Heredity and Disease, and Diseases of the Cardiovascular System
Discussion Question: #1
Discuss some of the risks and pathological changes associated with heart disease in older adults. Include any steps that can be taken in order to prevent this from happening.
Discussion Question: #2
List both modifiable and non-modifiable conditions that can lead to cardiovascular disorder or hypertension.
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Heredity and Disease, Diseases of the Cardiovascular System
There is a ton of great information we are covering this week.
First, check out the Healthy People 2020 goals related to heart disease and stroke: https://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke.
What correlation is there between heart disease and aging? https://www.nia.nih.gov/health/heart-health-and-aging
You should look up the difference between modifiable and non-modifiable risk factors. We teach patients to make lifestyle changes that will reduce modifiable risk factors.
Check out what the CDC says (for the public) about risk factors for heart disease: https://www.cdc.gov/heartdisease/risk_factors.htm.
NIH information on the genetic impact of hypertension: https://ghr.nlm.nih.gov/condition/hypertension.
Discussion Question #1:
Discuss some of the risks and pathological changes associated with heart disease in older adults. Include any steps that can be taken in order to prevent this from happening.
https://www.nia.nih.gov/health/heart-health-and-aging#changes
People age 65 and older are much more likely than younger people to suffer a heart attack, to have a stroke, or to develop coronary heart disease (commonly called heart disease) and heart failure.
Heart disease is also a major cause of disability, limiting the activity and eroding the quality of life of millions of older people.
Aging can cause changes in the heart and blood vessels. For example, as you get older, your heart can’t beat as fast during physical activity or times of stress as it did when you were younger. However, the number of heartbeats per minute (heart rate) at rest does not change significantly with normal aging.
Changes that happen with age may increase a person’s risk of heart disease. A major cause of heart disease is the buildup of fatty deposits in the walls of arteries over many years. The good news is there are things you can do to delay, lower, or possibly avoid or reverse your risk.
The most common aging change is increased stiffness of the large arteries, called arteriosclerosis (ahr-teer-ee-o-skluh-roh-sis), or hardening of the arteries. This causes high blood pressure, or hypertension, which becomes more common as we age.
High blood pressure and other risk factors, including advancing age, increase the risk of developing atherosclerosis (ath-uh-roh-skluh-roh-sis). Because there are several modifiable risk factors for atherosclerosis, it is not necessarily a normal part of aging.
Plaque builds up inside the walls of your arteries and, over time, hardens and narrows your arteries, which limits the flow of oxygen-rich blood to your organs and other parts of your body. Oxygen and blood nutrients are supplied to the heart muscle through the coronary arteries.
Heart disease develops when plaque builds up in the coronary arteries, reducing blood flow to your heart muscle. Over time, the heart muscle can become weakened and/or damaged, resulting in heart failure. Heart damage can be caused by heart attacks, long-standing hypertension and diabetes, and chronic heavy alcohol use.
Aging-associated cardiovascular changes and their relationship to heart failure
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223374/
While aging does not itself cause heart failure (HF), it does lower the threshold for manifestation of the disease. As the populations of most developed countries continue to become older, on average, the importance of aging as a risk factor for all car In the United States alone, it is estimated that there will be 70 million people over the age of 65 by the year 2030, representing almost 25% of the population1. In many respects, HF can be thought of as the quintessential final cardiovascular aging pathway, representing the convergence of age-associated changes in cardiovascular structure and function, aging changes in other organ systems, and the progressive increase in cardiovascular diseases in the elderly.
In the United States alone, it is estimated that there will be 70 million people over the age of 65 by the year 2030, representing almost 25% of the population1. In many respects, HF can be thought of as the quintessential final cardiovascular aging pathway, representing the convergence of age-associated changes in cardiovascular structure and function, aging changes in other organ systems, and the progressive increase in cardiovascular diseases in the elderly.
Cardiovascular disease increases in kind (Figure 1).
Average prevalence of heart failure according to age and sex: Framingham Heart Study, 16-year follow-up. (Modified from McKee et al “The natural history of congestive heart failure: the Framingham study.” NEJM, 1971; 285: 7796).
With the success of treatment options for ischemic and valvular diseases, there is an increasing number of older individuals with some degree of cardiac damage, type B heart failure at a minimum that are increasingly imperiled by the diminished cardiac reserve associated with normal aging. Half of all HF cases are found within the 6% of the United States population that is older than 752 (reviewed by Najjar et al3). These people often go on to develop more severe cardiac dysfunction with time. In contrast to other cardiovascular disorders, the prevalence of chronic heart failure (CHF) is increasing, with approximately 5.7 million Americans with CHF4. The incidence of heart failure doubles with each decade of life and the prevalence rises to almost 10% of those older than 80 years. CHF is a highly lethal condition, with significant mortality, morbidity, and associated costs in the older population. More than 90% of CHF deaths occur in adults older than 65 years. CHF is also the leading cause of hospitalization in Medicare beneficiaries, with those over 65 accounting for 75% of the 1.1 million heart failure discharge diagnoses4.
This review focuses on what is known about normal cardiovascular aging and the role that aging-associated changes play in reducing cardiac reserve to make the heart more susceptible to failure. There are a number of factors that link aging to HF5 and gradually reduce the amount of cardiac reserve until finally the heart is “more likely to fail” (Figure 2).
What Can I Do to Prevent Heart Disease?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223374/figure/F2/
Discussion Question #2:
List and discuss both modifiable and non-modifiable conditions that can lead to cardiovascular disorder or hypertension.
Changing these risk factors for the better means making some adjustments in your lifestyle. This may seem overwhelming at first, but you don’t have to do everything all at once – going on a diet and starting an exercise routine at the same time may exhaust your mental and physical resources. Instead, divide and conquer! Changing just one lifestyle factor often leads to changing another. For example, if you choose to eat more healthy foods, you may start feeling like you have more energy, which may make you want to move around more or start an exercise routine. This often leads to weight loss, and possibly a reduction in blood sugar levels and high blood pressure, closing the circle for your healthier lifestyle and reducing your risk of heart disease.
Non-Modifiable Risk Factors
Although changing modifiable risk factors can have a significant impact on your overall health, some people are at higher risk of heart disease, no matter how healthy a lifestyle they enjoy. These are the non-modifiable risk factors:
Reducing Your Risks Overall
Even if you don’t have any risk factors – either modifiable or non-modifiable – monitoring your heart health is essential to preventing heart disease or catching it in its earliest stages. Some tests are routinely performed, such as checking your blood pressure and measuring your cholesterol levels. The results of these tests may identify the need for further testing. The results could also indicate you may need more aggressive management of your risk factors.
ADMA/SDMA is a newer test offered through Cleveland HeartLab (CHL) that may help you understand the effects that blood sugar and blood pressure are having on the delicate lining of your blood vessels which may affect heart health. The thin layer of cells that form the interior lining of your blood vessels is called the endothelium. In order to stay healthy, these specialized endothelial cells need nitric oxide which helps blood vessels to widen, allowing blood to flow more freely.
When your blood sugar and/or blood pressure are not well-controlled, your body produces ADMA and SDMA and these block your body’s ability to produce nitric oxide. So, when this test is abnormal, your doctor may want to take preventive measures to help heal your endothelium and reduce your risk of a heart attack or stroke. The good news is that many of the preventive measures begin with small changes to your diet or lifestyle – choose foods with less sugar, exercise more and quit smoking.
Taking control of your heart health is a smart thing to do. Learn what your risks are and what you can do to stay as healthy as possible.
Check out knowyourrisk.com and take good care of you! You’re worth it!
So What Can You Do to Prevent Heart Disease?
There are many steps you can take to keep your heart healthy.
Try to be more physically active. Talk with your doctor about the type of activities that would be best for you. If possible, aim to get at least 150 minutes of physical activity each week. Every day is best. It doesn’t have to be done all at once.
Start by doing activities you enjoy—brisk walking, dancing, bowling, bicycling, or gardening, for example. Avoid spending hours every day sitting.
If you smoke, quit. Smoking is the leading cause of preventable death. Smoking adds to the damage to artery walls. It’s never too late to get some benefit from quitting smoking. Quitting, even in later life, can lower your risk of heart disease, stroke, and cancer over time.
Follow a heart-healthy diet. Choose foods that are low in trans and saturated fats, added sugars, and salt. As we get older, we become more sensitive to salt, which can cause swelling in the legs and feet. Eat plenty of fruits, vegetables, and foods high in fiber, like those made from whole grains. Get more information on healthy eating from NIA. You also can find information on the Dietary Approaches to Stop Hypertension (DASH) eating plan and the U.S. Department of Agriculture’s Food Patterns.
Keep a healthy weight. Balancing the calories you eat and drink with the calories burned by being physically active helps to maintain a healthy weight. Some ways you can maintain a healthy weight include limiting portion size and being physically active. Learn more about how to maintain a healthy weight from NIA.
Keep your diabetes, high blood pressure, and/or high cholesterol under control. Follow your doctor’s advice to manage these conditions, and take medications as directed.
Monitor and Reduce Stress.
Stress and Heart Health
https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/stress-and-heart-health
Stress causes all sorts of minor physical discomfort—think sweaty hands and an upset stomach. But it can also raise your risk of serious heart problems, says Johns Hopkins cardiologist Michael Blaha, M.D., M.P.H., who frequently offers his patients advice on how to keep stress from threatening their heart health.
Perhaps the most surprising part of the connection is that stress can pop up in many different scenarios—from relationships to “good” jobs to sporting events. And all can take a toll on your heart health.
Risk Factors for Heart Disease: Don’t Underestimate Stress
https://www.hopkinsmedicine.org/health/wellness-and-prevention/risk-factors-for-heart-disease-dont-underestimate-stress
How Does Stress Affect Your Heart?
https://www.cardio.com/blog/how-does-stress-affect-your-heart
How do You deal with your Stress??
Guided Imagery
https://www.mindtools.com/pages/article/newTCS_04.htm
Meditation
https://www.verywellmind.com/practice-basic-meditation-for-stress-management-3144789
Focused Breathing
https://www.webmd.com/balance/stress-management/stress-relief-breathing-techniques#1
Music and Imagery
https://www.youtube.com/watch?v=pAnr-ChiJqk
American Holistic Nursing Association Stress Management
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