CVD

Question 1

What does increase HDL levels mean?

Answer 1

• higher HDL reduces CVD risk at all LDL levels

- 1mg/dL increase in HDL reduces CVD risk by 2% in men and 3% in woman (Gordon et al., 1977)

Question 2

Physical inactivity as a risk factor?

Answer 2

-4th leading risk factor for global mortality
-Phys inactivity responsible for:
30% CHD
27% diabetes
25% colon/breast cancer
17% premature all cause mortality

Question 3

Fitness as predictor of death?

Answer 3

Fitness better predictor of death than established risk factors such as smoking, BP, cholesterol & diabetes

Question 4

CHD and PA in the workplace

Answer 4

• Obs that PA can protect against heart attack was first made in a cross-sectional study (Morris et al. 1953)
• Men in PA jobs have a lower incidence of CHD than men in inactive jobs
• annual rate of 2.7/1000 for drivers and 1.9/1000 for conductors
• employees who were in physically active positions had lower rates of CHD

Question 5

Current physical inactivity epidemiology

Answer 5

Problems with measurement 
•Questionnaires 
-reliability/validity
-ambiguous questions 
•accelerometry
-diff in methodology 
-inconsistent defining intensities
-adherence 
-expensive on large scale

Question 6

CVD death rates by fitness groups

Answer 6

• Death rates 17-39% lower in mod for vs less fit
• Low fitness strongest independent predictor
• cardiorespiratory fitness protects against other risk factoid

Question 7

Self reported PA in U.K.

Answer 7

In 2012 in England and Scotland, 67% of men and 55% of women over 16 met the guidelines

Question 8

CVD risk factors

Answer 8

• Obesity
• PA levels
• Unhealthy diet
• Tobacco use
• Raised BP
• Raised blood sugar
• Raised blood lipids
• Air pollution
• Poverty

Question 9

Risk factors

Answer 9

1) Age - men>45yrs or women >55yrs
2) Family history - myocardial infarction, coronary revascularization, or sudden death <55yrs age father or <65yrs mother
3) Smoking - current smoker or those quit within last 6months
4) systolic BP - >140 or diastolic >90
5) Total cholesterol - >200mg/dl, HDL <35 mg/dl, LDL >130mg/dl
6) Impaired fasting glucose - 5.6-6.9mmol/l
7) obesity - BMI >30
8) sedentary lifestyle - persons not participating in regular exercise