Chapter 5 - Cardiovascular disease Flashcards
- what is the number 1 cause of death in US?
- how many deaths has it caused? (2003)
- estimated economic cost?
- since 1960, gradual incline or decline in morbidity? why?
- cardiovascular disease?
- 900 000 Americans in US
- over 351 billion dollars in 2003
- DECLINE! due to better surgical procedures, medications. better nutrition
- how high is heart disease and stroke on the list of causes of death in Canada?
- is it only a male disease?
- why does heart disease and stroke cost >20.9B $ per year? (4)
- heart disease = #1 VS stroke = #3 causes of death in Canada
- no! we used to think so but CVD accounted for 28% of male death and 29.7% of female deaths
1. physician services
2. hospital costs
3. lost wages
4. decreased productivity
- what is the % hospitalizations from CVD in Canada? in 2009-2020
- decreasing, increasing or stable?
- hospitalization mainly for which heart disease?
- 16.9% from heart disease and stroke
- decrease from 1995 to 2001-2002, then stable
- 160 000 for ischemic heart disease, 61k for heart attack, 54k for congestive heart failure
in 2007, how many Canadians reported having heart disease?
- which province have the most self-reported heart disease?
- 1.3M (4.8% of Canadians, 4.2% girls/women, 5.3% boys/men)
- NS (6.4%) > NB > NL > PEI > QC (5.4%)
how to reduce your risk for developing CVD? (5)
- don’t smoke (as soon as you stop, CV risk decreases
- get regular exercise
- eat well
- maintain healthy body weight (increase f&v, decrease fat)
- manage stress
is visceral or subcutaneous fat more lethal? is apple or pear shape more at risk of CVD?
- visceral is more lethal!
- pear shape (fat in butt/hips) = less lethal VS apple shape (fat in stomach, breast) = more at risk
what are benefits (11) of PA
- increased cardiorespiratory endurance
- decrease and control blood pressure
- reduce body fat (vigorous will help tap into visceral fat)
- lower lipids (cholesterol, TG)
- improves HDL (especially vigorous)
- help control diabetes
- decrease low grade inflammation
- increase and maintain heart function (+ vascular/blood vessels)
- move toward smoking cessation (making better heart healthy decisions)
- alleviate tension and stress, anxiety
- counteract personal history of disease
name 11 types of cardiovascular diseases and conditions
- heart attack
- atherosclerosis
- angina pectoris (chest pain)
- congenital heart defects
- rheumatic heart disease
- congestive heart disease
- bacterial endocarditis
- aneurysms
- arrhythmias
- hypertension
- stroke (heart attack in brain)
- what are 2 other names for heart attack?
- what is a heart attack?
- can be caused by what?
- worst if its on which side of the heart?
- coronary thrombosis OR myocardial infarction
- lack of blood flow or supply to areas of the heart
- coronary heart disease
- on the left side! bc L side is the strong part of heart
- since 1952, cardiovascular death rate in Canada has declined by more than ___%
- ___% in the last decade
- largely due to (3)
- 75%
- 40% in the last decade
- surgical procedures, drug therapies, prevention efforts
what are warning signs for heart attack? (2 + lots more)
- what to do? (2 ish)
- uncomfortable pressure or pain in center of chest that lasts 2min or longer
- pain that spreads to shoulders, neck or arms
- severe pain, dizziness, fainting, sweating, nausea, shortness of breath
- carry nitroglycerin –> helps open up vessels in body
- call 911! emergency!
what is
- atherosclerosis?
- ANGINA PECTORIS
ATHEROSCLEROSIS:
- narrowing/blockage of artery
- can be partially occluded (loses elasticity + hardening + sticky, attracts other stuff) –> can be 95% occluded, and then fully occluded
ANGINA PECTORIS:
- or “stable angina”
- chest pain
- lack of blood flow and oxygen to areas of the heart
- increased risk of heart attack
what is:
CONGENITAL HEART DEFECTS
RHEUMATIC HEART DISEASE
CONGESTIVE HEART FAILURE
BACTERIAL ENDOCARDITIS
ANEURYSM
CONGENITAL HEART DEFECTS
- abnormal heart structures, vessels and valves at time of birth
- valve: work in sync with rhythmic nature of heart, prevents backflow
RHEUMATIC HEART DISEASE:
- bacterial infection of heart that damages heart valves
CONGESTIVE HEART FAILURE:
- condition that occurs when other diseases have damages the heart and limited its function
- often results in overworking heart = very large organ = becomes ineffective
BACTERIAL ENDOCARDITIS:
- infection of the lining or valves of heart
ANEURYSM:
- weakness or bulge in an artery that can burst and lead to massive internal bleeding (hemorrhagic stroke)
risk factors for coronary heart disease
- major alterable (6)
- major unalterable (4)
- contributing (3)
MAJOR ALTERABLE:
- hypertension
- tobacco smoking
- cholesterol
- physical inactivity
- obesity
- diabetes
MAJOR UNALTERABLE:
- age
- genetics
- gender
- race
CONTRIBUTING:
- stress
- excessive alcohol (leads to enlarged and inefficient heart)
- inflammation
- what does electrocardiograms record?
- acronym (2)
- what are 4 things we can interpret
- records electrical impulses that stimulate the heart –> measures electric activity
- ECG or EKG
1. heart rhythm
2. axis of heart (how heart is lying in cavity, usually mid region of L side)
3. enlargement or hypertrophy
4. myocardial infarction or damage to heart
what are the 5 important segments of a normal ECG?
- P wave: upper chambers contract, small wave
- PR segment: pause to allow ventricles to fill
- QRS complex: ventricles contract
- ST segment: blood is sent to body
- T wave: repolarization of heart
what is bradycardia vs tachycardia?
BRADYCHARDIA:
- slow heart rate
- < 60 bpm, regular rhythm
- happens in high level athletes or older people (might need pacemaker to control rhythm)
TACHYCARDIA:
- heart rate is too fast
- heart rate > 100 bpm
atrial vs ventricular fibrillation?
ATRIAL fibrillation:
- no P wave, but yes QRS complex
- not rhythmic
- random contractions, weird electrical activity
VENTRICULAR fibrillation:
- no QRS
- totally random, even worse than atrial fibrillation
- not rhythmic at all
*TV: put pads on chest: shocks the heart, stops it and make it start again hopefully rhythmically
what are the 4 major unalterable risk factors for CHD?
- explain which in each risk is more at risk?
- family history (hereditary)
- race (hereditary)
- sex: males are at higher risk
- age: increased age relates to increased risk
- systolic vs diastolic blood pressure?
- how to measure?
- normal blood pressure?
SYSTOLIC: maximal pressure in the vascular system when heart is contracted
DIASTOLIC: minimal pressure in vascular system when heart is relaxed
- cuff on arm to make sure no blood flow –> slowly release, heart initial sound = SBP, then another sound = DBP (?)
- 120/80 (debatable)
american heart association blood pressure classifications:
- normal
- high normal
- stage 1 hypertension (Mild)
- stage 2 HT (moderate)
- stage 3 HT (severe
- normal: <130/<85
- high normal: 130-139/85-89
- stage 1 hypertension (Mild): 140-159/90-99
- stage 2 HT (moderate): 160-179/100-109
- stage 3 HT (severe: >=180/ >= 110)
- how many canadians have high blood pressure? % of adult population?
- 1 in _____ Canadian adults have high normal range/pre-hypertensive
- 6M! –> 1/5 have high blood pressure –> 19% of adult pop
- 1 in 5 Canadian adults (20%)
- do men or women have more high blood pressure?
- do younger or older canadians have high blood pressure?
- women or men with high BP have higher risk of developing heart disease?
- men: 19.7% VS women: 19.0%
- older! 60-79 yo: 53.2% VS 40-59: 18.4%
- women have 3.5x greater risk of developing heart disease than women with normal blood pressure
- what is cholesterol?
- what are our 2 sources of cholesterol?
- fat-like substance found in body’s cells and bloodstream
- body produces cholesterol primarily through the liver + we consume cholesterol through diet
HDL-C vs LDL-C
- function?
- predictor of disease?
- decrease/increase risk of CHD?
HDL-C:
- scavenge and transport cholesterol out –> prevent formation of plaque
- low levels are strongest predictor of disease
- decrease risk of CHD
*vig PA increase HDL levels
LDL-C:
- tends to release cholesterol
- small particles (type B) pass through inner lining of coronary artery easily –> ore prone to plaque build-up
- increases risk of CHD
- about ___% of Canadians have high blood cholesterol?
- which age has higher cholesterol?
- 40%
- older! 60-79 yo > 40-59 yo > 20-39
standards for cholesterol:
- TC vs LDL-C vs HDL-C
Total Cholesterol (TC)
– Desirable: less than 200mg/dl
– Borderline high: between 200 and 239mg/dl – High: 240mg\dl or higher
LDL-C
– Optimal: less than 100mg/dl
– Borderline high: between 130 and 159mg/dl – High: between 160mg/dl and 189mg/dl
HDL-C
– Low: less than 40mg/dl
- what is the cholesterol ratio? formula
- American heart association recommends what ratio?
Ratio = TC/(HDL - C)
- high HDL can offset ratio!
- less than 3.5!
CHOLESTEROL FACTS:
- total cholesterol level should be below _______
- LDL-C count should be less than _________
- desirable that your ratio of total cholesterol to HDL-C be how much?
- < 200 mg/dL of blood
- < 130 mg/dL
- < 3.5
what are 5 ways to increase HDL?
- mostly genetic
- aerobic exercise
- weight loss
- high dose niacin
- quit smoking
how to decrease LDL (7)
- anti-oxidant vitamins
- dietary changes –> reduce sat and trans fat + less egg yolks
- losing body fat
- medication
- exercise
- increase fibre intake
- psyllium
what are 4 major risk factors for CHD?
- smoking –> doubles the risk for CHD
- diabetes –> inability to control blood sugar levels increases risk of CHD
- obesity: related to many health problems and greatly increases risk of CHD
- physical inactivity (identified as major risk by American heart association in 1992) –> low levels of PA and cardiorespiratory fitness can double risk of CHD
what are 3 contributing risk factors fo CHD?
- excessive and prolonged stress can increase risk of CHD
- personality traits of anger and hostility can increase risk of CHD (ie road ragers, type A behaviors)
- excessive use of alcohol
relative risk for coronary heart disease multiplies by how much if:
- smoking (1 pack a day)
- serum cholesterol (265 mg/dL)
- systolic BP (150 mmHg)
- Physical inactivity
- smoking (1 pack a day): 2.5
- serum cholesterol (265 mg/dL): 2.4
- systolic BP (150 mmHg): 2.1
- Physical inactivity: 1.9
- what is a stroke? (1 other name ish) –> 2 types ish
- severity of stroke relates to what?
- brain attack
1. CEREBRAL THROMBOSIS - blockage of blood flow to brain –> over 85% of all strokes
2. CEREBRAL HEMORRHAGE: - bursting of an aneurysm or a blow to the head that cause bleeding in the cranium
- relates to the amount of brain tissue affected
risk factors for stroke:
- UNALTERABLE (3)
- ALTERABLE (4)
- CONTRIBUTING (3)
UNALTERABLE:
- heredity (family history and race: african-americans have a much higher risk of stroke than Caucasian Americans do)
- sex: males have higher risk than females
- Age: as age increases, risk of stroke increases
ALTERABLE:
- hypertension: major risk factor for stroke
- smoking
- history of transient ischemic attacks (mini-strokes)
- high red blood cell counts
CONTRIBUTING:
- high blood cholesterol and TG
- physical inactivity
- obesity