Cardiovascular Disease Flashcards
(49 cards)
Define Cardiovascular Disease?
An umbrella term for all the diseases of the heart and circulation, including CHD, angina, heart attack, stroke and congenital heart disease.
-Other types of CVD include heart valve disease and cardiomyopathy (disease of the heart muscle)
What may cause Coronary Heart Disease and Stroke
Atherosclerosis- When your arteries become narrowed by a gradual build-up of fatty material (atheroma) within walls.
Stenosis
Reduced blood flow- a narrowing of the lumen that disturbs blood flow.
How does atheroma build up?
Fatty deposits cause a narrowing and restrict the flow of blood through the artery.
-Less surface area for the blood to flow through- heart has to work harder to pump.
-In time, arteries become so narrow that they cannot deliver enough oxygen-rick blood to the heart- ANGINA- pain or discomfort in your chest.
-
How does a heart attack occur?
-A piece of atheroma breaks away from the arteries- causes a BLOOD CLOT.
-If the blood clot blocks the Coronary artery and cuts off the supply of oxygen-rich blood to the heart muscle.
-The heart muscle may become permanently damaged- HEART ATTACK.
How does a stroke occur?
When a blood clot blocks an artery that carries blood to the brain, it can cut off the blood supply to part of the brain.
Facts about Atherosclerosis
When arteries become narrowed by a gradual build-up of fatty material (atheroma)
-Can cause CHD (angina and heart attack) and stroke.
-Doesn’t have any symptoms at the start-many unaware they have it-can eventually cause life-threatening problems, eg heart attack and stroke.
-Is largely preventable with a healthy lifestyle.
-If left to get worse- can lead to serious conditions, such as CVD (no symptoms until CVD develops)
What are the types of CVD?
-CORONARY HEART DISEASE- Main arteries that supply the heart (coronary arteries) become clogged with plaque/atheroma.
-ANGINA- short periods of tight, dull/ heavy chest pain caused by CHD- may precede to a heart attack.
-HEART ATTACK (myocardial infaction)- Blood supply to the heart is blocked- causes sudden crushing/indigestion-like chest pain- can radiate to nearby areas, as well as shortness of breath, dizziness.
-STROKE- blood supply to brain is interupted- causes face to drop to one side, weakness on one side of body and slurred speech.
-TRANSIENT ISCHAEMIC ATTACKS (TIAs)- mini stroke- temporary stroke symptoms
-PERIPHERAL ARTERIAL DISEASE- blood supply to legs is blocked- causes leg pain when walking- lead to blood clot in legs.
What are the Non-Modifiable Risk Factors (can’t change/control)
-Genetics
-Gender
-Age
-Socio-economic status
-Ethnicity
-Low birth weight
Explain the Non-Modifiable Risk Factors?
GENETICS
GENETICS (Family History)-
-Family History of CVD indicates a person’s risk.
-First-degree blood relative (mother, father, brother) has had Coronary Heart Disease/ stroke before 55 years (male) or 65 (female)- risk increases.
GENDER
Man is at greater risk of heart disease than a pre-menopausal woman
-Once past menopause- woman’s risk is similar to male
-Risk of stroke- similar in men and woman
Progesterone and Oestrogen levels in woman (pre-menopausal) play a protective role in heart disease/health
AGE
-CVD becomes increasingly common with age.- as person ages, heart undergoes subtle physiologic changes, even in absence of disease.
-Heart muscle of aged heart relax between beats- results in pumping chambers becoming stiffer and work less efficiently.
-When CVD affects heart, age-related changes can compound (worsen) or its treatment.
-Don’t engage in as much physical activity
-Important to do physical activity when younger- strengthens heart-keeps heart powerful for then aging.
SOCIO-ECONOMIC STATUS
-Research shows- those from a low socio-economic background have a 50% greater chance of developing CVD than the wealthy, better educated counterparts.
-Due to less knowledge + understanding of risk factors involved in development-
-less money to purchase fresh fruit and vegetables and low fat products
-less money to be involved in physical activity, eg join a gym/sports club
-May be less sociable due to a job- lead to stress/depression-turn to smoking/alcohol as a coping mechanism
-Housing-dust/dampness- breathing in
-Less educated- not know abt importance of physical activity
ETHNICITY
-Ethnic Backgrounds, eg South Asians- live in UK- twice as likely to develop CHD compared to rest of UK population-
-Indian/Chinese- their diet- high fat (frying)- body composition (naturally more apple shaped in comparison to pear shaped)- bigger waist circumference- visceral fat.
-Those from African Caribbean background- higher average risk of developing hypertension.
LOW BIRTH WEIGHT
-Low birth weight- increase inflammatory processes- CVD in adulthood
-Inflammation- normal physiologic response of body- provides a protective response to infection/ tissue injury.
If the infection/injury is not repressed, low grade inflammation can persist + may promote development of heart disease in later life.
-Born with congenital conditions (neural tube defects, down syndrome)- continue in later life.
-MODIFIABLE RISK FACTORS -SMOKING
Smokers- twice as likely to suffer heart attack
-Experience shortness of breath + increased heart rate- carboxyhaemoglobin
-Damages lining of artery-lead to build up of atheroma- narrows artery-cause angina/heart attack/stroke
-Carbon Monoxide in TOBACCO- reduces amount of oxygen in blood- heart pumps harder to supply body with oxygen
-ALSO, attaches to haemoglobin- tissues starved of oxygenated blood-suffocate + die
-NICOTINE- stimulates body to produce adrenaline- heart beats faster + raise blood pressure- make heart work faster
-Blood likely to clot- increases risk of heart attack/stroke
-ACROLEIN- causes increased blood cholesterol levels- affects way body processes cholesterol- greater amount stays in blood- decreases ratio of HDL to LDL- atherosclerosis
PHYSICAL ACTIVITY
-Adult- 150m- moderate intensity per week
1hr vigorous activity per week
- STUDIES show this reduces risk of CVD by 30%
-Small increases in physical fitness- associated with significant reduction in CVD
-Regulates weight- overweight increases risk
-Active- beneficial- lowers blood pressure- risk factor for CVD
-Exercise- regulates blood glucose levels- risk factor- lowers LDL(leads to heart disease) + raises HDL (protects against heart disease)
-Reduces inflammation- powerful factor in development
-More difficult for blood clots- cause blockage in coronary arteries
-Releases endorphins (feel good hormone)- reduces stress- risk factor
-strengthens heart muscle
FRUIT AND VEGETABLE INTAKE
-Naturally contain antioxidants- fight against free radicals- cause CVD.
-Eg, Vit A (beta-carotene), C+E- offer protection against CVD-prevent free radicals from damaging arteries+cells that repair damage-if arteries damaged- atheroma likely to build up
-Contain:
-Folate- along with vitamin B6 + B12- help to make enzymes- remove amino acid homocysteine- damages artery lining- cause atheroma build up
-Mag, Pottassium + Calcium- lower blood pressure-CVD risk factor
-Calcium- reduce CVD- fatty acids in bowel attach to unabsorbed calcium- leave body in faeces
-Dietary Fibre- not eating 30g-factor
-Soluble fibre- reduce total LDL- reduce risk of CVD
-NSP- improves satiety- less likely to snack on HFSS foods- reduces obesity-factor
-naturally low in saturated fat + calories
EXCESSIVE ALCOHOL INTAKE
-Men + women- no more than 14 units per week.
-Drinking can increase risk of CVD:
-Increases risk of hypertension- important risk factor for heart attack/stroke.Increased blood pressure also caused by weight gain from excessive drinking
-Heavy drinking- weakens heart muscle-heart can’t pump blood as efficiently- CARDIOMYOPATHY- cause premature death- through heart failure
-Increases TRIGLYCERIDES + VLDL (very low density lipoprotein)- cause sudden heart attack+death (VDL=BAD)
HIGH BLOOD CHOLESTEROL
-Fatty substance found in blood- too much can increase risk of CVD:
-fatty substance carried around body by proteins:
Cholesterol + Protein combined- LIPOPROTEINS-2 types:
-LOW DENSITY LIPOPROTEIN- BAD- carry cholesterol from liver to cells that need it
-HIGH DENSITY LIPOPROTEIN- GOOD- carry cholesterol away from cells to liver to be broken down
-Too much LDL in blood- cause fatty material to build up in artery walls
HIGH RISK= high levels of BAD + low levels of GOOD
measured in millimols per litre (mmol/l) aim for total cholesterol under 5mmol/l
aim for LDL under 3mmol/l + HDL above 1mmol/l
-Cholesterol level- determined by amount body produces + type of fat eaten
TRIGLYCERIDES
-Type of fat found in blood
-When you eat- any calories not used immediately- converted to triglycerides
-Triglycerides stored in fat cells- later hormone release triglycerides for energy between meals- if you eat regularly more than you burn, eg “easy” calories- carbs and fats- high triglycerides- HYPERTRIGLYCERIDEMIA
-Unclear how- high triglycerides contribute to hardening of arteries/thickening of artery walls- ATHEROSCLEROSIS- increases risk of stroke, heart attack + heart disease
-HIGH TRIGLYCERIDES- sign of other conditions that increase risk of heart disease + stroke-inc. obesity + metabolic syndrome- cluster of conditions that includes too much fat around waist, hypertension, high triglycerides, high blood sugar + abnormal cholesterol levels
HOW TO LOWER TRIGLYCERIDES
-LOSE WEIGHT- If overweight, losing 5-10pounds can lower triglycerides
-CUT BACK ON CALORIES- Extra calories converted to TRIGLYCERIDES-stored as fat
-AVOIMD SUGARY + REFINED FOODS- simple carbs- eg. sugar + foods made with white flour- increase triglycerides
-CHOOSE HEALTHIER FATS- Swap SATURATED FAT- found in meats for healthier MONOSACCHARIDES- found in plants- eg olive + peanut oils.
Substitute fish- high in OMEGA-3 fatty acids, eg mackerel+salmon- for red meat
LIMIT ALCOHOL CONSUMPTION- alcohol- high in CALORIES + sugar + potent effect on TRIGLYCERIDES- small amounts can raise TRIGLYCERIDES
-EXERCISE REGULARLY- lower TRIGLYCERIDES and boost GOOD (HDL) cholesterol
TOTAL FAT
Contribution to dietary energy should be reduced to 35%- effect of dietary fats on blood cholesterol + triglyceride levels- influences risk of CVD
SATURATED FATS
Contribution of saturated fats to dietary energy- reduced to 10% because:
-Increases TOTAL BLOOD CHOLESTEROL= ATHEROSCLEROSIS
-Increases LDL (Bad) cholesterol
-Make blood more sticky- likely to clot
-Contribute to obesity- risk of CVD
-MYRISTIC ACID- main fat acid responsible for raising serum(blood) cholesterol levels:
-SOURCES: Butter, cheese, milk, eggs, meat
-Suppresses the cleaning mechanism at LDL receptors- hence raising blood levels
