Chapter 9 1 Hypertension abnormally high high blood pressure don t have to know specific numbers systolic is the pressure of the blood in the vessels beating a b Diastolic is the pressure between beats with the heart relaxes relaxing c Causes i Genetic and environmental ii Some are same as for CVD d Consequences i Increased risk for heart disease 1 2 Heart attack 3 4 5 6 Cognitive problems Stroke Kidney failure H damages blood vessel in kidney Eye damage blood vessels damaged blindness a Learning memory attention abstract reasoning mental flexibility others e Prevalence 2 CAD and CHD i 33 or 67 million Americans ii Silent killer many people don t know they have it Coronary artery disease refers to damage to the coronary arteries a b Coronary heart disease refers to damage to the myocardium heart c Causes i Arteriosclerosis hardening of the arteries ii Atherosclerosis formation of plaque in the arteries arteries carry oxygen other nutrients from heart to other parts of body read about this if heart is damaged that is CHD these often happen together so terms are often used interchangeably d e f g h why are arteries or heart damaged i arteriosclerosis ii iii atherosclerosis is a type of arteriosclerosis terms used interchangeably 1 plaque is calcium deposits in arteries 2 arteries become narrow i Blood flow to heart is decreased ii Heart doesn t get enough oxygen and nutrients to the heart i Pain in heart ii May be acute may occur just once iii May occur multiple times iv Due to shortages of oxygen and nourishment in heart v Sign of CAD or CHD vi Tightness vii Prompts people to go to the doctor deprivation of oxygen and nourishment to the heart i Potential consequences 1 Scar tissue will cause less effective heart functioning 1 3 CAD and CHD consequences a Ischemia shortages of oxygen and nourishment to the heart causes restriction of blood flow b Angina pectoris pain that radiates to the chest and arm due to temporary shortages of oxygen and nourishment c Myocardial infarction heart attack less effective heart contractions or heartbeat is disrupted due to severe 4 CAD and CHD prevalence 2 Death each year a Very prevalent 785 000 new cases First major cause of death in the US b i 600 000 people die annually in the US 5 Stroke damage to the brain from lack of oxygen a Causes i Atherosclerosis and arteriosclerosis ii hypertension c d 1 out of every 4 deaths 33 of deaths due to CAD and CHD are considered premature occurred before the person s expected age of death i ii Problems with motor problems will occur on opposite side of body from where stroke happened Left side of brain controls movements on right side of the body and vice versa b Motor problems c Social problems d Cognitive problems i Need help with walking dressing ii Rely more on others can change dynamics in a family or among friends i Stroke on left may cause problems with communication ii Right brain damage may be unable to process visual feedback iii Functions on opposite side affected e Emotional problems i Left side anxiety and depression ii Right side no emotional reaction Death 6 Stroke Prevalence f a b c 1 out of every 18 deaths in 2009 795 000 people have a stroke each year 3rd major cause of death in the US 7 Changes in CVD over time CVD is a modern disease a b People didn t used to live long enough to develop heart disease c Died from infectious diseases at a young age d Can be attributed to changes in diet and activity level i That s accompanied modern life ii More fat and calories now iii More sedentary now e Deaths declining i Better medical care 1 2 Detection ii Healthier life styles Surgery 1 Framington Heart Study in book a Our behavior may affect if we get heart disease b 1st study to look at a group of people and their risk factors for heart disease longitudinal Surgeon general s report on dangers of smoking 2 8 Risks for CVD and others a Inherent risks i Age positive correlation between age and chances of dying from CVD 1 Simple relationship 2 2 As age increases risk for CVD or dying from stroke or heart attack increases ii Family History people with a family history of CVD are more likely to die of CVD Simple relationship 1 2 May be due to genes and environmental interaction People in family have same genes that make them vulnerable a b People in family also share an environment i The might make genes express themselves or turn on c Refers to epigenetics iii Can t change these factors iv Gender 1 Complicated relationship a Rate of CVD is higher in men than women b Men have earlier onset of CVD than women may explain why rates are higher 2 Why men develop sooner Lifestyle difference a b More likely to smoke drink and have an unhealthy diet c Men might not cope with stress as well 3 Why more dangerous for women a 1 st heart attack i Women 50 chance of dying ii Men 30 chance of dying iii Of those that survive 38 of women die within the year 25 of men die within the year b More research on why women develop CVD later 1 2 i Women tend to not develop until after menopause ii Women gain weight after menopause and don t lose it weight is a risk factor iii Changes in blood pressure and cholesterol 4 Men are more likely to have a stroke than women v Ethnic Background 1 African American 2x risk for CVD than Euro Americans a Most researchers think the difference is not biological but due to social economic and behavioral differences b AA s are more likely to be discriminated against i Social difference c AA s often have lower SES d AA s may have an unhealthier lifestyle 2 Native Americans Asian Americans and Hispanic Americans a Have a lower risk for CVD 9 Physiological Risks a Hypertension best predictor of biggest risk factor for CVD regardless of age or gender i As your blood pressure increases your risk factors increase for CVD b Serum cholesterol level serum cholesterol levels are a risk factor for CVD Lipoprotein fats and proteins i ii High density Lipoprotein HDL protects against CVD good iii iv v High cholesterol is a bigger risk factor for middle age 55 or 60 than older people Low density Lipoprotein LDL risk factor for developing CVD bad Look at total cholesterol levels and 4 5 to 1 or less Total compared to HDL c Problems in glucose metabolism i Problems in glucose metabolism are particularly damaging to arteries and increases the risk for CVD ii Don t have to be diabetic to have problems digesting glucose ex metabolic syndrome d Inflammation response of the immune system 3 i Chronic inflammation