Download Understanding the Cardiovascular System

Understanding the
Cardiovascular System
Sub-Components of the Cardiorespiratory System
Heart
Blood
Blood Vessels
Lungs
Function of Cardio-Respiratory
Systems
Primarily to:
Transport and exchange gases(O2 and
CO2)
Deliver nutrients to cells
Anatomical Considerations of
the Heart
Size of a closed fist
Located in the mediastium of the
chest cavity
Basics Of Heart Anatomy
It is a four chambered structure
Two upper chambers: atria or atrium
Two lower chambers: ventricles
It is divided into right and left sides
by muscular tissue known as the
septum
Basics Of Heart Anatomy #2
By being divided into right and left
sides, the heart is able to serve two
systems:
Pulmonary
Systemic
Blood Flow in the Heart
www.medicine.osu.edu/exam
The Circulatory System
Exchange of Gasses
Oxygen rich air is
delivered to alveoli
with inspiration
Oxygen diffuses
into the blood
The body does not
use all of the
inhaled oxygen
Hypertension/High Blood
Pressure
Blood Pressure:
The driving force that moves blood
throughout the body.
The pressure exerted by the blood on
the walls of the arteries.
Normal Blood Pressure
120/80
120 is the systolic reading
80 is the diastolic reading
NEVER 80/120
Systolic Blood Pressure
120/80
The highest pressure or value
Occurs during heart contraction
phase (ventricular contraction)
Diastolic Blood Pressure 120/80
The lowest pressure or value
Occurs during heart relaxation phase
(resting or refilling stage of the
contraction)
Cardiovascular Disease
60-70 million Americans have one or
more forms of CVD
Cardiovascular Disease
1 million deaths each year
275 billion dollars
Cardiovascular Disease
Cardiovascular disease (CVD) is the
number one cause of death in the
United States.
Cardiovascular Disease
2600 Americans die each day from
CVD
1 death every 33 seconds
Claims more lives each year than the
next 7 causes of death combined
(AHA ’99)
Forms of Cardiovascular Disease
Coronary artery disease (CAD or
CVD)
Hypertension (high blood pressure)
Cerebral vascular accidents (strokes)
Angina pectoris
Peripheral vascular disease
Forms of CVD #2
Valve disease
Rheumatic heart disease
Congenital heart disease
Congestive heart failure
Coronary Artery Disease (CAD)
Primary form of heart disease
A disease involving waxy plaque build-up
in the arteries
Atherosclerosis
Cardiovascular Disease
Has anyone in your family had bypass
surgery?
Blocked arteries?
Plaque build-up
Related to high cholesterol levels
sustained over time
Occurs, primarily, in vessels closest to
the heart
Surgical Procedures
Plaque rupture
Bypass (7 yr.average)
Angioplasty
Roto Blade
CAD Post-Op Patient
What behavioral and dietary changes
were suggested for the patient?
Can One Be FIT But Not
Healthy?
Personal profile example
Run 3 miles daily
Lift weights
Stretching exercises
Smokes, stress, excessive alcohol,
fatty foods, drugs, etc.
Jim Fixx
36 years old, 215 pounds
2 pack a day smoker
No regular exercise
Family history of heart disease
father had a heart attack at 35, died at 43
Began to exercise at age 36
Ran 60-80 miles per week
Was FIT but not HEALTHY
Coronary Risk Factors
Primary Risk Factors: Factors that
have been definitively associated with
or directly cause coronary artery
disease.
Secondary Risk Factors: Factors
believed to contribute to or advance
the severity of atheroschlerosis and
CAD.
Primary Risk Factors (Alterable)
Smoking
Hypertension (high blood pressure)
High serum cholesterol
Physical inactivity
Diabetes mellitus
Obesity
Family History?
Secondary Risk Factors
Stress
Age
Gender (male vs. female)
Arkansas Stats from the Center
for Disease Control/Mortality
Rates
Males #2 in deaths from CAD
Males #2 in deaths from lung cancer
Males and Females # 1 in deaths from
stroke
Additional Ark. Stats
1/3 of deaths in AR related to CVD
(l998)
90% of adults report no vigorous
activity
36% do not engage in any physical
activity
Arkansans are gaining weight 3 times
faster than the rest of the nation
Examining CAD Risk
Factors
(Primary
followed by Secondary)
Smoking #1
The single most important,
preventable cause of illness and early
death
Smoking #2
400,000 related deaths per year
>$50 billion
Cancer, heart disease, respiratory
diseases (emphysema)
Cigarette smoking and passive smoke
inhalation are highly related to CAD.
Smoking #3
Smokers have a 70% greater level of
coronary risk than nonsmokers.
Magnitude of risk is related to
number of cigarettes smoked.
Pipe, cigar, pot
Personal economics of smoking
Secondary Smoke
53,000 annual deaths
For each pack of cigarettes smoked,
the non smoker, sharing the same air,
will inhale the equivalent of 3 to 5
cigarettes.
Smokeless Tobacco
Chewing tobacco
Actions of Cigarette Smoke on
the Body
Injures the inner lining of the
arteries
Increases the risk of blood clotting
Increases the risk of myocardial
infarction
Lowers HDL cholesterol
Hypertension (High Blood
Pressure)
A silent killer
140/90 : considered mild stage of
hypertension
Which is more problematic? 140/80
or 130/95
Potentially leads to stroke
Hypertension #2
Related to stroke/aneurysms
Hypertension may be the result of
another health problem
Factors Affecting Blood
Pressure
Hypertensive medications
Time of day
Full bladder content
Body posture
Recent intake of caffeine
Nicotine
Alcohol
Recent strenuous activity
Impact of Hypertension
25% or 50 million Americans are
hypertensive
67% are not treated
1/2 are unaware of the complication
Factors Contributing To
Hypertension
Age
Race
Sodium sensitivity
Chronic alcohol abuse
Oral contraceptives
Sedentary living
Lifestyle Interventions to
Maintain or Lower Blood
Pressure
Body weight reduction or
maintenance
Smoking cessation
How To Lower Blood Pressure
Aerobic exercise
Reduce stress
Reduce cholesterol, sodium, high fat
diet (saturated)
Medications
Hyperlipidema/High Serum
Cholesterol
Definition of Cholesterol
A type of lipid (fat) found in animal
tissues
This fat (Lipid) is insoluble in blood
It binds to proteins (lipoproteins) in
order to be transported in the body
Plant sources have no cholesterol
What Foods Do I Eat That
Contain Cholesterol and
Saturated Fat?
Primarily, animal products and byproducts
A few plants contain saturated fat
but no cholesterol
Tropical oils (palm, coconut)
What Are Some Foods That
Contain Tropical Oils?
Commercially baked products
Popcorn at the movie
What Happens When I Eat Saturated
Fat and Cholesterol Containing (Dietary
Cholesterol) Foods?
The body takes in the cholesterol
The body takes in the saturated fat
and makes increased amounts of “bad”
cholesterol (LDL)
Raises the body’s serum cholesterol
level
What Is So Bad About Having
High Cholesterol Levels??
High levels lead to a waxy, plaque
build-up in the arteries, especially
those near the heart.
The result is Coronary Artery
Disease (CAD)
Tell Me More About Plaque
Affects all of us
May begin as early as 10 years of age
May be genetic
Medications??
Cholesterol: 3 basic facts
Provides for basic functions of the
metabolic process
Is manufactured in the liver – nonessential
The body makes additional cholesterol
(LDL) from saturated fats
Lipoprotein Types or Cholesterol
Types
LDL
HDL
VLDL
LDL
Low density lipoproteins (BAD)
enhances plaque build up in the arteries
increases with a diet high in saturated
and trans-fatty acids (hydrogenated
products)
Undesirable, increases risk of CAD
HDL
High density lipoproteins (GOOD)
Offers protection from CAD
May remove plaque from the arteries
Aerobic activity will raise HDL level
Can be raised by consuming small
amounts of alcohol daily
VLDL
Very low density lipoproteins (VLDL)
undesirable and are associated with
increase risk of CAD
Serum Cholesterol Levels
Desirable
Borderline high
Risk for CVD
below 200
200-239
240or >
High Serum Cholesterol #2
If your cholesterol is 250, your risk
of heart attack is twice that of 200
If your cholesterol is 300, your risk
of heart attack is four times that of
200
Understanding Total Serum
Cholesterol Values
Knowing an individual’s total
cholesterol is not adequate when
determining coronary risk
Understanding Cholesterol
Ratios
Determine the ratio of total cholesterol to
HDL’s
Formula: TC/HDL
Example: Male, TC = 190, HDL = 34 (5.4)
190 divided by 34 = 5.4
Values equal to or greater than 5.0 for
men and 4.5 for women are associated
with risk.
6.0 = increased risk
4.0 = low risk
Usually, if HDL is < 35, heart attack risk is
Cholesterol Value Examples
Male
TC: 210
HDL:
32
Divide 210 by 32 =
6.56
6.56 : 1 ratio
Ratio is >5.0
Increased risk of
CAD
Male
TC: 220
HDL:
49
Divide 220 by 49 =
4.49
4.49 : 1 ratio
Ratio is <5.0
Low risk of CAD
Cholesterol Value Examples
Female
TC: 195 HDL: 36
Divide 195 by 36 =
5.42
5.42 : 1 ratio
Ratio is >4.5
Increased risk of
CAD
Female
TC: 195 HDL: 40
Divide 195 by 40 =
4.9
4.9 : 1 ratio
Ratio is > 4.5
Increased risk of
CAD
Cholesterol Value
Actual Example
Female
TC 207 HDL 74
207 divided by 74= 2.8
2.8 : 1 ratio
< 4.5
Very low risk CAD
How To Control Or Lower
Cholesterol
Avoid saturated
fats
fats from animal
sources
red meats
animal fats
animal by-products
Controlling Cholesterol #2
Avoid dietary cholesterol
Exercise
Consume a low fat diet (20% or less)
Watch egg consumption
Limit red meats (fewer than 3 times per
week)
Avoid commercially baked goods (tropical
oils and trans-fatty acids/hydrogenation)
Use skim milk
Controlling Cholesterol #3
Eat fish 2-3 times
per week
Bake, broil, steam
Remove excess fat
(soup, chili)
Is ground turkey
better?
Controlling Cholesterol #4
Avoid fatty sauces (fettuccini alfredo)
Substitute in recipes
Egg whites for eggs
Applesauce for oil in cakes
Salsa instead of butter for baked potatoes
Are there substitutions you make?
Maintain proper body weight
Physical Inactivity
Physical activity
levels and CAD are
strongly inversely
related.
Physical Inactivity #2
Sedentary individuals have:
2-3 times greater risk of CAD than
active individuals.
Twice the risk of fatal heart attacks
Physical Activity
Physical activity is
argumentably be
the single best
method of
controlling or
reducing CAD.
Collateralization
Physical Activity #2
Increases strength of the heart
Helps to establish and maintain
normal blood pressure.
Helps to control obesity due to
increase in caloric expenditure
Physical Activity #2
Raises HDL levels, while lowering LDL,
triglyceride and total cholesterol
levels.
Decreases resting heart rates
Helps to manage stress levels
Physical Activity #3
Increases resting and exercising
stroke volumes
Amount of blood pumped by the heart in
a single beat
Reduces the risk of diabetes
Diabetes Mellitus
Arkansas ranks 11th in the prevalence
of diabetes
New trends:
Increased cases of Type 2 diabetes
children
Increase in adults in the 30’s.
Diabetes Mellitus
A condition in which glucose is unable to
enter the cells
A disease associated with problems in
controlling blood glucose or blood sugar
The disease results when the pancreas has
problems producing insulin or the body can
no longer use insulin properly
Insulin is the “taxi” that carries sugar
from the blood to the cells
Blood Sugar Levels
Normal blood sugar levels: 65-110
Hyperglycemia
High levels of blood sugar
When sugar levels remain high, over time, it
damages the walls of the vessels
Leads to impairment of the circulatory system
Affects functioning of most organs
Problems healing (small cuts, amputations)
Blindness
Hypoglycemia
Low levels of blood sugar
It is appropriate to give sugar to the
diabetic in a hypoglycemic emergency
Some may experience hypoglycemia
but are not diabetic
protein is often recommended
Types of Diabetes
Type I: insulin dependent or juvenile
onset
Type II: maturity or adult onset,
usually non-insulin dependent
Gestational onset
Diabetes Mellitus: Adult Onset
The pancreas does
not produce enough
insulin or has just
forgotten how
Directly related to
obesity
90% of all cases
are Type II
Adult Onset #2
An 20% increase in body weight
doubles the chances of developing
diabetes
Example:
Appropriate weight = 160
20% weight gain = 192
How To Avoid Adult Onset
Diabetes
Control cholesterol
Control weight
Control blood pressure
Exercise regularly (aerobic)
Diabetics must plan for meals, insulin
injections, and exercise
Obesity
61% Americans are
overweight
25% are obese
Obesity: Fat Distribution
“Apples” Android Obesity
Fat distributed in upper body
Higher risk of CAD, strokes, diabetes
“Pears” Gynoid Obesity
Fat is distributed in the hips and legs
Obesity Is Related To:
High cholesterol
Hypertension / stroke
Elevated LDL levels
Lower HDL levels
Physical Inactivity
Diabetes
Obesity is also related to joint problems
Other Diseases Associated With
Obesity
Renal disease
Gallbladder disease
Pulmonary disease
Degenerative arthritis
Psychological problems
Some cancers
Post menopausal obese women 5 times more
likely to develop uterine cancer
Problems administering anesthesia
What Constitutes Obesity?
BMI > 25
> 20 lbs overweight
Body fat percentages
Men > 20% (25)
Women > 25% (30)
Secondary Risk Factors
Stress
Age
Gender
???Family History???
Stress:
Unmanaged stress
is related to CAD.
Type A personality
is related to CAD.
Age:
Men : 45 and over
Women: 55 and over
menopausal women who do not take
estrogen replacement therapy (2000
research contradicts this statement)
Family History: Primary or
Secondary?
The risk is greater when:
Father or other first degree relative
has a MI or sudden death prior to 55
Mother or another female family
member has a MI or sudden death prior
to 65
Family history of diabetes, hypertension
Gender
Men have a greater
history of CAD
earlier in life.
CAD is a disease of
“equal opportunity”