高血压英文PPT精品课件PositiveRiskFactorsfor
合集下载
--高血压英文PPT精品课件Renovascular
– The overall prevalence rate of RVD (>60% stenosis) was 6.8%, which would represent 2.4 million affected individuals in the U.S.
– Those variables independently associated with the presence of RVD were increasing age (OR 1.87), increasing systolic blood pressure (OR 1.44) and HDL <40 (OR 2.63).
Etiology
Atherosclerosis (ARAS) – 70-90% of cases
– Usually involves the ostium and/or proximal third of the main renal artery, with non-ostial lesions comprising only 15-20% of cases
– 834 patients consecutive patients who were participants in the Forsyth county cohort of the Cardiovascular Health Study underwent RAD. The Cardiovascular Health Study is a longitudinal cohort study of cardiovascular disease risk factors among adults >65 y/o.
Fibromuscular dysplasia (FMD) – 10-20% Renal thromboembolic disease Renal atheroembolic disease Aortorenal dissection Vasculitis involving the renal artery (i.e. PAN) AVMs involving the renal artery Nephroangiosclerosis (hypertensive injury) Trauma Irradiation of the renal artery Scleroderma
– Those variables independently associated with the presence of RVD were increasing age (OR 1.87), increasing systolic blood pressure (OR 1.44) and HDL <40 (OR 2.63).
Etiology
Atherosclerosis (ARAS) – 70-90% of cases
– Usually involves the ostium and/or proximal third of the main renal artery, with non-ostial lesions comprising only 15-20% of cases
– 834 patients consecutive patients who were participants in the Forsyth county cohort of the Cardiovascular Health Study underwent RAD. The Cardiovascular Health Study is a longitudinal cohort study of cardiovascular disease risk factors among adults >65 y/o.
Fibromuscular dysplasia (FMD) – 10-20% Renal thromboembolic disease Renal atheroembolic disease Aortorenal dissection Vasculitis involving the renal artery (i.e. PAN) AVMs involving the renal artery Nephroangiosclerosis (hypertensive injury) Trauma Irradiation of the renal artery Scleroderma
高血压英文PPT精品课件Antihypertensive
• Diagnosis is generally based on repeated, reproducible measurements of elevated blood pressure and not on patient symptoms. Patient compliance is a major obstacle to therapy
Kidney
Na loss
Thiazides
Summary of Long Term Renal Control of BP
Regulates BP by Changing:
1.
Directly – by allowing more or less fluid to enter kidney tubules
• Pakistan (NHSP):the prevalence of hypertension is 17.9%
• 24% of the USA adult population representing 43,186,000 persons had hypertension.
Diagnosis
CNS
BV
Na retention Clonidine
CO
Venous tone
NE release
Sympathetic tone
TPR
Arteriolar tone
dry mouth sexual dysfunction
The left ventricle is markedly thickened in this patient with severe hypertension that was untreated for many years. The myocardial fibers have undergone hypertrophy.
Kidney
Na loss
Thiazides
Summary of Long Term Renal Control of BP
Regulates BP by Changing:
1.
Directly – by allowing more or less fluid to enter kidney tubules
• Pakistan (NHSP):the prevalence of hypertension is 17.9%
• 24% of the USA adult population representing 43,186,000 persons had hypertension.
Diagnosis
CNS
BV
Na retention Clonidine
CO
Venous tone
NE release
Sympathetic tone
TPR
Arteriolar tone
dry mouth sexual dysfunction
The left ventricle is markedly thickened in this patient with severe hypertension that was untreated for many years. The myocardial fibers have undergone hypertrophy.
--高血压英文PPT精品课件_5
Hypertension is often symptom less, so screening is vital - before damage is done. Many surveys continue to show that hypertension remains under diagnosed, undertreated and poorly controlled in the UK
Approximately 25% are due to Reno vascular disease - most frequently atheromatous (e.g. elderly cigarette smokers with peripheral vascular disease) or fibromuscular dysplasia (more common in younger females). Endocrine disease
Secondary hypertension 5% Underlying cause
Causes of Secondary Hypertension
Renal disease
Approximately 75% are from intrinsic renal disease: glomerulonephritis, polyarteritis nodosa, systemic sclerosis, chronic pyelonephritis, or polycystic kidneys.
Hypertension, Introduction.
Hypertension is one of the most important preventable causes of premature morbidity and mortality in the UK. Hypertension is a major risk factor for stroke (ischemic and haemorrhagic), myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. Untreated hypertension may result in vascular and renal damage that can culminate in a treatment-resistant state.
Approximately 25% are due to Reno vascular disease - most frequently atheromatous (e.g. elderly cigarette smokers with peripheral vascular disease) or fibromuscular dysplasia (more common in younger females). Endocrine disease
Secondary hypertension 5% Underlying cause
Causes of Secondary Hypertension
Renal disease
Approximately 75% are from intrinsic renal disease: glomerulonephritis, polyarteritis nodosa, systemic sclerosis, chronic pyelonephritis, or polycystic kidneys.
Hypertension, Introduction.
Hypertension is one of the most important preventable causes of premature morbidity and mortality in the UK. Hypertension is a major risk factor for stroke (ischemic and haemorrhagic), myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. Untreated hypertension may result in vascular and renal damage that can culminate in a treatment-resistant state.
高血压(英文版) ppt课件
Hypertension
Introduction
Hypertension is a major public health problem throughout the world because of its high prevalence and its association with increased risk of cardiovascular disease.
<90
130140-159 140-149
Epidemiology
Prevalence rate ( 患 病 率 ) China: In 1959, In 1979, 5.11% 7.73% of hypertension in
In 1991,
11.88%
The prevalence of high BP increases with age. Hypertension is more common in men than in women up to age 50, after that age, hypertension is more common in women. Hypertension is more common in northern China than in southern China.
For instance:
21/3 1st visit: 146/98mmHg, 150/98mmHg 23/3 2nd visit: 128/84, 126/80
27/3 3rd visit: 130/80, 130/82
Notes(continue)
4. Optimal BP with respect to cardiovascular risk is less than 120/80 mmHg. However, unusually low readings should be evaluated for clinical significance. For example, 70/50 mmHg is less than 120/80 mmHg, but it is not optimal.
Introduction
Hypertension is a major public health problem throughout the world because of its high prevalence and its association with increased risk of cardiovascular disease.
<90
130140-159 140-149
Epidemiology
Prevalence rate ( 患 病 率 ) China: In 1959, In 1979, 5.11% 7.73% of hypertension in
In 1991,
11.88%
The prevalence of high BP increases with age. Hypertension is more common in men than in women up to age 50, after that age, hypertension is more common in women. Hypertension is more common in northern China than in southern China.
For instance:
21/3 1st visit: 146/98mmHg, 150/98mmHg 23/3 2nd visit: 128/84, 126/80
27/3 3rd visit: 130/80, 130/82
Notes(continue)
4. Optimal BP with respect to cardiovascular risk is less than 120/80 mmHg. However, unusually low readings should be evaluated for clinical significance. For example, 70/50 mmHg is less than 120/80 mmHg, but it is not optimal.
高血压英文PPT精品课件Cerebrovascular
deficit that has a sudden onset, lasts more than 24 hours, and results from cerebrovascular disease.
A stroke occurs when there is a disruption
of blood flow to a region of the brain.
Dysphasia: difficulty in speaking and putting words into the correTATIONS
A stroke is usually characterized by the sudden onset of focal neurological impairment.
About one-fourth of strokes are hemorrhagic, resulting from hypertensive vascular disease (which causes an intracerebral hemorrhage), a ruptured aneurysm, or an arteriovenous malformation.
Risk factors for stroke include smoking, hypertension, obesity, cardiac disease, hypercholesterolemia, diabetes, and use of birth control pills.
Prevention efforts focus on lifestyle changes that can modify risk factors.
PATHOPHYSIOLOGY
A stroke occurs when there is a disruption
of blood flow to a region of the brain.
Dysphasia: difficulty in speaking and putting words into the correTATIONS
A stroke is usually characterized by the sudden onset of focal neurological impairment.
About one-fourth of strokes are hemorrhagic, resulting from hypertensive vascular disease (which causes an intracerebral hemorrhage), a ruptured aneurysm, or an arteriovenous malformation.
Risk factors for stroke include smoking, hypertension, obesity, cardiac disease, hypercholesterolemia, diabetes, and use of birth control pills.
Prevention efforts focus on lifestyle changes that can modify risk factors.
PATHOPHYSIOLOGY
《高血压英语》课件
了解高血压可能导致的一些严重健康问题,如心脏病、中风和肾脏问题。
预防与治疗
饮食
了解如何通过健康的饮食来预防和管理高血压。
减肥
了解如何通过控制体重来降低高血压的风险。
运动
探索适合高血压患者的运动方式,以维持健康。
药物治疗
介绍高血压的常用药物和治疗选项。
与高血压相关的英语词汇
1 血压
了解血压的定义和测量方 式。
2 心脏
探索心脏的结构和功能, 以及它与高血压之间的关 系。
ห้องสมุดไป่ตู้
3 动脉
了解动脉的作用和与高血 压的相关性。
4 血管
了解血管的结构和功能,以及其在高血压中 的角色。
5 测量血压的工具
介绍用于测量血压的不同工具和设备。
医生的面诊
了解在与医生交流时使用的常见英语表达,如病症描述和治疗方案。
处理心理问题
1
《高血压英语》PPT课件
# 高血压英语PPT课件 探索高血压的定义,症状和风险。了解如何预防和治疗高血压以及相关的英 语词汇。
什么是高血压?
高血压是一种常见的健康问题,也称为高血压。了解什么是高血压以及它对 身体的影响。
高血压的症状
探索高血压可能引起的一些常见症状,如头痛、头晕和呼吸困难。
高血压的风险
被诊断出患有高血压的心理反应
了解当你被诊断出患有高血压时可能出现的心理反应。
2
减轻心理负担的方法
探索如何通过积极的心理策略来减轻与高血压相关的心理负担。
3
支持小组
介绍参加支持小组的好处,并了解如何加入。
总结
高血压的关键知识点
简要回顾高血压的关键知识点, 以加强理解。
处理高血压的英语技能
预防与治疗
饮食
了解如何通过健康的饮食来预防和管理高血压。
减肥
了解如何通过控制体重来降低高血压的风险。
运动
探索适合高血压患者的运动方式,以维持健康。
药物治疗
介绍高血压的常用药物和治疗选项。
与高血压相关的英语词汇
1 血压
了解血压的定义和测量方 式。
2 心脏
探索心脏的结构和功能, 以及它与高血压之间的关 系。
ห้องสมุดไป่ตู้
3 动脉
了解动脉的作用和与高血 压的相关性。
4 血管
了解血管的结构和功能,以及其在高血压中 的角色。
5 测量血压的工具
介绍用于测量血压的不同工具和设备。
医生的面诊
了解在与医生交流时使用的常见英语表达,如病症描述和治疗方案。
处理心理问题
1
《高血压英语》PPT课件
# 高血压英语PPT课件 探索高血压的定义,症状和风险。了解如何预防和治疗高血压以及相关的英 语词汇。
什么是高血压?
高血压是一种常见的健康问题,也称为高血压。了解什么是高血压以及它对 身体的影响。
高血压的症状
探索高血压可能引起的一些常见症状,如头痛、头晕和呼吸困难。
高血压的风险
被诊断出患有高血压的心理反应
了解当你被诊断出患有高血压时可能出现的心理反应。
2
减轻心理负担的方法
探索如何通过积极的心理策略来减轻与高血压相关的心理负担。
3
支持小组
介绍参加支持小组的好处,并了解如何加入。
总结
高血压的关键知识点
简要回顾高血压的关键知识点, 以加强理解。
处理高血压的英语技能
高血压(英文版) ppt课件
arteriole structure Compliance of Vessel wall
ppt课件 6
Psychological factors Renin –angiotensin aldosterone system(RAAS) Sodium and hypertension Abnormality of vascular endothelium(ET,NO, AngII, PGI2, etc) Insulin resistance revascularization other(obesity,smoking,drinking,hypocalcium, hypomagnesium, hypopotassium)
Heart failure Systolic hypertension 长效) Diabetes, proteinuria Renal insufficiency(mild) Myocardial infarction ACEI Stable angina Disorder of lipid pregnancy Prostate proliferation
ppt课件
12
Risk factor of cardiovascular disease
male > 55, female> 65 smoking Total cholesterol> 5.72mmol/L (250mg/dl) diabetes Early cardiovascular family history(early onset of CV disease male<55;female <65)
Diuretics ß–blocker a-blocker Calcium channel blocker ACE inhibitor Angiotensin II receptor blocker compound anti-hypertensive agents
高血压(英文版) ppt课件
Etiology and pathogenesis of EH
No
cause can be established Possible mechanisms Genetic tendency
Spontaneous hypertension rat EH tends to cluster in families
Classification of Blood Pressure Levels (mmHg)
Category Systolic Diastolic Hypotension??? <60 Optimal <120 <80 Normal <130 <85 High-normal 139 85-89 Grade 1 hypertension(mild) 90-99 Subgroup: borderline 90-94
Optional investigations
Plasma renin( 肾 素 ) activity & aldosterone (醛固酮), urinary VMA(香草杏仁酸),to identify secondary hypertension Echocardiography, to detect ventricular hypertrophy Vascular ultrasonography should be performed if arterial disease is suspected. Renal ultrasonography should be performed if renal disease is suspected.
perhaps by catecholamines儿茶酚胺
高血压英文PPT精品课件WORLDKIDNEY
What Can WKD Do (2)?
2. Advocate i. With National, State and Local Governments for Better Kidney Disease: - Education - Prevention - Detection - Treatment ii. With Other Major Organizations; e.g., Insurance Agencies, Large Health Care Providers, Universities, etc.
Kelley et al, In1-1437
Challenges of CKD
Management problems, enormous everywhere, are particularly great, even overwhelming, in developing countries: 1. Little awareness of CKD or its consequences 2. Few financial resources for prevention, detection or treatment 3. Little expertise 4. High prevalence of CKD
Annual CVD Mortality (%)
10
1 0.1 0.01 0.001
25-34 35-44 45-54 55-64 66-74 75-84
Age (years)
GP Male GP Female GP Black GP White Dialysis Male Dialysis Female Dialysis Black Dialysis White
高血压英文PPT精品课件AnestheticManagementofthePatientwith
Magnesium Sulfate Therapy
Potentiation of neuromuscular blockade (for all relaxants)
Weakness Respiratory depression Cardiovascular effects
ECG changes Cardiac arrest Hypotension
CAUSE Embolism Indirect causes
Hypertension in pregnancy
Ectopic pregnancy complications Hemorrhage Stroke Anesthesia Complications of termination Cardiomyopathy Infection Other
DRUGS FOR TREATMENT OF SEVERE HYPERTENSION IN PREGNANCY
Drug Hydralazine
Labetalol
Nifedipine
Nicardipine Sodium nitroprusside Nitroglycerin
Dose
5–10 mg IV q 20 min
FACTORS THAT DIFFERENTIATE MILD FROM SEVERE PREECLAMPSIA
Systolic arterial pressure Diastolic arterial pressure Urinary protein
Urine output Headache Visual disturbances Epigastric pain Right upper quadrant abdominal pain Pulmonary edema Cyanosis HELLP Platelet count
高血压英语PPTPPT课件
Blood pressure readings of 180/110 mmHg or higher
Headache
Vision changes
Shortness of Breath
Fatigue
Dizziness
Chest pain or discomfort
01
02
03
04
05
06
Symptoms of Hypertension
Mental stress
Sleep quality
Chronic stress
03
The HAZARDS of Hypertension
Increased risk of heart disease
High blood pressure can damage the heart muscle, leading to heart disease
Hypertension English PPT courseware
contents
目录
Introduction to Hypertension The causes of hypertension The HAZARDS of Hypertension Diagnosis and prevention of hypertension
Diagnostic method
ቤተ መጻሕፍቲ ባይዱ
Preventive measure
Healthy die: A balanced die rich in fruits, vegetables, whole grains, and lean protein can help reduce blood pressure Limiting salt and reducing intake of saturated fat and trans fat are also important
Headache
Vision changes
Shortness of Breath
Fatigue
Dizziness
Chest pain or discomfort
01
02
03
04
05
06
Symptoms of Hypertension
Mental stress
Sleep quality
Chronic stress
03
The HAZARDS of Hypertension
Increased risk of heart disease
High blood pressure can damage the heart muscle, leading to heart disease
Hypertension English PPT courseware
contents
目录
Introduction to Hypertension The causes of hypertension The HAZARDS of Hypertension Diagnosis and prevention of hypertension
Diagnostic method
ቤተ መጻሕፍቲ ባይዱ
Preventive measure
Healthy die: A balanced die rich in fruits, vegetables, whole grains, and lean protein can help reduce blood pressure Limiting salt and reducing intake of saturated fat and trans fat are also important
高血压英语课件
Moderate exercise
Moderate exercise is beneficial for controlling blood pressure and avoiding physical discomfort caused by excessive exercise.
Weight control
Extreme heat or cold can temporarily raise blood pressure levels
Mental stress
Chronic stress
Constant exposure to severe situations or emotional trauma can lead to persistent elevation in blood pressure
Drug therapy
要点一
Antihypertensive drugs
These drugs are used to lower blood pressure by relaxing the blood vessels, reducing the heart rate, or removing excess fluid from the body Commonly used antihypertensive drugs include angiotensin converting enzyme inhibitors, beta blockers, and diuretics
Dizziness or falling
High blood pressure can lead to insufficient blood flow to the brain, causing dizziness or falling falls
Moderate exercise is beneficial for controlling blood pressure and avoiding physical discomfort caused by excessive exercise.
Weight control
Extreme heat or cold can temporarily raise blood pressure levels
Mental stress
Chronic stress
Constant exposure to severe situations or emotional trauma can lead to persistent elevation in blood pressure
Drug therapy
要点一
Antihypertensive drugs
These drugs are used to lower blood pressure by relaxing the blood vessels, reducing the heart rate, or removing excess fluid from the body Commonly used antihypertensive drugs include angiotensin converting enzyme inhibitors, beta blockers, and diuretics
Dizziness or falling
High blood pressure can lead to insufficient blood flow to the brain, causing dizziness or falling falls
高血压英文PPT精品课件Cardiovascular
Myocarditis Morphology
• Gross –dilated, flabby heart, pale patches with hemorrhage
• Microscopic – interstitial inflammatory infiltrate with myocyte necrosis, fibrosis
– Dilated Cardiomyopathy – Hypertrophic Cardiomyopathy – Restrictive Cardiomyopathy
Congestive Heart Failure
• Cardiac output insufficient for metabolic requirements of the body
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy – myofiber dysarray – not all fibers are pulling the same direction. Thus the contraction is ineffective. However, the cardiac conduction system can have these same problems, which might cause the arrhythmias and sudden death these patients tend to die of.
Cardiomyopathies
Dilated Cardiomyopathy
【高血压英文PPT精品课件】 EPLAN 2011-2015
– Low or no reimbursement
Access to Health Care Community Plan
Outcome Objectives
Impact Objectives
Intervention Strategies
Resources Available
Barriers and Challenges
EPLAN Survey
• Conducted during September to December 2010
• Random sample of Evanston residents • Survey questions adopted from the BRFSS
standardized surveys • Investigated health behaviors and beliefs of
• Risk and Contributing Factors • Community Health Plan Objectives and
Strategies
Access to Health Care
Risk and Contributing Factors
Lack of/Inadequate Health Insurance
health priorities for Evanston
– Access to health care – Csical activity and
nutrition
Digging Deeper
• Access to Health Care • Chronic Health Conditions • Nutrition and Physical Activity
Access to Health Care Community Plan
Outcome Objectives
Impact Objectives
Intervention Strategies
Resources Available
Barriers and Challenges
EPLAN Survey
• Conducted during September to December 2010
• Random sample of Evanston residents • Survey questions adopted from the BRFSS
standardized surveys • Investigated health behaviors and beliefs of
• Risk and Contributing Factors • Community Health Plan Objectives and
Strategies
Access to Health Care
Risk and Contributing Factors
Lack of/Inadequate Health Insurance
health priorities for Evanston
– Access to health care – Csical activity and
nutrition
Digging Deeper
• Access to Health Care • Chronic Health Conditions • Nutrition and Physical Activity
高血压英文PPT精品课件CardiovascularDiseasePreventive
Acceptable methods of treatment must be available for the condition (YES).
The condition must have an asymptomatic period during which detection and treatment significantly reduce morbidity or mortality (YES).
CAD screening and EKG (4)
Stress testing (EKG only) more sensitive and specific than resting EKG, but many false + (not specific enough Still, only 1-11% w/ abnormalities suffered
Atherosclerotic Vascular Disease
Risk Factors, Screening to Prevent
Athertery disease (CAD) Cerebrovascular disease CVD) Peripheral vascular disease (PVD) Reno-vascular dis. and renal failure (CRF) >> hypertension
Obesity, diabetes, hypertension and dyslipidemia
80%-90% of type II diabetics are obese Prevalence of obesity and of diabetes type II have risen in parallel since 1980. 33% increase in prevalence of D/M between 1990 and 1998
The condition must have an asymptomatic period during which detection and treatment significantly reduce morbidity or mortality (YES).
CAD screening and EKG (4)
Stress testing (EKG only) more sensitive and specific than resting EKG, but many false + (not specific enough Still, only 1-11% w/ abnormalities suffered
Atherosclerotic Vascular Disease
Risk Factors, Screening to Prevent
Athertery disease (CAD) Cerebrovascular disease CVD) Peripheral vascular disease (PVD) Reno-vascular dis. and renal failure (CRF) >> hypertension
Obesity, diabetes, hypertension and dyslipidemia
80%-90% of type II diabetics are obese Prevalence of obesity and of diabetes type II have risen in parallel since 1980. 33% increase in prevalence of D/M between 1990 and 1998
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Younger individuals who are asymptomatic and meet no more than one risk factor threshold
Moderate risk
Older individuals (men 45 years of age; women 55 years of age) or those who meet the threshold for two or more risk factors
3.8mmol/l TG: 2.4 mmol/l No regular exercise No signs or symptoms of cardiopulmonary disease
Positive Risk Factors for CHD ACSM
Family History
(2006)
Case study
Mr. Wong is a 48-year old male, sales representative who travels often
170cm, 84kg , BMI 29 His brother just suffered from MI at age 40. Concerned about his health Want to do start exercise and lose weight
Hypertension
Client on Hypertensive medications
Resting SBP > 140 mmHg and/ or DBP > 90 mm Hg
Fasting Glucose
Fasting blood glucose of >100mg/dL 5.6mmol/L)
Myocardial infarction, coronary revascularization (bypass surgery) or sudden death before :
the age of 55 years in ther or other male first degree relative (i.e. brother or son)
the age of 65 years in mother or other female first degree relative (i.e. sister or daughter)
Cigarette smoking
Current cigarette smoker or those who have quit in the last six months
Identify secondary risk factors
Obesity, alcohol consumption, stress levels
Case Study
Recently diagnosed to have type 2 DM, put on Daonil BP 160/90 mmHg on metoprolol 50mg bd Half pack a day smoking habit due to stress of his job His brother just suffered from MI at age 40. Cholesterol level: 6.2mmol/l , HDL 0.90 mmol/l, LDL
Evaluation
Classify client according to Risk Stratification Criteria
ACSM/ ACP/ACCVPR/ AHA
Identify Major Coronary Artery Disease Risk Factors
Identify signs or symptoms suggestive of cardiopulmonary disease
Positive Risk Factors for CHD ACSM
(2006)
Dyslipidemia Total serum cholesterol > 200mg/dL (5.2 mmol/L) or High density lipoprotein (HDL) < 40mg/dL (1.03 mmol/L) Low density lipoprotein (LDL) > 130mg/dL (3.4mmol/L) Obesity Body Mass Index (BMI) > 30 kg/m2 or Waist girth >= 102 cm (M); >= 88 cm (F) or Waist/hip ration >= 0.95 (M); >= 0.86 (F) Sedentary Lifestyle Not participating in a regular exercise program Accumulating less than 30 minutes moderate intensity exercise 3-5 days
weekly
Negative Risk Factors for CHD ACSM
(2006) High level of HDL
HDL cholesterol > 1.6 mmol/L (60 mg/dl)
Initial Risk
Stratification
Low risk
Men<45 years of age and women <55 years of age
High Risk
Individuals with one or more signs/symptoms or known cardiovascular, pulmonary, or metabolic disease
What recommendations in reference to medical examination and testing prior to participation in an exercise program?
Moderate risk
Older individuals (men 45 years of age; women 55 years of age) or those who meet the threshold for two or more risk factors
3.8mmol/l TG: 2.4 mmol/l No regular exercise No signs or symptoms of cardiopulmonary disease
Positive Risk Factors for CHD ACSM
Family History
(2006)
Case study
Mr. Wong is a 48-year old male, sales representative who travels often
170cm, 84kg , BMI 29 His brother just suffered from MI at age 40. Concerned about his health Want to do start exercise and lose weight
Hypertension
Client on Hypertensive medications
Resting SBP > 140 mmHg and/ or DBP > 90 mm Hg
Fasting Glucose
Fasting blood glucose of >100mg/dL 5.6mmol/L)
Myocardial infarction, coronary revascularization (bypass surgery) or sudden death before :
the age of 55 years in ther or other male first degree relative (i.e. brother or son)
the age of 65 years in mother or other female first degree relative (i.e. sister or daughter)
Cigarette smoking
Current cigarette smoker or those who have quit in the last six months
Identify secondary risk factors
Obesity, alcohol consumption, stress levels
Case Study
Recently diagnosed to have type 2 DM, put on Daonil BP 160/90 mmHg on metoprolol 50mg bd Half pack a day smoking habit due to stress of his job His brother just suffered from MI at age 40. Cholesterol level: 6.2mmol/l , HDL 0.90 mmol/l, LDL
Evaluation
Classify client according to Risk Stratification Criteria
ACSM/ ACP/ACCVPR/ AHA
Identify Major Coronary Artery Disease Risk Factors
Identify signs or symptoms suggestive of cardiopulmonary disease
Positive Risk Factors for CHD ACSM
(2006)
Dyslipidemia Total serum cholesterol > 200mg/dL (5.2 mmol/L) or High density lipoprotein (HDL) < 40mg/dL (1.03 mmol/L) Low density lipoprotein (LDL) > 130mg/dL (3.4mmol/L) Obesity Body Mass Index (BMI) > 30 kg/m2 or Waist girth >= 102 cm (M); >= 88 cm (F) or Waist/hip ration >= 0.95 (M); >= 0.86 (F) Sedentary Lifestyle Not participating in a regular exercise program Accumulating less than 30 minutes moderate intensity exercise 3-5 days
weekly
Negative Risk Factors for CHD ACSM
(2006) High level of HDL
HDL cholesterol > 1.6 mmol/L (60 mg/dl)
Initial Risk
Stratification
Low risk
Men<45 years of age and women <55 years of age
High Risk
Individuals with one or more signs/symptoms or known cardiovascular, pulmonary, or metabolic disease
What recommendations in reference to medical examination and testing prior to participation in an exercise program?