includes several diseases process including various diseases of the heart, stroke and high blood pressure, congestive heart failure and atherosclerosis

1. HEALTH CHECK OF FOUR IMPORTANT
HEALTH PARAMETERS
INTRODUCTION

2. Cardiovascular system is a system responsible for delivering oxygen and other nutrients to the
body. Major components of the cardiovascular system are the heart, blood, and the vessels that
carries the blood.
Cardiovascular diseases (CVD) is a term that includes several diseases process including
various diseases of the heart, stroke and high blood pressure, congestive heart failure and
atherosclerosis. The heart muscles may become damaged or lose its ability to contract
effectively. The vessels that supply the heart with oxygen may become blocked or damaged and
subsequently compromise the heart muscles.
Finally the peripheral vascular system (all of the vessels outside the heart) may become damaged
and decrease ability to provide oxygen to other parts of the body.

3. Who is at risk of CVD?
The surgeon General’s report (satcher,1996) placed a physical inactivity as a significant risk factor for
cardiovascular diseases and other health disorders.
There are an estimated 80 million Americans that have some forms of CVD. Many factors can
predispose a person to be at risk for CVD. Sedentary living, habitual stress, smoking, poor diet, high
blood pressure, diabetes, obesity, high cholesterol, and family history can all increase risk.
Advanced age increases risk. Men typically have a higher risk than women ,until women are post-
menopause, then the risk evens out. Misconceptions still exist that CVD is not a real problem for
women (AHA,2009). Because more women have heart attacks when they are older, the initial heart
attacks is more likely fetal.

4. It is important for women to realize that CVD is an equal opportunity killer just like men, more women
die from heart diseases than anything else.
Certain populations have an inherently higher risk such as African, Americans, and Hispanics. Genetic
predisposition is a strong factor. familial tendencies toward elevated triglycerides, fat distribution
(abdominal fat accumulation denotes a higher health risk than hip/thigh accumulation of fat), and high
LDL-C (low density lipoprotein cholesterol) increase risk.
LDL-C is a blood lipid that indicates a higher cardiac risk.

5. HYPERTENSION (high blood pressure)
•High blood pressure ,is a risk factor for many forms of cardiovascular disease
including heart attack and strokes, itself considered as cardiovascular disease
Blood pressure, is a force exerted by the blood in the vessel walls created by the
pumping action of the heart . High blood pressure occurs when too much force is
exerted against the walls of the arteries.
•Hypertension is often called “the silent killer” because typically there are no
symptoms. Because hypertension is asymptomatic, it is important to get your
blood pressure checked on regular basis. In 2005, the estimated prevalence of
hypertension (a blood pressure reading of 140/90mm or higher) was 73million
Americans.

6. •High blood pressure is associated with shortened life span . Under the age of 45 more males typically
have a high blood pressure, while after age 55, more females tend to have higher blood pressure
(AHA, 2008)
•High blood pressure cause the heart to work harder, chronic untreated hypertension can lead to
aneurysms in blood vessels, heart failure from an enlarged heart, kidney failure, atherosclerosis and
blindness.
•Top number is the systolic reading which represents the arterial pressure when the heart is
contracting and forcing the blood through the arteries. The bottom number is diastolic reading, which
represents the force of the blood in the arteries while the heart is relaxing between.
In 2003 new blood pressure guidelines were issued with a new “pre-hypertensive” category identified

7. • A blood pressure reading of 115/75mmHg is the new threshold above which cardiovascular
complications can occur .
• The pre-hypertensive category include a systolic pressure from 120-139mmHg and a diastolic
pressure from 80-89mmHg as a warning zone.
If you are considered pre-hypertensive, it is a time to take action by modifying your life styles. any
reading consistently over 139/89mmHg is high blood pressure and indicates a high risk.
NOTE; Hypertension can not be cured but it can be successfully treated and controlled. Exercise has
been shown to help symptoms of high blood pressure in mild to moderate hypertension.

8. Source; Seventh report of the joint national committee on prevention, detection, evaluation
and treatment of high blood pressure (JNC 7 express) NIH publication No.03-5233, may 2003.
Unusually low reading should be evaluated for clinical significance
Blood pressure category Systolic (mmHg) Diastolic(mmHg)
normal Less than 120 Less than 80
Pre-hypertension 120-139 80-89
Hypertension stage 1 140-159 90-99
Hypertension stage 2 160 or higher 100 or higher

9. STROKE
• Stroke is also called cerebral vascular accident (CVA) occurs when the blood supply to the brain is
cut off. If brain cells are deprived of blood for more than few minutes, they die because of
insufficient oxygen. Once brain cells begin to die about two millions cells are lost every minute
that blood flow is not restored. Prompt treatment of stroke can greatly decrease the permanent
disability. Stroke is more recently called brain attack. It is a third leading cause of death affecting
780,000 Americans per year (AHA, 2009). The cerebral artery the main supply of nutrients to the
brain can be narrowed due to atherosclerosis.

10. Atherosclerosis is a form of arterial sclerosis or thickening and hardening of the arteries. In
atherosclerosis arteries become narrowed by deposit of fat, cholesterol, and other substances
FORMS OF STROKE
a) Ischemic( thrombosis and embolism) strokes
These are most common forms of stroke (87%) and occur as the result of blockage to the
cerebral artery. Cerebral embolism as a cause of stroke occurs due to a clot or foreign body forms in
some other parts of the body and travel to the brain
b) cerebral thrombosis stroke occurs when there is a blood clot in the brain (AHA 2009)

11. c) Intra-cerebral hemorrhage (aneurysm).in this form the vessel may rapture and cause bleeding
inside the head and result in pressure of brain. This form contribute (10%) of stroke.
Other list common form result from compression that can occur as a result of hemorrhage or brain
tumor
Africans-Americans have almost twice the risk of stroke than Caucasian (AHA 2009). One third of all
stroke victims die, one third of stroke victims suffer permanent disability and one third of stroke
victims gradual return to their normal routine.

12. Different forms strokes

13. Stroke symptoms
• Sudden numbness or weakness of the face, arm, or legs especially on one side of the body
• Sudden confusion, trouble speaking, or understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause.
• Depending on the area of brain affected, stroke may cause paralysis.

14. Fats ( lipids) as an influence to CVD
Fats are the body's primary source of energy and supply the body with calories of energy per gram
ingested. Dietary fat is not necessary a bad component of an individuals diet at moderate level of
consumption.
At moderate amount 25 and 30 percent daily calories is crucial to good nutrition.
Fat has many essential functions including the following
• Provide the body with stored energy.
• Insulating the body to preserve the body heat

15. cont
• Contributing to cellular structure.
• Protecting vital organ by absorbing shock.
• Is the major fuel for the body during rest and light activities.
• Fat adds flavor and texture to food and helps satisfy an individual appetite because it is digested
slowly.
• It supplies the body with essential fat acid and transport fat-soluble vitamins A, E, D, and K.
• It is necessary for the normal body growth and health skin.
• It is essential in synthesis of certain hormone.
• Linoleic acid and alpha linoleic acid are essential used in the maintenance of the blood pressure
and progress of a health pregnancy.

16. TYPES OF DIETARY FATS
There are different types of dietary fat, as follow
i. Saturated fat.
ii. Trans fat.
iii. Unsaturated fats.
I. Saturated fats.
These are primarily found in the animal products such as meat, lard, cream, cheese, and whole milk.
How ever coconut and palm oil are two source of saturated fats.
A defining characteristics of saturated fats is that they typical do not melt at room temperature.

17. Saturated fats increase low density lipoproteins (LDL) or “bad cholesterol” level and in turn increase an
individuals risk for heart disease and colorectal cancer; prostate cancer and colon cancer.
II) Trans fat
This is the fats formed after hydrogenation of unsaturated fat especially when hydrogen is added to
vegetable oil (vegetable oil are made into solid)
This process is used to increase the shelf life of food, and to help foods maintain their original flavor
Many backed and fried foods are prepared with hydrogenated vegetable oils, which means they can be
relatively high in saturated and trans fatty acid.
Leading sources of trans fats in the American diet are deep fried fast foods such as French fries and fried
chicken (typically fried in vegetable shortening rather than oil) ,backed and snack food such as pot, pies,
cookies, pastries, doughnuts and chips, and stick margarine.

18. In general the more solid a hydrogenated oils, the more saturated and trans fat it contains. For
example, stick margarine typically contains more saturated and trans fat than do hub or squeeze
margarines.
Small amount of trans fatty acids are found naturally in meat and milk.
III. Unsaturated fat ; These are derived primarily from plant product such as vegetable oils,
avocados and most nuts, and does not raise the body's blood cholesterol.
Unsaturated fats includes both monounsaturated and polyunsaturated fats.

19. Monounsaturated fats are found in foods such as olives, peanuts, canola oil, peanut oil, and olive oil.
Polyunsaturated fats are found in margarine, pecans, corn oil, sunflower oil and soybeans oil.
Table; composition of oil (%)
Composition of oil (%) Saturated Poly unsaturated Mono unsaturated
Sunflower 10 66 24
Safflower 9 75 16
Corn 13 59 28
soybean 14 58 28
sesame 14 42 44
peanut 17 32 51
palm 49 9 42
Olive 14 8 78
Canola 7 35 58

20. FATS AND HEALTH
Different types of fat have very different effects on health. Many studies have examined the effects of
dietary fat intake on blood cholesterol levels and the risk of heart disease.
Saturated and trans fat acid raise blood level of low- density lipoprotein (LDL) or bad cholesterol
thereby increasing a person’s risk of heart diseases
Unsaturated fatty acids on other hand lower LDL.
Mono unsaturated fatty acids such as those found in olive and canola oils, may also increase levels of
high density lipoprotein (HDL)or good cholesterol, provides even greater benefits for heart health

21. Saturated fat have been found to impair the ability HDL’s to prevent inflammation of the blood
vessels, one of the key factors in vascular disease; they have also been found to reduce the ability of
the blood vessels to react normally to stress.
Thus to reduce the risk of heart disease, it is important to choose unsaturated and trans fats
Unhealthy cholesterol levels
Cholesterol is a fatty wax-like substance that circulate through the blood stream and is an important
component of the cell membrane; sex hormone, vitamin D, the fluid that cools the lungs and
protective sheath around the neurons. Adequate cholesterol is essential for the proper functioning of
the body. Excess cholesterol however can clog arteries and increase the risk of CVD . Your liver
manufactures cholesterol, you also get cholesterol from food.

22. GOOD VERSUS BAD CHOLESTEROL:
Cholesterol is carried in the blood by protein-lipid package called lipoproteins. Low density
lipoprotein (LDLs) shuttle cholesterol from the liver to the organs and tissues that regain it. LDLs is
known as a bad cholesterol because if there is more than the body can use, the excess is deposited
in the blood vessels. LDL that accumulate and becomes trapped in artery walls may be oxidized by
free radicals, speeding inflammations and damage to artery walls and increasing the likelihood that
an artery will become blocked causing a heart attack or stroke.
High density lipoprotein (HDLs) or a GOOD cholesterol shuttle increased cholesterol back to the
liver for re-cycling by removing from blood vessels, HDL helps to protect against atherosclerosis.

23. RISK FACTORS FOR CARDIOVASCULAR DISEASE.
Controllable risk factors.
I. cigarette smoking. Smokers have two to four times the risk of developing cardiovascular
disease than non smokers (AHA2009). Cigarette smoking is the most potent of the
preventable risk factor. Former US surgeons general C.Eveett Koop claims that cigarette
smoking is the number one preventable cause of death and disease in the USA and the most
important health issues of our time. Smoking account for 50% of the female death due to
heart attack before the age of 55 (Rosato,1994).

24. II. hypertension: the AHA (2009) reports that approximate 73 millions Americans adult and
children have high blood pressure. Reports from the Harvad alumni study (1986) shows that
subjects who did not engage in vigorous sports or activities were 35% more likely to develop
hypertension than those who were regularly active.
III. Cholesterol; dietary cholesterol contribute to blood cholesterol (circulating in the blood) which
can contribute to heart disease

25. IV. In activity; physical activity can be very debilitating to the human body. Consistent moderate
port amount of physical activity can promote health and longevity . The surgeon general report
(Stacher 1996) state that, expanded daily excising can dramatically decrease CVD risk.
V. Obesity; highly correlated to heart disease, mild to moderate obesity is associated with an
increase in risk of CVD
VI. fat distribution; this can also predict higher risk CVD. A waist-to-hip ratio that is greater than
1.0 for man and greater than 0.8 for woman constitute a higher risk because abdominal fat is
more easily mobilized and dispersed into the blood stream, thereby elevating a serum
cholesterol level . A BMI over 30 is considered obese.

26. V. Diabetes; at list 65% of diabetes dies of some CVD(CDC, 1999). Excise is critical to help
increase the sensitivity of the body’s.
uncontrollable risk factors
I. Age. Risk of CVD rises as a person age increase.
II. Gender; men have a higher risk than women until women rich post-menopause age.
III. Heredity; a family history of heart disease will increase risk.

27. MEASURING HEALTH RISK.
there are several ways of measuring health risk to CVD, in our practical we used the following
measurements to measure the health risk to CVD
a. Body mass index (BMI)
b. body fat %
c. waist to hip ratio
d. blood pressure.

28. 1. Measuring blood pressure.
procedures;
The blood pressure of the individuals was measured. In this, the subject was in the rest sitting and
relax for at least about 5minutes before blood pressure readings were taken, the arm with the
cuff on was relaxed and supported on a table. The three readings were taken and the average of
the last two reading was taken. Also the readings was taken when the subjects was standing and
after few minutes.

29. 2. Measuring height in metres and weight in kg.
Height of the subjects were measured by means of ruler, and weight was weighed by means of
weighing scale, and the readings were recorded.
3. Measuring of body fat.
The body fat was measured by means of body fat monitor, this was done by entering values such as
age, sex, height, weight in which the subjects held the body fat monitor through the electrodes on
the hands. The S-button was pressed to measure the body fat and BMI of the subjects

30. 4. BMI also was calculated manually using the following formula.
BMI = mass (kg)
( height in metres)
4. Measurements of hip-to-waist ratio.
By means of tape measure, the waist and hips of different subjects were measured where by a tape
measure was wrapped around the waist , sites on the narrowest of a torso (above the belly button).the
tape was horizontal and flat against a skin. Also the tape measure was wrapped around a hip
circumference. The readings were taken and recorded.
then the ratio of waist circumference and hip circumference was calculated and recorded.

31. MEASUREMENTS
SUBJECTS
A B C D
SEX Male Female Female Male
AGE (years) 24 22 23 24
HEIGTH (Cm) 170 157 160 161
WEIGHT (kg) 60 45 59 50
FAT RATIO(%) 15.2 22.0 28.3 13.4
BMI(mass kg
(height in m)2
20.8 18.25 23.0 19.2
CAROLIES 1563 1153 1368 1388
WAIST
CIRCUMFERENCE (Cm)
32 30 33 31
HIP CIRCUMFERENCE
(Cm)
36 36 41 33
WAIST TO HIP RATIO 0.89 0.83 0.80 0.94

32. MEASUREMENTS SUBJECTS
PRESSURE
(mmHg)
A B C
AT
SITTING
Systolic 125 111 104
Diastolic 75 71 63
STANDING Systolic 119 124 117
Diastolic 80 74 73
AFTER
EXERCISE
Systolic 130 147 123
Diastolic 75 83 82

33. OBSERVATIONS AND DISCUSIONS
From the measurements taken, the following observations were observed.
1. BMI (body mass index) measurements; from the calculated BMI, it follows that the BMI for
the three subjects A, D and C were 20.7, 19.2 and 23.0 respectively . This data follows under the
normal ranges of 18.5 - 24.9 which is the range of Normal weight. So it is better they maintain this
range so that they reduce the risk of CVD.
But one of the subject has a BMI of 18.2 which indicates under weight, therefore she is at a risk of
CVD. A subject is advised to take the dietary food in a required amount, also is advised to have
further health checkup for more detail about her health condition.

34. NOTE. Body mass index (BMI) is a simple way to determine if your body weight falls within
healthily range. Because BMI is a ratio between weight and height, there are certain populations
that can not use this parameter as a gauge of body composition. A person with a large amount of
muscles mass, will have higher BMI.
Athletes, body builders, pregnant or lactating woman, young children or sedentary older populations
should not use BMI as a reliable measure for health risk.
BMI over 25 is considered overweight . BMI over 30 is considered obese.
A higher BMI may indicate your at an elevated risk for heart disease, type 2 diabetes and most of the
conditions related to obese.

35. 2. Body fat percentage measurement.
from the readings obtained the four subjects A, C, B and D have the body fat percentage of 15.2%,
28.2%, 22.0% and 13.4% respectively. According to the age adjusted body fat percentage
recommendations, it show that they follows under Healthy range of 21 -33% for women and 8 -19%
for men. Therefore both subjects have reduced risk to CVD.
consider the age adjusted body fat percentage recommendations.
WOMEN.
AGE UNDER FAT HEALTHY
RANGE
OVERWEIGHT OBESE
20 -40 Yrs Under 21% 21 – 33% 19 – 25% Over 25%
41 - 60 Yrs Under 23% 23 – 35% 22 – 27% Over 27%
61 – 79 yrs Under 24% 24 – 36% 25 – 30% Over 30%

36. MEN
AGE UNDER FAT HEALTHY
RANGE
OVERWEIG
HT
OBESE
20 – 40 Yrs Under 8% 8 – 19% 19 – 25% Over 25%
41 – 60 Yrs Under11% 11 – 22% 22 – 27% Over 27%
61 – 79 Yrs Under 13% 13 – 23% 25 – 30% Over 30%

37. Measurements of waist – to hip ratio.
From the measurements made for four subjects, A, B, C, and D, the waist to hip ratio was 0.89, 0.83,
0.80 and 0.94 respectively, this indicate that for two subjects A&D (males) have low risk of
Cardiovascular disease (CVD) risk because their waist to hip ratio are below 1. The subject C
(female) also has low risk of Cardiovascular disease (CVD) because her waist to hip ratio is not
greater than 0.8. but the subject B has higher risk to CVD since her waist to hip ratio is above 0.8.
When the fat is highly distributed in hips than in the abdomen, the individual will have low risk to
CVD since the hip fat is slowly mobilized and dispersed into the blood stream compared to
abdominal fat which is easily mobilized there by elevating serum cholesterol level (AHA, 2007).

38. Measurements of pressure
from the obtained results of the measurements of pressure, the subjects B&C their pressure at resting
are below 120/80mmHg this show that their blood pressures are normal. However their pressures
tend to increase when the subjects states changes from sitting, standing and after exercise.
The pressure measurements for subject A shows small deviation where by the pressure at standing
(119/80mmHg) was less than pressure at sitting (125/75mmH), pressure after exercise increased to
130/75mmHg, the small deviation for two measurements may be due to personal or instrumental
errors.

39. Consider the AHA recommendation for healthy blood pressure.
blood pressure category Systolic (mmHg)
(upper number)
Diastolic (mmHg)
(lower number)
Normal Less than 120 less than 80
Pre-hypertension 120 -139 80 – 89
hypertension stage 1 140 – 159 90 – 99
Hypertension stage2 160 or higher 100 or higher
Emergence care needed higher than 180 higher than 100

40. According to the recommendation above it shows that the subjects are in the reduced risk to CVD,
however is better for the subjects whose their reading shows small deviation to make further accuracy
measurements of pressure to confirm for this deviations.
Also from the result obtained it shows that the rate of heart beat increase with the increase of body
activity which account for the increase of blood pressure. As the body activity increase the pumping
action of the heart tend to increase so that to push more blood to different parts of the body
especially in muscles so that to ensure efficient supply of oxygen for glucose metabolism.

41. REFERENCES.
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state of Amerca
Fahey T.D, Insel PM and Roth WT (2011) Fit and well ninth edition. McGraw Hill companies inc.
united state of Amerca.
S. David, B. Jackie & L. Ricki (2009). Hole’s essentials of human anatomy and physiology, 10th
edition, McGrau Hill, Wtrick publishers, New York.
S.R. Brian (2007). Applied anatomy and physiology, Paradigm publishing inc, USA.