Exam 1 - Cardiac Education

What is primary prevention of cardiovascular disease?

Preventing cardiovascular disease before it develops by addressing modifiable risk factors and promoting ideal cardiovascular health.

What is secondary prevention of cardiovascular disease?

Preventing recurrent cardiovascular events or progression in someone who already has cardiovascular disease.

What are major modifiable cardiovascular risk factors addressed in cardiac education?

• Smoking

• physical inactivity

• obesity

• hypertension

• abnormal cholesterol

• diabetes

• poor nutrition

• psychological stress

What are examples of non-modifiable cardiovascular risk factors?

• Age

• sex/gender

• family history

• race/ethnicity

How does smoking affect the cardiovascular system?

It increases resting and exercising HR and BP and decreases exercise tolerance.

Does decreasing the number of cigarettes smoked eliminate cardiovascular risk?

No, only smoking cessation does

What is the PT's role regarding smoking?

Assess and document smoking status, advise cessation, educate about avoiding secondhand smoke, and refer to appropriate providers

What combination is most successful for smoking cessation?

Pharmacotherapy + behavioral therapy

How does regular physical activity affect cardiovascular health?

It increases longevity, decreases disease, improves cardiovascular/pulmonary systems, improves lipid profile and glucose tolerance, reduces body fat and platelet aggregation, and improves mental and functional health

What is the AHA recommendation for aerobic exercise?

• 150 min/week moderate-intensity

• 75 min/week vigorous-intensity

What is the PT's role in physical activity-based cardiovascular prevention?

Provide exercise education, prescribe exercise training, encourage an active lifestyle, and incorporate aerobic and resistance training

What BMI does the lecture identify as ideal?

20–25 kg/m²

What is considered clinically meaningful weight loss?

≥5% of initial body weight

What cardiovascular/metabolic improvements can occur with clinically meaningful weight loss?

Moderate improvements in BP, LDL cholesterol, triglycerides, and glucose levels, as well as delayed onset of type 2 diabetes.

What are preferred strategies for weight management?

Aerobic physical activity + reduced caloric intake

How does obesity affect exercise capacity/physiology?

Exercise capacity decreases while HR, RR, minute ventilation, and absolute oxygen consumption increase; dyspnea on exertion is also common

What exercise strategy should initially be emphasized in patients with obesity?

Moderate-intensity exercise, with emphasis on duration rather than intensity.

Why is hypertension an important cardiovascular risk factor?

It is a leading cause of ASCVD deaths and has a log-linear relationship with ASCVD risk. Managing BP also helps prevent stroke, kidney disease, and retinopathy

What is the BP goal with hypertension and cardiac health?

SBP <130 mmHg and DBP <80 mmHg

What non-pharmacological interventions can reduce BP?

Weight loss, heart-healthy diet, sodium reduction, increased physical activity, dietary potassium supplementation, and limited alcohol intake

At what BP should exercise be withheld according to APTA parameters?

SBP >180 mmHg or DBP >110 mmHg

What hypotensive BP values are listed as reasons not to exercise?

SBP <80 mmHg or MAP <65 mmHg

What is an exaggerated BP response to exercise?

An abnormally large increase in BP during exercise, indicating a hypertensive response that should influence exercise management.

What are the components of a cholesterol panel?

Total cholesterol, LDL, HDL, and triglycerides

Which lipoprotein is considered "bad" cholesterol?

LDL

Which lipoprotein is considered "healthy" cholesterol?

HDL

What does HDL do?

It reverses cholesterol transport by bringing free-floating cholesterol back to the liver for storage.

What dietary component has a particularly strong influence on lipoproteins?

Saturated fat intake has a much greater influence than cholesterol intake

What is the recommended LDL reduction for patients at intermediate ASCVD risk receiving moderate-intensity statin therapy?

>30% reduction.

What LDL reduction is targeted with high-intensity statin therapy in high-risk patients?

>50% reduction

What skeletal muscle side effects should PTs monitor in patients taking statins?

Cramping, soreness, fatigue, weakness, and potentially rhabdomyolysis

How can you distinguish exercise-induced muscle soreness from statin-related myopathy?

Exercise-related soreness/strength changes should improve within 48–72 hours, whereas statin-related symptoms may persist, affect all muscles, and may be associated with dark/discolored urine

What types of exercise may worsen statin-related myopathies?

Prolonged, eccentric, intense, and weight-bearing exercise

How does diabetes affect cardiovascular risk?

Adults with diabetes have a 2–4× increased risk of CVD

What cardiovascular conditions are associated with diabetes?

Atherosclerosis, autonomic dysfunction, arrhythmias, sudden cardiac death, diabetic cardiomyopathy, silent myocardial ischemia, and stroke

What should a PT educate a patient with diabetes about regarding cardiovascular prevention?

Heart-healthy diet, appropriate exercise, glucose monitoring, medication adherence, and recognition of hypo/hyperglycemia.

What blood glucose levels does this lecture identify as reasons not to exercise?

<80 mg/dL or >300 mg/dL

When should blood glucose be measured around exercise?

30 minutes before, immediately after, and 2 hours after exercise.

When should blood glucose be checked during exercise?

If the patient exhibits signs of hypoglycemia

Why can exercise be particularly risky during the peak effect of rapid-acting insulin?

Exercise during peak insulin effect increases the risk of severe hypoglycemia.