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  • 1. 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
  • 2. Topics Of Focus For This Chapter Cardiometabolic Heart Attack Health Diabetes Stroke Hypertension Cancer Cholesterol Lifestyle
  • 3. Cardiometabolic Health Approaching the connection between risk factors, symptoms and diseases Heart Cardio Blood vessels Biochemical processes involved in Metabolic body functioning
  • 4. Control Weight and Waist Circumference Overweight teens have high risk of diabetes and heart disease in future Weight Obese men have dramatically higher risk of dying Subcutaneous fat and visceral fat are dangerous Waist Avoid waists of: Size  40 inches for men  30 inches for women  Potbelly with normal weight
  • 5. Physical Activity Decreases Risk All Least fit are at greater risk of death More rigorous exercise = greater Men protection and longevity 30 minutes/day of moderate activity lessens risk Women Fitness more important than overweight or obesity in cardiometabolic risk
  • 6. 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
  • 7. 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
  • 8. High Blood Pressure Increases Work Of Heart Systolic = pressure during heart Systolic contraction Over Diastolic = pressure during heart Diastolic relaxation Heart muscle gets strong and stiff Effects Accelerated development of plaque Control with diet, exercise and possibly Action medication
  • 9. Control Cholesterol and Triglycerides Total Cholesterol less than 200 AND:  HDL over 40 mg/dL Desired  LDL less than 100 Numbers Low Triglycerides Effects Best indicator of plaque in arteries Action Cut back on high-fat foods Exercise more
  • 10. Cholesterol In Food
  • 11. Risk Factors You Cannot Control Family history Race and ethnicity Age
  • 12. Metabolic Syndrome Is An Epidemic High blood pressure High insulin levels General Abnormal cholesterol levels Effects Abdominal obesity Waist measurement (40 in, 35 in) Triglycerides 150 or more Diagnosis = HDL less than 40 mg/dL 3 or more Blood Pressure of 130/85 or higher Blood Sugar 110 mg/dL or higher
  • 13. 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
  • 14. 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
  • 15. Diabetes
  • 16. Diabetes Shortens Life Expectancy Men
  • 17. Normal Response To Eating
  • 18. Uncontrolled Diabetes
  • 19. Effects Of Uncontrolled Diabetes • Damaged blood vessels • Blindness • Amputation • Kidney failure • Heart attack and stroke
  • 20. Types Of Diabetes Immune system attacks insulin producing cells in pancreas Type 1 Develops often in young people, but can appear in adults Pancreas does not make enough Type 2 insulin or body is resistant to its insulin Diabetes during pregnancy Gestational At risk for diabetes later in life
  • 21. 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
  • 22. 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
  • 23. 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
  • 24. Controlling Diabetes Decreases Risk A A1c less than 7 percent B Blood Pressure 115/75 C Cholesterol LDL less than 160
  • 25. Hypertension Family history Risks Obesity when young Race Death especially for those with Effects diabetes, kidney disease and obesity Lifestyle changes Decrease sodium to 1.5 grams/day Treatment Increase potassium to 4.7 grams/day Exercise Medication
  • 26. Numerous Effects Of High Blood Pressure
  • 27. 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
  • 28. Lipoproteins: Cholesterol And Triglycerides Total Risk Triglycerides Cholesterol Less than None Less than 200 150 Borderline 200-239 150-199 High High 240 + 200 +
  • 29. Lowering Lipoproteins Decreases Risks Include nuts, soy, oats, plant sterols Diet Weight management Physical activity Statins Medication Needed for about half of those with high lipoprotein levels
  • 30. 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
  • 31. Heart Anatomy
  • 32. Heart Anatomy
  • 33. Overview Of Blood Flow Through Heart Right• Blood from Ventricle body moves Contracts • Blood moves into right atrium into right ventricle Right Atrium Contracts Left Ventricle • Blood moves Contracts to lungs and • Blood moves • Blood moves through aorta then pulmonary vein into left to brain and ventricle body Left Atrium Contracts
  • 34. How Blood Flows Through Body
  • 35. Understanding The Heart Myocardium Heart muscle 2-layer membrane surrounding heart Pericardium Lubricant between layers allows heart muscle to move freely Systole Contraction of heart Period between contractions when Diastole heart fills with blood Smallest blood vessels in body Capillaries Deliver oxygen via the blood and take up waste
  • 36. Cardiovascular Risk Factors Education Low education level at higher risk Chronic = plaque & high blood pressure Stress Episodic = creates unstable plaque Acute = trigger heart attack Depression and heart disease are linked Depression Depressed women more likely to have heart attack Anger Angry men at much higher risk
  • 37. Cardiovascular Risk Factors Continued C-Reactive protein signals inflammation CRP Increased CRP increases risk Homo- May influence atherosclerosis cysteine Sudden increases in blood pressure Illegal Left ventricular contraction Drugs Irregular heart rhythms Bacterial Streptococcus and chlamydia Infection
  • 38. 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
  • 39. 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
  • 40. 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
  • 41. 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
  • 42. Heart Health Conditions Coronary Artery Disease Arteriosclerosis – degeneration and hardening of arterial walls Atherosclerosis – arteriosclerosis plus plaque deposits on walls of arteries
  • 43. Heart Conditions Angina Pectoris Due to brief lack of oxygen to heart Severe, suffocating chest pain Heart Attack / Myocardial Infarction When portion of heart does not receive oxygen and begins to die Cardiac Arrest Heart stops beating
  • 44. 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
  • 45. If experiencing heart attackIf experiencing heart attacksymptoms, take 325 mg of symptoms, take 325 mg ofaspirin and seek immediateaspirin and seek immediate medical attention medical attention
  • 46. Cardiac Arrest Cardio-pulmonary resuscitation CPR Combining rescue breaths with chest compressions creates circulation Automatic External Defibrillator AED Portable device available in most public places can restart a heart that has a lethal rhythm Control with diet, exercise and possibly Action medication
  • 47. Cerebrovascular Accident Explained ‘Stroke’ occurs when blood supply to Defined brain in blocked Ischemic – blockage of flow by cerebral Types thrombus or cerebral embolism Hemorrhagic – blood vessels rupture Transient Ischemic Attack TIA Little strokes with minimal damage Doubles risk of heart attack
  • 48. Cerebrovascular Accident Risk Women, especially during hormonal changes Men across the lifespan Heart disease and diabetes Risk Obesity and diet high in fat and sodium Factors Age – risk doubles every decade after 55 Race – high in blacks and Hispanics High red blood cell count High blood pressure
  • 49. Effects Of Stroke On Brain
  • 50. Cancer Uncontrolled growth and spread of abnormal cells Defined 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
  • 51. How Cancer Metastasizes
  • 52. Cancer Risk Affects all social, economic and educational levels • Obesity • Black Americans have higher mortality • Heredity – such as BRCA gene • Infectious Agents – Viruses
  • 53. Common Cancers Carcinoma Arises in epithelium Starts in supporting or Sarcoma connective tissues of body Leukemia Begins in blood-forming tissues Lymphoma Forms in lymph cells
  • 54. 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
  • 55. Skin Cancer Basal Cell Cells in top level of skin Squamous Cells in epidermis Cell Actinic Not cancer, but 40% become Keratoses squamous cell carcinoma Malignant Most lethal form of skin cancer Melanoma
  • 56. Malignant Melanoma Is Most Dangerous Fair skin, light eyes or fair hair Tendency to burn instead of tan Risk Childhood sunburn or intermittent, Factors intense sun exposure Personal or family history Large number of moles or atypical moles
  • 57. Warning Signs Of Melanoma A Asymmetry B Border Irregularity C Color D Diameter
  • 58. 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 White or African day American Family History
  • 59. Risk Increases With Age
  • 60. Detecting Breast Cancer Recommended annually for Mammography women over 40 Best detection tool Monthly at home Breast Self- Exam Every 3 years by trained practitioner Recommended if strong family MRI history or Hodgkin’s Disease
  • 61. Cervical and Ovarian Cancer Risks for cervical cancer  Sexual activity before 16  Genital herpes  Multiple sexual partners  HPV  Secondhand smoke Risks for ovarian cancer Family history of ovarian cancer Infertility Personal history of breast cancer Obesity Low levels of transferase
  • 62. Testicular Cancer Rates Are Increasing Men at 18-35 Risk Undescended testicle Chronic marijuana use Perform monthly testicular exam Detection One testicle larger than other Dull ache in groin or abdomen Surgery to remove testicle Treatment Radiation, chemotherapy
  • 63. Colon And Colorectal Cancer Age over 50 History of rectal cancer or polyps Smoking Alcohol consumption Risk Prolonged high consumption of red Factors and processed meats High-fat or low-fiber diet Ulcerative colitis Detection Colonoscopy at 50
  • 64. Prostate Cancer Increasing age Family history Exposure to cadmium Risk High number of sexual partners Factors Frequent STIs High-fat diet Detection Prostate-specific antigen test Hormones and low-fat diet Treatment Chemotherapy and radiation
  • 65. Epilepsy Sudden attacks of violent muscle Defined contractions and unconsciousness Electroencephalogram (EEG) Diagnosis Recurring attacks Treatment Anticonvulsant drugs
  • 66. Asthma African American Risk Inner-city Factors Secondhand smoke exposure Wheezing Shortness of breath Symptoms Tightness of chest Coughing
  • 67. 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
  • 68. Ulcers Open sores in lining of stomach or Defined duodenum Cause Excessive acidic digestive juices Symptom Burning pain in upper abdomen Antibiotics (if H. pylori) Avoiding aspirin Eating small, frequent meals Treatment Taking antacids Not smoking or drinking and avoiding caffeine