10 Test your knowledge
Referring to Figure 6 reproduced again for you below, state how many people per 10 000 of the North American population had heart attacks in (i) 1990; (ii) 1995; (iii) 2000. Make sure that you are reading from the correct y-axis (labelled ‘heart attacks per 10 000 population’).
Figure 6: The numbers of heart attacks and surgical procedures (angioplasty and coronary bypass) per 10 000 of the population in the USA between 1980 and 2005 (Swanton and Frost, 2007)
(i) 10; (ii) 8; (iii) 7.
Name two distinct areas of the body that may be affected by the deposit of fatty plaques in the blood vessels.
Two of the following: heart or coronary arteries; blood vessels in brain; blood vessels in periphery, e.g. arms, legs.
What factors increase the risk of someone developing cardiovascular diseases?
Age (increasing); smoking; gender (being male); diet (unhealthy or unbalanced); family history (genetic); inactivity (sedentary lifestyle); race/ethnicity; excess alcohol consumption; high blood cholesterol; psychosocial factors, e.g. stress, depression and anger; high blood pressure; diabetes (types 1 and 2); obesity and being overweight.
Produce a table of risk factors for cardiovascular diseases (using your answers to Question 3), separating them into three columns of modifiable (biological and lifestyle) and non-modifiable (biological) risk factors. Explain your reasoning for which category you have placed the risk factor diabetes.
Place a tick alongside any risk factors that you have identified as being relevant to yourself or someone else you know. Suggest what measures you can take to positively influence any modifiable risk factors.
Your table should look like Table 6 below.
Table 6: Risk factors for cardiovascular diseases
|Biological risk factors: non-modifiable||Biological risk factors: modifiable by treatment or altered lifestyle||Lifestyle risk factors: modifiable|
|age (increasing)||high blood cholesterol||smoking|
|male||high blood pressure (hypertension)||diet (unhealthy or unbalanced)|
|family history (genetic)||overweight and obesity||inactivity (sedentary lifestyle)|
|race/ethnicity||diabetes (Type 2)||excess alcohol consumption|
|diabetes (Type 1)||psychosocial factors, e.g. stress, depression, anger|
There are two types of diabetes. Type 1 would be classed as a biological non-modifiable risk factor, but Type 2 can be improved with appropriate management and so is modifiable – especially if it has arisen as a result of lifestyle, developed following weight gain.
Suggestions to positively influence modifiable risk factors could include:
- reducing or give up smoking and alcohol intake
- improving diet by following healthy eating guidelines
- becoming more active, e.g. by taking the stairs instead of the escalator or lift or starting an exercise programme after a medical assessment
- taking measures or obtaining advice on how to manage psychosocial factors.
List three different causes of chest pain.
You could have mentioned any of the following: angina pectoris; ischaemia; pericarditis; myocardial infarction; musculoskeletal problems; indigestion (acid reflux); gallbladder disease; coronary artery disease.
Distinguish between primary and secondary prevention strategies for developing cardiovascular diseases. Suggest why this distinction is important in relation to cardiovascular disease treatment.
Primary prevention strategies for developing cardiovascular diseases involve preventing the onset of disease in individuals without symptoms. Secondary prevention strategies refer to the prevention (or delay) of death or recurrence of disease in individuals with pre-existing symptoms. This distinction is made because recommendations are slightly different, depending on whether cardiovascular diseases have already been established in the patient. For example, the ‘Sheffield table’ to estimate cardiovascular disease risk is not appropriate for secondary prevention, that is, in people with established cardiovascular diseases such as myocardial infarction and angina.
Explain why preventive measures (i.e. reduction of risk factors) are still required following any surgical treatment for cardiovascular diseases.
Following successful surgery, it remains essential to control the symptoms and further development of cardiovascular diseases by reducing the risk factors that contributed to the development of disease in the first place. For instance, a diet high in saturated fat would need to be modified.
Explain why monitoring blood pressure and blood cholesterol levels are important in the management of cardiovascular diseases.
Hypertension and high blood cholesterol levels are early indicators, common to the development of many cardiovascular diseases. Regular monitoring of blood pressure and blood cholesterol levels is important so that medical interventions can take place to keep the levels of both under control.