BBH 119 Test Set
Q: What were the major killers of Americans at the turn of the 20th century?
A: Two deadly infections: tuberculosis and pneumonia
Q: By 1925, what had become the number one cause of death in the United States?
A: Diseases of the heart, followed by pneumonia and influenza
Q: What disease had edged out pneumonia by the 1940s for the second most lethal disease?
A: Cancer
Q: What fraction of adults in the United States have at least one chronic health condition?
A: Approximately half
Q: What fraction of adults in the United States have two or more chronic health conditions?
A: Approximately a quarter
Q: Does heredity affect vulnerability to many illnesses?
A: True
Q: In a recent landmark study, what lowered the likelihood of disease and premature death even in individuals at high genetic risk for cardiovascular disease?
A: A healthy lifestyle
Q: What childhood experiences have been shown to increase the risk of chronic health problems in college students?
A: Loneliness and a dysfunctional family environment
Q: What are the American Heart Association's recommended steps to take to safeguard your well-being?
A: - Get moving
- Eat healthfully
- Maintain a healthy weight
- Control blood sugar
- Control cholesterol
- Stop smoking
Q: How does physical inactivity affect health risks?
A: Physical inactivity increases the likelihood of obesity, which in turn leads to greater risk of many diseases
Q: What does "cardio" refer to in cardiometabolic health?
A: The heart and blood vessels of the cardiovascular system
Q: What does "metabolic" refer to?
A: The biochemical processes involved in the body's functioning
Q: How many Americans die of cardiovascular diseases every day?
A: More than 2,200
Q: How frequently do cardiovascular deaths occur in America?
A: There is one death every 39 seconds
Q: What fraction of deaths are accounted for by cardiovascular diseases?
A: 1 in 3 deaths
Q: What age group has seen an increasing number of cardiovascular deaths?
A: Younger adults age 35-54
Q: What fraction of young Americans get passing grades for heart-healthy behaviors?
A: Only about half
Q: What percentage of Americans eat "ideal" diets?
A: Less than 1%
Q: What fraction of Americans have high body mass indexes?
A: About one-third
Q: What fraction of Americans have unfavorable cholesterol readings?
A: About one-third
Q: How does drinking sugary beverages in youth affect long-term health?
A: It increases the odds of disease in old age and lowers the likelihood of surviving to age 55
Q: For individuals who reach age 55 with low blood pressure and cholesterol levels, don't smoke, and don't have diabetes, how does their risk for heart disease or heart attack compare to those with risk factors?
A: Their risk is significantly lower than for those with two or more risk factors
Q: In a study of healthy young adults age 21 to 35, what sleep disturbances increased risk factors for metabolic syndrome?
A: - Getting less than six hours of total sleep time
- Waking for more than 60 minutes after sleep onset
Q: What are the effects of sleeping less than six hours at night?
A: Higher waist circumference and an increase in the hormones related to hunger and satiety
Q: At what age does BMI start affecting future risk of type 2 diabetes and heart disease?
A: During adolescence
Q: Is it true that teens with a BMI in the high healthy range face an increased likelihood of health problems?
A: True
Q: What additional risk factors are overweight and obese individuals more likely to have for cardiovascular disease?
A: - Physical inactivity
- Hypertension
- High cholesterol
- Diabetes mellitus
Q: Can overweight teens who lose weight and keep their BMI within a healthy range as adults eliminate the danger of diabetes?
A: True
Q: How do apple-shaped vs pear-shaped body types compare in terms of cardiometabolic risk?
A: Apple-shaped people who carry most of their excess weight around their waists are at greater risk than pear-shaped individuals who carry most of their excess weight below their waist
Q: What fraction of U.S. adults are sedentary?
A: About one-quarter
Q: What fraction of U.S. adults are not active enough to reach a healthy level of fitness?
A: One-third
Q: What is prolonged sitting defined as?
A: Being seated from 8 to 12 hours a day
Q: According to research analysis, what health risks does prolonged sitting significantly increase?
A: - Heart disease
- Diabetes
- Cancer
- Death
Q: What is the recommended break schedule for prolonged sitting?
A: Take a 5-minute break every 30 minutes
Q: What benefit do periodic movement breaks have on brain function?
A: Increasing the blood flow to the brain, which can help improve focus, creativity, and critical thinking
Q: By how much can following the Mediterranean diet reduce the risk of heart disease?
A: By almost half
Q: What are the additional benefits of the Mediterranean diet beyond reduced heart disease risk?
A: - Weight management
- Lower blood pressure and cholesterol levels
- Lower risk of diabetes
Q: What type of eating behaviors may increase the risk of metabolic syndrome and diabetes development among adults (age 27 to 41)?
A: Problematic eating behaviors and attitudes, such as binge eating
Q: Do vitamin D and fish oil supplements prevent and lower the risk of cardiovascular disease or cancer in the same way that consuming foods high in those nutrients do?
A: False
Q: What are the signs of high blood glucose?
A: - Frequent thirst
- Blurry vision
- Weakness
- Unexplained weight loss
- Unusual hunger
Q: What is considered a healthy blood glucose level?
A: Under 100 mg/dL
Q: What blood glucose levels indicate prediabetes?
A: 100-125 mg/dL
Q: What blood glucose level indicates diabetes?
A: Over 125 mg/dL
Q: What is systolic blood pressure?
A: Blood pressure when your heart contracts
Q: What is diastolic blood pressure?
A: Blood pressure between contractions
Q: What are blood pressure readings a measure of?
A: Systolic over diastolic blood pressure
Q: In what units is blood pressure recorded?
A: Millimeters of mercury (mmHg)
Q: What occurs in high blood pressure, or hypertension?
A: The artery walls become constricted so that the force exerted as the blood flows through them is greater than it should be
Q: How does blood pressure relate to stroke and heart disease risk?
A: The higher the reading, the greater the risk of stroke and heart disease
Q: What did studies of young adults age 18 to 40 show about elevated blood pressure?
A: It predicted hypertension and other metabolic abnormalities later in life
Q: What happens to the heart muscle of a person with hypertension?
A: It can become thicker
Q: What complications can result from the heart muscle becoming thicker due to hypertension?
A: - Shortness of breath with exertion
- Damage to the arteries in the kidneys, which can lead to kidney failure
- Accelerated development of plaque buildup in the arteries
Q: What is cholesterol?
A: A fatty substance found in certain foods and is also manufactured by the body
Q: What is one of the most reliable indicators of plaque formation?
A: The measurement of cholesterol in the blood
Q: What is plaque?
A: The sludgelike substance that builds up on the inner walls of arteries
Q: How can you lower blood cholesterol levels?
A: By cutting back on foods that are high in saturated fats and trans fats while increasing the volume of plants in your diet and your intake of fiber
Q: Who is less likely to have high cholesterol?
A: Those who exercise regularly and who maintain a healthy body weight
Q: What are lipoproteins?
A: Compounds in the blood that are made up of proteins and fat
Q: How are lipoproteins classified?
A: By their size or density
Q: What are the heaviest lipoproteins?
A: High-density lipoproteins (HDLs), which have the highest proportion of protein
Q: What is the function of high-density lipoproteins (HDLs)?
A: They pick up excess cholesterol in the blood and carry it back to the liver for removal from the body
Q: What HDL level substantially increases the risk of heart disease?
A: 40 mg/dL or lower
Q: In what units are cholesterol levels measured?
A: Milligrams of cholesterol per deciliter of blood (mg/dL)
Q: What is the average HDL for men?
A: About 45 mg/dL
Q: What is the average HDL for women?
A: About 55 mg/dL
Q: Which lipoproteins carry more cholesterol than HDLs and deposit it on the walls of arteries?
A: Low-density lipoproteins (LDLs) and very low-density lipoproteins (VLDLs)
Q: What is the relationship between LDL cholesterol levels and heart disease risk?
A: The higher your LDL cholesterol, the greater your risk for heart disease
Q: If you are at high risk of heart disease, what LDL level may increase your danger?
A: Any level higher than 100 mg/dL
Q: What are triglycerides?
A: Fats that flow through the blood after meals and have been linked to increased risk of coronary artery disease, especially in women
Q: What have triglycerides been linked to?
A: Increased risk of coronary artery disease, especially in women
Q: In whose diets are triglyceride levels tend to be highest?
A: Those whose diets contain excess calories and are high in added sugar, alcohol, and refined starches
Q: What may high levels of triglycerides increase the risk of?
A: Obesity
Q: What do cardiologists consider when assessing an individual's risks beyond just levels of blood fats?
A: Their ratios and associations
Q: Can certain cardiometabolic risk factors, such as abnormally high blood levels of lipids, be passed down from generation to generation?
A: True
Q: How do diabetes rates compare between racial groups?
A: Blacks and Hispanics have double the rates of diabetes as Whites
Q: Is it true that Native Americans have a higher rate of diabetes than Blacks and Hispanics?
A: True
Q: Are Mexican Americans likely to have heart-damaging risk factors such as high blood pressure and high blood sugar levels, even if they are not obese?
A: True
Q: Among Hispanic Americans, what fraction have cardiovascular disease?
A: Nearly 3 in 10
Q: How much more likely are African Americans to develop high blood pressure compared to Whites?
A: Twice as likely
Q: How do African Americans differ from Whites in terms of stroke occurrence?
A: They suffer stroke at an earlier age and of greater severity
Q: How much more likely are Black women to suffer a heart attack and die from heart disease compared to White women?
A: Twice as likely
Q: What medical treatment disparity exists between Black women and White women regarding heart disease?
A: Black women are less likely to receive medications, such as cholesterol-lowering drugs, to lower their risk of heart disease
Q: Have longitudinal studies proven that childhood experiences have a significant impact on health status in adulthood and beyond?
A: True
Q: How can poverty in childhood and young adulthood contribute to increased cardiometabolic risk?
A: In part because families with low incomes are less likely to receive medical treatments or undergo corrective surgery
Q: At what age do cardiometabolic risk factors particularly increase?
A: Especially past age 45
Q: What happens to blood vessels and arteries as people age?
A: They lose elasticity in their blood vessels and are more likely to have accumulated plaque in their arteries
Q: What lifestyle changes tend to occur as people age that can increase cardiovascular disease risk?
A: Many individuals tend to exercise less, lose muscle mass, and experience more stress
Q: What was metabolic syndrome once called?
A: Syndrome X
Q: What is another modern name for metabolic syndrome?
A: Insulin-resistant syndrome
Q: What is metabolic syndrome?
A: A cluster of disorders of the body's metabolism—including high blood pressure, high insulin levels, abdominal obesity, and abnormal cholesterol levels—that make a person more likely to develop diabetes, heart disease, or stroke
Q: What specific disorders make up metabolic syndrome?
A: - High blood pressure
- High insulin levels
- Abdominal obesity
- Abnormal cholesterol levels
Q: What conditions is a person with metabolic syndrome more likely to develop?
A: - Diabetes
- Heart disease
- Stroke
Q: Has the national prevalence of metabolic syndrome fallen or risen?
A: Fallen
Q: Who now has relatively lower levels of triglycerides and higher levels of HDL cholesterol?
A: Teenagers
Q: What three or more characteristics are indicative of metabolic syndrome?
A: - Larger-than-normal waist measurement
- Higher-than-normal triglyceride level
- Lower-than-normal HDL level
- Higher-than-normal blood pressure
- Higher-than-normal fasting blood sugar
Q: What indicates a larger-than-normal waist measurement for people without a genetic predisposition to diabetes?
A: 40 inches or more in men and 35 inches or more in women
Q: What indicates a larger-than-normal waist measurement for people with a genetic predisposition to diabetes?
A: 37 to 39 inches in men and 31 to 35 inches in women
Q: What indicates a higher-than-normal triglyceride level?
A: 150 mg/dL or more
Q: What indicates a lower-than-normal HDL level?
A: Less than 40 mg/dL in men or 50 mg/dL in women
Q: What indicates higher-than-normal blood pressure?
A: 130 mmHg systole over 85 mmHg diastole (130/85) or higher
Q: What indicates higher-than-normal fasting blood sugar?
A: 110 mg/dL or higher
Q: How does having three factors of metabolic syndrome affect heart attack and stroke risk compared to having no factors?
A: Those with three factors are nearly twice as likely to have a heart attack or stroke and more than three times as likely to develop heart disease
Q: What are the increased risks for men with four or five characteristics of metabolic syndrome?
A: Nearly four times the risk of heart attack or stroke and more than 24 times the risk of diabetes
Q: What condition are young adults with metabolic syndrome more likely to have that indicates atherosclerosis?
A: Thicker neck arteries
Q: What is atherosclerosis?
A: The buildup of fatty plaques in arteries
Q: How does maintaining weight affect the development of metabolic syndrome in college-age men and women?
A: Those who maintain their weights as they get older are much less likely to develop metabolic syndrome
Q: What percentage of body weight loss may reverse the symptoms of metabolic syndrome in obese individuals?
A: Losing 7 to 10 percent of their body weight
Q: Can kidneys process excessive glucose?
A: False
Q: Is it true that kidneys cannot process excessive glucose and instead put it out of the body through urine?
A: True
Q: In those who have diabetes, what is true about insulin secretion?
A: It is either nonexistent or deficient
Q: What does insulin do?
A: Enhances the movement of glucose into various body cells
Q: What happens if you don't have sufficient insulin?
A: Glucose is unable to enter most body cells, so their energy needs are not met
Q: What does the body do when it is deprived of the fuel it needs, due to low insulin or other factors?
A: It begins to break down stored body fat as a source of stored energy
Q: What does the breaking down of stored fat as a source of energy produce?
A: Weak acids, called "ketones"
Q: What are ketones?
A: The weak acids produced by the breakdown of stored body fat
Q: What does a buildup of ketones lead to?
A: Ketoacidosis
Q: What is ketoacidosis?
A: An upheaval in the body's chemical balance that brings on nausea, vomiting, abdominal pain, lethargy, and drowsiness
Q: What can severe ketoacidosis lead to?
A: Coma and death
Q: What kind of damage does ketoacidosis cause?
A: Damage to blood vessels, kidneys, and increased risk of blindness, amputation, heart attack, and stroke
Q: What proportion of Americans have diabetes?
A: About 1 in 10
Q: What fraction of Americans are expected by the CDC to have diabetes by 2050 if current trends in weight and exercise continue?
A: One third
Q: What is the "diabetes belt"?
A: The name of the 15 states in the South that have a much higher rate of diabetes
Q: How many states are in the diabetes belt?
A: 15
Q: How do people in the diabetes belt differ from the country as a whole?
A: They are more likely to be obese, sedentary, and less educated
Q: What racial-ethnic minorities around the country have higher rates of diabetes?
A: Native Americans, African Americans, and Hispanic Americans
Q: What is insulin resistance?
A: A condition in which the body produces insulin but does not use it properly
Q: What does the pancreas do when muscle, fat, and liver cells do not properly respond to insulin?
A: Tries to keep up with insulin production until it eventually cannot due to beta cells that make insulin wearing out
Q: Which gender is more at risk when they have risk factors such as genetic predispositions and a lack of physical activity for insulin resistance?
A: Men
Q: What other names is prediabetes sometimes called?
A: - Impaired fasting glucose
- Impaired glucose tolerance
- Intermediate hyperglycemia
Q: What is prediabetes?
A: A condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes
Q: Do all individuals that are told they have prediabetes develop diabetes over time?
A: False
Q: Is it true that many individuals told that they are prediabetic do not develop diabetes over time?
A: True
Q: What fraction of the US population can be assessed as prediabetic?
A: More than one-third
Q: How many people in the US can be assessed as prediabetic?
A: 79 million
Q: What percent of people in the US are aware of the risk of prediabetes?
A: 10%
Q: What risks do people with prediabetes face?
A: Cardiovascular events such as heart attack and stroke
Q: In those with diabetes mellitus, what happens to the pancreas?
A: The pancreas doesn't function as it should
Q: Is it true that almost every body system can be damaged by insulin deficiency?
A: True
Q: What rank is diabetes mellitus in the leading causes of death in the United States?
A: 7th
Q: By how much can diabetes mellitus shorten life expectancy?
A: 10 years or more
Q: How much higher is the risk of premature death in people with diabetes when compared to people without it?
A: Twice
Q: What conditions can obesity, diabetes, and heart disease work together to speed up?
A: Dementia and other brain disorders, such as cognitive impairment
Q: What are the three types of diabetes?
A: Type 1, type 2, and gestational
Q: What was type 1 diabetes once called?
A: Juvenile-onset or insulin-dependent diabetes
Q: What causes type 1 diabetes?
A: The immune system attacking the pancreatic beta cells
Q: How many years do people with type 1 diabetes lose from their lives?
A: 11 years for men and 13 years for women
Q: How much greater risk do women with type 1 diabetes have compared to men with type 1 diabetes?
A: Women have a nearly 40 percent greater risk of dying from any cause and more than double the risk of dying from heart disease
Q: What is a speculated reason why women with type 1 diabetes have higher rates of death than men?
A: High levels of blood sugar may cause more damage to women's blood vessels
Q: What form of treatment do individuals with type 1 diabetes require?
A: Insulin therapy
Q: What was type 2 diabetes once called?
A: Adult-onset or non-insulin-dependent diabetes
Q: Is it true that intensive control of blood glucose prolongs the life of people with type 1 diabetes?
A: True
Q: What percentage of diabetics does type 2 diabetes affect?
A: 90 to 95 percent
Q: Why is type 2 diabetes becoming more common in children and teenagers?
A: Increased obesity in the young
Q: What are the two potential conditions behind type 2 diabetes?
A: - The pancreas does not make enough insulin
- The body is unable to use insulin correctly
Q: What are the two important factors in both type 1 and 2 diabetes?
A: - Inherited predisposition
- Something in the environment that triggers diabetes
Q: Are genes alone enough to trigger type 1 diabetes?
A: False
Q: What are the potential environmental triggers for type 1 diabetes?
A: - Prenatal nutrition
- A virus
- Other unknown agents
Q: What is the highest risk factor for getting type 2 diabetes only in Western Countries?
A: Family history
Q: Do people in less developed nations tend to get diabetes more frequently when they have genetic predisposition?
A: False
Q: What can really help people with type 2 diabetes get blood sugar under control?
A: Losing weight
Q: Is it true that women who get diabetes while they are pregnant are more likely to have a family history of diabetes?
A: True
Q: Is it true that women who get diabetes while they are pregnant are at increased risk of developing diabetes later in life?
A: True
Q: Is exercising fewer than three times a week a risk factor for diabetes?
A: True (it is a risk factor)
Q: Is giving birth to a baby weighing more than nine pounds a risk factor for diabetes?
A: True
Q: What level of blood pressure is a risk factor for diabetes?
A: 140/90 mmHg
Q: What are the previous testing glucose conditions that are risk factors for diabetes?
A: Impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
Q: What triglyceride levels are a diabetes risk factor?
A: Above 250 mg/dL
Q: What HDL levels are a diabetes risk factor?
A: Below 35 mg/dL
Q: What medications can increase the risk of type 2 diabetes?
A: Antibiotics such as penicillin and cholesterol-lowering statin drugs
Q: What was type 2 diabetes once called?
A: Adult-onset or non-insulin-dependent diabetes
Q: Is it true that intensive control of blood glucose prolongs the life of people with type 1 diabetes?
A: True
Q: What percentage of diabetics does type 2 diabetes affect?
A: 90 to 95 percent
Q: Why is type 2 diabetes becoming more common in children and teenagers?
A: Increased obesity in the young
Q: What are the two potential conditions behind type 2 diabetes?
A: - The pancreas does not make enough insulin
- The body is unable to use insulin correctly
Q: What are the two important factors in both type 1 and 2 diabetes?
A: - Inherited predisposition
- Something in the environment that triggers diabetes
Q: Are genes alone enough to trigger type 1 diabetes?
A: False
Q: What are the potential environmental triggers for type 1 diabetes?
A: - Prenatal nutrition
- A virus
- Other unknown agents
Q: What is the highest risk factor for getting type 2 diabetes only in Western Countries?
A: Family history
Q: Do people in less developed nations tend to get diabetes more frequently when they have genetic predisposition?
A: False
Q: What can really help people with type 2 diabetes get blood sugar under control?
A: Losing weight
Q: Is it true that women who get diabetes while they are pregnant are more likely to have a family history of diabetes?
A: True
Q: Is it true that women who get diabetes while they are pregnant are at increased risk of developing diabetes later in life?
A: True
Q: Is exercising fewer than three times a week a risk factor for diabetes?
A: True (it is a risk factor)
Q: Is giving birth to a baby weighing more than nine pounds a risk factor for diabetes?
A: True
Q: What level of blood pressure is a risk factor for diabetes?
A: 140/90 mmHg
Q: What are the previous testing glucose conditions that are risk factors for diabetes?
A: Impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
Q: What triglyceride levels are a diabetes risk factor?
A: Above 250 mg/dL
Q: What HDL levels are a diabetes risk factor?
A: Below 35 mg/dL
Q: What medications can increase the risk of type 2 diabetes?
A: Antibiotics such as penicillin and cholesterol-lowering statin drugs
Q: What is the recommended screening pattern for diabetes by the American Diabetes Association?
A: Every 3 years for all men and women beginning at age 45
Q: What is the recommended screening pattern for diabetes by the American College of Endocrinology?
A: Screening at age 30 for individuals who are at risk, including those who are overweight, are sedentary, have a family history of diabetes, or have high blood pressure or heart disease
Q: What tests can detect diabetes?
A: - Random blood sugar test
- Fasting blood glucose test
- Glucose challenge test
Q: What blood glucose level should a random blood glucose test not exceed?
A: 200 mg/dL
Q: What are the warning signs of type 2 diabetes?
A: - Increased thirst and frequent urination
- Flulike symptoms
- Weight loss or weight gain
- Blurred vision
- Slow-healing sores or frequent infections
- Nerve damage (neuropathy)
- Red, swollen, tender gums
Q: Before what development was diabetes a fatal illness?
A: Insulin injections
Q: What is diabetes the number one cause of?
A: Blindness
Q: What three conditions is diabetes the number one cause of?
A: - Blindness
- Nontraumatic amputations
- Kidney failure
Q: How much does diabetes increase the risk of heart attack or stroke?
A: Two or three times
Q: What are the ABCs to delay or prevent the serious complications of diabetes?
A: - A1c test
- Blood pressure
- Cholesterol
Q: How often should individuals with diabetes have their A1c levels checked?
A: At least twice a year
Q: What is the life cycle of a blood cell?
A: 75-90 days
Q: What is the A1c goal according to different organizations?
A: 7 percent by American Diabetes Association, and 6.5 for American College of Endocrinology (normal levels are below 6)
Q: What is the LDL goal for most people?
A: Less than 160 mg/dL
Q: What happens when you have more hemoglobin molecules with glucose attached?
A: Greater risk of damage to eyes, kidneys, and feet
Q: What are the American Diabetes Association's exercise recommendations for individuals with diabetes?
A: Mild to moderate physical activity for 3 minutes at 30-minute intervals
Q: What allows individuals with diabetes to check their blood sugar levels as many times a day as necessary and to adjust their diet or insulin doses as appropriate?
A: Home glucose monitoring, including new continuous glucose monitors
Q: How do types of insulin differ?
A: In how long they take to start working after injection (onset), when they work hardest (peak), and how long they last in the body (duration)
Q: What are the ways those with type 1 diabetes can receive their required daily doses of insulin?
A: - Injections
- An insulin infusion pump
- Oral medication
Q: How can those with type 2 diabetes often control their disease?
A: Through a well-balanced diet, exercise, and weight management
Q: What are the methods to "cure" diabetes?
A: - Pancreas transplants (only half continue to function for 10 years)
- Gastric bypass surgery (changes hormones and amino acids produced during digestion)
- Pancreatic rejuvenation
- Autoimmune blocking antibodies for type 1
- Artificial pancreas
Q: What are alternatives to fingersticks for blood sugar monitoring?
A: - Smartphone apps
- Blood sugar monitoring contact lenses
- Breathalyzer
- Saliva tests
- Tattoos that reflect light back through a mirror to translate readings into blood sugar levels
Q: What does blood pressure refer to?
A: The force of blood against the walls of arteries
Q: What complications can hypertension cause?
A: - Heart attack
- Stroke
- Blindness
- Kidney disease
Q: What fraction of adults over 20 have hypertension?
A: One third
Q: How much has the overall death rate from hypertension increased since 2000?
A: 23 percent for both men and women
Q: What age group experienced the greatest spike in blood pressure as of recently?
A: 45-54
Q: How does blood pressure compare between low-income and affluent states?
A: People living in low-income states are more likely to have high blood pressure than the residents of more affluent states
Q: How has blood pressure in less developed countries changed over the last four decades?
A: Increased significantly
Q: How many heart attacks and strokes could be prevented annually by regulating blood pressure for all Americans?
A: 56,000 heart attacks and strokes and 13,000 deaths
Q: What percentage of adults with elevated blood pressure do not have it under control?
A: 44 percent
Q: How many heart attacks and strokes could be prevented globally over 10 years by treating half of people with uncontrolled high blood pressure?
A: 10 million
Q: How can even mild hypertension affect young people?
A: It can cause organs such as the heart, brain, and kidneys to start to deteriorate
Q: At what age can high blood pressure begin damaging the structure of the brain?
A: As young as age 40
Q: In individuals with genetic risk, what condition may high blood pressure accelerate?
A: Development of brain plaques characteristic of Alzheimer disease
Q: What factors combine with hypertension to greatly increase cardiovascular risks?
A: - Obesity
- Smoking
- High cholesterol levels
- Diabetes
Q: What did a 25-year study of nearly 4,700 young adults in their 20s with mildly elevated blood pressure show?
A: They may face an increased risk of clogged arteries by middle age
Q: What is the relationship between binge drinking and hypertension in college students?
A: Binge drinking has been linked with an increased short- and long-term risk of hypertension
Q: How do racial differences affect high blood pressure complications?
A: An African American with the same elevated blood pressure reading as a Caucasian faces a greater likelihood of hospitalization and risk of stroke, heart disease, and kidney problems
Q: How does a small increase in blood pressure affect Black people?
A: A rise of as little as 10 mmHg in systolic blood pressure raises the risk of dying and is even greater for Black people under age 60
Q: How does family history affect blood pressure risk?
A: If one or both of your parents have high blood pressure, you should have yours checked regularly
Q: How does gender affect hypertension risk?
A: Men and women are equally likely to develop hypertension
Q: What blood pressure risk do women face during pregnancy?
A: Women who develop high blood pressure during pregnancy may face an increased risk of heart and kidney disease
Q: When else might women face increased blood pressure risk?
A: Blood pressure also tends to rise around the time of menopause
Q: What is the relationship between chronic insomnia and blood pressure?
A: People with chronic insomnia who take longer than 14 minutes to fall asleep may have a 300 percent higher risk of high blood pressure. The longer before sleep onset, the greater their risk
Q: What is the key to preventing stroke?
A: Lowering blood pressure
Q: What are the blood pressure categories and their corresponding measurements?
A: - Normal: Less than 120/80 mmHg
- Elevated: Systolic between 120-129 and diastolic less than 80
- High Blood Pressure Stage 1: Systolic between 130-139 or diastolic between 80-89
- High Blood Pressure Stage 2: 140 or higher systolic or 90 or higher diastolic
- Hypertensive Crisis: Higher than 180 systolic and/or higher than 120 diastolic
Q: Do the new blood pressure guidelines differentiate based on age?
A: No, unlike previous recommendations
Q: When are medications recommended for stage 1 hypertension?
A: Only if individuals already had a heart attack or stroke. For others with stage 1 hypertension, lifestyle changes alone are recommended
Q: What is the recommended blood pressure screening schedule for healthy adults?
A: Screening should begin at age 51, with repeat evaluations at least every 2 years, or more often depending on current health, medical history, and risk factors
Q: According to the National College Health Assessment survey, what percentage of undergraduates have been diagnosed or treated for high blood pressure?
A: 3.2 percent
Q: What type of blood pressure monitor is recommended for home use?
A: A monitor that goes around your upper arm
Q: Why are wrist and finger monitors not recommended for blood pressure monitoring?
A: They are not as precise
Q: What features should you look for in a home blood pressure monitor?
A: - An automated monitor with a self-inflating cuff
- Large, bright digital readout
- If possible, ability to transfer readings to a smartphone app
Q: What should you avoid 30 minutes before testing blood pressure?
A: Caffeinated or alcoholic beverages
Q: What is the proper position for taking blood pressure?
A: - Sit quietly for five minutes with back supported
- Do not cross legs
- Rest arm at or near heart level
- Wrap cuff over bare skin
- Don't talk
Q: What is the recommended process for taking multiple blood pressure readings?
A: - Leave the deflated cuff in place
- Wait a minute
- Take a second reading
- If readings are close, average them
- If not, repeat again and average the three readings
Q: What is the first-line weapon in the fight against high blood pressure?
A: Lifestyle changes
Q: What combination of changes yields the best results for lowering blood pressure?
A: - Losing weight
- Eating heart-healthy foods
- Reducing sodium
- Exercising more
Q: What has research shown about low sodium intake (less than 3 grams a day)?
A: It has been linked with cardiovascular problems and greater risk of dying regardless of an individual's blood pressure
Q: When does high sodium intake (7+ grams daily) increase risks?
A: Only for those with hypertension
Q: What does DASH stand for?
A: Dietary Approaches to Stop Hypertension
Q: What organization developed the DASH eating pattern?
A: The National Heart, Lung, and Blood Institute (NHLBI)
Q: How effective is the DASH eating pattern in lowering blood pressure?
A: It has proved as effective as drug therapy
Q: What additional benefits does the DASH diet provide beyond lowering blood pressure?
A: It also lowers harmful blood fats, including cholesterol and LDL, and the amino acid homocysteine
Q: What types of exercise can lower blood pressure?
A: Both aerobic workouts and resistance training
Q: How does walking compare to running for cardiovascular benefits?
A: Walking has proven as beneficial as running in lowering blood pressure and other cardiovascular risk factors
Q: What lifestyle modifications are recommended to lower blood pressure?
A: - Get moving (regular exercise can lower blood pressure by 10 points)
- Eat a healthy diet with more fruits, vegetables, low-fat dairy, whole grains, poultry, fish, and nuts
- Don't smoke
- Hold the salt
- Stick with medications if prescribed
- Avoid caffeinated energy drinks
Q: Can Stage 1 hypertension be improved with healthy lifestyle modifications alone?
A: Yes, but most people also require medication
Q: What characteristics should be considered when choosing blood pressure medications?
A: - Regimens (once a day to several times a day)
- Effects on other conditions
- Interactions with other drugs
- Potential side effects
Q: What benefits do blood pressure medications provide?
A: They have been shown to lower the risk of stroke and add years to life expectancy
Q: What is recommended for individuals at high cardiovascular risk?
A: Treatment with a combination of medications may lead to a faster reduction in blood pressure
Q: What test is recommended for individuals age 20 and older by the NHLBI's National Cholesterol Education Program?
A: A comprehensive testing called a lipoprotein profile
Q: When should the lipoprotein profile be performed?
A: After a 9- to 12-hour fast
Q: How often should the lipoprotein profile be repeated?
A: At least once every 5 years
Q: What four measurements does a lipoprotein profile provide?
A: - Total cholesterol
- LDL (bad) cholesterol
- HDL (good) cholesterol
- Triglycerides
Q: How does long-term exposure to higher cholesterol affect heart health?
A: People who live for more than a decade with high cholesterol have four times the risk of heart disease than those with shorter exposure
Q: What total cholesterol level is considered ideal?
A: Less than 200 mg/dL
Q: What total cholesterol range is considered borderline high?
A: 200 to 239 mg/dL
Q: What total cholesterol level is considered high and doubles your risk of heart disease?
A: Above 240 mg/dL
Q: Why is HDL cholesterol particularly important for women?
A: Good cholesterol (HDL) is important in everyone, but particularly women
Q: What HDL reading is defined as a major risk factor for developing heart disease?
A: Less than 40 mg/dL
Q: What HDL levels are considered protective and lower the risk of heart disease?
A: 60 mg/dL or more
Q: What is the ideal level for triglycerides?
A: Below 150 mg/dL
Q: What triglyceride readings are considered borderline?
A: 150 to 199 mg/dL
Q: What treatment approach is recommended for those with borderline or higher triglyceride readings?
A: They may benefit from weight control, physical activity, and, if necessary, medication
Q: What fraction of Americans may require treatment to lower cholesterol level?
A: About 1 in 5 Americans
Q: What percentage of people who need cholesterol treatment don't get it?
A: Nearly half
Q: By how much can cholesterol treatment reduce the risk of heart disease over 5 years?
A: By 30 percent
Q: What lifestyle changes can improve lipoprotein profile?
A: - Dietary changes
- Weight management
- Physical activity
Q: By how much can lifestyle changes lower harmful LDL levels?
A: 5 to 10 percent
Q: What is required for a greater reduction of 30 to 40 percent in LDL levels?
A: Either intensive lifestyle changes, including an extremely low-fat diet or the addition of cholesterol-lowering medication
Q: What are some common statin drugs?
A: - Lipitor
- Mevacor
- Pravachol
- Zocor
Q: By how much can statins cut the risk of dying of a heart attack in individuals with very high total cholesterol?
A: By as much as 40 percent
Q: How do statins work?
A: They work in the liver to block production of cholesterol. When the liver can't make cholesterol, it draws LDL cholesterol from the blood to use as raw material
Q: What additional benefits do statins provide beyond lowering cholesterol?
A: They appear to stabilize cholesterol-filled deposits in artery walls and cool down inflammation
Q: What combination provides the most dramatic effect on cholesterol levels and reduced risk of dying?
A: The combination of statins with moderate exercise, such as 30 minutes a day of brisk walking
Q: Who else can benefit from statins besides those who have had heart attacks?
A: Patients who have not had a heart attack but are at high risk for developing cardiovascular disease because of high cholesterol or other risk factors
Q: What additional protection do statins provide for older adults?
A: They protect against heart attack and stroke even in older adults without known cardiovascular disease or diabetes and with low cholesterol—if these patients also have high levels of CRP or C-reactive protein
Q: What fraction of deaths are caused by cardiovascular diseases in the United States?
A: About 1 of every 3 deaths
Q: How many Americans die of cardiovascular diseases annually?
A: About 787,000
Q: How does cardiovascular disease rank globally as a cause of death?
A: It is the leading cause of death, claiming more lives than all cancers combined
Q: How frequently does someone die of a heart-related disease in America?
A: Every 40 seconds
Q: What is the size of a human heart?
A: About the size of a clenched fist
Q: What are the four chambers of the heart?
A: - Two upper chambers (atria)
- Two lower chambers (ventricles)
Q: What is the function of the atria?
A: They receive blood, which then flows through valves into the ventricles
Q: What do the ventricles do?
A: They contract to pump blood out into the arteries through a second set of valves
Q: What divides the right side of the heart from the left side?
A: A thick wall
Q: What is systole?
A: Contraction of the ventricles
Q: What is diastole?
A: The period of relaxation between contractions
Q: Where are heart valves located and what do they do?
A: Located at the entrance and exit of the ventricular chambers; they have flaps that open and close to allow blood to flow through the chambers of the heart
Q: What is the myocardium?
A: The heart muscle that consists of branching fibers that enable the heart to contract
Q: How often does the heart typically beat?
A: Between 60 and 80 times per minute, or about 100,000 times a day
Q: How much blood does the heart pump with each beat?
A: About 2 ounces of blood, which adds up to nearly 5 quarts of blood in 1 minute, or about 75 gallons per hour
Q: What is the pericardium?
A: Two layers of a tough membrane surrounding the heart, containing lubricating fluid that allows the heart muscle to move freely
Q: What is the endocardium?
A: A smooth membrane lining the inside of the heart and its valves
Q: How does blood circulate from the right ventricle through the lungs?
A: The right ventricle pumps blood via the pulmonary arteries to the lungs, where it picks up oxygen and gives off carbon dioxide
Q: Where does blood go after returning from the lungs?
A: It returns via the pulmonary veins to the left side of the heart, which pumps it via the aorta to the arteries in the rest of the body
Q: What happens as arteries divide?
A: They divide into smaller and smaller branches and finally into capillaries
Q: What are capillaries?
A: The smallest blood vessels, only slightly larger in diameter than a single red blood cell
Q: What is the function of blood within capillaries?
A: It supplies oxygen and nutrients to the cells of the tissues and takes up various waste products
Q: How does blood return to the heart from the upper body?
A: Through the superior vena cava
Q: How does blood return to the heart from the lower body?
A: Through the inferior vena cava
Q: Why might young people be unaware of heart risks?
A: Many people, including college students and other young adults, are often unaware of habits and conditions that put their hearts at risk
Q: What misconception do many undergraduates have about heart disease?
A: They view heart disease as mainly a problem for White men and underestimate the risks for women and ethnic groups
Q: How do students rate their knowledge of heart disease compared to other health issues?
A: They rate their own knowledge of heart disease as lower than that of sexually transmitted infections and psychological disorders
Q: What rank is heart disease as a cause of death among adults age 25 to 44?
A: Third leading cause of death
Q: What is the relationship between aerobic fitness in college years and heart attack risk?
A: High aerobic fitness in the college-age years has been linked with a lower risk of heart attack later in life
Q: How does binge drinking affect heart health in students?
A: It may hinder the function of the blood vessels and increase the likelihood of stroke, sudden cardiac death, and heart attack
Q: What condition causes one in every three cases of sudden cardiac death in young athletes?
A: Hypertrophic cardiomyopathy (HCM), an excessive thickness of the heart muscle
Q: What does HCM make the heart more prone to?
A: Dangerous heart irregularities
Q: What are the three categories of psychological risk factors for heart disease?
A: - Chronic factors (like job strain or lack of social support)
- Episodic factors (like depression lasting several weeks to two years)
- Short-term or acute factors (like an angry outburst)
Q: How does stress affect heart health in teenagers?
A: According to longitudinal analysis, teens who scored high in stress early in life were more likely to develop atherosclerosis by their mid-40s
Q: What is the relationship between depression and heart disease?
A: - People with heart disease are more likely than others to be depressed
- Some seemingly healthy people with depression are at greater risk of heart problems
- Depressed women younger than age 60 are more likely to suffer a heart attack than those without depression
Q: What is the "psychosocial perfect storm"?
A: The combination of stress, depression, and heart disease that increases the risk of heart attack or death among men and women with heart disease
Q: How does anger affect men's heart health?
A: The angriest men are three times more likely to develop heart disease than the most placid ones
Q: How does hostility affect heart health in men?
A: It more than doubles the risk of recurrent heart attack in men (but not women)
Q: What specific risks has research linked to hostility in men?
A: - Increased cardiac risk factors
- Decreased survival in men with coronary artery disease below age 61
- Increased risk of heart attack in men with metabolic syndrome
- Increased risk of abnormal heart rhythms
Q: When is the risk of heart attack highest in relation to angry outbursts?
A: In the two hours following an angry outburst
Q: How does anger frequency affect cardiovascular risk?
A: The more frequent the outbursts, the greater the danger to heart health
Q: What is the relationship between anger in young men and future heart health?
A: The angriest young men were more likely to suffer a heart attack by age 55 and to develop any form of cardiovascular disease
Q: How does anger physically affect the heart?
A: - Triggers a surge in stress hormones that can provoke abnormal and potentially lethal heart rhythms
- Activates platelets, the tiny blood cells that trigger blood clotting
- High levels can trigger a spasm in a coronary artery
Q: How does anger affect women's heart health differently from men's?
A: Women who outwardly express anger may be at increased risk only if they also have other risk factors for heart disease, such as diabetes or unhealthy levels of lipoproteins
Q: What is the relationship between positive emotions and heart health?
A: People who showed more positive emotions (enthusiasm, joy, contentment) were less likely to develop heart disease than less happy individuals
Q: How does optimism affect heart health?
A: When socioeconomic factors are accounted for, optimistic people are more likely to be in ideal cardiovascular health, with lower blood sugar, cholesterol, blood pressure, and BMIs compared with pessimistic people
Q: How does a sense of purpose affect heart health?
A: Individuals who feel motivated by a sense of meaning and direction in life and view life as worth living are at lower risk of cardiovascular disease, stroke, and death from any cause
Q: What smoking-related factors contribute to atherosclerosis?
A: Both active and passive smoking (exposure to environmental tobacco smoke)
Q: What is inflammation's role in the body?
A: It is the process by which the body responds to fever, injury, or infection and plays an essential role in healing and recovering from infection
Q: How can chronic low-grade inflammation affect cardiovascular health?
A: It may contribute to atherosclerosis and set the stage for heart attack, stroke, and other forms of cardiovascular disease
Q: What are the most common triggers of inflammation?
A: - Smoking
- Lack of exercise
- High-fat and high-calorie meals
- Highly processed foods
Q: What is C-reactive protein (CRP)?
A: A protein produced in the liver that rises whenever the body responds to inflammation
Q: How do CRP levels relate to heart disease risk?
A: Individuals with the highest CRP levels are more likely to develop heart disease than those with the lowest levels
Q: What can high concentrations of CRP predict?
A: Greater risk of sudden death
Q: What chronic inflammatory diseases are associated with increased cardiovascular disease risk?
A: - Rheumatoid arthritis
- Systemic lupus erythematosus
- Psoriasis
Q: How do illegal drugs affect cardiovascular health?
A: Ecstasy, amphetamines, and cocaine can cause:
- Sudden rise in blood pressure
- Increased heart rate
- Contractions of the left ventricle
- Increased risk of heart attack
Q: What cardiovascular effects do hallucinogens like LSD and psilocybin have?
A: They have the potential for:
- Triggering irregular heartbeat
- Triggering heart attack
- Temporary rise in blood pressure (more common)
Q: What cardiovascular effects do morphine and heroin have?
A: They can:
- Lower blood pressure
- Affect heart rate
- Account for almost half of drug-related deaths
Q: What can inhalants cause?
A: Fatal heartbeat irregularities
Q: What bacteria has been implicated in atherosclerotic plaque buildup?
A: Streptococcus sanguis, the bacterium found in dental plaque
Q: How does periodontal disease affect cardiovascular risk?
A: Individuals with periodontal disease are at increased risk of heart disease and stroke
Q: How can the risk from dental bacteria be reduced?
A: Through regular brushing, flossing, and dental visits
Q: What is the relationship between Chlamydia pneumoniae and heart health?
A: Individuals with high levels of antibodies to this bacterium are more likely to suffer a heart-related problem
Q: What potential protective effect do antibiotics have on heart health?
A: Antibiotics taken to treat common infections may protect against first-time heart attacks
Q: How do heart attack outcomes compare between young men and women?
A: Although men have a higher incidence of cardiovascular problems before age 45, young women who have heart attacks are more likely to die as a result
Q: What is the most common heart attack symptom for both men and women?
A: Chest pain or discomfort
Q: What additional physical symptoms are women more likely to report during heart attacks?
A: - Jaw pain
- Tiredness
- Labored breathing or shortness of breath
- Nausea and vomiting
- New or worse headaches
- Chest discomfort (feeling "heavy" or "tight," or burning feeling)
- Pain in the back, between the shoulders
- Pain or tightness that spreads to jaw, neck, shoulders, ear, or arms
- Pain in the belly above the belly button
Q: What percentage of heart disease cases in young and middle-aged women may be related to unhealthy lifestyles?
A: Almost 75 percent
Q: How can exercise affect middle-aged women's heart disease risk?
A: Even a few bouts of moderate exercise each week can cut a middle-aged woman's odds for heart disease, blood clots, and stroke
Q: How many women under age 65 experience a heart attack every year?
A: 35,000
Q: How many women younger than age 55 die from heart disease in the United States each year?
A: More than 15,000
Q: How does high blood pressure compare as a risk factor between men and women?
A: High blood pressure is a stronger risk factor for women than for men
Q: How does diabetes affect heart disease risk in young women compared to young men?
A: Diabetes raises a young woman's heart disease risk up to five times higher compared to young men
Q: How do heart attack rates compare between Black and White women?
A: Black women of any age have a higher incidence of heart attack than White women
Q: What risk factors are more common in Black and Hispanic women at the time of heart attack compared to White women?
A: Obesity, diabetes, and high blood pressure
Q: What proven lifestyle choices can reduce heart disease risk regardless of age or sex?
A: - Not smoking
- Exercising at least 2.5 hours a week
- Maintaining a healthy weight
- Watching fewer than seven hours of television a week
- Following a healthy diet
- Drinking no more than one glass of alcohol a day
Q: What is arteriosclerosis?
A: The general term for any impairment of blood flow through the blood vessels, often referred to as "hardening of the arteries"
Q: What is atherosclerosis?
A: The most common form of arteriosclerosis, a disease of the lining of the arteries in which plaque deposits narrow the artery channels
Q: What is plaque composed of?
A: - Fat
- Fibrin (a clotting material)
- Cholesterol
- Other cell parts
- Calcium
Q: How does atherosclerosis begin?
A: When LDL cholesterol penetrates the wall of an artery
Q: What is the ideal process for handling cholesterol in arteries?
A: HDL cholesterol carries the cholesterol out of the artery wall to the liver for disposal
Q: What happens when LDL accumulates in artery walls?
A: The artery responds by releasing chemical messengers called cytokines, which trigger active inflammation in the artery wall
Q: What proteins are directly associated with the risk of atherosclerosis?
A: Elevated levels of LDL cholesterol and apolipoprotein B (apoB), the main structural protein of LDL
Q: What cells move from the bloodstream into the artery to deal with LDL?
A: T lymphocytes and macrophages (specialized white blood cells)
Q: What are foam cells?
A: Enlarged macrophages that have engulfed LDL
Q: What happens when foam cells rupture?
A: They release cholesterol into the artery wall, where the cycle of damage begins again
Q: How does the artery wall respond to inflammation?
A: The smooth muscle cells create a fibrous cap over the inflamed area
Q: Why are hard-capped plaques dangerous?
A: They:
- Narrow arteries
- Reduce blood flow
- Produce angina (chest pain)
Q: What type of plaques usually cause heart attacks?
A: Smaller, softer plaques that can rupture
Q: What happens when a plaque ruptures?
A: The body responds with clotting factors, platelets, and blood cells, forming a blood clot (thrombus) on the disrupted plaque's surface
Q: What is the medical name for a heart attack?
A: Myocardial infarction (MI)
Q: What happens during a myocardial infarction?
A: When an artery is blocked by a clot or plaque, or by a spasm, the myocardial cells don't get sufficient oxygen, and the portion of the myocardium deprived of its blood supply begins to die
Q: What percentage of people who suffer a fatal heart attack have at least one major risk factor prior to the event?
A: 95 percent
Q: What symptoms indicate someone should seek immediate medical care and take an aspirin?
A: - Tight ache, heavy squeezing pain, or discomfort in center of chest lasting 30+ minutes
- Chest pain radiating to shoulder, arm, neck, back, or jaw
- Sweating or cold, clammy skin
- Nausea and vomiting
- Shortness of breath
- Dizziness, fainting, or loss of consciousness
Q: How do women's heart attack symptoms differ from men's?
A: In the month before an attack, many report:
- Unusual fatigue
- Disturbed sleep
- Less chest pain
- More shortness of breath
- Weakness and fatigue
- Clammy sweat
- Dizziness
- Nausea
Q: What everyday activities can trigger a heart attack?
A: - Eating
- Drinking coffee
- Having sex
- Air pollution
- Drinking alcohol
- Physical exertion
- Eating a heavy meal
Q: What should you do if someone shows signs of a heart attack for two minutes or more?
A: Act at once, even if they deny the possibility of a heart attack, and call 911 immediately
Q: Why is time critical during a heart attack?
A: The sooner emergency personnel administer cardiac life support, the greater the odds of survival
Q: How long do most patients wait after initial symptoms before seeking help?
A: Three hours, by which time half of the affected heart muscle may already be lost
Q: What is cardiac arrest?
A: When the heart stops beating
Q: How long can the brain survive without circulation before shutting down completely?
A: Four to five minutes
Q: What is CPR?
A: An emergency procedure for a person whose heart has stopped or who is no longer breathing
Q: What is the most effective method of CPR?
A: The combination of mouth-to-mouth "rescue" breathing and chest compressions performed by individuals trained in CPR
Q: What is "hands-only" CPR?
A: Chest compressions without rescue breathing, which can keep blood circulating until emergency help arrives
Q: What are automated external defibrillators (AEDs)?
A: Portable computerized devices that can restart a heart with a lethal rhythm or that is not beating at all
Q: Where are AEDs commonly available?
A: - Airplanes
- Public places like stadiums
- College buildings
Q: How does the combination of CPR and defibrillation affect survival rates?
A: It boosts the survival rate much higher than from CPR alone
Q: What state-of-the-art treatments are available for heart attacks?
A: - Clot-dissolving drugs
- Early administration of blood-thinning medications
- Intravenous nitroglycerin
- Beta-blockers in some cases
Q: What is percutaneous transluminal coronary angioplasty (PTCA)?
A: The most often performed heart operation that opens blood vessels in the heart that are narrowed but not completely blocked
Q: What is cardiac catheterization?
A: The precise technique used in PTCA involving threading a narrow tube or catheter through an artery to the heart
Q: What is a coronary bypass?
A: A procedure where an artery from the patient's leg or chest wall is grafted onto a coronary artery to detour blood around the blocked area
Q: How many coronary bypasses are performed in the United States each year?
A: Hundreds of thousands
Q: What is the mortality rate for coronary bypass surgery?
A: About 1 to 5 percent of patients die as a result of surgical complications
Q: What is a cerebrovascular accident, or stroke?
A: When the blood supply to a portion of the brain is blocked
Q: What age group has seen a rising proportion of strokes?
A: Young adults between age 20 and 45
Q: What may be causing the increase in young adult strokes?
A: Higher incidence of obesity, hypertension, and diabetes
Q: What additional risk do young adults who suffer a stroke face?
A: Higher risk of diabetes and further "vascular events"
Q: How does stroke rank as a cause of death in the United States?
A: Third, after heart disease and cancer
Q: How does stroke rank worldwide as a cause of death?
A: Second only to heart disease
Q: What percentage of stroke victims die within 3 months?
A: An estimated 20 percent
Q: What percentage of stroke victims are disabled?
A: 50 to 60 percent
Q: What happens to those who survive a stroke before age 50?
A: One-third are unable to live independently or require assistance with daily activities 10 years later
Q: What percentage of strokes are preventable?
A: As many as 80 percent
Q: What are the most important steps for preventing stroke?
A: - Treating hypertension
- Not smoking
- Managing diabetes
- Lowering cholesterol
Q: What three tasks can help identify signs of stroke?
A: - Ask the individual to smile
- Ask the person to raise both arms
- Ask the person to speak a simple sentence
Q: What should you do if someone shows signs of stroke?
A: Call 911 immediately and describe the symptoms to the dispatcher
Q: What is the time window for effective treatment with a clot-busting drug?
A: Within three hours of the first symptoms
Q: How do stroke risks compare between men and women up to age 85?
A: Men have a greater risk of stroke than women
Q: When are women at increased risk of stroke?
A: At times of marked hormonal changes, particularly pregnancy and childbirth
Q: How do newer low-dose oral contraceptives affect stroke risk?
A: They have not shown an increased stroke risk among women age 18 to 44
Q: How does early menopause affect stroke risk?
A: Early menopause (before age 42) may double a woman's stroke risk
Q: How does race affect stroke incidence?
A: The incidence is two to three times greater in Blacks than in Whites in the same communities, and Latinx are more likely to develop hemorrhagic strokes than Whites
Q: How does age affect stroke risk?
A: A person's risk of stroke more than doubles every decade after age 55
Q: How does obesity affect stroke risk?
A: The more overweight individuals are, the more likely they are to have a stroke. Obesity may increase stroke risk by contributing to high blood pressure and diabetes.
Q: How does hypertension relate to stroke prevention?
A: Detection and treatment of high blood pressure are the best means of stroke prevention
Q: How does red blood cell count affect stroke risk?
A: A moderate to marked increase in the number of red blood cells increases the risk of stroke
Q: How can heart problems lead to stroke?
A: - Heart problems can interfere with blood flow to the brain
- Clots that form in the heart can travel to the brain and clog an artery
- Atrial fibrillation may increase stroke risk
Q: What may be more important than lowering LDL levels for stroke risk?
A: An increase in the levels of protective HDL
Q: How does diabetes affect stroke risk?
A: People with diabetes have a higher incidence of stroke than those without diabetes
Q: How does estrogen-only therapy affect stroke risk in postmenopausal women?
A: It significantly increases the risk of stroke
Q: How does diet affect stroke risk?
A: Individuals consuming the largest amounts of fatty foods and sodium are at much greater risk than those eating low-fat, low-salt diets
Q: What are the two types of stroke?
A: - Ischemic stroke
- Hemorrhagic stroke
Q: What is an ischemic stroke?
A: A stroke that results from a blockage that disrupts blood flow to the brain
Q: What is a cerebral thrombosis?
A: The blockage of a brain artery by a thrombus (blood clot)
Q: What is a cerebral embolism?
A: When a wandering blood clot (embolus) becomes wedged in one of the cerebral arteries
Q: What is a hemorrhagic stroke?
A: When a diseased artery in the brain floods the surrounding tissue with blood
Q: What conditions make hemorrhagic stroke more likely?
A: A combination of hypertension and atherosclerosis
Q: What other causes can lead to hemorrhagic stroke?
A: - Head injury
- Bursting of an aneurysm (a blood-filled pouch that balloons out from a weak spot in the wall of an artery)
Q: What is a "silent stroke"?
A: A "silent cerebral infarct" that does not produce clear symptoms but causes damage within the brain
Q: How common are silent strokes compared to full-blown strokes in people under 65?
A: At least five times more common
Q: What can silent strokes affect?
A: Mood or memory
Q: What do doctors note about "silent" strokes?
A: They aren't really silent but "whisper," causing very subtle symptoms that people might ignore
Q: What are transient ischemic attacks (TIAs)?
A: "Little strokes" that cause minimal damage but serve as warning signs of a potentially more severe stroke
Q: How does a TIA affect heart attack risk?
A: A TIA doubles the risk for a heart attack
Q: What is the risk of stroke after having TIAs?
A: One of three people who suffer TIAs will have a stroke during the following five years if they don't get treatment
Q: What are the two major types of TIAs?
A: - Transient monocular blindness
- Transient hemispheral attack
Q: What is transient monocular blindness?
A: Blurring, a blackout or whiteout of vision, a sense of a shade coming down, or another visual disturbance in one eye
Q: What is a transient hemispheral attack?
A: Diminished blood flow to one side of the brain, causing numbness or weakness of one arm, leg, or side of the face, or problems speaking or thinking
Q: What typically causes many TIAs?
A: A narrowing of blood vessels in the neck (carotid arteries) because of a buildup of plaque
Q: What methods can specialists use to diagnose carotid artery problems?
A: - Feeling and listening to the arteries
- Ultrasound
- Measuring pressure or circulation rate from carotid arteries to eyes
- Arterial angiography
Q: What happens to brain tissue when deprived of oxygen?
A: It begins to die, which may cause difficulty speaking and walking, as well as loss of memory
Q: What determines the severity of stroke effects?
A: The effects may be slight or severe, temporary or permanent, depending on:
- How widespread the damage is
- Whether other areas of the brain can take over the function of the damaged area
Q: What drugs can restore brain blood flow after a thrombotic stroke?
A: Thrombolytic drugs such as tissue-type plasminogen activator (tPa)
Q: What is the time window for effective thrombolytic drug treatment?
A: Must be administered within 3 hours after the stroke
Q: What is the time window for heparinoid treatment?
A: Must be given within 24 hours
Q: How does quick arrival at a hospital affect treatment outcomes?
A: People who get to a hospital within an hour of having the first symptoms of a stroke are twice as likely to receive tPa
Q: What percentage of people having a stroke do not call 911?
A: More than one-third
Q: What percentage of stroke victims live more than an hour away from a stroke center?
A: An equally large percentage (more than one-third)
Q: What is cancer?
A: A group of diseases characterized by the uncontrolled growth and spread of abnormal cells
Q: How does cancer rank as a cause of death worldwide?
A: Second leading cause of death worldwide; 8.7 million die from the disease
Q: What is the lifetime risk of developing cancer for men and women?
A: 1 in 3 for men and 1 in 4 for women
Q: How many new cancers are diagnosed in the United States annually?
A: About 1.7 million
Q: How many Americans die of cancer every year?
A: About 607,000
Q: What percentage of cancers are preventable?
A: An estimated 42 percent
Q: What are the preventable causes of cancer?
A: - Tobacco smoking
- Heavy alcohol consumption
- Overweight and obesity
- Physical inactivity
- Poor nutrition
- Excessive sun exposure and indoor tanning
- Infections that could be avoided by behavioral changes or vaccination
- Cancers detectable through screening
Q: By how much have cancer death rates declined since 1991?
A: By 27 percent
Q: What controls a cell's functioning, including its ability to grow and reproduce?
A: The DNA within the nucleus of a cell
Q: What happens when DNA's operation is altered?
A: The cell goes out of control, the nucleus no longer regulates growth
Q: What are neoplasms?
A: New formations, or tumors, created when abnormal cells divide to create other abnormal cells
Q: What are the two types of tumors?
A: - Benign (slightly abnormal, not considered life-threatening)
- Malignant (cancerous)
Q: How can benign tumors be distinguished from malignant ones?
A: Only by microscopic examination of their cells
Q: What characteristics distinguish cancer cells from benign tumor cells?
A: Cancer cells have:
- Larger nuclei
- More variation in shape and size
- More frequent division
Q: How many cancer cells need to form before a cancer can be detected?
A: 1 billion cancer cells, which is the number of cells in a tumor that measures 1 centimeter (about 0.3 inch)