• Heart disease includes a wide variety of cardiac and vascular conditions effecting the entire body.• Congenital heart disease caused by abnormal heart development before birth and is responsible for more deaths in the first year of life.
• In 2000 in United states approximately 22 million adults or 1 in 12 people had heart disease.• American Heart Association …the prevalence of heart disease in United states may double by 2050.• Heart disease is one of the primary preventable cause of death.
INDICATIONS: Chest pain near the heart before, during or after exercise warrants special attention. Pleurisy (inflamed membranes around the lungs. Indigestion (causing heart burn ). Dizziness ,when standing up due to inadequate venous return to heart. Orthostatic hypotension (condition associated with dizziness when changing position from lying to upright. caused by low B.P.
• According to study at McMaster university with over 29,000 participants from 52 countries.• Two most imp. Risk factor for myocardial infraction Cigarette smoking Abnormal blood lipid profileRisk factors:-o High blood pressureo Diabeteso Abdominal obesityo Stresso Less consumption of fruit & vegetables
Secondary prevention intervention include the following: Controlling weight Eating healthy, low saturated fat diet Quitting smoking Controlling diabetes & BP Controlling cholesterol & homeocyte Taking antioxidants Considering the benefits & risks of hormone replacement therapy (HRT) Taking low dose aspirin Reducing hostility and engage in physical activity Using healthy interventions to manage stress
HYPERTENSION A mean systolic blood pressure of 140mmHg and a mean diastolic blood pressure of 90mmHg or taking hypertensive medication is prevalent in 50 million American. Factors:o Compounding factors of obesityo Metabolic disorders• Such as• Coronary artery disease• Enlargement of the heart ‘s left ventricle
• According to American Heart Association “Physical inactivity” is major risk factor for developing coronary artery disease and it increase the risk factor for stroke.• Other factorso Obesityo High BPo Low HDLo Cholesterolo Diabeteso American Heart Association Recommends: Daily combination of moderate and vigorous physical activity for both Children & adults
According to AHA Special recommendation:• Total 30 min of moderate intensity activities on most days of the week.• Minimum of 30 min of vigorous physical activity at least 3 to 4 days each week to achieve cardiovascular fitness. Preventive measures:• Reduce cigarette smoking.• Reduce coffee consumption to a maximum of two cups per day .• Increase intake of potassium. calcium & magnesium.• Increase intake of polyunsaturated fat.• Reduce saturated fat intake
• Recommendations :-• A diet that is low sodium• Low calories• High fiber
HYPERLIPIDEMIA Increase in blood levels of triglycerides & cholesterol that can lead to cardiovascular disease & other chronic pathologies. 101 million Americans have cholesterol greater to or equal to 200mg/dL e.g.: 1 in 3 Americans have HL It has been shown that patients aged 65 to 75 yr can benefit from intervention at least as much as younger pt.
• Guidelines by American Heart Association:• Intense lifestyle interventions are more effective for improving not only blood lipids but also other risk factors & individual quality of life.• Other study …more intense supervised aerobic exercise as opposed to un supervised exercise increased the participants exercise capacity (1.6 to 1.9 METS) reduce body weight by 10% & reduced LDL by 7-6 %
ARTERIOSCLEROSIS It is used to describe several diseases characterized by loss of elasticity and thickening of the arterial wall. Damage of arterial endothelium is initiated by risk factors like dyslipidemia,hypertension,diab etes mellitus & smoking . Coronary artery disease is an example of pathology resulting from arteriosclerotic processes affecting the myocardium.
Atherosclerosis a form of arteriosclerosis is the most common vascular disease. Characterized by deposition of plaques containing cholesterol & lipid in innermost layers of walls of large & medium sized arteries.
PERIPHERAL VASCULAR DISEASEPeripheral arterial disease (P.A.D.) is a disease inwhich plaque (plak) builds up in the arteries that carryblood to your head, organs, and limbs. Plaque ismade up of fat, cholesterol, calcium, fibrous tissue,and other substances in the blood. People aged 50 or older who have diabetes ,smoke ,have high BP, high cholesterol levels are at risk of PVD.o Highly treatable disease in its early stage.o Often be detected by the appearance of extremities.o Bruises & other skin discoloration may also attributed to PVD.
• PVD warning signs:- o heart attack (supply of blood to the heart muscle is severely reduced or stopped) o Stroke( supply of blood to the brain is severely reduced or stopped) o Aneurysm( localized dilatation of the wall of an artery, a vein, or the heart)
PVD can be treated with:- Lifestyle changes Medication BothTo improve Vascular flow Anticipated drugs to slow blood clotting Cholesterol lowering agents (statins)