Unit 3 Lecture Chapter 20

Chapter 20: Introduction to Cardiovascular Disease and Metabolic Syndrome

Objectives

  • Understand the definitions and classifications of cardiovascular disease and metabolic syndrome.

  • Discuss the risk factors, lifestyle contributions, and treatment options for metabolic syndrome.

Cardiovascular Disease Overview

  • Definition: Any disorder of the circulatory system, which includes the heart and blood vessels.

  • Subdivisions:

    • Heart Disorders:

      • Coronary artery disease

      • Angina pectoris

      • Myocardial infarction

      • Cardiac dysrhythmias

    • Brain Disorders:

      • Strokes (Cerebrovascular accidents - CVAs) and mini strokes (Transient Ischemic Attacks - TIAs)

    • Blood Vessel Disorders:

      • Hypertension

      • Peripheral vascular disease

      • Atherosclerosis

      • Deep Vein Thrombosis (DVT)

  • Short-term Effects: Painful episodes and short-term dysfunction.

  • Long-term Effects: Permanent dysfunction, disability, or death.

Metabolic Syndrome

  • Definition: A group of risk factors increasing the likelihood of heart disease, diabetes, and stroke.

  • Key Characteristics:

    • Type 2 diabetes

    • Abdominal obesity (visceral fat)

    • Hypertriglyceridemia (elevated triglycerides)

    • Low HDL (high density lipoprotein) levels

    • Hypertension

    • Central obesity plus at least two other characteristics results in a diagnosis of metabolic syndrome.

  • Contributing Factors:

    • Predominantly lifestyle choices, although genetics play a role.

Risk Factors

  • Lifestyle Factors:

    • Poor diet & sedentary lifestyle

    • Alcohol consumption (excessive)

    • Smoking

    • Stress (work-related)

    • Genetic predisposition

  • Measurement of Obesity:

    • Body Mass Index (BMI) over 25 is considered obese.

  • BMI Calculation:

    • Weight (kg) / Height (m^2)

    • Weight (lbs) / Height (inches^2) * 703

Statistics on Physical Activity

  • Over 25% of Americans are not regularly active.

  • Nearly 35% of US adults have metabolic syndrome, and over 4% of adolescents ages 12-19 are affected.

Treatment Goals and Lifestyle Modifications

  • Initial Treatment:

    • Weight loss, increased physical activity, smoking cessation, reduced alcohol intake, reduced sodium intake, stress management.

  • Exercise Recommendations:

    • Aim for at least 150 minutes of moderate exercise weekly.

    • Include resistance training to preserve muscle mass.

  • Diet Recommendations:

    • DASH diet and Mediterranean diet

    • Utilize MyPlate guidance from the CDC.

Treatment Goals

  • Reduce risk of ischemic heart disease.

  • Prevent the onset of type 2 diabetes.

  • Minimize long-term health complications and mortality.

  • BP Targets:

    • Blood pressure less than 130/80 mm Hg.

  • Lipid Targets:

    • LDL less than 100

    • Triglycerides less than 150

    • HDL greater than 40 (men) and 50 (women)

  • Glucose Management:

    • Hemoglobin A1c less than 7% for good blood sugar control.

Drug Therapy Considerations

  • Initiated if lifestyle modifications are insufficient.

  • Tailored to address hypertension, dyslipidemia, and glucose management:

    • Hypertension: ACE inhibitors, calcium channel blockers, ARBs.

    • Lipid Management: Statins, fabric acid derivatives.

    • Type 2 Diabetes: Medications to target glucose management and improve insulin sensitivity.