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U2 Health Psychology > Lecture 13 - Heart disease, hypertension, stroke and diabetes > Flashcards

Lecture 13 - Heart disease, hypertension, stroke and diabetes Flashcards

1
Q

what is Cardiovascular Disease (CVD)

A

CVD = disease anywhere within the cardiovascular system (i.e. the heart blood vessels, and veins)

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2
Q

what are the different types of CVD

A

Coronary Heart Disease

Atherosclerosis in Coronary Arteries

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3
Q

Coronary Heart Disease: What is it?

A

General term referring to illnesses caused by atherosclerosis
ì narrows or blocks the coronary arteries (vessels that supply heart with blood)

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4
Q

what can Heart Disease lead to

A

ì Angina pectoris ì Heart attack

Stroke

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5
Q

explain the CHD: Role of Stress

A

Exposure to chronic stress
􏲐In the worry and strain of modern life arterial degeneration is not
only very common, but develops often at a relatively early age. For this I believe that the high pressure at which men live, and the habits of working the machine to its maximum capacity, are responsible, rather than excesses in eating or drinking.􏲑 Sir William Osler, 1901

Anger, particularly cynical hostility, is most related to CHD

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6
Q

Atherosclerosis and Stress: Possible Mechanism 1

A

Cardiovascular Reactivity to Stress
• Responsiveness of the cardiovascular system to stress
• Differs between people
• Stronger stress reactions –> 􏲐 contribute to inflammatory
processes leading to atherosclerosis

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7
Q

Atherosclerosis and Stress - Possible Mechanism 2:

A

The Role of Systolic BP Reactivity

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8
Q

Atherosclerosis and Stress: Possible Mechanism 3

A

Personality: Hostility, in particular cynical hostility, most related to higher inflammation in the arteries and thus CHD
• Higher levels of pro-inflammatory cytokines

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9
Q

CHD: Associations

A 
Negative Emotions
ì Strong associations between
ì Depression and heart attack
ì Hopelessness and heart attack
ì Anxiety and sudden cardiac death

Assumed to be due to direct and indirect effects.

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10
Q

Other (Related) Risk Factors for CHD

A 
ì Cigarette smoking
ì Diabetes
ì Hypertension
ì Obesity
ì Physical inactivity
ì Metabolic syndrome
     Obesity centered around the waist, high levels of triglycerides and low levels of HDL cholesterol. and difficulty metabolizing blood sugar
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11
Q

High Blood Pressure: Behavioural Influences

A 
Sodium consumption
• Increases water retention and blood volume
• Sodium reactivity
• Stress
• Obesity
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12
Q

what is Nocturnal Dipping

A

blood pressure lowers at night

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13
Q

why is lack of nocturnal BP dipping an issue

A

higher cardiovascular mortality
Non-dipper:
• BP drops less than 10% at night
Correlates with sleep quality, age, stress

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14
Q

what is the Treatment of Hypertension

A

Serious Hypertension: Medications
• Reduce blood volume (Diuretics)
• Reduce sympathetic activity (cardiac output)
• Beta-blocking agents are used in cardiac rehabilitation to
resist the effects of sympathetic nervous system stimulation

Meditation

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15
Q

what happens if poor adherence for hypertension

A

• Long term treatment (life-long) • Few symptoms

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16
Q

Treating/Healing Coronary Artery Disease: Lifestyle vs. Stents

A

Lifestyle changes: whole foods, plant-based diet, smoking cessation, moderate exercise, stress management (yoga, meditation), psychosocial support
Shows that partial reversal is possible through lifestyle change

17
Q

what is a Stroke

A

ì Blood flow to localized areas in brain interrupted
ì Cerebral hemorrhage
ì Transient ischemic attacks

18
Q

what are Transient ischemic attacks

A

Small strokes that produce temporary weakness, clumsiness, or loss of feeling in one side or limb

19
Q

Risk Factors for Stroke

A

Overlap heavily with those for heart disease
Some factors are hereditary, others result from lifestyle, and still others come from unknown causes
Risk factors include: ì High blood pressure
ì Heart disease
ì Cigarette smoking
ì High red blood cell count ì Transient ischemic attacks ì Psychological distress

20
Q

what is the correlation between Stroke and Depression

A

Depression is highly prevalent among stroke patients
Predictors of depression in such individuals include:
ì Overprotection by a caregiver
ì Site and severity of the stroke
ì Poor relationship with a caregiver
ì A caregiver with a negative viewpoint on the caregiving situation

21
Q

what are the forms of Cardiac Rehabilitation

A

ì Physical
ì Psychological ì Social
ì Vocational

22
Q

is exercise a good treatment for cardiac issues

A

Exercise

ì 50% drop-out rate within first 6 months

23
Q

explain the Cardiovascular Disease and Psychological Distress

A

n Anxiety and fear of future attacks n Leads to cardiac invalidism
n Depression extremely common

24
Q

how many canadians how diabetes

A

over 1.1 million

25
Q

what is diabetes

A

pancreas produces none or too little insulin

26
Q

what is a risk factor for diabetes

A

Overweight/Obesity as Risk Factor

27
Q

what is type I diabetes

A

Type I (􏲐insulin dependent􏲑): little to no insulin produced; ~10% of cases – insulin-dependent

28
Q

what is type II diabetes

A

Type II: insulin insufficiently produced or used,
~90% of cases
ì Generally develops relatively late in life (after age 40), but is becoming more common in children and adolescents

29
Q

what is Gestational Diabetes:

A

Temporary condition, affects 2% to 4% of pregnant women

30
Q

Diabetes: Warning Signs

A 
ì Very frequent urination
ì Excessive thirst
ì Often hungry, even after eating ì Unexplained large weight loss
ì Chronically tired
ì Occasional blurry vision
ì Wounds heal very slowly
ì Tingling or numbness in your feet
31
Q

explain how Stress Negatively Affects Diabetes

A

Stress has been implicated in:
ì Problems in glucose metabolism
ì Disruption of the performance of preventative health behaviours related to diabetes self- management
ì Adverse effects on adherence to diabetic treatment regimens and diet
ì The aggravation of both Type I and Type II diabetes after diagnosis

32
Q

explain Diabetes: Medical Treatment

A

ì Complex self-management regimen

ì 1/3 of deaths can be prevented through proper self-management

33
Q

what are the Adherence Issues in Diabetes

A

ì 80% of patients administer insulin in an unhygienic manner.
ì 58% administer the wrong dose of insulin.
ì 77% test or interpret the glucose levels incorrectly.
ì 75% do not eat the prescribed foods.
ì 75% do not eat with sufficient regularity

34
Q

what are some Diabetes: Interventions to Improve Adherence

A 
Interventions include:
ì Helping in self-injections
ì Training in monitoring blood sugar levels
ì Increasing self-efficacy
ì Mobilizing social support
ì Stress-management programs
ì weight control

Any intervention that focuses on improving a sense of self-efficacy and the ability to independently regulate one’s behaviour best predicts adherence with a diabetic treatment regimen in patients with diabetes

For adolescents (type 1 diabetes), the best outcomes are found among those whose parents are actively involved in tasks such as monitoring glucose levels

35
Q

is diabetes reversal possible

A

yes, type II with weight management

U2 Health Psychology (20 decks)

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