Heart Failure
100
What are the stages of atherosclerosis?
1. plaque buildup begins, endothelial cells damaged by smoking, high BP, etc
2. in response to damage, platelets collect and create a fibrous cap (early stage plaque = fatty streak)
3. attraction of further buildup (advanced plaque includes LDL, WBC, connective tissues, etc)
101
What is plaque?
deposits of fat, cholesterol, and other substances
102
Which arteries are particularly susceptible to plaque buildup?
coronary arteries
103
What causes coronary heart (artery) disease?
atherosclerosis
104
What are the health consequences of atherosclerosis?
coronary HD
angina pectoris
heart attack
stroke
105
What is a heart attack (myocardial infarction)?
death of heart muscle tissue
106
What causes a heart attack?
blockage of coronary artery
107
What are the signs & symptoms of a heart attack?
pain
shortness of breath
difficulty breathing
nausea, indigestion, etc.
108
Do women have different signs & symptoms of a heart attack compared to men?
yes
```
Shortness of breath
Weakness
Unusual fatigue
Cold sweat
Dizziness
Nausea
```
109
What is angina pectoris?
signal that heart is not receiving required oxygen
110
What is a coronary thrombosis?
heart attack caused by a blood clot in one of the coronary arteries supplying blood to the heart
111
What is an arrhythmia?
irregularity in the force or rhythm of the heartbeat
112
What is the most common cause of sudden cardiac death?
arrhythmia
113
What are the signs & symptoms of cardiac arrest?
suddenly not responsive
| not breathing when you tilt head back & check for at least 5 seconds
114
Which tests or methods are used to diagnose heart disease?
```
exercise stress test + ECG
MRI
electron beam computed tomography
echocardiograms
angiograms
```
115
How can heart disease be treated?
```
low-fat diet
regular exercise
smoking cessation
prescription drugs
balloon angioplasty
coronary stents
coronary bypass
```
116
What is pulmonary edema?
fluids back up in the lungs because the heart cannot pump enough blood away
117
What are the treatment methods for congestive heart failure?
reduce workload on the heart
modify salt intake
drugs to eliminate excess fluids
118
Does social isolation increase a person’s risk of dying from a CVD?
yes
119
Is high blood pressure due to an increase in cardiac output or an increase in the resistance to blood flow in the arteries?
both, but usually an increase in resistance
120
How does the human body obtain cholesterol?
```
synthesized by the liver (80%)
from foods (only animal sources)
```
121
What do lipoproteins carry?
lipids (triglycerides, phospholipids, cholesterols)
122
Which lipoproteins are synthesized in the small intestine after the consumption of a meal & transport dietary (exogenous) lipids from the small intestine to various tissues of the body?
chylomicrons
123
Which lipoproteins are synthesized by the liver & transport endogenous lipids to various tissues of the body?
very-low-density lipoproteins (VLDL)
124
Which lipoproteins are formed by the liver or from VLDLs in the blood, & transport cholesterol from the liver to the organs & tissues that require it?
low-density lipoproteins (LDL)
125
Which lipoproteins are formed mainly by the liver & transport cholesterol from the body’s tissue for recycling or excretion in a process known as reverse cholesterol transport?
high-density lipoproteins
126
Which lipoproteins are known as “bad” and “good” cholesterol?
bad: LDL
good: HDL
127
Which lipoproteins can prevent or reverse heart disease?
HDL
128
Which lipoproteins can increase the risk of heart disease?
LDL
129
What are ideal or desirable concentrations for LDL, HDL, & total cholesterol?
LDL: =1.6 mmol/L
total: <5.2 mmol/L
130
What are high concentrations for LDL, HDL, & total cholesterol?
LDL: <6.2 mmol/L
131
Do type 1 & type 2 diabetes have an increased risk of developing CVD?
yes
132
Does a person with pre-diabetes or controlled diabetes have an increased risk of CVD?
yes
133
Which risk factors that increase the risk of CVD have been identified in individuals with type 1 & type 2 diabetes?
type 1: unknown
```
type 2:
Elevated blood glucose levels,
Atherosclerosis,
Hypertension,
Obesity,
Unhealthy cholesterol levels,
Unhealthy triglyceride levels, &
Platelet & blood coagulation abnormalities
```
134
What is the main purpose of the DASH diet?
prevent and control hypertension
135
Can the DASH dietary plan be used to lower the risk for other chronic diseases?
yes, such as cancer and stroke
136
What are the major forms of cardiovascular disease?
atherosclerosis
HD & Heart Attacks
Stroke
Congestive Heart Failure
137
What are the stages of atherosclerosis?
1. plaque buildup begins, endothelial cells damaged by smoking, high BP, etc
2. in response to damage, platelets collect and create a fibrous cap (early stage plaque = fatty streak)
3. attraction of further buildup (advanced plaque includes LDL, WBC, connective tissues, etc)
138
What is plaque?
deposits of fat, cholesterol, and other substances
139
Which arteries are particularly susceptible to plaque buildup?
coronary arteries
140
What causes coronary heart (artery) disease?
atherosclerosis
141
What are the health consequences of atherosclerosis?
coronary HD
angina pectoris
heart attack
stroke
142
What is a heart attack (myocardial infarction)?
death of heart muscle tissue
143
What causes a heart attack?
blockage of coronary artery
144
What are the signs & symptoms of a heart attack?
pain
shortness of breath
difficulty breathing
nausea, indigestion, etc.
145
Do women have different signs & symptoms of a heart attack compared to men?
yes
```
Shortness of breath
Weakness
Unusual fatigue
Cold sweat
Dizziness
Nausea
```
146
What is angina pectoris?
signal that heart is not receiving required oxygen
147
What is a coronary thrombosis?
heart attack caused by a blood clot in one of the coronary arteries supplying blood to the heart
148
What is an arrhythmia?
irregularity in the force or rhythm of the heartbeat
149
What is the most common cause of sudden cardiac death?
arrhythmia
150
What are the signs & symptoms of cardiac arrest?
suddenly not responsive
| not breathing when you tilt head back & check for at least 5 seconds
151
Which tests or methods are used to diagnose heart disease?
```
exercise stress test + ECG
MRI
electron beam computed tomography
echocardiograms
angiograms
```
152
How can heart disease be treated?
```
low-fat diet
regular exercise
smoking cessation
prescription drugs
balloon angioplasty
coronary stents
coronary bypass
```
153
What is pulmonary edema?
fluids back up in the lungs because the heart cannot pump enough blood away
154
What are the treatment methods for congestive heart failure?
reduce workload on the heart
modify salt intake
drugs to eliminate excess fluids
155
Does social isolation increase a person’s risk of dying from a CVD?
yes
156
Is high blood pressure due to an increase in cardiac output or an increase in the resistance to blood flow in the arteries?
both, but usually an increase in resistance
157
How does the human body obtain cholesterol?
```
synthesized by the liver (80%)
from foods (only animal sources)
```
158
What do lipoproteins carry?
lipids (triglycerides, phospholipids, cholesterols)
159
Which lipoproteins are synthesized in the small intestine after the consumption of a meal & transport dietary (exogenous) lipids from the small intestine to various tissues of the body?
chylomicrons
160
Which lipoproteins are synthesized by the liver & transport endogenous lipids to various tissues of the body?
very-low-density lipoproteins (VLDL)
161
Which lipoproteins are formed by the liver or from VLDLs in the blood, & transport cholesterol from the liver to the organs & tissues that require it?
low-density lipoproteins (LDL)
162
Which lipoproteins are formed mainly by the liver & transport cholesterol from the body’s tissue for recycling or excretion in a process known as reverse cholesterol transport?
high-density lipoproteins
163
Which lipoproteins are known as “bad” and “good” cholesterol?
bad: LDL
good: HDL
164
Which lipoproteins can prevent or reverse heart disease?
HDL
165
Which lipoproteins can increase the risk of heart disease?
LDL
166
What are ideal or desirable concentrations for LDL, HDL, & total cholesterol?
LDL: =1.6 mmol/L
total: <5.2 mmol/L
167
What are high concentrations for LDL, HDL, & total cholesterol?
LDL: <6.2 mmol/L
168
Do type 1 & type 2 diabetes have an increased risk of developing CVD?
yes
169
Does a person with pre-diabetes or controlled diabetes have an increased risk of CVD?
yes
170
Which risk factors that increase the risk of CVD have been identified in individuals with type 1 & type 2 diabetes?
type 1: unknown
```
type 2:
Elevated blood glucose levels,
Atherosclerosis,
Hypertension,
Obesity,
Unhealthy cholesterol levels,
Unhealthy triglyceride levels, &
Platelet & blood coagulation abnormalities
```
171
What is the main purpose of the DASH diet?
prevent and control hypertension
172
Can the DASH dietary plan be used to lower the risk for other chronic diseases?
yes, such as cancer and stroke
