Wednesday, November 6, 2019

Coronary risk factors Essays

Coronary risk factors Essays Coronary risk factors Paper Coronary risk factors Paper Coronary heart disease affects more than 7 million Americans. It remains the number one cause of death in the United States – mortality is more than 500,000 death cases per year. Many of these deaths can be prevented by lifestyle changes. American Hearth Association developed some evidence based factors that increase the risk of coronary heart disease and heart attack. All risk factors coulld be generally divided into two groups: controllable and uncontrollable. Uncontrollable risk factors include gender, age and heredity. Family history of premature CHD (coronary hart disease) is especially imortant for men younger than 55 and women younger than 65. Males generally are at greater risk initially, but in postmenopausal period women have equal risk. And, of course, risk increases with age. We can control blood pressure, blood cholesterol, harmful habits (like smoking, sedentary lifestyle), avoid stress. For example, people with HDL (high denisty lipids) cholesterol less than 40 mg/dl and high total level of cholesterol (more than 240 mg/dl) are at high risk of cornary diseases. Experts agree the decline in death rates from heart disease in the United States is due in part to the publics adopting a healthier lifestyle. Many deaths associated with heart disease are preventable. Many aspects of lifestyles are the key to prevention of coronary heart disease (CHD). By modifying lifestyle factors, individuals themselves hold the key to lowering their risk for developing and preventing illness and death from CHD. We need to be conscious of coronary risk factors and take the necessary steps to reduce and eliminate them. In almost all risk factors, exercise and physical activity can have a positive physiological and psychological impact to reduce or remove the contributor to he art disease. Regular, moderate to vigorous intensity exercise plays a significant role in preventing heart disease. Studies have shown that moderate exercise, when done regularly, is beneficial in reducing risk for heart disease. According to the US Surgeon Generals report, Physical Activity and Health, regular physical activity also improves life quality and its duration, prevent cancers, type 2 diabetes, arthritis and osteoporosis, relieves symptoms of depression and anxiety and improves mood, controls weight. But we should remember that exercise capacity is reduced in many patients with cardiovascular disease. In post-acute myocardial infarction, ischemic heart disease and heart failure patients, exercise capacity has a strong independent prognostic impact. Even in subjects without history of heart disease, the lower the cardiorespiratory fitness the higher is the risk for cardiovascular events and mortality. With appropriate physical activity, exercise capacity is improved in most individuals. Improvement of functional capacity is associated with improvement of survival. To develop appropriate exercise program we should to determine present exercise levels (functional capacity), existing risk factors and get data of medical examinations. Client should be well motivated to reduce risk and to improve his/her cardiovascular fitness. To define exercises capacity we usually use aerobic fintness test (1-mile walkin on a treadmill), muscular fitness (push-ups or similar exercies), flexibility, BMI (body-mass index) defeninion. We should discuss the results with client, calculate a target heart range of pulse for him/her, to teach him/her how to take pulse, provide exact instructions and demonstrations. A comprehensive exercise program combines stretching, aerobic conditioning, and weight training. Inactive adults can improve their health by becoming moderately active. Exercise intensity, frequency, and duration are terms used in describing an exercise plan. Certain level of intensity is determined by the results of stress-test. The level of intensity should be â€Å"somewhat hard† to client. At least 30 – 60 minutes should be devoted to aerobic activity and maintaining heart rate within. To improve cardio respiratory capacity and control weight we usually recommend to exercise at least 3 – 5 days a week and to be moderately active most days of the week. Walking is the safest and most effective ways to improve cardiovascular fitness – it’s an ideal low impact aerobic exercise. In persons who have been sedentary in recent months, in those with known cardiovascular disease or at high risk, and in persons aged more than 40 years, the initial duration and intensity of the endurance phase should be suitably reduced. Ten minutes of gentle activity such as walking may be an appropriate first step, increasing at intervals of one week or longer according to tolerance, as fitness increases. Increments are first achieved by increasing duration. Later intensity is increased, for example by walking briskly, or by alternate walking and jogging. Dosage is affected by duration, intensity and frequency of exercise. The preferred frequency is 4-5 times weekly with an endurance phase of 20 30 minutes when a more gentle programme is chosen, or (in young fit persons) 3 times weekly with an endurance phase of 40 up to 60 minutes if it is more vigorous. While the latter option is suitable for younger persons and for fit middle-aged and older persons, a lesser duration and moderate intensity are appropriate to most middle-aged and older people, e.g. walking, fast walking, or alternate walking and jogging, or gentle swimming for 30 minutes at least 4-5 times weekly. Many authorities regard it as acceptable to divide moderate exercise such as walking into shorter aerobic periods of 10-15 minutes, 2-3 times a day, if the person finds this more acceptable. Intensity can be judged subjectively, or objectively by instructing the subject to monitor pulse rate during exercise. A training effect is obtained at rates of 60% of maximum rate fo r age, and this is the initial target rate. Supervised exercise is recommended for clients at higher risk. Such persons at higher risk, including those aged 35 years and over who have been sedentary, should undergo formal exercise ECG testing prior to selection of a programme of exercise. References: 1: Gohlke H. [Lifestyle modification is it worth it?] Herz. 2004 Feb;29(1):139-44. 2: Vallebona A, Gigli G.   [Significance of exercise capacity in cardiology] Ital Heart J Suppl. 2003 Sep;4(9):712-9. 3:   Batty GD.   Physical activity and coronary heart disease in older adults. A systematic review of epidemiological studies. Eur J Public Health. 2002 Sep;12(3):171-6. 4: LaMonte MJ, Eisenman PA, Adams TD, Shultz BB, Ainsworth BE, Yanowitz FG.   Cardiorespiratory fitness and coronary heart disease risk factors: the LDS Hospital Fitness Institute cohort. Circulation. 2000 Oct 3;102(14):1623-8. 5:   Haapanen N, Miilunpalo S, Vuori I, Oja P, Pasanen M.   Association of leisure time physical activity with the risk of coronary heart disease, hypertension and diabetes in middle-aged men and women. Int J Epidemiol. 1997 Aug;26(4):739-47. 6: Folsom AR, Arnett DK, Hutchinson RG, Liao F, Clegg LX, Cooper LS. Physical activity and incidence of coronary heart disease in middle-aged women and men. Sci Sports Exerc. 1997 Jul;29(7):901-9. 7 Moller LF, Kristensen TS, Hollnagel H.   Physical activity, physical fitness, and cardiovascular risk factors. an Med Bull. 1991 Apr;38(2):182-7.

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