Cardiovascular Disease

1
Cardiovascular Disease

• Health Psychology
• 4/16, 4/18, 4/23/06

2
CVD Statistics (2006 update from American Heart
Association)

• 1 killer in the U.S.
• Deaths in 2003
• Men 426.8K
• Women 483.8K
• One death from CVD every 35 seconds!!
• Prevalence
• White men 34, women 32
• African American men 41, women 45
• Mexican American men 29, women 29
• 1 in 3 Adults (34) has some form of
  Cardiovascular Disease

3
Forms of CVD

• High Blood Pressure
• Coronary Heart Disease
• Myocardial Infarction (Heart Attack)
• Angina Pectoris (Chest Pain)
• Heart Failure
• Stroke
• Congenital cardiovascular defects

4
Cardiovascular System

• Consists of the heart and approximately 60,000
  miles of arteries and veins
• The transport of oxygen and the removal of carbon
  dioxide
• The heart generates the necessary force for the
  circulatory process.
• The human heart beats about 100,000 times per
  day.

5
Coronary Artery Disease (CAD)

• Coronary arteries become narrowed ultimately
  resulting in decreased blood flow to the heart.
• Atherosclerosis
• The narrowing of coronary arteries increases the
  possibility that blood clots can form.
• may result in an obstruction of blood flow (and
  hence oxygen) to the heart.
• angina pectoris - pain and tightness in the
  chest.
• myocardial infarction or heart attack in which
  part of the heart muscle dies

6
Atherosclerosis and the Immune System

• Immune system plays a pivotal role in the
  cardiovascular disease
• Endothelial (inside lining of the artery) damage
• Immune cells such as macrophages and T-cells bind
  and migrate to the site of damage
• These immune cells proliferate and release a
  variety of cytokines (e.g., immune system
  hormones such as IL-1, IL-6)
• Immune cells begin to ingest lipids (e.g.,
  oxidized LDL) to form the foam cell that is
  characteristic of the advancing lesion.

7
Atherosclerosis and the Immune System

• These immune processes are generally beneficial
  under normal conditions
• However, processes can lead to a vicious cycle as
  more fats are recruited to vessel walls
• The resulting advanced lesion has a cap that
  protrudes from the vessel wall and contains
  elements of the immune response including
  macrophages, T-cells, foam cells, and lipids.

8
Hypertension

• Sustained elevated blood pressure over 140/90
• Often called the silent killer - no overt
  symptoms
• Increased workload within the cardiovascular
  system as well as the increased pressure in
  various organ systems
• SBP between 120 to 139 and DBP between 80 to 89
  are pre-hypertension

9
Race/Ethnicity and HBP

• HBP in Blacks in the U.S. is among the highest in
  the world
• Compared to whites develops earlier and average
  BP is higher.
• Rates of complications are higher
• 1.3 X greater rate of non-fatal strokes
• 1.8 X greater rate of fatal stroke
• 1.5 X greater rate of heart disease death
• 4.2 X greater rate of end stage kidney disease