Comprehensive Cardiovascular, Obesity, and Disability Models Overview

Medical Model

Views disability as a feature of the person, caused by disease, trauma, or health condition. Focus is on cure or normalization of the individual.

Social Model

Views disability as a socially created problem. It is a matter of full integration into society, with the focus on fixing the environment or society to remove barriers.

Biopsychosocial Model of Health (BPS)

A model that suggests health and illness are determined by a complex interaction of biological (e.g., genetics, physiology), psychological (e.g., thoughts, emotions, behaviors), and social (e.g., culture, family, socioeconomic status) factors in combination, which play a role in an individual's ability to function.

Condition: Alzheimer's Disease

An example of Inhibition of Functioning.

Body Function/Structure

Central Nervous System (CNS) damage, cognitive impairment (e.g., severe memory loss, executive function decline).

Activity (Limitation)

Inability to drive a car independently due to memory impairment and loss of spatial-perceptual skills.

Environmental Factors (Barrier)

Lack of readily available public transportation in their community, which prevents them from maintaining independent mobility.

International Classification of Functioning, Disability and Health (ICF)

Views health and disability as a continuum resulting from the interaction between health conditions and contextual factors (environmental and personal).

Health Condition

The disorder, disease, or trauma.

Impairment

A problem in body function or structure (e.g., lost limb, memory loss).

Activity Limitation

Difficulty executing a task or action (e.g., difficulty walking, speaking).

Participation Restriction

Problems an individual may experience in involvement in life situations (e.g., inability to work, engage in social activities).

Function

The umbrella term for all body functions, activities, and participation.

Capacity

An individual's ability to execute a task or an action in a standard environment (what a person can do).

Performance

What an individual does in their current environment (what a person does do).

Environmental factors

Determine the gap between capacity and performance (e.g., a ramp allows capacity to equal performance).

Disease

A pathological condition of the body or mind; a deviation from a biological norm (objective, biomedical fact).

Illness

The subjective, personal experience of a health condition; how the individual perceives and lives with the condition.

Stable

A health condition that is not worsening.

Progressive

A health condition that continues to worsen over time (e.g., Alzheimer's, Parkinson's, ALS).

Episodic

Occurrences of a health condition are interspersed with periods of wellness (e.g., Multiple Sclerosis flare-ups, Asthma attacks).

Degenerative

Tissues/organs break down over time (e.g., joints in Arthritis, neurons in PD).

Exacerbations

Periods when symptoms become more active or severe (a 'flare-up').

Remissions

Periods when symptoms remain stable or lessen.

Stress

The brain's response to any demand. Can be physical (e.g., illness) or psychological (e.g., job loss).

Typical Reactions to Stress

Denial, fear/anxiety, grief, anger.

Repercussions of Stress

Increased risk for complications, delayed recovery, chronic pain, poor coping behaviors (e.g., substance abuse), and worsening of the health condition itself.

Denial

Unconsciously disavowing the reality of the condition.

Regression

Unconsciously reverting to earlier, less mature behavior.

Compensation

Overemphasizing a desirable characteristic to cover up a less desirable one (e.g., excessive exercise after a condition limits mobility).

Rationalization

Finding plausible reasons for illogical behavior.

Diversion of Feelings

Redirecting emotions (e.g., anger) from the source to an unrelated object or person.

Common Emotions

Grief (for loss of self, function, or future), fear/anxiety (about the unknown or future deterioration), anger (at the injustice or loss of control), and ultimately, adjustment (a healthy emotional integration of the condition into one's life).

Self-Concept

All the perceptions and beliefs a person has about themselves (who am I?).

Self-Esteem

The value a person places on their self-concept (how good am I?).

Self-Efficacy

The expectation that one can perform a task or achieve a desired outcome (can I do it?).

Body Image

The mental image one has of their own body (how do I look?).

Body Mass Index (BMI)

A person's weight in kilograms divided by the square of height in meters (kg/m²).

BMI Categories

Underweight: <18.5; Healthy Weight: 18.5 to <25; Overweight: 25 to <30; Obesity Class I: 30 to <35; Obesity Class II: 35 to <40; Obesity Class III (Extreme): ≥40.

General U.S. Prevalence (Adults)

The overall obesity prevalence in the U.S. is approximately 42.4% (2017-2018 data).

Obesity Trends by Age

Increases with age (most prevalent in middle-aged adults: 40−59 years).

Obesity Trends by Gender

Obesity prevalence is slightly higher among women than men in some groups, though overall rates are similar.

Obesity Trends by Race/Ethnicity

Non-Hispanic Black adults have the highest age-adjusted prevalence (≈49.6%); Hispanic adults (≈44.8%); Non-Hispanic White adults (≈42.2%); Non-Hispanic Asian adults have the lowest prevalence (≈17.4%).

Obesity Trends by Socioeconomic Status (SES)

Generally, prevalence of obesity is higher in lower socioeconomic groups, particularly among women.

Causes of Obesity

A complex interplay of factors: Genetics, Behavioral, Environmental.

Psychological Factors

Stress, poor sleep, emotional eating, mental health conditions.

Physiological Factors

Certain medications, hormonal disorders, metabolism rate.

Obesity Health Risks

Obesity is a major risk factor for numerous chronic diseases.

Cardiovascular Diseases

Hypertension, Coronary Artery Disease (CAD), Stroke, Congestive Heart Failure (CHF).

Metabolic Diseases

Type 2 Diabetes Mellitus, Dyslipidemia (high cholesterol/triglycerides).

Other Health Risks

Sleep Apnea, Gallbladder disease, Osteoarthritis, certain Cancers, nonalcoholic fatty liver disease, and reduced lifespan/quality of life.

Obesity Stigma

Negative bias, stereotypes, and discrimination directed toward individuals based on their weight.

USA Body Ideals

Historically have shifted, but the current dominant ideal promotes thinness and muscularity for health/attractiveness.

Heart Function

Pumps blood through the circulatory system to deliver oxygen and nutrients to the body and remove waste (e.g., CO2).

Arteries/Arterioles

Carry oxygenated blood away from the heart; arterioles are smaller arteries that regulate blood flow/pressure.

Veins/Venules

Carry deoxygenated blood back to the heart; venules are small veins that drain capillaries.

Capillaries

Tiny vessels where the exchange of oxygen/nutrients and waste products occurs between the blood and tissues.

Normal Blood Pressure

<120/80 mmHg.

Normal Total Cholesterol

<200 mg/dL.

Normal LDL ('Bad' Cholesterol)

<100 mg/dL (less is better).

Normal HDL ('Good' Cholesterol)

≥40 mg/dL (higher is better).

Normal Triglycerides

<150 mg/dL.

Normal Fasting Blood Glucose

70−99 mg/dL.

Modifiable Risk Factors for CVD

Tobacco Smoking, Hypertension, Hyperlipidemia, Diabetes Mellitus, Physical Inactivity, Obesity/Overweight, Poor Diet, Excessive Alcohol Intake, Stress.

Non-modifiable Risk Factors for CVD

Age, Gender, Heredity/Family History, Race/Ethnicity.

Hypertension (HTN)

Chronically elevated blood pressure (BP ≥130/80 mmHg or higher) that forces the heart to work harder and damages arteries.

Hypertension Risk Factors

Obesity, poor diet (high sodium), physical inactivity, stress, excessive alcohol, family history, race.

Hypertension Manifestations

Often called the 'silent killer'—usually no symptoms until it causes organ damage.

Atherosclerosis

A disease where plaque (fat, cholesterol, calcium, and other substances) builds up inside the arteries, hardening and narrowing them.

Risk Factors for Atherosclerosis

High cholesterol/LDL, hypertension, smoking, diabetes, obesity, physical inactivity.

Manifestations of Atherosclerosis

Usually none until a severe blockage occurs (e.g., Angina, MI, Stroke, PAD).

Diagnostics for Atherosclerosis

Blood tests (lipid panel), stress test, angiogram.

Medication & Care for Atherosclerosis

Medication: Statins (to lower cholesterol/LDL), antiplatelets (Aspirin), ACE inhibitors. Care: Surgical options (Angioplasty/Stenting, Bypass Surgery).

Lifestyle Medicine for Atherosclerosis

Same as HTN—low-fat diet, regular exercise, smoking cessation.

Aneurysm

A localized, weakened, bulging section of an artery wall (like a balloon). If it ruptures, it can cause severe bleeding/hemorrhage (e.g., hemorrhagic stroke, aortic rupture).

Risk Factors for Aneurysm

Atherosclerosis, long-term uncontrolled hypertension, smoking, genetic factors.

Manifestations of Aneurysm

Often asymptomatic. May include deep pain in the back/abdomen (aortic) or a sudden, severe headache (brain/cerebral aneurysm rupture).

Diagnostics for Aneurysm

Ultrasound, CT scan, MRI.

Medication & Care for Aneurysm

Medication: BP control medications. Care: Surgical repair (stent graft or clipping) to prevent rupture.

Lifestyle Medicine for Aneurysm

Strict blood pressure control, smoking cessation.

CAD (Coronary Artery Disease)

Narrowing of the small blood vessels that supply oxygen and nutrients to the heart muscle (myocardium), caused by atherosclerosis in the coronary arteries.

Risk Factors for CAD

Same as Atherosclerosis (smoking, high BP, high cholesterol, diabetes).

Manifestations of CAD

Angina Pectoris (chest pain), shortness of breath, fatigue, or can be silent (no symptoms).

Diagnostics for CAD

ECG/EKG, Stress Test, Coronary Angiography (gold standard).

Medication & Care for CAD

Same as Atherosclerosis, plus anti-anginal drugs (Nitrates).

Lifestyle Medicine for CAD

Aggressive management of risk factors.

Angina Pectoris

Temporary chest pain or discomfort that occurs when the heart muscle doesn't get enough oxygen (ischemia). It is a symptom of CAD.

Types of Angina

Stable Angina: Occurs predictably with exertion, relieved by rest or nitroglycerin. Unstable Angina: Occurs unpredictably (often at rest), is more severe, and signals a rapidly worsening condition (a medical emergency).

Risk Factors for Angina Pectoris

All CAD risk factors.

Manifestations of Angina Pectoris

Squeezing, pressure, heaviness, or burning chest pain, often radiating to the arm, shoulder, neck, or jaw.

Diagnostics for Angina Pectoris

ECG (may show changes during pain), stress test.

Medication & Care for Angina Pectoris

Nitroglycerin (quick relief), Beta-blockers, antiplatelets.

Lifestyle Medicine for Angina Pectoris

Avoid large meals/extreme temperatures, stress management.

MI (Myocardial Infarction - Heart Attack)

Permanent damage and death of an area of the heart muscle due to a complete, prolonged blockage of a coronary artery (often by a clot in an artery narrowed by atherosclerosis).

Risk Factors for MI

All CAD risk factors.

Manifestations of MI

Severe, crushing chest pain (often unrelieved by rest/nitroglycerin), shortness of breath, profuse sweating, nausea, pain radiating to the jaw/left arm. Women may experience atypical symptoms (fatigue, indigestion).

Diagnostics for MI

Cardiac Enzymes/Troponin (released into blood when heart muscle is damaged), ECG (shows specific changes).

Medication & Care for MI

Immediate: Aspirin, Oxygen, Nitroglycerin, Morphine. Treatment: Angioplasty/Stenting (within 90 mins), Thrombolytic drugs, Bypass Surgery.

Lifestyle Medicine for MI

Cardiac Rehabilitation, long-term risk factor management (smoking cessation, diet/exercise).