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 Modifiable risk factors for heart disease o Hypertension 140 90 mmHg confirmed on 2 or more occasions or on blood pressure meds o Dyslipidemia 130 mg dl LDLs or on lipid lowering meds or HDL 40 mg dl If total serum cholesterol I all that is available 200 mg dl total cholesterol Negative risk factor HD L cholesterol 60 mg dl o Obesity 30 kg m2 or waist girth men 102 cm 40 in women 88 cm 35 in o Prediabetes Impaired Fasting Glucose IFG 100 mg dl but 126 mg dl or IOGT 140 mg dl but 200 mg dl confirmed on 2 occasions o Sedentary lifestyle not participating in at least 30 mins of moderate intensity 40 60 VO2 on at least 3 days week for at least 3 months o Smoking or those who quit within 6 months or exposure to environmental tobacco Non modifiable risk factors for heart disease o Age Men 45 years old Women 55 years old o Family history MI revascularization open heart angioplasty etc death Before 55 yrs old for father or first degree male relative Before 65 yrs old for mother or first degree female relative o Male gender Emerging risk factors for CAD o Triglycerides o Small LDLs o Lipoprotein o Lipoprotein remnants o Apolipoproteins o Total cholesterol to HDL ratios o Homocysteine o Inflammatory markers ex C reactive protein o Thrombogenic and hemostatic factors ex fibrinogen clotting 2 What are the sources of injury that can happen to the endothelium of the arteries What is Nitric Oxide Sources of injury to the endothelium of the arteries o Dyslipidemia abnormal lipid levels o Hypertension increase in BP o Immune responses body attacks itself o Smoking o Vasoconstrictor substances o Viral or bacterial infections o Homocysteine red meat damage to vessels o Diabetes high levels of glucose o Menopause loss of estrogen risk of heart disease Nitric Oxide vasodilator helps prevent injury to the endothelium of arteries decreases platelet aggregation etc 3 What are the range of values for cholesterol HDLs LDLs triglycerides hematocrit hemoglobin fasting glucose blood pressure BMI waist circumference and hip to waist ratio Total serum cholesterol levels o 200 mg dl desirable cholesterol o 200 239 mg dl borderline high cholesterol o 240 mg dl high cholesterol HDL cholesterol levels o 40 mg dl low HDL cholesterol LDL cholesterol levels o 100 mg dl optimal o 100 129 mg dl near optimal o 130 159 mg dl borderline high o 160 189 mg dl high o 190 mg dl very high o 150 mg dl normal o 150 199 mg dl borderline high o 200 499 mg dl high o 500 mg dl very high Triglyceride levels Hematocrit o Men 40 52 o Women 36 48 Hemoglobin o Men 13 5 17 g dl o Women 11 5 15 5 g dl Fasting glucose o 60 99 mg dl Blood pressure mmHg o Optimal systolic 120 diastolic 80 o Pre hypertension systolic 120 139 or diastolic 80 89 o Hypertension Stage 1 systolic 140 159 or diastolic 90 99 Stage 2 systolic 160 or diastolic 100 BMI criteria kg m2 o Normal 18 5 24 9 o Overweight 25 0 29 9 o Obesity Class I 30 0 34 9 Class II 35 0 39 9 Extreme 40 0 Waist circumference o High risk Men 0 95 Women 0 86 Waist to hip ratio o Risk factor for CVD other diseases Men 40 in 102 cm Women 35 in 88 cm 4 What blood tests are used to check the health of the kidneys and liver Kidney tests Liver tests o Blood Urea Nitrogen BUN o Creatine o Bilirubin o Serum Glutamic Oxaloacetic Transaminase SGOT o Serum Glutamic Pyruvic Transaminase SGPT 5 What are some health and fitness benefits of regular physical activity Premature mortality CVD CAD hypertension stroke osteoporosis type 2 diabetes mellitus metabolic syndrome obesity colon cancer breast cancer depression functional health falls and cognitive function 6 What is a PAR Q test PAR Q Physical Activity Readiness Questionnaire o Minimal standard for entry into moderate intensity exercise program o Yes No question If answers yes should see physician 7 What are the components of a medical history and informed consent Medical history o Medical diagnosis o Previous findings on physical examinations o History of symptoms allergies o Recent illnesses and surgical procedures o Orthopedic problems o Medications o Other habits o Exercise habits o Work history o Family history Informed consent o Purpose and explanation of procedures or test o Risks and discomforts o Responsibilities of the participant o Benefits to be expected o Inquiries o Use of medical records o Freedom of consent o Place to sign 8 Know signs and symptoms of cardiovascular and pulmonary disease Pain in chest Shortness of breath at rest or with exertion Dizziness or syncope Orthopnea or nocturnal dyspnea Ankle edema sign of congestive heart failure Palpitation or tachycardia resting HR 100 bpm Known heart murmur most are benign but still need clearing by doctor Unusual fatigue or shortness of breath Intermittent claudication 9 How do you classify individuals as low moderate or high risk Low risk Moderate risk High risk o Asymptomatic men and women who have 1 CVD risk factor o Asymptomatic men and women who have 2 CVD risk factors o Individuals with signs symptoms or have known cardiovascular pulmonary or metabolic disease 10 When should a doctor be present during a submaximal or maximal test Submaximal test high risk Maximal test moderate or high risk 11 When starting a moderate or vigorous exercise program when does one need a physical exam or clearance from a physician Moderate exercise program high risk Vigorous exercise program moderate or high risk 12 Know systolic diastolic and mean arterial pressure Know how to calculate all three formulas of MAP Know formulas for PP and RPP Systolic BP maximal pressure in the arteries during contraction of the heart Diastolic BP minimum pressure in the arteries during relaxation of the heart Mean Arterial Pressure MAP o Direct measure MAP CO x TPR o Indirect measures Pulse Pressure PP o PP SBP DBP Rate Pressure Product RPP o RPP HR x SBP 100 When HR 100 bpm MAP 1 3 SBP DBP DBP When HR 100 bpm MAP 1 2 SBP DBP DBP 13 Know how to calculate BMI Know how to make conversions from English measurements 14 Know the different ECG leads chest leads limb leads precordial extremity unipolar to metric 2 54 cm 1 inch 100 cm 1 m
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