Arteriosclerosis and Coronary Heart Disease (CHD)

1. Arteriosclerosis and
Coronary Heart
Disease (CHD)

2. Arteriosclerosis
Disease of the arteries characterized by
thickening, loss of elasticity and calcification
of arterial walls
Resulting in decreased blood supply
particularly to the cerebrum and lower
extremities
Often develops with:
• aging
• hypertension
• diabetes

4. Progression of Arteriosclerosis

5. Risk factors
• High blood pressure (hypertension)
• High blood cholesterol
• Smoking
• Obesity
• Physical inactivity
• Diabetes
• Stress (?)
Controllable

6. Risk Factors (cont’d)
• Gender
• Heredity
• Age
Uncontrollable

7. Major Risk Factors:
The Big Three
• Hypertension
• High cholesterol
• Cigarette smoking
All three increase risk
factor eight times
AND…. we should add LACK OF EXERCISE

9. Hypertension
• Commonly called high blood pressure
• Systolic and diastolic measurements
• Normal systolic - 110-130 mmHg
• Normal diastolic - 70-90 mm Hg

10. Symptoms of CHD
• Chest pain (angina)
• Shortness of breath
• Heaviness, tightness, pain, burning,
pressure or squeezing
behind the breastbone or in the arms,
neck, or jaws
• Pain may vary
• Perhaps no pain

11. Cause & Consequencess of CHD
• Lack of oxygen due to ischemia (lack
of blood supply)
• Narrowing of coronary arteries
• Heart responds with angina
• Finally, heart attack (myocardial
infarction
local ischemia usually due to thrombus
(clot) or embolus (clot that has moved
from another site and lodged in a
smaller vessel)
• Possible permanent damage

12. Diagnosis of CHD
• Electrocardiogram (EKG)
• Stress test
• Nuclear scanning
• Coronary angiography

13. Treatment for CHD
• Lifestyle changes
• Medication
• Surgery

14. Lifestyle Changes
• Change of habits
• Low fat diet
• Lower weight
• Increase exercise
• Stop smoking

15. Surgery to Treat CHD
• Balloon angioplasty
• Atherectomy
• Laser angioplasty
• Stent insertion
• Coronary artery bypass operation
(CABG)

17. Gender Disparity
• Coronary Artery Disease (CAD) more
common in men
• Women have higher mortality rates
Older and sicker when first heart attack occurs
Less aggressively treated than men
Failure to recognize symptoms in timely fashion
• MI in young, healthy women is rare
Occurrence greater in those who use OC
Age 30-39: 2.7X; 40-44: 5.7X; (complilcated by
cigarette use)

18. Effects of Smoking
• For adult males, smoking has
declined from 53 % to 38%
• For women, remains at 30%
• Has increased for younger and
teenaged women
• Heavy smoker = 20- 30 cigs/day

19. Effects of Smoking (cont’d)
• Cigs contain about 2000 compounds
• Main harmful are tar, nicotine and CO
Tar contains hydrocarbons and other carcinogenic
substances
Nicotine causes release of epinephrine and
norepinephrine resulting in increased HR, BP,
cardiac output, stroke volume, contractility, oxygen
consumption, and coronary blood flow
CO reduces oxygen carrying capacity of the blood;
can precipitate angina

20. Effects of Smoking (cont’d)
• Contributes to development of
atherosclerosis
• Lowers levels of HDL
causes deterioration of elasticity of
vessels
Responsible for 20% of all deaths from
heart disease
• Female smokers have a higher risk
than male smokers

21. STRESS
• Sociocultural
Mobility
• Socioeconomic
Status
• Status Incongruity
• Education Level
• Anxiety and
Neuroses
• Life Dissatisfaction
• Life Change
• Behavior Pattern

22. DIET
• Reduce saturated fats
• Increase polyunsaturated fats
• Higher protein to fat ratio
• Count calories