lifestyle factors & cardiovascular disease Flashcards
what are the 3 pathways affecting cardiovascular disease?
1) health related behaviours such as diet, smoking, exercise
2) causing acute or chronic physiology changes that lead to CHD
3) access to and use medical care
what are physical CVD risk factors?
- age
- sex
- family history
- genes
what are psychological (modifiable) CVD risk factors?
- health behaviours
- stress
- depression
- social support
what does metabolic syndrome lead to?
overweight and abdominal fat distribution, hypertension, insulin, resistance, hyperglycemia
what does the EPIC-Norfolk study on diet show?
compared to those eating 5+ a day, other people were:
- 1.7x more likely to die early from CVD
- 1.4x more likely to have a stroke
what does the US nurses healthy study on diet show?
compared to people in the lowest 20% for total fat intake:
- top 20% total fat = 1.3x more likely to develop CVD
- top 20% saturated fat = 1.5x more likely to develop CVD
what is the secondary prevention for diet?
interventions can improve diet and
= lower death rates (CVD and total)
= lower risk of further cardiac events
what does the EPIC-Norfolk study on smoking show?
compared to non-smokers, smokers were
- 1.9x more likely to die early form CVD
- 1.7x more likely to have a stroke
what is the secondary prevention of smoking?
compared to CHD patients who keep smoking quitters had:
- 36% lower risk of premature death
- 32% lower risk of another MI
what does the EPIC-Norfolk study on exercise show?
compared to active people, those below activity threshold were:
- 1.3x more likely to die early from CVD
- 1.3x more likely to have a stroke
what is the secondary prevention of exercise?
meta-analytic evidence that interventions can increase exercise and that interventions can:
- reduce all-cause mortality
- reduce cardiovascular mortality
- reduce non-fatal cardiac events
compared to the top 20% income, the lowest 20% income have…?
- 2.7x greater risk of CVD death
- 4.3x greater risk of MI
after adjustment of behavioural risk factors the top 20% income to the lowest 20% income have…?
- no greater risk of CVD death
- 2.8x greater risk of acute MI
what are the percentages of factors contributing to a heart attack in hospital?
- stress = 35%
- smoking = 27%
- dont know = 25%
- hereditary = 16%
- overweight = 10%
- hyperlipidemia = 8%
- lack of activity = 6%
what are the percentages of factors contributing to a heart attack 2-2.5 years after discharge?
- stress = 40%
- smoking = 32%
- dont know = 10%
- hereditary = 33%
- overweight = 12%
- hyperlipidemia = 30%
- lack of activity = 24%
what factors shortern the time to get to hospital when having an MI?
- being male
- being married
- believing that MI has more serious consequences
- active coping style
- using problem-focused coping
- more non-pain symptoms
what are the different responses to stress?
- physical = fight or flight response
- behavioural = poor diet, smoking, alcohol, drugs
- emotional = anxiety, anger, depression
- cognitive = poor concentration
what are the coping responses to stress?
- approach = problem-solving
- avoidance = distraction - physiological or behavioural
what things triggers ischaemia in patients with CHD?
- intense physical activity
- stressful mental activity
- feeling tense
- frustrated
- angry
- sad
what type of stress does job strain cause?
chronic stress
what is ‘type A personality’?
- hard-driving competitive behaviour
- vigorous speech characteristics
- impatience
- potential for hostility
what are the links between type A personality and heart disease?
- equivocal evidence
- 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 complement
what disorders raise the prevalence of physiological symptoms post MI?
- depression (up to 30%)
- anxiety symptoms (approx 40%)
- PTSD (up to 15%)
how much more likely is depression after an MI than other times in life?
2-3 times more likely
how does depression link to CHD?
- more severe following earlier or more severe cardiac events
- an independent predictor of premature death in CHD patients
- associated with poorer adherence to medication or lifestyle modification post MI
what is the goal for health care in patients with CHD and depression?
target those most in need of treatment and support
what is the effective treatment of depression?
via medication of psychotherapy can reduce depression and improve survival in MI patients with depression
