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103 Theme 5 - Lifestyle > Lifestyle factors and cardiovascular disease > Flashcards

Lifestyle factors and cardiovascular disease Flashcards

1
Q

What are the 3 leading causes of death in the UK and what percentage do they represent?

A

24% cardiovascular diseases

21% cancer (excluding lung cancer)

20% respiratory diseases

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2
Q

The onset and progression of cardiovascular diseases is strongly influenced by what?

A

Lifestyle (behaviour)

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3
Q

What percentage of cardiovascular disease would be prevented if there was elimination of modifiable risk factors - including unhealthy lifestyles?

A

80%

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4
Q

Via what 3 pathways does behaviour (including lifestyle) affect cardiovascular disease?

A

1] health-related behaviours such as diet, smoking, exercise

2] causing acute or chronic physiological changes that lead to CHD

3] access to, and use of medical care

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5
Q

Name 3 physical (immutable) risk factors for CVD

A

age

sex

family history other demographics

(genes)

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6
Q

Name 4 pyschosocial (modifiable) risk factors for CVD

A

health behaviours

stress

depression

social support

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7
Q

What are the clinical features of metabolic syndrome?

A

overweight and abdominal fat distribution, hypertension, insulin

resistance, hyperglycemia

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8
Q

EPIC-Norfolk study:

compared to those eating 5+ a day, other people were …

______ x more likely to die early from CVD

______ x more likely to have stroke

A
  1. 7
  2. 4
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9
Q

In the US Nurses Health Study:

compared to people in lowest 20% for total fat intake …

top 20% total fat = ______ x more likely to develop CVD

top 20% saturated fat = ______ x more likely to develop CVD

A
  1. 3
  2. 5
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10
Q

Can primary or secondary preventions -

improve diet

and = lower death rates (CVD and total)

= lower risk of further cardiac events

A

Secondary preventions

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11
Q

EPIC-Norfolk study:

compared to non-smokers, smokers were

_________ x more likely to die early from CVD

__________ x more likely to have stroke

A
  1. 9
  2. 7
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12
Q

Secondary prevention:

compared to CHD patients who keep smoking, quitters had

________ lower risk of premature death

__________ lower risk of another MI

A

36%

32%

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13
Q

EPIC-Norfolk study:

compared to active people, those below activity threshold were

_________ x more likely to die early from CVD

__________ x more likely to have stroke

A
  1. 3
  2. 3
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14
Q

Meta-anyalytic evidence shows that preventions can…

A

increase exercise

= reduce all-cause mortality

= reduce cardiovascular mortality

= reduce non-fatal cardiac events

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15
Q

lower social classes have greater CVD risk (Lynch et al., 1996)

compared with top 20% income, lowest 20% income have

________ x greater risk of CVD death

_________ x greater risk of acute MI

A
  1. 7
  2. 3
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16
Q

after adjustment for behavioural risk factors (smoking, diet, exercise) lowest 20% income have

no greater risk of CVD death

________ x greater risk of acute MI

A

2.8

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17
Q

Why do people risk their health?

A

biased risk perception
health optimism
general risk vs personal risk

18
Q

general public people acknowledge influence of various CVD risk factors
- but underestimate impact of what?

A

Diet and excersise

19
Q

“what do you think contributed to you having a heart attack?”

What are men more likely to cite?

A
  • poor diet
  • hard work
20
Q

“what do you think contributed to you having a heart attack?”

What are women more likely to cite?

A

chance or bad luck

21
Q

What are factors which decrease time to get to hospital with an MI?

A

= being male
= being married

= believing that MI has more serious consequences
= active coping style
= using problem-focused coping

= more non-pain symptoms (breathlessness, dizziness, etc.)

22
Q

What are the 4 types of response to stress and are they acute or chronic?

A

physical fight / flight response acute

behavioural poor diet, smoking, alcohol, drugs chronic

emotional anxiety, anger, depression chronic

cognitive poor concentration acute/chronic

23
Q

What are the 2 types of coping responses?

A

approach - problem-solving
avoidance - distraction - psychological or behavioural

24
Q

Name an epidemiological study that shows acute stress is associated with MI and cardiac death

A

MI and cardiac death after disasters
examples ? 9/11 terrorist attacks
football world cup

25
Q

What have animal studies proven about chronic stress?

A

induces atherosclerosis
lowers threshold for arrhythmia

26
Q

What have experimental studies shown about acute stress?

A

triggers ischaemia in patients with CHD
associated with cardiovascular changes (HR, BP)

27
Q

Name 3 examples of how acute stress can trigger ischaemia in patients with CHD

A

intense physical activity
stressful mental activity
feeling tense, frustrated, angry, sad

28
Q

What factors cause job stress to become chronic stress?

A

demands are high
control is low
support is low

29
Q

What type of stress is associated with greater CVD risk?

A

Chronic stress

30
Q

What is an individual vulnerability factor?

A

cardiac reactivity

31
Q

Name examples of chronic risk

Standard and pyschosocial

A

“standard”

age

sex

family history

smoking

cholesterol

hypertension

“psychosocial”

hostility

depression

low support

chronic stress

32
Q

Name examples of acute risk

A
33
Q

Complete the diagram on accumulation of lifetime risk

A
34
Q

What are the features of a type-A personalilty?

A

hard-driving competitive behaviour
vigorous speech characteristics
impatience
potential for hostility

35
Q

Is a type-A personality linked to cardiovascular disease?

A

may be a risk factor for CHD in healthy people
not a risk for further problems in people with CHD
hostility appears to be most important component

36
Q

What is the emotional impact of a MI?

A

depression (up to 30%)

anxiety symptoms (approx. 40%)

PTSD (up to 15%)

37
Q

depression is
- ________ times more common after MI than at other times in life

A

2-3

38
Q

Which mental illness is an independent predictor of premature death in CHD patients?

A

Depression

39
Q

What is depression associated with a poorer adherence to post-MI?

A

associated with poorer adherence to medication or lifestyle
modification post MI

40
Q

How is depression treated?

A

via medication or psychotherapy can reduce depression and improve survival in MI patients with depression

41
Q
A

103 Theme 5 - Lifestyle (3 decks)

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