Exam 2 Study cards Flashcards
1
Q
Cardiovascular system includes
A
heart, arteries, lungs veins
2
Q
how many times does the heart beat in a normal lifetime?and how many gallons of blood?
A
3 billion times, 42 million gallons of blood
3
Q
Heart disease represents how many diseases?`
A
more than 20
4
Q
What is the leading cause of death since 1900 (exception of 1918)
A
heart disease
5
Q
how many americans die from CVD?
A
1 american every 34 seconds (just less than a million a year) 4 of 10 coffins in US contain a victim of CVD and 1/3 of deaths occur prematurely (before 73)
6
Q
CVD includes what diseases?
A
heart disease, stroke, high blood pressure, heart failure, arrhythmias, atrial fibrillation, cardiomyopathy, peripheral artery disease
7
Q
2006 CVD statistics
A
Age-adjusted CVD (heart and stroke) death rate per 100,000 was 256, compared to 268 in 2005
831,272 deaths
8
Q
CVD MORTALITY rates are decreasing but prevalence is
A
remain unchanged (not dwindling) what happens is our health care system is better at keeping people alive who have CVD
9
Q
main cause of CVD
A
atherosclerosis
10
Q
atherosclerosis is
A
build up of fatty plaque in inner layer of artery wall contributes 85% of CVD
can block vessels in brain and lead to strokes
strokes are 3rd leading cause of death and kill 160,000people /year
11
Q
CHD
A
when atherosclerosis blocks a coronary vessel its called CHD (major form of CVD but NOT the same)
can cause a heart attack of MI afflicts 1.2/year and 4 in 10 die
12
Q
How can the artery wall be damaged
A
hypertension hypercholesterolemia oxidized low-density lipoprotein (LDL) cigarette smoking toxins and viruses blood flow turbulence
13
Q
3 layers of the arteries
A
1) the intima, a single squamous cell thickness; 2) the media, a smooth muscle layer; and 3) the adventitia, or outermost layer
14
Q
where is the site of plaque burden for atherosclerosis? .
A
is at the intima-media interface
15
Q
process of atherosclerosis
A
first, artery wall damaged / injured
next
Injuries lead to changes in normal endothelium function and chronic inflammatory response begins.
Monocytes and T cells penetrate the endothelium in to the intima.
Monocytes convert to macrophages and ingest oxidized LDL and other substances.
Macrophages convert to foam cells.
Additional LDL causes further injury, attracting more monoctyes and a vicious cycle leads to development of a fatty streak.
Injured endothelial cells attract platelets and begin to release growth factors that stimulate migration of smooth-muscle cells from the outer layers of artery into the intima.
Macrophages and smooth muscle cells release collagen and other proteins (fibrous component of atherosclerosis).
Engorged foam cells die and release cholesterol debris into the artery wall.
Mature plaque may become hardened (calcified) and develop cracks or ulcers, prompting formation of blood clots.
16
Q
Heart Risk reduction
A
Quitting smoking 50–70% decrease within 5 years Decreasing cholesterol 2–3% decrease for each 1% drop in total cholesterol Decreasing high BP 2–3% decrease for each 1 mmHg drop in DBP Becoming physically active 45% decrease for those who maintain Maintaining ideal body weight 35–55% decrease vs. obesity
17
Q
Reducing risk of CHD can be somewhat cumulative T/F
A
true
18
Q
Toxic environment for CVD
A
Physical Activity
Few opportunities for activities of daily living
Little need to be physically active for survival
Little need to expend energy for foods
Diet
Abundance of high kcal dense foods
Large portion sizes
19
Q
calories in a bagel 20 years ago and now
A
20 years ago 3 inches 140 caloreis
6-inch diameter = 350 caloreis
20
Q
why might a person need an exercise test
A
irregular heartbeat, chest pain, or difficulty breathing
helps find out how well a person’s heart can handle a workload
can show if there is a lack of blood supply through arteries of heart due to heart disease
21
Q
malignant neoplasm
A
abnormal tissue that grows by cellular proliferation more rapidly than surrounding tissue and continues to grow after the stimuli that initiated the new growth ceases
22
Q
benign vs malignant
A
benign = tumors that are not cancerous, result of abnormal cell growth, but cannot invade surrounding tissue or move to distant site through metastasis malignant = cancerous and formed from abnormal cells that are unstable and can enter the blood stream, circulatory system, and lymphatic system
23
Q
suspected causes of cancer
A
obesity smoking alcohol consumption poor diet environmental pollution heavy metal exposure household chemicals
24
Q
angiogenesis
A
creation of blood supply, tumors sends cellular signals to begin this, once it has its own blood supply it can metastasize
25
carcinoma
Carcinoma
cancer that begins in the skin or in tissues that line or cover internal organs
lung, breast, stomach, etc.
skin, large intestine, lung, and prostate in men
lung and breast in women
more common than sarcoma
accounts for 8% of all cancers
26
sarcoma
cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue
generally more lethal than carcinoma
most common is osteosarcoma (bone) and chondrosarcoma (cartilage) lymphoma, leukemia, mylenoma
27
cancer staging
T—primary tumor
N—lymph node involvement
M—distant metastases
28
Modifiers for cancer
```
I = early stage
IV = late stages
```
29
Cancer has more ___ than heart disease
years of life lost
is leading cause of death for people 35-74
75+ = heart disease
30
New cancer cases per year
1,373,000
31
cancer deaths per year
570,000
32
lifetime risk of developing cancer
1 in 2 for men
| 1 in 3 for women
33
survival rate for all cancers 5 years
64%
34
Americans alive with history of cancer
9.8 million
35
cost of cancer per year nationwide
190 billion
36
Lifetime probability of developing cancer for men top and lowest 3
Top 3
prostate = 1 in 7
lung and bronchus 1 in 13
colon and rectum 1 in 21
lowest = stomach 1 in 93 oral cavity 1 in 65
leukemia 1 in 59
37
Lifetime probability of developing cancer by site Women
Top 3
Breast 1 in 8
lung and bronchus 1 in 16
colon and rectum 1 in 22
```
Lowest
uterine cervis 1 in 154
urinary blader
1 in 88
pancreas 1 in 68
```
38
Most lethal cancers
Lung for men and women
prostate for men
breast cancer for women
3rd leading is colon and rectal cancer for men and women
39
Reduction of cancer deaths have occurred but some are the same T/F
T
40
which cancers have increased slightly for men and women 1980-1990
pancreatic and liver cancer
41
incidence rates of cancer has decreased for men
lung and colorectal cancer
42
incidence rates of cancer of increased for men
liver, thyroid and melanoma
43
incidence rates of cancer for women have decreased for
colorectal cancer
44
incidence rates of cancer for women increased for
thyroid, liver and melanoma
45
increases in survival of all cancer types attributed mostly to
improvements in cancer treatment
46
decreases in incidence rates for cancer are attributed to changes in
lifestyle (not smoking) and greater participation in routine screenings
47
susceptibility to cancer is primarily associated with
lifestyle and environmental risk (only small percent genetic)
48
susceptibility to cancer is ___ percent lifestyle related
80
49
how much cancer in the US could be prevented through proper diet and physical activity habits (normal healthy weight)?
1/3 more than 577,000 deaths
50
how much cancer could be eliminated by elimination of tobacco use
1/3
51
causes of cancer death in US
```
tobacco - 30%
nutrition / obesity - 30%
inactivity - 5%
alcohol 3%
environmental pollution - 2%
```
52
PA and colon cancer?
Of all cancers, colon cancer has the strongest link with physical inactivity.
3 in 4 published studies show an average of 50% (70% max) reduction in colon cancer risk in the most physically active men and women.
How?
Decreased transit time
Enhanced immune function
Decreased insulin levels
Enhanced defense vs. oxidative stress
53
PA and lung cancer
Only a few studies support this link
Likely physical activity is protective through associated obesity reduction and good dietary habits
How?
Not well established
54
PA and prostate cancer?
Half of studies show a link, but they are the better-designed studies
The effect of exercise is seen only in men older than 60 years old, and may reduce risk 50–70%, but average reduction is 10–30%.
How?
Repeated long bouts of exercise may lower blood testosterone levels.
Enhanced immune function
55
PA and breast cancer?
Physical Activity and Breast Cancer
3 in 4 studies support 30–40% reduction in breast cancer with physical activity.
Strenuous exercise is most strongly related to lower incidence of breast cancer.
How?
Lower cumulative exposure to ovarian hormones with strenuous exercise
Delayed age of menarche
Decreased obesity Friendenreich and Orenstein. J Nutr. 2002 Nov; 132(11Suppl):3456S-3464S
The American Cancer Society recommends the following lifestyle patterns for reducing the risk of cancer:
56
what percent of cancer death attributed to alcohol?
3%, but every drink increases risk
57
alcohol increases risk of cancer in
areas of the body where the alcohol comes into contact with tissues or organs. Alcohol consumption increases the risk of liver cancer, oral and esophageal cancer, and stomach and intestinal cancer.
58
national recommendations for alcohol consumption
If you don’t drink, don’t start.
If you do drink, do so in moderation.
Men should have no more than two drinks per day.
Women should have no more than one drink per day.
59
processed meats are linked to
increased risk in colon cancer risk
relative risk of colorectal cancer when comparing the highest and the lowest category of consumption was 1.20, or a 20 percent increase in risk
60
whole grain and natural whole foods containing fiber
colorectal and esophageal cancer decreases
61
best evidence indicates meat should be eaten sparingly no more than ___ times a week
2
62
aflatoxin increases risk of liver cancer which is in
is attributed to fungus that produces anflatoxin when grains are not stored or preserved properly
63
evidence suggests risk of cancer is reduced with increased consumption of whole grains especially
colon cancer
64
for every 10 grams of fiber consumed a day there is a ___ percent reduction in risk of colon cancer
10 percent
65
Obesity / amount of calorie consumed increases risk for
cancer in sites such as colorectum, gall bladder, breast, oesophagus, pancreas, endometrium, kidney
66
premenopausal breast cancer and women
One study 20-40 percent decreased risk of breast cancer in obese women compared to normal but another there is a 50 percent and 70 percent increased risk of premenopausal breast cancer in overweight and obese women
67
what food has the highest total phenolic content and highest antioxidant activity as well as the highest antiproliferative effect on in vitro cancerous human liver cells?
cranberry
68
fruit high in phenolic content and antioxidant activity
cranberry, apple, red grape strawberry,
69
anti proliferative activity highest fruits
cranberry, lemon apple strawberry
70
which vegetable has the highest phenolic content?
broccoli
71
which vegetable has the highest antioxidant activity?
red peppers
72
which vegetable has the highest inhibitory effect on spreading of cancer in in vitro human liver cells?
spinach
73
which type of activity reduces blood pressure in both hypertensive and normotensive persons?
aerobic exercise
74
risk factors for hypertension
```
obesity
smoking
little or no exercise
too much salt in the diet
drinking too much alcohol
stress
ethnic background
family history
age
```
75
what is it called when blood pressure is extremely low?
orthostatic hypotension
76
how many times does the heart beat per minute?
60-75
77
systolic blood pressure
when the heart is contracting the pressure in the arteries is called
78
diastolic blood pressure
when the heart is resting pressure in the arteries is called
79
guidelines for being diagnosed as hypertensive
systolic / diastolic is 140/90
| NEW guidelines 130/80
80
incidence and prevalence of hypertension rise with
age
81
how many new hypertensives added to the US each year?
2 million
82
in US normotensive individuals age 55 years have a ___ percent lifetime risk for developing hypertension
90
83
T/F in unaccultured societies age-related increases in BP are uncommon
True
84
why is hypertension called the "silent killer"?
there are no warning signs for is
85
deaths for hypertenstion
primary cause of death for more than 37,000 americans and contributes to seven hundred deaths annually
86
hypertension increases risk for
CHD stroke and kidney failure
87
hypertension left untreated causes
the heart to get larger, which can lead to heart failure
small blisters (aneurysms) to form, which can lead to stroke
blood vessels in kidney to narrow, which can lead to kidney failure
arteries to harden faster (heart, brain, and kidney)
Long-term loss of cognitive ability
memory, problem solving, concentration, and judgment
88
Hypertension normal
120/80 or less
89
pre hypertension
120-139 / 90-99 was OLD
| NEW = 120-129 or <80 diastolic
90
stage 1 hypertension
old 140-159 90-99
| NEW 130-139 80-89
91
Stage 2 hypertension
160 or 100 NEW 140 >90
92
hypertensive crisis
systolic over 180 and diastolic over 120
93
guidelines
high blood pressure should be treated earlier with lifestyle changes and sometime medication at 130/80 (rather than older 140/90) based on ACC and AHA guidelines
94
definition of high blood pressure
accounts for complications that can occur at lower BP numbers for earlier intervention
results in half of US population (46%) having high blood pressure
HBP expected to triple in men under 45 and double in women under 45
95
guidelines for taking BP
should be based on average of at least 2 careful readings on 2 occasions
96
changes in BP guidelines
only prescribe medication for stage 1 if a patient has already had a cardiovascular event or at high risk of heart attack based on age, diabetes, chronic kidney disease or atherosclerosis
many people need 2+ medications to control blood pressure better to combine multiple medications in one pill
identifying socioeconomic status and psychosocial stress as risk factors for high blood pressure
97
stroke risk increases ___ at stage ___ levels of hypertension
exponentially 2
98
lifestyle changes in China and other populations primarily related to diet and inactivity have these characteristics
NA+ and alcohol intakes are high
K+ intake is low
physical inactivity and obesity are the norm
incidence of hypertension is high
99
how many adults in the US have HBP
70 million 30%
healthy people 2020 goal is reduce prevalence by 10-27%
only 52% have their high blood pressure under control and 70% are taking some kind of action to lower it
average blood pressure has increased with children
100
Treatment for HBPAll should include
All should include lifestyle changes
Medication when indicated
Stage 1 and 2 should combine lifestyle modification with appropriate drug therapy
Most patients with hypertension will require lifestyle modifications and two or more antihypertensive medications
101
lifestyle and weight control
Weight control
Overweight results in a 2–6x increase in risk for hypertension
Average systolic and diastolic BP is reduced 1.6/1.1 mmHg per kilogram (2.2 lb) of weight loss
102
if a person lost 10kg of body mass expected change in systolic and diastolic blood pressure could be
16 point and 11 point drop
103
Healthy People 2020 goal for sodium / how many meet it
less than 2,300 mg per day
lower for those with hypertension older, or at-risk ethnicities
only 30% get less than 2,400mg/day
104
average sodium intake
3,655mg/day
105
by reducing sodium consumption to 2300 a day prevalence would drop
28%
| reduce cases of hypertension by 11.1 million
106
if reduced to 1200mg per day of sodium
prevalence of hypertension is changed to 25% and 17.7 million fewer cases
107
western societies average sodium
2,500-5,000 mg / day 6-12 g of salt
men consume 4,000mg and women 3,--- from food alone
minimum recommendation is 500mg and 2,000-3,000 is safe
108
1 teaspoon difference in salt consumption is associated with
2.2mmHg difference in systolic BP
| and a 9mmHg attenuation in the rise of systolic BP for 25-55 years
109
clinical trials lowering salt
reduced systolic BP by 5mmHg and diastolic BP by 2.5
110
lifestyle and NA what to do
learn to read food labels
choose more fresh fruits and vegetables
reduce use of salt during cooking, and use herbs, spices, and low-sodium seasonings
avoid using the salt shaker on prepared foods at the table
limit the use of foods with visible salt on them (snacks, chips, salted nuts, crackers, etc.)
111
DASH method / diet
dietary approaches to stop hypertension DASH diet recommended
NHLBI of NIH proposes the DASH diet.
Clinical studies with hypertensives lowered systolic BP by 11 mmHg and diastolic BP by 66 mmHg.
Reductions were seen within two weeks.
Rich in whole grains, fruits, vegetables, low-fat dairy
High in potassium, calcium, magnesium, and fiber—low in saturated fat, cholesterol, Na+
112
Lifestyle and alcohol
Consuming 40 g of ethanol per day from drinking alcohol can increase blood pressure (three drinks per day).
The prevalence of hypertension is four times greater for heavy drinkers than abstainers.
Heavy drinking refers to >14 drinks per week for men and >7 drinks per week for women.
About 50–60% of the risk for developing alcoholism is genetic.
About 50% of trauma beds in the United States are occupied by patients who were injured while under the influence of alcohol.
113
Exercise and HBP
effect of exercise and physical activity on blood pressure reduction is, in part, due to how the body recovers from exercise through relaxation and vasodilation of blood vessels
During exercise, heart rate and systolic blood pressure increase and diastolic blood pressure stays about the same.
In the post-exercise period, systolic blood pressure will fall below resting levels for about 22 hours.
The greatest effect is seen in those with the highest levels for resting blood pressure
relaxation and vasodilation of blood vessels in legs and visceral organ areas
114
T/F exercise alone can be as effective as prescription medicine treatments
True
115
resting systolic BP levels can remain below pre-exercise levels for up to ___ hours
24
| so if you exercised every day or every other day, they could have a new permanent resting level of systolic pressure
116
mild hypertensives can expect systolic and diastolic BP to drop an average ___ in response to regular exercise
5-7 mmHg
117
depression is associated with the risk, occurence, management, progression and outcome of chronic diseases including
diabetes, hypertension, stroke, heart disease, and cancer
118
acute
refers to something that occurs at a specific time for a short duration. In terms of anxiety, it is the same as state anxiety.
119
State anxiety
anxiety present in very specific situations
120
chronic
persists for a long period of time
121
trait anxiety
anxiety present on a regular basis
122
Mental health and PA with reducing anxiety
best results with aerobic exercise
best after weeks of regular exercise
best benefits for low fit to begin with
best benefits for high anxiety to begin with
123
mental healthy and PA for depression
best after weeks of regular exercise
best when done several times per week
best with more vigorous exercise
best for those who are more depressed (more research needed)
124
regular PA associated with
improved self-esteem, more restful sleep, and a better ability to respond to stress
125
kinds of anxiety disorders
post-traumatic, obsessive compulsive and phobias
| collectively most common mental health disorders
126
prevalence of anxiety
12-Month Prevalence: 18.1% of U.S. adult population
| Severe: 22.8% of these cases (e.g., 4.1% of U.S. adult population) are classified as "severe"
127
demographics for lifetime prevalence of anxiety
Sex: Women are 60% more likely than men to experience an anxiety disorder over their lifetime
Race: Non-hispanic blacks are 20% less likely, and Hispanics are 30% less likely, than non-Hispanic whites to experience an anxiety disorder during their lifetime.
age: higher in 30-44
128
each year nearly ___ % of adults experience a major depressive disorder
7
129
women are what% more likely than men to experience depression
70
130
depression is more common among
youth and young adults
131
depressed persons spend
one and a half times more money on health care and 3 times more money on outpatient pharmacy costs than those non-depressive
132
depression and exercise
at least as effective as psychotherapy and behavioral interventions or social contact
decreased depression more than relaxation training or engaging in enjoyable activities
effects consistent across age, gender, size and type of depression
133
in a study of 65 year+ women ___ % lower risk of alzheimer's disease cognitive decline and dementia in active women
30-50
134
```
___ reduction in risk with high levels of physical activity for
cognitive impairment
alzheimers
dementia
any type
```
```
cognitive = 42%
alzheimer's = 50%
dementia = 37%
```
135
neuroprotection
creates "stress-response" and vulnerability to brain damage by increasing neurotrophic factors
increasing heatshock proteins
decreases free radicals
stabilizes Ca+ homeostasis
136
nuerogenesis
increases neural cell proliferation and survival
regulates gene transcription especially in the hippocampus (inolved in neuronal activity, synaptic structure, and neuronal plasticity (learning and memory)
137
Neurotransmitters
decrease choline uptake
increase muscarinic quinuclidinylbenzilate binding to the hippocampus
decrease norepinephrine release
138
neurotrophic factors
increased IGF FGF BDNF GDNF = increased neurogenesis
increase MAPK phosphorylation
increase CREB phosphorylation which increases neurotropin
139
what foods have detrimental effects with depression / mental health
sugar and salt
140
what foods have positive outcomes?
pulses
141
there is a strong correlation between consumption of what food and depression
fish
r= -.85
BUT correlation is NOT causation
142
excess of calories can
reduce synaptic plasticity and increase likelihood of cell damage through excess of free radical production
increases oxidative stress
143
decreased caloric intake
elevated levels of BDNF decreased deficits in cognitive function
144
when omega 3 fatty acid is a part of dietary intake or exercise is part of your lifestyle
learning ability increases
145
Population attributable risk
the amount of disease or death that could have been avoided if all of the women in this study were in that low-risk profile
