CV Risk Factors

Question 1

what is a cardiovascular risk factor?

Answer 1

factor that predisposes an individual to development of atherosclerosis

Question 2

considerations taken into account when labeling something as a CV risk factor

Answer 2

strong statistical association
consistent across gender, age…
biology: makes biological sense
treatment that favorably changes risk factor should reduce the incidence of disease
factor must make independent contribution to increasing an individual’s risk of developing disease

Question 3

CV risk factor types

-examples

Answer 3

modifiable
-blood pressure
-obesity
-alcohol consumption
-smoking
-exercise
direct CV markers
-abnormal blood lipid levels
-high-sensitivity to C-reactive protein
-NT-proBNP
unmodifiable risk factors
-age
-gender
-family history
-ethnic origin
-diabetes type I
-previous MI/stroke

Question 4

CV risk factors or health indicators (8)

Answer 4

age
smoking
obesity
BP
cholesterol
diabetes
family history
physical activity level

Question 5

smoking as a risk factor

• counted toward risk stratification if…
• has adverse effects on…

Answer 5

counted if
-current
-quit w/in last 6 months
adverse effects on
-tissue healing times
-lung function
-CV function

Question 6

HP 2020

• what is it for?
• what does it say?

Answer 6

for nutrition/weight status and risk of illness
maintain healthy diet and weight to reduce risk of
-pretty much any bad disease

Question 7

role of diet in health

Answer 7

important in preventing disease and controlling morbidity

Question 8

increased consumption of energy dense foods high in _____ and low in _____ has led to increases in obesity, diabetes, CV disease, cancer, and osteoporosis

Answer 8

high in saturated fat

low in unprocessed carbs

Question 9

current nutritional patterns

• energy intake averages (industrialized countries)
• increase in calories from _____ fat
• fat to energy ratio is…
• servings of fruits/vegetables…

Answer 9

3380 kcal per capita per day
increase in calories from aimal fat
fat to energy ratio above recommended 35%
fruit/vegetable servings varies significantly i different parts of world

Question 10

proper nutrition national resources

Answer 10

choose my plate

my pyramid worksheet

Question 11

obesity

-definition

Answer 11

imbalance of energy intake and expenditure

Question 12

BMI

• how do you calculate it?
• categorizations

Answer 12

weight (in kg)/height squared (in meters)
categories
-underweight: below 18.5
-normal: 18.5-24.9
-overweight: 25.0-29.9
-obese: 30.0 and above

Question 13

energy expenditure for weight loss (expenditure vs. intake)

Answer 13

200-300 kcal more expended than consumed

Question 14

obesity relation to physical function

Answer 14

negative effect on performance in children (mental and physical)
negative effect on physical function in older adults
increased musculoskeletal pain limiting work
increased low back pain and depression limiting work
decreased force production and muscle activation
increased frequency of total hip and knee and poorer total knee outcomes

Question 15

implications of obesity for PTs

Answer 15

measure BMI in all clients
-consider waist circumference and waist:hip ratio as well
prescribe appropriate exercise for weight loss and other musculoskeletal limitations
evaluate effect of obesity on PT outcomes

Question 16

central adiposity study findings

Answer 16

low fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehab

Question 17

abdominal adiposity associated with increased risk for…(4)

Answer 17

type 2 diabetes
dyslipidemia
hypertension
CV disease

Question 18

waist circumference evidence

Answer 18

when BMI is normal, waist circumference not enough
when BMI is overweight, waist circumference can indicate whether weight is muscle or fat
risk increase when waist circumference measures
-women > 35 inches (88 cm)
-men > 40 inches (102 cm)

Question 19

waist and hip circumference and risk

Answer 19

slide 25

Question 20

systolic vs. diastolic

Answer 20

systolic
-time when heart contracts and blood moves out along vessels
diastolic
-time when heart relaxes and blood fills the heart

Question 21

high BP can lead to…

Answer 21

stroke
blood vessel damage arteriosclerosis)
heart attack or heart failure
kidney failure

Question 22

classification of BP in adults

Answer 22

-systolic 160 OR diastolic > 100 = hypertension stage 2

Question 23

classification of BP

Answer 23

for individuals not taking antihypertensive medication and not acutely ill
higher risk category should be used

Question 24

potential lifestyle modifications for HTN

Answer 24

weight control
dietary management
increase physical activity
alcohol moderation
restriction of dietary sodium (Na+)
adequate intake of dietary Ca2+, K+, Mg2+
stress managment
smoking cessation
check with MD

Question 25

endurance training and BP

Answer 25

generally reduces resting BP | training-induced changes generally reverse if training is stopped

Question 26

HTN and physical therapy outcomes

Answer 26

HTN management may affect post-stroke outcomes HTN associated with faster rates of mental and physical decline in community dwelling older adults comordidity has negative effect on physical functioning patients with LBP who used narcotics have higher incidence of HTN

Question 27

cholesterol and atherosclerosis

Answer 27

-phospholipids start in liver and are synthesized in all body cells cholesterol is an essential component of cell membranes and myelin sheaths

Question 28

lipid component sources

Answer 28

exogenous (absorbed from GI tract) | endogenous (formed within cells)

Question 29

main lipids (4)

Answer 29

triglycerides VLDL LDL HDL

Question 30

VLDL - produced in... - rich in... - transports... - breaks down into...

Answer 30

produced in liver rick in TG (>65%) and cholesterol (20%) transports endogenous lipids outside liver breaks down into LDL

Question 31

LDL - occurs from... - composed of... - accounts for how much of total blood cholesterol - contain... - high _____ potential - activates... - if there is too much...

Answer 31

occurs from breakdown of VLDL > 60% cholesterol accounts for >60% of total blood cholesterol contain apoprotein B-100 high atherogenic potential activates monocytes --> macrophages (inflammation in vessels) if too much, it builds up in the blood and creates plaque, causing atherosclerosis

Question 32

HDL - produced where? - function - does not contain... - protective against

Answer 32

produces outside liver transports cholesterol released due to cell membrane turnover (normal) to the liver (scavenger) do not contain apoprotein B-100 protective against atherosclerosis

Question 33

triglycerides - used by... - stored in... - how are they transported and why that way?

Answer 33

used by muscle cells for energy production stored in adipose tissue for later use packaged in lipoproteins for transport in blood because all lipid molecules (cholesterol and TG) are insoluble in water

Question 34

chylomicrons and lipoproteins

Answer 34

``` transport dietary lipids to other parts of body inner core of sterols -cholesterol -steroid hormones outer shell of protein receptors -lipoprotein a -lipoprotein b they could not travel around in blood without shell of proteins ```

Question 35

relationships between cholesterol and heart disease

Answer 35

marked increase in incidence of MI with total cholesterol > 200 mg/dl MI correlation stronger for LDL than with total cholesterol elevated apoB (LDL like) also associated with CHD low levels of HDL

Question 36

cholesterol panel in adults

Answer 36

``` desirable -LDL 60 borderline -LDL 130-159 -total 200-239 high -LDL >160 -total >240 ```

Question 37

effects of exercise on lipoproteins

Answer 37

``` increases HDL endurance training increases -receptor activity -HDL -lipoprotein lipase LPL (enzyme that changes VLDL to LDL) endurance training decreases -LDL (increases transformation of cholesterol into bile) -triglycerides ```