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Preventing Major Disease• Define cardiometabolic health, and list actions for lowering
cardiometabolic risk.• Explain the disease process of diabetes mellitus, and
describe the early symptoms and treatment for this disease.• Define hypertension, and discuss why it is dangerous and
ways to prevent it.• Describe the types of cholesterol that compose their
lipoprotein profile and the effects of each on heart health.• Explain how the heart functions, and define a myocardial
infarction.• Define stroke and transient ischemic attacks.• Discuss the most common types of cancer, and describe the
treatments for each.• List their cardiometabolic and cancer risk factors.
Chapter Learning Objectives
Topics Of Focus For This Chapter
Cardiometabolic Health
Heart Attack
Diabetes Stroke
Hypertension Cancer
Cholesterol Lifestyle
Cardiometabolic Health
Approaching the connection between risk factors, symptoms and diseases
CardioHeart
Blood vessels
MetabolicBiochemical processes involved in body functioning
Control Weight and Waist Circumference
Weight
Overweight teens have high risk of diabetes and heart disease in future
Obese men have dramatically higher risk of dying
Waist Size
Subcutaneous fat and visceral fat are dangerous
Avoid waists of: 40 inches for men 30 inches for women Potbelly with normal weight
Physical Activity Decreases Risk
All Least fit are at greater risk of death
MenMore rigorous exercise = greater protection and longevity
Women
30 minutes/day of moderate activity lessens risk
Fitness more important than overweight or obesity in cardiometabolic risk
Smoking Is The Most Significant Risk Factor
Causes over 250,000 deaths per year
Causes peripheral arterial disease
Active and passive smoking
Accelerate artery clogging Increase risk of developing coronary heart disease
Control Blood Sugar To Decrease Risk
Check your blood sugar to see if you are at risk
Blood Sugar
Healthy Under 100
Prediabetes 100-125
Diabetes Over 125
High Blood Pressure Increases Work Of Heart
Systolic
Over
Diastolic
Systolic = pressure during heart contraction
Diastolic = pressure during heart relaxation
EffectsHeart muscle gets strong and stiff
Accelerated development of plaque
ActionControl with diet, exercise and possibly medication
Control Cholesterol and Triglycerides
Desired Numbers
Total Cholesterol less than 200 AND: HDL over 40 mg/dL LDL less than 100
Low Triglycerides
Effects Best indicator of plaque in arteries
Action Cut back on high-fat foods
Exercise more
Cholesterol In Food
Risk Factors You Cannot Control
Family history
Race and ethnicity
Age
Metabolic Syndrome Is An Epidemic
General Effects
High blood pressure
High insulin levels
Abnormal cholesterol levels
Abdominal obesity
Diagnosis = 3 or more
Waist measurement (40 in, 35 in)
Triglycerides 150 or more
HDL less than 40 mg/dL
Blood Pressure of 130/85 or higher
Blood Sugar 110 mg/dL or higher
Metabolic Syndrome Risk Factors
Overweight or obese
Age 60 or older
Physically inactive or exercise less than 3 times/week
Parent or sibling with diabetes
Having baby over 9 pounds or gestational diabetes
Blood pressure 140/90 or higher
More Metabolic Syndrome Risk Factors
African American, Alaskan Native, American Indian, Asian American, Hispanic/Latino or Pacific Islander
HDL below 35 or Triglycerides above 250
Impaired fasting glucose or impaired glucose tolerance test
History of cardiovascular disease
Conditions associated with insulin resistance
Fasting blood sugar 101-125 = Prediabetes
Diabetes
Diabetes Shortens Life Expectancy
Men
Normal Response To Eating
Uncontrolled Diabetes
Effects Of Uncontrolled Diabetes
Damaged blood vessels
Blindness
Amputation
Kidney failure
Heart attack and stroke
Types Of Diabetes
Type 1
Immune system attacks insulin producing cells in pancreas
Develops often in young people, but can appear in adults
Type 2Pancreas does not make enough insulin or body is resistant to its insulin
GestationalDiabetes during pregnancy
At risk for diabetes later in life
Decrease Risk Of Type 2 Diabetes
Exercise 30 minutes 5 days/week
If overweight, lose weight
Diet rich in complex carbohydrates and fiber
Diet low in sodium and fat
Eat fruits and vegetables
Take medication recommended by physician
Signs And Symptoms Of Diabetes
Increased thirst and urination
Flu-like symptoms
Weight loss or gain
Blurred vision
Slow-healing sores or frequent infections
Nerve damage
Red, swollen, tender gums
Detecting Diabetes
Anyone over age 45 should be screened for diabetes every 3 years
Random blood sugar test
Fasting blood glucose test
Glucose challenge test
Controlling Diabetes Decreases Risk
A1c less than 7 percent
Blood Pressure 115/75
Cholesterol LDL less than 160
A
B
C
Hypertension
Risks
Family history
Obesity when young
Race
EffectsDeath especially for those with diabetes, kidney disease and obesity
Treatment
Lifestyle changes
Decrease sodium to 1.5 grams/day
Increase potassium to 4.7 grams/day
Exercise
Medication
Numerous Effects Of High Blood Pressure
Understanding Blood Pressure Numbers
Type of BP Systolic Diastolic
Prehypertension 120-139 80-89
Mild 140-159 90-99
Moderate-Severe 160 + 100
Low Less than 90
Hypertension is any one of the values above or a combination of values
Lipoproteins: Cholesterol And Triglycerides
RiskTotal
CholesterolTriglycerides
None Less than 200Less than
150
Borderline High
200-239 150-199
High 240 + 200 +
Lowering Lipoproteins Decreases Risks
Diet
Include nuts, soy, oats, plant sterols
Weight management
Physical activity
MedicationStatins
Needed for about half of those with high lipoprotein levels
Few Meet Criteria For Ideal Heart Health
Never smoked or quit more than 1 year ago
BMI less than 25
150 + moderate or 75 + vigorous minutes of exercise/week
4 + components of healthful diet
Total cholesterol less than 200
Blood pressure below 120/80
Fasting blood sugar below 100
Heart Anatomy
Heart Anatomy
• Blood moves through aorta to brain and body
Overview Of Blood Flow Through Heart
• Blood from body moves into right atrium
Right Atrium Contracts
• Blood moves into right ventricle
Right Ventricle Contracts
• Blood moves to lungs and then pulmonary vein
Left Atrium Contracts
• Blood moves into left ventricle
Left Ventricle Contracts
How Blood Flows Through Body
Understanding The Heart
Myocardium Heart muscle
Pericardium2-layer membrane surrounding heart
Lubricant between layers allows heart muscle to move freely
Systole Contraction of heart
DiastolePeriod between contractions when heart fills with blood
CapillariesSmallest blood vessels in body
Deliver oxygen via the blood and take up waste
Cardiovascular Risk Factors
Education Low education level at higher risk
Stress
Chronic = plaque & high blood pressure
Episodic = creates unstable plaque
Acute = trigger heart attack
DepressionDepression and heart disease are linked
Depressed women more likely to have heart attack
Anger Angry men at much higher risk
Cardiovascular Risk Factors Continued
CRPC-Reactive protein signals inflammation
Increased CRP increases risk
Homo-cysteine
May influence atherosclerosis
Illegal Drugs
Sudden increases in blood pressure
Left ventricular contraction
Irregular heart rhythms
Bacterial Infection
Streptococcus and chlamydia
Tips For Women To Avoid Heart Disease
Abstain from smoking
BMI less than 25
Exercise 150 + moderate or 75 + vigorous minutes each week week
Eat 4 + components of healthful
Non-HDL cholesterol less than 230
Blood pressure below 120/80
Fasting blood sugar below 100
Heart Disease Symptoms Different In Women
Pay attention to these early signs of disease
Pain in back, between shoulders
Sick to stomach
Feeling scared or nervous
Pain in belly above belly button
New or worse headaches
More Symptoms In Women
Tiredness, even after getting enough sleep
Trouble breathing
Trouble sleeping
Ache in chest
Chest feeling ‘heavy’ or ‘tight’
Burning feeling in chest
Pain or tightness in chest that spreads
Aspirin Is Recommended For Some
Aspirin may reduce heart attack risk, but may also increase bleeding
Aspirin decreases clotting risk, but increases bleeding risk
Must consider risk of gastrointestinal bleeding when choosing to take aspirin
Men 45 to 79 to reduce risk of heart attack
Women 55-70 to reduce risk of stroke
Heart Health Conditions
Coronary Artery DiseaseArteriosclerosis – degeneration and hardening of arterial walls
Atherosclerosis – arteriosclerosis plus plaque deposits on walls of arteries
Heart Conditions
Angina PectorisDue to brief lack of oxygen to heart
Severe, suffocating chest pain
Heart Attack / Myocardial InfarctionWhen portion of heart does not receive oxygen and begins to die
Cardiac Arrest
Heart stops beating
Symptoms Of A Heart Attack
30 minutes or more of chest pain that is not relieved with rest
Chest pain radiating to shoulder, arm, neck, back or jaw
Anxiety
Sweating or cold, clammy skin
Nausea and vomiting
Shortness of breath
Dizziness, fainting or loss of consciousness
If experiencing heart attack symptoms, take 325 mg of aspirin and seek immediate
medical attention
If experiencing heart attack symptoms, take 325 mg of aspirin and seek immediate
medical attention
Cardiac Arrest
CPRCardio-pulmonary resuscitation
Combining rescue breaths with chest compressions creates circulation
AED
Automatic External Defibrillator
Portable device available in most public places can restart a heart that has a lethal rhythm
ActionControl with diet, exercise and possibly medication
Cerebrovascular Accident Explained
Defined‘Stroke’ occurs when blood supply to brain in blocked
TypesIschemic – blockage of flow by cerebral thrombus or cerebral embolism
Hemorrhagic – blood vessels rupture
TIA
Transient Ischemic Attack
Little strokes with minimal damage
Doubles risk of heart attack
Cerebrovascular Accident Risk
Risk Factors
Women, especially during hormonal changes
Men across the lifespan
Heart disease and diabetes
Obesity and diet high in fat and sodium
Age – risk doubles every decade after 55
Race – high in blacks and Hispanics
High red blood cell count
High blood pressure
Effects Of Stroke On Brain
Cancer
Defined
Uncontrolled growth and spread of abnormal cells
Abnormal cells divide and create tumors
Forms Countless and with different genetics
Action Infiltration – Crowds out healthy cells
Metastasis – spreads through blood or lymph to other parts of body
How Cancer Metastasizes
Cancer Risk
Affects all social, economic and educational levels
Obesity
Black Americans have higher mortality
Heredity – such as BRCA gene
Infectious Agents – Viruses
Common Cancers
Carcinoma Arises in epithelium
SarcomaStarts in supporting or connective tissues of body
Leukemia Begins in blood-forming tissues
Lymphoma Forms in lymph cells
Cancer Warning Signs
Change in bowel or bladder habits
Sore that doesn’t heal
Unusual bleeding or discharge
Thickening or lump in breast, testis or elsewhere
Indigestion or difficulty swallowing
Obvious change in wart or mole
Nagging cough or hoarseness
Skin Cancer
Basal Cell Cells in top level of skin
Squamous Cell
Cells in epidermis
Actinic Keratoses
Not cancer, but 40% become squamous cell carcinoma
Malignant Melanoma
Most lethal form of skin cancer
Malignant Melanoma Is Most Dangerous
Risk Factors
Fair skin, light eyes or fair hair
Tendency to burn instead of tan
Childhood sunburn or intermittent, intense sun exposure
Personal or family history
Large number of moles or atypical moles
Warning Signs Of Melanoma
Asymmetry
Border Irregularity
Color
Diameter
A
B
C
D
Every Woman Is At Risk For Breast Cancer
Increased Age Age at first childbirth
Breast biopsies First period before 12
Many occupations Hormone Therapy
Obesity Sedentary lifestyle
2 or more drinks per day
White or African American
Family History
Risk Increases With Age
Detecting Breast Cancer
Mammography
Recommended annually for women over 40
Best detection tool
Breast Self-Exam
Monthly at home
Every 3 years by trained practitioner
MRIRecommended if strong family history or Hodgkin’s Disease
Cervical and Ovarian Cancer
Risks for cervical cancer Sexual activity before 16 Genital herpes Multiple sexual partners HPV Secondhand smoke
Risks for ovarian cancerFamily history of ovarian cancer
Infertility
Personal history of breast cancer
Obesity
Low levels of transferase
Testicular Cancer Rates Are Increasing
Risk
Men at 18-35
Undescended testicle
Chronic marijuana use
Detection
Perform monthly testicular exam
One testicle larger than other
Dull ache in groin or abdomen
TreatmentSurgery to remove testicle
Radiation, chemotherapy
Colon And Colorectal Cancer
Risk
Factors
Age over 50
History of rectal cancer or polyps
Smoking
Alcohol consumption
Prolonged high consumption of red and processed meats
High-fat or low-fiber diet
Ulcerative colitis
Detection Colonoscopy at 50
Prostate Cancer
Risk
Factors
Increasing age
Family history
Exposure to cadmium
High number of sexual partners
Frequent STIs
High-fat diet
Detection Prostate-specific antigen test
TreatmentHormones and low-fat diet
Chemotherapy and radiation
Epilepsy
DefinedSudden attacks of violent muscle contractions and unconsciousness
DiagnosisElectroencephalogram (EEG)
Recurring attacks
Treatment Anticonvulsant drugs
Asthma
Risk
Factors
African American
Inner-city
Secondhand smoke exposure
Symptoms
Wheezing
Shortness of breath
Tightness of chest
Coughing
Steps To Control Asthma
1. Get away from trigger
2. Assess severity of attack
3. Use quick reliever
4. Suppress inflammation
5. Know when to call for help
Ulcers
DefinedOpen sores in lining of stomach or duodenum
Cause Excessive acidic digestive juices
Symptom Burning pain in upper abdomen
Treatment
Antibiotics (if H. pylori)
Avoiding aspirin
Eating small, frequent meals
Taking antacids
Not smoking or drinking and avoiding caffeine
