Behavioral Factors in Cardiovascular Disease

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Behavioral Factors in Cardiovascular Disease

• Chapter nine

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The cardiovascular system

• Heart and blood vessels
• Transports blood throughout the body
• Delivers oxygen and nutrients
• Removes wastes from cells

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Cardiovascular system

• Arteries carry oxygenated blood
• Branch into smaller vessels called arterioles
  and then capillaries which connect to veins
• Veins return blood stripped of oxygen to the heart

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Coronary arteries

• Deliver blood to the myocardium (heart muscle)
• Vulnerable to damage
• Formation of plaque restricts blood flow to
  myocardium

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Coronary arteries

• Atherosclerosis occlusion of the arteries from
  restricted blood flow
• Arteriosclerosis loss of elasticity of veins

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Coronary Artery Disease (CAD)

• Caused by build up of plaque
• May lead to coronary heart disease (CHD)
• Ischemia restricted blood flow to heart
• Myocardial infarction heart attack
• Angina pectoris chest pain , difficulty in
  breathing
• Coronary bypass surgery

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Stroke

• Compromised arteries restrict blood flow to
  brain death of neurons

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Blood pressure

• Reflection of health of cardiovascular system
• Systolic pressure exerted by ventricular
  contractions
• Diastolic pressure between contractions
• Essential hypertension no identifiable cause
• Secondary hypertension from other diseases

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Measures of cardiovascular functioning

• Electrocardiogram
• Electrical activity of heart
• Must be significantly blocked for this to
  revealed on test
• Angiogram
• Catheter injects dye into heart , revealed with
  x-ray
• Angioplasty
• Stent used to open blocked arteries

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Death rate Cardiovascular disease

• 37 of all American deaths leading cause
• Slight reduction since 1920
• Better medical care
• Healthier diets
• 1964 Surgeon Generals report on hazards of
  smoking
• Increased risk in developing countries

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Inherent Risk factors

• Advancing age
• Glucose metabolism
• Diabetes
• Metabolic syndrome
• Excess abdominal fat, high bp,high cholesterol
• Family history
• Family member had before age 50 increased risk

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Inherent Risk factors..

• Gender
• Male? Maybe no a significant difference
• Ethnic background
• African Americans 50 higher rate than European
  Americans

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Physiological conditions

• Hypertension
• Best predictor of CVD
• Cholesterol

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Behavioral factors

• Smoking
• 35 of worlds heart disease and stroke
• Diet
• Saturated fats
• Impact of healthy diet
• Physical activity

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Psychological factors

• Education and income
• Social support and marriage
• Stress, anxiety and depression
• Cynical hostility and anger
• Expression of anger damaging
• Anger and cardiovascular reactivity
• African American males at higher risk
• Suppression of anger

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Reducing risks changing behaviors

• Preventing first heart attacks
• Problem of optimistic bias
• Reducing hypertension lack of awareness
• Lowering cholesterol
• Modifying psychosocial risk factors
• Relaxation, appropriate expression of anger,
  learning about anger trigggers

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Rehabilitation

• Change lifestyle and avoid future problems
• Risk of depression higher death rate
• Control weight, diet alcohol, stress, adhere to
  medication regiment
• 15-35 follow program as prescribed