cardiovascular disease power point
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CARDIOVASCULAR DISEASE AND PHYSICAL ACTIVITY
CARDIOVASCULAR DISEASE AND PHYSICAL ACTIVITY
CHAPTER 20CHAPTER 20
Learning Objectives
Find out the major causes of chronic diseases in the United States and how a lack of physical activity contributes to these conditions.
Learn how atherosclerosis, hypertension, and coronary artery disease (CAD) develop and at what age they begin.
Discover what specific physiological alterations that result from exercise training reduce the risk of death from CAD, hypertension, and heart disease.
(continued)
Learning Objectives
Learn what blood pressure changes result from endurance exercise training in moderately hypertensive individuals.
Review the value of cardiac rehabilitation in treating a person who has suffered a heart attack.
Find out if there is any risk of death with endurance exercise training.
1995 CAUSES OF DEATH IN THE U.S.
DECLINE IN DEATHS
Factors Contributing to Decline in Deaths
Better and earlier diagnosis
Better emergency and medical care
Improved drugs for specific treatment
Improved public awareness
Increased use of preventive measures, including lifestyle changes
Cardiovascular Diseases
Coronary artery disease (CAD)
Hypertension and stroke
Congestive heart failure
Peripheral vascular disease
Valvular, rheumatic, and congenital heart disease
Coronary Artery Disease
Atherosclerosis—progressive narrowing of arteries due to build up of plaque
Coronary artery disease (CAD)—atherosclerosis in the coronary arteries
Ischemia—deficiency in blood to heart caused by CAD
Myocardial infarction—heart attack due to ischemia
Did You Know…?
Atherosclerosis begins in infancy and progresses at different rates, depending primarily on heredity and lifestyle choices such as smoking history, diet practices, physical activity, and stress.
Classification of Blood Pressure for Adults, Age 18 Years and Older
Normal < 130 < 85
High normal 130-139 85-89
Hypertension 140 90
Stage 1 (mild) 140-159 90-99
Stage 2 (moderate) 160-179 100-109
Stage 3 (severe) 180-209 110-119
Stage 4 (very severe) 210 120
Systolic DiastolicCategory (mmHg) (mmHg)
Hypertension
Is chronically elevated blood pressure
Causes the heart to work harder
Is uncommon in childhood but can appear during midadolescence
Places strain on arteries causing them to become less elastic over time
Affects about one in every four adult Americans
Stroke
Also called a cerebral vascular accident (CVA).
Cerebral infarction refers to when blood flow is blocked to one part of the brain due to a blood clot or atherosclerosis.
Cerebral hemorrhage refers to a rupture of a blood vessel that diminishes blood flow beyond the rupture.
CEREBRAL INFARCTION AND HEMORRHAGE
Congestive Heart Failure
Heart muscle becomes too weak to meets oxygen demands of the body
Can result from damage to heart, hypertension, atherosclerosis, and heart attack
Blood backs up in veins causing edema
Can progress to irreversible damage, thus requiring a heart transplant
AN ARTERY WALL
DEVELOPMENT OF ATHEROSCLEROSIS
Primary Risk Factors of CAD
Cigarette smoking
Hypertension
Elevated blood lipids (cholesterol and triglycerides)
Physical inactivity
Secondary Risk Factors of CAD
Obesity
Diabetes and high blood levels of insulin
Family history of CAD
Male gender
Advanced age
Did You Know…?
The ratio of total cholesterol (Total-C) to high-density-lipoprotein cholesterol (HDL-C) may be the most accurate lipid index of risk for CAD. Values of 5.0 and greater indicate increased risk while values of 3.0 and lower represent low risk.
Controllable Risk Factors for Hypertension
Insulin resistance
Obesity
Diet
Use of oral contraceptives
Physical inactivity
Uncontrollable Risk Factors for Hypertension
Family history of hypertension
Advanced age
Race
Did You Know…?
It appears that hypertension, coronary artery disease, obesity, and diabetes are linked through the common pathway of insulin resistance. Metabolic syndrome, syndrome x, and civilization syndrome are terms used to describe this interrelationship.
AMERICANS AT INCREASED CAD RISK
Did You Know…?
Epidemiological evidence shows that physical inactivity doubles the risk of CAD. Low-intensity activity is sufficient to reduce the risk of this disease.
Aerobic Training Adaptations
Produces larger coronary arteries
Increases heart size
Increases heart pumping capacity
Improves circulation of blood to vessels surrounding heart
Reduces blood pressure in individuals with moderate hypertension
How Exercise Reduces Risk of Disease
Improves the heart’s contractility, work capacity, and circulation
Improves ratio of blood lipids
Controls and prevents moderate hypertension
Controls weight, reduces body fat, and increases muscle mass
Reduces insulin resistance
Alleviates stress and decreases cigarette smoking
ARTERY COMPARISONS
Key Points
There is an increased risk of heart attack during actual exercise; however, over a 24-hour period, those who exercise regularly have a reduced risk of heart attack.
Deaths during exercise are rare.
Risk of Death During Exercise
In people over 35 most deaths during exercise are caused by a cardiac arrhythmia due to atherosclerosis.
Deaths during exercise in people under age 35 are usually caused by hypertrophic cardiomyopathy, congenital conditions, aortic aneurysm, or myocarditis.
HEART ATTACK RISK AND EXERCISE