Chapter 9 Behavioral Factors in Cardiovascular Disease 10 22 2014 Objectives Describe hypertension coronary artery disease CAD coronary heart disease CHD and stroke o Hypertension Causes refers to abnormally high blood pressure Genetic causes Environmental causes Consequences Heart disease Stroke Kidney failure Eye damage Cognitive problems Prevalence 33 of US adults referred to as silent killer because many people don t know they have it o Normal blood pressure less than 120 80 mmHg 120 systolic pressure pressure of blood in the vessels when the heart beats 80 diastolic pressure pressure between beats when the heart relaxes High blood pressure 140 90 or higher Prehypertension between 120 139 and or 80 89 CAD and CHD o Coronary artery disease CAD refers to damage to the o Coronary heart disease CHD refers to damage to the coronary arteries myocardium heart Causes Arteriosclerosis hardening of the arteries Atherosclerosis formation of plaque in the arteries Consequences Ischemia shortage of oxygen and nourishment to the heart causes restriction of blood flow Angina pectoris pain that radiates to the chest and arm due to temporary shortages of oxygen and nourishment to the heart Myocardiam infarction heart attack less effective heart contractions or heartbeat is disrupted due to severe deprivation of oxygen and nourishment to the heart Scar tissue will cause less effective heart functioning Death Prevalence 785 000 new causes each year first major cause of death in the US 600 000 premature death o Stroke damage to brain from lack of oxygen Cause Atherosclerosis and arteriosclerosis Hypertension Consequences Motor problems Social problems Cognitive problems Emotional problems Death Prevalence 795 000 people have a stroke each year third major cause of death in the US Know about the changing rates of cardiovascular disease o CVD is a modern disease however deaths have been declining Inherent Risks Age Positive correlation between age and chances of dying from CVD Family history People with a family history of cardiovascular disease are more likely to die of CVD o May be due to genes and environmental interaction Gender The rate of CVD in men is higher but o Men have earlier onset o Women have later onset but disease is more dangerous Ethnic background African Americans Asian Americans and Hispanic Americans have lower risk than European Americans Physiological Risks Hypertension Best predictor of CVD biggest risk factor Serum Cholesterol Level Risk factor for CVD o High density lipoprotein protects against o Low density lipoprotein is a risk factor Problems in glucose metabolism Particularly damaging to arteries and increases the risk for CVD Inflammation Chronic inflammation increases risk for CVD Behavioral Risks Smoking Increases risk for heart attacks by 3x Weight diet Obesity is a risk factor Abdominal fat is a risk factor Diets which reduce risks o Low sodium o Potassium o Fruit and vegetable intake o Some fish Physical activity Low physical activity increases risk o Physical activity reduces abdominal fat blood pressure increase blood glucose metabolism Psychosocial Risks SES Social Support CVD Lower SES is a risk factor for CVD Having little social support is a risk factor for o Marriage generally provides social support Psychological problems Stress anxiety depression are risk factors for CVD o Difficult to assess o May develop in childhood o Contribute to progression Helplessness pessimism and rumination are risk factors for CVD Hostility and anger Cynical hostility o Who o Why Expressed anger and suppressed anger are risk factors for CVD Know ways to prevent heart attacks o Medication o Cognitive behavioral therapy Relaxation o Weight loss o Anger Management o Dietary changes o Physical activity Heart attacks and rehabilitation o Drugs Beta blockers Aspirin help prevent blood clots Statins o Diet and exercise Low cholesterol diet Quit smoking Lose weight Control alcohol consumption Less emotional distress after heart attack if they exercised o Control stress Stress management programs o Risk factor after heart attack Cognitive behavioral therapy to reduce depression Depression can compromise adherence of medication o Social support o Next steps enough How or when to resume normal activities Should be returning to job as soon as they are healthy Those with lower income have a lesser chance of survival if they cannot work after as quickly Know ways people who have had heart attacks are rehabilitated Know ways people who have had strokes are rehabilitated o Strokes and rehabilitation Have problems with Emotions Psychotherapy o Includes family therapy sessions Cognitions Interventions including remedial training to restore intellectual functioning Stroke patient may not even realize their cognition isn t working as well as before stroke Motor functioning skills Movement therapies Objectives from test Cardiovascular system Chapter 10 Behavioral Factors in Cancer Objectives Know what cancer is and the different types 10 22 2014 Cancer disease characterized by the presence of new cells neoplastic cells that grow and spread beyond control o These cells provide no benefit to the body o Neoplastic cells are either benign or malignant Will interfere with other functions that your body is performing Malignant tumors are more dangerous because the cells travel to other parts of the body Benign stay in one place and are easier to remove o Types of cancer Carcinomas most common 80 90 of all cancer cases Cancer that begins in the skin or in tissues that line or cover internal organs Sarcomas Skin stomach and breast cancer not very common Cancer that begins in the connective tissues cartilage fat muscles tendons and bones Bone tumors Lymphoma not very common nodes and glands Leukemia Cancer that begins in the lymphatic system Cancer that begins in the bone marrow Myeloma marrow Cancer that begins in the plasma cells of the bone o Lung cancer is more common to lead to death for both men and women Be able to describe rates of cancers Be able to describe changing rates of cancer Cancer Is the second leading cause of death in the US Rates increase from 1900 1990 Rates decrease from 1993 o Why o Have more screenings to detect cancer sooner o Have new cancer drugs o Smoking has decreased in the US 562 die of cancer each year in US o Be able to identify inherent environmental behavioral and psychosocial factors Inherent Risks o Ethnic background and skin cancer European American men are more