Exercise Testing and Prescription PET 4551 Study Guide Exam 1 1 Know the modifiable and non modifiable risk factors for heart disease How does exercise improve the risk factors How else can individuals modify their risk factors Know how to determine someone s risk factor for cardiovascular disease What are the emerging risk factors Make sure you know the updated risk factors presented in class this summer Risk Factors for Cardiovascular Disease Risk or Dyslipidemia Smoking Hypertension Obesity Physical Inactivity Impaired Fasting Glucose Family History MI Revascularization death etc Age High HDL Characteristics cholesterol 200 mg dL total 130 mg dL LDL 40 mg dL HDL Or on medication Active Smoker Quit w in the last 6 months Systolic 140 Diastolic 90 BMI 30 kg m2 Waist circ M 40in F Hip to Waist Ratio M 35in 0 95 F 0 86 Physical activity of less than 30 minutes a day 3 days a week 100 mg dL but Oral glucose levels 126mg dl 140 but 200 History of CV disease Primary male relative Primary female before age 55 relative before age 65 Men 45 years old Women 55 years old High HDL of Negates a positive risk 60mg dL factor Modifiable Risk Factors of CV CAD disease Maximum amount of risk factors a person can have is 8 Minimum amount of risk factors a person can have is 1 Stress and Type A personality hostility also increase likelihood of CVD Hypertension Hyperlipidemia HDL 40mg dL Obesity Smoking Physical inactivity Impaired fasting glucose stages of diabetes physical inactivity exercising less than 30 minutes 3 times a w week for three months Non Modifiable Risk Factors of CV CAD disease Advancing age Sex males at higher risk Family history of first degree relatives o Male first degree relative 55 years o Female first degree relative 65 years Emerging Risk Factors of CV disease Triglycerides Lipoprotein A Lipoprotein remnants Small LDL particles HDL sub species Apolipoproteins Total cholesterol to HDL level Ratio Homocysteine Thrombogenic and Hemostatic factors fibrinogen Inflammatory markers Effects of Exercise on Risk Factors Exercise reduces BP increases HDL levels improves glucose tolerance reduces eliminates physical inactivity can reduce BMI can help reduce serum cholesterol levels 2 What are the sources of injury that can happen to the endothelium of the arteries What is Nitric Oxide Dyslipidemia Hypertension Immune Responses Smoking Sources of Injury Vasoconstrictor Substances Viral or Bacterial Infection Homocysteine High levels of glucose and loss of estrogen Nitric Oxide Potent vasodilator If not being produced at the levels needed cannot be sufficient blood flow Impaired synthesis can promote the risk factors of hypertension diabetes smoking and hyperlipidemia Can cause atherosclerosis Diminished nitric oxide bioactivity may facilitate vascular inflammation that could lead to oxidation of lipoproteins and foam cell formation the precursor of the atherosclerotic plaque 3 What are the range of values for cholesterol HDLs LDLs triglycerides hematocrit hemoglobin fasting glucose blood pressure BMI and waist circumference Classification of Cholesterol and Triglycerides Optimal Desired Normal Above Near Optimal Borderlin e High High Very High 100 129 130 159 200 239 240 160 189 60 high is good 190 200 100 Low 40 low is bad 150 150 199 Blood Pressure 200 499 500 Hypertensive if have systolic or diastolic numbers are high don t have to Lifestyle Modification Encourage yes yes yes Systolic BP Diastolic BP 120 120 139 140 159 160 80 80 89 90 99 100 Obesity Systolic BP max pressure in the arteries during contraction of the heart Diastolic BP min pressure in the arteries during the relaxation of the mg dL Total Cholestero l LDL HDL Triglycerid es Fasting be both Normal Optimal Pre Hypertension Hypertension Stage 1 Hypertension Stage 2 heart Normal Overweight Obese Class 1 Obese Class 2 Obese Extreme Class 3 BMI 18 5 24 9 25 29 9 30 34 9 35 39 9 40 Waist circumference Waist to Hip Ratio Males 40 in 102 cm Females 35 in 88 cm Males 0 95 Females 0 86 BMI kg m2 Kg lb 2 2 Cm inches x 2 54 m cm 100 Hematocrit men 40 52 and women 36 48 Hemoglobin g dl men 13 5 17 and women 11 5 15 5 Fasting Glucose mg dl 60 99 Impaired Glucose Tolerance IGT and Impaired Fasting Glucose IFG IGT is defined as a blood glucose of 140 199 mg dL in response to an OGTT IFG is defined as a fasting blood glucose of 100 125 mg dL o Major risk factor for NIDDM Diagnostic Criteria for Diabetes When fasting glucose of 126 mg dL Confirmed blood glucose of 200 mg dL in response to an oral glucose tolerance test Confirmed non fasting blood glucose of 200 mg dL in the presence of symptoms of OGTT diabetes 4 What blood tests are used to check the health of the kidneys and liver Kidney Tests Blood urea nitrogen BUN creatinine Liver Tests Bilirubin SGOT Serum Glutamic Oxaloacetic Transaminase SGPT Serum Glutamic Pyruvic Transaminase 5 What are some health and fitness benefits of regular physical activity Reduction of CVD risk factors increase HDL increase bone mineral density increase nerve conduction improved functionality increase in functional capacity weight control increase glucose tolerance and insulin sensitivity decrease in blood pressure in people with hypertension decrease in blood lipids increase in fibrinolytic capacity control of coronary vasospasm and increase endothelial function 6 What is a PAR Q test Physical Activity Readiness Questionnaire for people age 15 68 Minimal standard for entry into moderate intensity exercise program Series of yes and no questions If answered yes to one or more questions should talk to a doctor 7 What are the components of a medical history and informed consent Medical History Medical diagnosis Previous findings on physical exams History of symptoms allergies Recent illness and surgical procedures Orthopedic problems Medications Other habits Informed Consent Exercise family and work history Purpose and explanation of procedures or test Risks and discomforts Responsibilities of the participant Benefits to be expected Use of medical records Freedom of consent Place to sign Injuries inquires 8 Know signs and symptoms of cardiovascular and pulmonary disease Pain or discomfort in the chest neck jaw arms or other areas that may result from ischemia decrease in blood supply due to vasoconstriction standing position or paroxysmal nocturnal dyspnea Shortness of breath at rest or with mild exertion Dizziness or syncope loss of consciousness Orthopnea difficulty breathing at rest except when in
View Full Document
Unlocking...