CV Risk Factors Flashcards
what is a cardiovascular risk factor?
factor that predisposes an individual to development of atherosclerosis
considerations taken into account when labeling something as a CV risk factor
strong statistical association
consistent across gender, age…
biology: makes biological sense
treatment that favorably changes risk factor should reduce the incidence of disease
factor must make independent contribution to increasing an individual’s risk of developing disease
CV risk factor types
-examples
modifiable -blood pressure -obesity -alcohol consumption -smoking -exercise direct CV markers -abnormal blood lipid levels -high-sensitivity to C-reactive protein -NT-proBNP unmodifiable risk factors -age -gender -family history -ethnic origin -diabetes type I -previous MI/stroke
CV risk factors or health indicators (8)
age smoking obesity BP cholesterol diabetes family history physical activity level
smoking as a risk factor
- counted toward risk stratification if…
- has adverse effects on…
counted if -current -quit w/in last 6 months adverse effects on -tissue healing times -lung function -CV function
HP 2020
- what is it for?
- what does it say?
for nutrition/weight status and risk of illness
maintain healthy diet and weight to reduce risk of
-pretty much any bad disease
role of diet in health
important in preventing disease and controlling morbidity
increased consumption of energy dense foods high in _____ and low in _____ has led to increases in obesity, diabetes, CV disease, cancer, and osteoporosis
high in saturated fat
low in unprocessed carbs
current nutritional patterns
- energy intake averages (industrialized countries)
- increase in calories from _____ fat
- fat to energy ratio is…
- servings of fruits/vegetables…
3380 kcal per capita per day
increase in calories from aimal fat
fat to energy ratio above recommended 35%
fruit/vegetable servings varies significantly i different parts of world
proper nutrition national resources
choose my plate
my pyramid worksheet
obesity
-definition
imbalance of energy intake and expenditure
BMI
- how do you calculate it?
- categorizations
weight (in kg)/height squared (in meters) categories -underweight: below 18.5 -normal: 18.5-24.9 -overweight: 25.0-29.9 -obese: 30.0 and above
energy expenditure for weight loss (expenditure vs. intake)
200-300 kcal more expended than consumed
obesity relation to physical function
negative effect on performance in children (mental and physical)
negative effect on physical function in older adults
increased musculoskeletal pain limiting work
increased low back pain and depression limiting work
decreased force production and muscle activation
increased frequency of total hip and knee and poorer total knee outcomes
implications of obesity for PTs
measure BMI in all clients
-consider waist circumference and waist:hip ratio as well
prescribe appropriate exercise for weight loss and other musculoskeletal limitations
evaluate effect of obesity on PT outcomes
central adiposity study findings
low fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehab
abdominal adiposity associated with increased risk for…(4)
type 2 diabetes
dyslipidemia
hypertension
CV disease
waist circumference evidence
when BMI is normal, waist circumference not enough
when BMI is overweight, waist circumference can indicate whether weight is muscle or fat
risk increase when waist circumference measures
-women > 35 inches (88 cm)
-men > 40 inches (102 cm)
waist and hip circumference and risk
slide 25
systolic vs. diastolic
systolic
-time when heart contracts and blood moves out along vessels
diastolic
-time when heart relaxes and blood fills the heart
high BP can lead to…
stroke
blood vessel damage arteriosclerosis)
heart attack or heart failure
kidney failure
classification of BP in adults
-systolic 160 OR diastolic > 100 = hypertension stage 2
classification of BP
for individuals not taking antihypertensive medication and not acutely ill
higher risk category should be used
potential lifestyle modifications for HTN
weight control dietary management increase physical activity alcohol moderation restriction of dietary sodium (Na+) adequate intake of dietary Ca2+, K+, Mg2+ stress managment smoking cessation check with MD
endurance training and BP
generally reduces resting BP
training-induced changes generally reverse if training is stopped
HTN and physical therapy outcomes
HTN management may affect post-stroke outcomes
HTN associated with faster rates of mental and physical decline in community dwelling older adults
comordidity has negative effect on physical functioning
patients with LBP who used narcotics have higher incidence of HTN
cholesterol and atherosclerosis
-phospholipids start in liver and are synthesized in all body cells
cholesterol is an essential component of cell membranes and myelin sheaths
lipid component sources
exogenous (absorbed from GI tract)
endogenous (formed within cells)
main lipids (4)
triglycerides
VLDL
LDL
HDL
VLDL
- produced in…
- rich in…
- transports…
- breaks down into…
produced in liver
rick in TG (>65%) and cholesterol (20%)
transports endogenous lipids outside liver
breaks down into LDL
LDL
- occurs from…
- composed of…
- accounts for how much of total blood cholesterol
- contain…
- high _____ potential
- activates…
- if there is too much…
occurs from breakdown of VLDL
> 60% cholesterol
accounts for >60% of total blood cholesterol
contain apoprotein B-100
high atherogenic potential
activates monocytes –> macrophages (inflammation in vessels)
if too much, it builds up in the blood and creates plaque, causing atherosclerosis
HDL
- produced where?
- function
- does not contain…
- protective against
produces outside liver
transports cholesterol released due to cell membrane turnover (normal) to the liver (scavenger)
do not contain apoprotein B-100
protective against atherosclerosis
triglycerides
- used by…
- stored in…
- how are they transported and why that way?
used by muscle cells for energy production
stored in adipose tissue for later use
packaged in lipoproteins for transport in blood because all lipid molecules (cholesterol and TG) are insoluble in water
chylomicrons and lipoproteins
transport dietary lipids to other parts of body inner core of sterols -cholesterol -steroid hormones outer shell of protein receptors -lipoprotein a -lipoprotein b they could not travel around in blood without shell of proteins
relationships between cholesterol and heart disease
marked increase in incidence of MI with total cholesterol > 200 mg/dl
MI correlation stronger for LDL than with total cholesterol
elevated apoB (LDL like) also associated with CHD
low levels of HDL
cholesterol panel in adults
desirable -LDL 60 borderline -LDL 130-159 -total 200-239 high -LDL >160 -total >240
effects of exercise on lipoproteins
increases HDL endurance training increases -receptor activity -HDL -lipoprotein lipase LPL (enzyme that changes VLDL to LDL) endurance training decreases -LDL (increases transformation of cholesterol into bile) -triglycerides
