EDKP 330

What are the major unalterable risk factors of CHD? (4)

1. Age (risks increase with age)

2. Sex (males at higher risk)

3. Genetics (heredity - predispose us to disease)

4. Race - African Americans at higher risk

What is the function of LDL-C?

Low Density Lipoprotein "bad cholesterol"

- transports cholesterol into artery walls promoting plaque build up

- Type B particles can pass through inner lining of coronary artery easily

- plaque is made of cholesterol, calcium, fibrin

- high amounts = disease

What are the normal, borderline high, and high amounts of LDL-C?

- normal: want

What are the major alterable risk factors of CHD? (6)

1. Tobacco use

2. Diabetes

3. Hypertension

4. Physical Inactivity

5. Obesity

6. High Cholesterol

What is Sinus Bradycardia?

HR < 60 bpm

What is Tachycardia?

HR > 100 bpm

What are the EKGs and ECGs?

Electrodiograms, record electrical impulses that stimulate the heart

What are 4 ways of interpreting EKGs and ECGs?

1. Heart rate/rhythm

2. Axis of the heart

3. Hypertrophy (enlargement)

4. Myocardial infraction

What is Atherosclerosis?

Disease where there is plaque build up in the arteries causing them to be occluded, blood vessels lose elasticity, less blood can flow to the heart

What is the cholesterol ratio and what should it be no more than?

TC / HDL-C

No more than a 3.5 ratio difference

What is the function of HDL-C and how much should be in the body?

High Density Lipoprotein "good cholesterol"

- transports cholesterol out of arteries, helping prevent the formation of plaque

- athletes have higher levels

- low levels = disease

- no less than 40 mg/dl

What are the leading causes of death in canada? how often do people die from this?

heart disease and strokes (2/3 leading causes)

every 7 mins someone dies

What are the % of deaths from heart disease and strokes? Name the total, female and male

Total: 29%

Male: 28%

Female: 29.7%

What is the cost per year of heart disease?

20.9 billion $

How many hospitalizations for heart disease in 2009-2010? how much less is this than in _____

- 2.8 million in 2009-2010

- 14% less than in 1995, but remains unchanged

What is the % of hospitalizations due to heart diseases and strokes? Name the total, female and male

Total: 16.9%

Male: 19.8%

Female: 14%

What is angina pectoris?

chest pain caused by inadequate flow of blood and oxygen to the heart, increases risk of heart attacks

what are the contributing risk factors to CHD (3)

1. Stress and hostile personalities/anger

2. Inflammation

3. Excessive alcohol use

How many canadians have hypertension? How many canadians are pre-hypertensive?

6 million, 1/5 or ~20%

How many females aged 29-79 have hypertension?

19%

How many males aged 20-79 have hypertension?

19.7%

How many people ages 40-59 have hypertension?

18.4%

How many people ages 60-79 have hypertension?

53.2%

How many times more likely are women with a high BP more likely of heart disease than women with a normal BP?

3.5 x

What is considered a normal BP?

What is considered a high normal BP?

130-139/85-89

What is considered stage 1 hypertension?

140-159/90-99

What is considered stage 2 hypertension?

160-179/100-109

What is considered stage 3 hypertension?

>180/>110

What province has the highest % of self reported heart disease?

Nova Scotia - 6.4%

What province has the lowest % of self reported heart disease?

Northwest territories - 2.7%

Where do we get our cholesterol from?

produced in liver, or consumed in diet

What % of canadians have high blood cholesterol?

40%

What is the

1. Desirable amount of cholesterol

2. Borderline high cholesterol

3. High cholesterol

1.

What are ways to increase HDL cholesterol? (6)

Aerobic Exercise, estrogen, niacin, weight loss, quit smoking, genetic

What are ways to decrease LDL cholesterol? (7)

Antioxidant vitamins, less egg yolk and trans fats, lose body fat, increase fiber intake, psyllium, exercise, medication

What is systolic blood pressure?

pressure in vascular system when heart is contracted - ejection phase

What is diastolic blood pressure?

pressure in vascular system when heart is relaxed - filling phase

What is a normal BP?

120/80 mmHg

Since ____ CHD death rate has declined over ___% and ___% over the last decade

1952

75%

40%

Name 3 warning signs of a heart attack:

1. pain in chest lasting ~ 2+ minutes

2. pain in arms, shoulder, chest

3. dizziness, nausea, fainting, shortness of breath, sweating

What is a heart attack?

- flow of blood to the heart is blocked due to build up of plaque in coronary arteries (atherclerosis)

- when plaque ruptures, a blood clot can form causing lack of blood flow to the heart muscle

- tissue in the heart muscle can die

- myocardial infraction or coronary thrombosis

- collateral circulation = backup of blood vessels in body

What is congenital heart defects?

abnormal heart structure, vessels, valves at BIRTH

What is Rhematic Heart Disease?

inflammatory disease, bacterial infection of the heart

What is congestive heart failure?

A chronic condition in which the heart doesn't pump blood as well as it should.

What is bacterial endocarditis?

bacterial infection of the endothelial layer of the heart and valves

What are aneurysms?

- Bulging blood vessels that can burst and cause internal bleeding

- balloon like bulge in aorta

X times increases risk

1. smoking - 1 pack a day

2. serum cholesterol - 265 mg/dl

3. systolic blood pressure - 150 mm Hg

4. physical inactivity

1. 2.5

2. 2.4

3. 2.1

4. 1.9

What are alterable factors to strokes? (4)

Hypertension

Smoking

High RBC count

History of mini-strokes

what are the contributing factors to stokes? (3)

High Blood cholesterol

Physical inactivity

Obseity

What are the unalterable factors to strokes? (4)

Genetics - heredity

Age - increase as we age

Sex - Males

Race - African Americans

What is a cerebral thrombosis?

Damage to the brain from interruption of its blood supply, over 85% of all strokes

What is cerebral hemorrhage?

rupture of a blood vessel in the brain, aneurysm, causing bleeding into the brain

Severity of a stroke depends on

location of brain involved

extent- how long did the ischemia last

When was the first fitness fad?

1970, increase in participation of organized activities, inactivity trending downwards

What is the current fitness trend?

- modern technology

- sedentary death syndrome

- inactivity trending upwards

Define physical activity

any bodily movement produced by skeletal muscles that results in energy expenditure

Define exercise

planned, structured, repetitive movement intended to improve or maintain physical fitness

- vigorous intensity

What are the physical activity recommendations from CSEP and ACSM?

- 30 mins moderate physical activity on most days of week

- bouts of at least 10 mins

- burning 1,000 calories a week

- burning 150 calories/day

What are the 5 pillars of public health?

1. Epidemiology and disease control

2. Environmental health

3. Health promotion and health education

4. Health administration and policy

5. Biostatistics

hippocrates and ancient greeks were...

1st physicians for public health

400 BC

In 1950s:

Jeremy N Morris conducted the London Transit Authority study - 1st study to find low PA associated with heart disease

In 1990:

Healthy people 2000 guidelines

In 1996:

Report from surgeon general

- stated that low PA is hazardous to our health, almost as much as smoking

In 2000:

Healthy people 2010 guidelines

What is the average canadian lifespan?

For men?

For women?

Average: 80 years

Men: 79.9 years

Women: 84.9 years

In 1900 the average lifespan was

48 years

What is the importance of population surveillance?

helps us understand which groups are at greater risk, can observe trends over time

What are the activity guidelines for adults ages 18-64 years?

- weekly

- 150 mins moderate intensity/week

- 75 mins of vigorous intensity/week

or a combination equivalent to 150 mins/week

- involves ALL major muscle groups, strengthening exercises at least 2 times a week

What are the activity guidelines for children and adolescents ages 6-17 years?

- daily

- muscle strength: 3x/week

- bone strength: 3x/week

- moderate/vigorous intensity

-60 mins/day

- aerobic activities

What are the activity guidelines for older adults ages 65+?

- same guidelines as for adults, but if cannot be completed:

balance exercises

only use relative intensity to determine level of effort

Physical activity promotes.... (3)

- psychological well being

- weight control

- health bones, muscles and joints

Physical activity lowers the risk of.... (7)

Early death

Dying from heart disease

High blood pressure (hypertension)

Diabetes

Breast and colon cancer

Obesity

Depression + anxiety

What are efficacy trials?

studies used to establish that a certain intervention or public health program can change a certain condition

What was the stairs experiment?

2 different motivational signs encouraging shoppers to take the stairs vs escalator

What did the two signs display?

1. health benefits

2. improve waistline

What categories were used to evaluate the signs?

- sex

- age

- race

- weight

What sign was responded best to overall?

Weight Control

What sign was responded to best over 40 vs under 40?

Over 40 for both

What sign was responded to best normal weight vs overweight?

Health benefits sign - normal weight

Weight control - overweight

What sign was responded best to caucasians vs african americans?

Caucasians for both

Harvard Alumni Study

- 17,000 alumni aged 35-74

- 1413 deaths during 12-16 year follow up

- mortality rates were 25%-33% lower among those expending over 2000 cal/week vs under 2000 cal/week

Aerobics Center Longitudinal Study first assessment

1. max treadmill time and mortality in 10,000 women and 3000 women over 8 years

- Men: low fit 3x rate compared to most fit group

- Women: low fit rate 4x compared to most fit

Aerobics Center Longitudinal Study follow up

2. 8 year follow up with 25,000 men and 7000 women

- Fit men: RR = 0.49 compared to low fit

- Fit women: RR = 0.37 compared to low fit

Aerobics Center Longitudinal Study Results

lower mortality rate among moderately fit showing even some exercise is better than none

What is screening?

Way to determine if it is safe for someone to participate in health/skill related fitness

What is the PAR-Q?

Questionnaires for ages 15-69 by health canada

- ask yes/no questions about heart conditions, dizziness, pain etc

Who was the 1st epidemiologist and what was their study + year?

Dr John Snow 1854

Cholera outbreak in London

How much longer do physically active people live? What is the healthiest age?

2 years

30s

3 countries with longest life expectancy

1. Japan

2. Sweden

3. Switzerland

What diseases were in 1900 vs 2018?

1900: infectious (communicable)

2018: chronic, age related and lifestyle (noncommunicable)

Why do men die younger?

- at more risk of disease

- women generally more health concious

Define epidemiology

Study of disease distribution in a population and factors that influence/determine this distribution

Disease and illness are not _____

Each of us has certain characteristics that either _____

Randomly distributed in a population

Predispose us or protect us from diseases

Who was T.K Cureton? (3 different years and accomplishments)

1936: tests of condition

1944: physical fitness research lab in department of phys ed for men (uni illinois)

1945: physical fitness and appraisal guide

When is world health day?

April 7, São Paulo Brazil

What is Alameda County Healthy 7? Who created it?

Dr Prezlow

- cohort study looking at mortality and cancer prevalence

- longitudinal study

Name the Alameda County Healthy 7 guidelines

1. Sleeping 7-8 hours

2. Breakfast every day

3. Never/rarely snack

4. At an ideal weight

5. Never smoke

6. Moderate use of alcohol

7. Regular physical activity

Name the healthy people 2000 objectives (8)

- physical activity and fitness

- nutrition

- tobacco reduction

- alcohol and drugs

- family planning

- mental health

- violence

- education

Who was Joseph B. Wolf? (3 different years and accomplishments)

1940s: heart health

1946: heart of an athlete - journal lancet

1954: cardiologist becomes the 1st president of ACSM