Cardiovascular Health
Chapter 11
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Cardiovascular Disease
• Cardiovascular disease (CVD) = disease
of the heart and blood vessels
• CVD is the leading cause of death among
Americans
• Some CVD risk factors are controllable;
others are not
• There are many things individuals can do
to reduce their risk of CVD
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Cardiovascular Disease
Age-Adjusted Rates* of Death from Heart Disease, by Race and Sex --United States, 1979--2006†
* Per 100,000 standard population.
† Data for 2006 are preliminary.
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Major CVD Risk Factors That Can Be Changed
• Tobacco use and exposure to ETS
– Causes about 1 in 5 deaths from CVD
– Damages artery linings
– Reduces HDL
– Raises LDL and triglycerides
– Causes platelets to stick together
– Raises heart rate and blood pressure
– Displaces oxygen in the blood
– Increases the rate of the accumulation of
fatty deposits in arteries
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Major CVD Risk Factors That Can Be Changed
• High blood pressure (hypertension) =
sustained abnormally high blood pressure
– Systole = pressure when heart contracts
– Diastole = pressure when heart relaxes
• High blood pressure strains the heart,
damages the arteries, and increases risk of
heart attack, stroke, kidney failure, and
blindness
• CVD can be reduced with regular exercise,
healthy diet (reduced salt, increased
potassium and fiber), and moderation of
alcohol intake
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Blood Pressure Classification
Category
Systolic
(mm Hg)
Normal
Below 120
and
Below 80
120–139
or
80–89
140–159
160 and above
or
or
90-99
100 and above
Prehypertension
Hypertension
Stage 1
Stage 2
Diastolic
(mm Hg)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Blood Pressure
Source: Centers for Disease Control and Prevention
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Major CVD Risk Factors That Can Be Changed
• Unhealthy Cholesterol Levels
– Low-density lipoprotein (LDL) = unhealthy
(“bad”) cholesterol; excess amounts are
deposited in artery walls
– High-density lipoprotein (HDL) = healthy
(“good”) cholesterol; shuttle unused
cholesterol back to the liver for recycling
– Levels can be improved by quitting smoking,
exercising, and improving diet (less
saturated and trans fat, more fruits,
vegetables, fiber, and whole grains)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Cholesterol Guidelines
LDL cholesterol (mg/dl)
Less than 100
Optimal
100–129
Near optimal/above optimal
130–159
Borderline high
160-189
High
190 or more
Very high
Total cholesterol (mg/dl)
Less than 200
Desirable
200–239
Borderline high
240 or more
High
HDL cholesterol (mg/dl)
Less than 40
Low (undesirable)
60 or more
High (desirable)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Travels with Cholesterol
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Cholesterol Checked Among Americans
Source: Centers for Disease Control and Prevention
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Major CVD Risk Factors That Can Be Changed
• Physical inactivity
– Exercise decreases blood pressure and
resting heart rate, improves cholesterol,
improves the condition of blood vessels, and
helps prevent obesity and diabetes
• Obesity
– Strains the heart, especially excess fat in
the torso
• Diabetes
– Increases CVD risk even when controlled
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Contributing CVD Risk Factors That Can Be Changed
• High triglyceride levels
– Lower with exercise, healthy diet, quitting
smoking, reducing alcohol intake
Triglycerides (mg/dl)
Less than 150
150–199
200–499
Normal
Borderline high
High
500 or more
Very high
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Contributing CVD Risk Factors That Can Be Changed
• Psychological and social factors
– Stress
– Chronic hostility and anger
– Suppressing psychological distress
– Depression and anxiety
– Social isolation
– Low socioeconomic status
• Alcohol and drug use
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Major CVD Risk Factors That Cannot Be Changed
• Family history/heredity
– Multiple genes contribute to CVD risk
• Aging
– CVD risk goes up with age
• Being male
– Men face a higher risk, especially earlier in life
• Ethnicity
– African Americans have higher rates of
hypertension and stroke
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Annual Incidence of Heart Attack
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Women and CVD
• Women underestimate their CVD risk
– Nearly 1 in 2 women dies from CVD
– About 1 in 30 women dies from breast cancer
• Women are protected from CVD at younger
ages by natural estrogen
• After menopause, women are more likely than
men to die after a heart attack
• Women are more likely to have a heart attack
without chest pain
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
African Americans and CVD
• African Americans have higher rates of
hypertension and stroke
• Genetic, biological, and lifestyle factors
may play a role
• Lifestyle changes can reduce risk, as can
medical treatment
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Major Forms of Cardiovascular Disease
• Hypertension (a risk factor and a form of
CVD)
• Atherosclerosis
• Heart disease and heart attacks
• Stroke
• Congestive heart failure
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Atherosclerosis
• Atherosclerosis: Arteries are narrowed
by deposits of fat, cholesterol, and other
substances called plaques
• Once narrowed by a plaque, an artery is
vulnerable to blockage by blood clots
• Blockage in the coronary arteries
(coronary heart disease) can lead to a
heart attack
• Blockage in the brain can cause a stroke
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Atherosclerosis
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Heart Disease and Heart Attacks
• Heart attack = Damage to, or death of, heart muscle,
sometimes resulting in a failure of the heart to deliver enough
blood to the body; myocardial infarction.
• Angina pectoris = A condition in which the heart muscle
does not receive enough blood, causing severe pain in the
chest and often in the left arm and shoulder.
• Arrhythmia = An irregularity in the force or rhythm of the
heartbeat.
• Sudden cardiac death = A nontraumatic, unexpected death
from sudden cardiac arrest, most often due to arrhythmia (in
association with underlying heart disease).
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Heart Attack
Symptoms of heart attack
require immediate action.
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Diagnosis and Treatment for Heart Disease
• Diagnosis
– Exercise stress test
– MRI, echocardiogram, angiogram
• Treatment
– Lifestyle changes (diet and
exercise)
– Low-dose aspirin therapy
– Prescription medications
– Balloon angioplasty
– Coronary bypass surgery
Video: http://www.youtube.com/watch?v=S9AqBd4RExk
Video:
http://www.youtube.com/watch?v=kY
5gKdFWT3k&feature=related
Video: http://www.youtube.com/watch?v=veP5R-pzJVk&NR=1
Video: http://www.youtube.com/watch?v=3Nf6Q2skGOM&feature=related
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Treatment of Heart Disease
Surgery is one possible
treatment for heart
disease.
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Stroke
• Stroke = An impeded blood supply to some
part of the brain resulting in the destruction of
brain cells
– Ischemic stroke = caused by stroke
– Hemorrhagic stroke = caused by ruptured blood
vessel
• Strokes may cause paralysis, walking
disability, speech impairment, or memory loss
• Treatment may include clot-dissolving and
antihypertensive drugs
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Types of Stroke
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Stroke
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Congestive Heart Failure
• Congestive heart failure = condition resulting
from the heart’s inability to pump out all the
blood that returns to it
• Blood backs up in the veins leading to the
heart, causing an accumulation of fluid in
various parts of the body
• Caused by high blood pressure, heart attack,
atherosclerosis, birth defects, rheumatic fever
(delayed complication of upper respiratory
streptococcus infection)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Protecting Yourself Against
Cardiovascular Disease
• Eat heart-healthy
– Decrease fat and cholesterol
intake
• Especially limit saturated
and trans fats
– Increase fiber intake
– Alcohol intake—moderate, if
at all
– DASH (Dietary Approaches
to Stop Hypertension)
• Exercise regularly
• Avoid tobacco
http://www.nhlbi.nih.gov/health/public/heart/hb
p/dash/new_dash.pdf
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Protecting Yourself Against
Cardiovascular Disease (cont’d)
• Know and manage your blood pressure
• Know and manage your cholesterol
levels
• Develop ways to handle stress and
anger
• Know your risk factors
sphygmomanometer
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Reducing Your Risk of CVD
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Mitral Valve
Mitral valve prolapse is
the most common
cause of heart
murmur.
When the ventricles
contract, the redundant
leaflets prolapse (flop
backwards) into the left
atrium, sometimes
allowing leakage of
blood through the valve
opening (mitral
regurgitation).
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.
Wellness Worksheet Assignment
Wellness Worksheets can be accessed
online at www.mhhe.com/fahey8e
1.
2.
3.
4.
5.
From the website above, click on “student edition” at
the bottom left column.
Click on “wellness worksheets”
Click on “126 Wellness Worksheets are available
online” in the middle of the page.
Click on “89: Facts About Cardiovascular Disease” and
complete the worksheet.
Print out the completed worksheet and submit on
Monday, February 14th
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
Fahey/Insel/Roth, Fit & Well:
Core
Concepts and
Labs
in Physical
and Wellness, Chapter 1
©2007
McGraw-Hill
Higher
Education.
AllFitness
rights reserved.
© 2007 McGraw-Hill Higher Education. All rights reserved.
Reminders
• Study guide for Exam I will be posted on
instructor’s website.
• Review for Exam I on Monday, February
14th
• Exam I (Chapters 1, 2, 3 and 11) on
Wednesday, February 16th
• Please bring a pencil and Scantron 882-E
for Exam I
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 11
©2007 McGraw-Hill Higher Education. All rights reserved.