Cardiovascular Disease and Diabetes (Chapter 10) - Lecture Notes

Cardiovascul ar Disease and Diabetes (Chapter 10)  Trivia Time! ▹ Cardiovascular disease (CVD) is the leading cause of death in the TRU United States. E TRU ▹ Most cases of CVD result from athe...

Cardiovascul ar Disease and Diabetes (Chapter 10)  Trivia Time! ▹ Cardiovascular disease (CVD) is the leading cause of death in the TRU United States. E TRU ▹ Most cases of CVD result from atherosclerosis, a condition in which the E linings of the arteries thicken with an accumulation of cholesterol. ▹ Breast cancer takes the lives of five times as many American women FALS as heart disease. E TRU TRU ▹ Chronic Einflammation increases the risk of plaques forming in the inner lining of arteries. FALS E  Trivia Time! ▹ Genetically high levels of cholesterol are associated with a high rate of TRU at a young age. cardiovascular disease, beginning E that higher saturated fat consumption ▹ Recent research has confirmed FALS is associated with a higher risk of CVD compared to high-carb consumption. E TRU E ▹ Suppressed anger may be as hazardous to cardiac health as expressed anger. TRU ▹ There is an inverse E relationship between psychological well-being and the risk of a coronary event. TRU  The Healthy Heart: Some Biological Basics ▹ The size of a clenched fist; 11 ounces ▹ Consists of three layers of tissue (epicardium, endocardium, myocardium) ▹ Pumps five or more quarts of blood each minute into four heart chambers and then throughout the body ▹Derived from Greek myo (muscle) and kardia (heart)What do you do to exercise your myocardium?  Cardiovascular Disease ▹ Cardiovascular Disease (CVD) ▸ Disorders of the heart and blood vessel system, including stroke and coronary heart disease ▸ Coronary Heart Disease (CHD) ⬩ Chronic disease in which the arteries that supply the heart become narrowed or clogged ▹ Causes of CVD ▸ Atherosclerosis ▸ Arteriosclerosis  Atherosclerosis ▹ A common disease in which cholesterol and other fats are deposited on the walls of coronary arteries ▹ Caused by chronic inflammation and activation of the immune  Arteriosclerosis ▹ The coronary arteries lose their elasticity and are unable to expand and contract as blood flows through them ▹ Ischaemia: a restriction of blood flow to the heart ▸ angina pectoris  Cardiovascular Diseases ▹ Results of Cardiovascular Malfunction ▸ Angina Pectoris ⬩ Condition of extreme chest pain caused by a restriction of the blood supply to the heart; ischemia ▸ Myocardial Infarction (MI) ⬩ Heart attack; the permanent death of heart tissue in response to an interruption of blood supply ▸ Stroke ⬩ Cerebrovascular accident that results in damage to the brain due to lack of oxygen; usually caused by atherosclerosis or arteriosclerosis ⬩ Ischemic stroke; hemorrhagic stroke; aneurysm  9 What happens during a heart attack?  Stroke Damage to the Brain ▹ Cerebrovascular accident that results in damage to the brain due to lack of oxygen ▹ Common Types ▸ Ischemic stroke ▸ Hemorrhagic stroke  11 What happens during a stroke?  Uncontrollable CVD Risk Factors ▹ Family History and Advancing Age Predict CVD ▸ Heart attacks before age 55 for close male relatives and before age 65 for close female relatives ▸ Hypertension ▹ Gender ▸ Sharp rise in CVD risk for men after 40; low for women until menopause (unless smokers) ▸ Difference in CVD mortality may be related to differences in testosterone and estrogen ▸ Gender risk not worldwide; findings point to lifestyle factors rather than biology How can you make a difference in your CVD risk? Controllable Factors: ▸ Working toward lowering blood pressure ⬩ For every one point drop in blood pressure, there is an estimated 2% to 3% reduction of a heart attack ▸ Eating healthy diet ▸ Exercising regularly ▸ Maintaining normal body weight  Controllable Risk Factors ▹ Prehypertension ▸ Associated with increased risk of progression to full-blown hypertension (120–139/80–89 mmHg) ▹ Hypertension (high blood pressure) ▸ Sustained elevation of diastolic and systolic blood pressure (exceeding 140/90 mmHg) ▸ Contributing factors ⬩ Obesity, lack of exercise, dietary salt, excessive stress  Additional Controllable Risk Factors: Cardiovascular Reactivity, Hemostasis, and Inflammation ▹ Cardiovascular Reactivity (CVR) ▸ Individual’s characteristic reaction to stress ▹ Hemostasis ▸ Too little or too much blood clotting ▹ Inflammation ▸ Chronic inflammation increases risk of atherosclerosis ▹ Obesity ▸ Abdominal obesity promotes the greatest risk of CVD ▹ Cholesterol Level ▸ High cholesterol related to high rate of CVD ▹ Metabolic Syndrome ▹ Tobacco Use: doubles change of heart attack or stroke.  Psychosocial Factors in Cardiovascular Disease ▹ Type A Personality ▸ Friedman & Rosenman’s term for competitive, hurried, hostile people who may be at increased risk for developing CVD ▸ Toxic core behaviors: Hostility and anger (Williams & Williams, 1994) ▹ Type B Personality ▸ More relaxed people who are not pressured by time considerations and thus tend to be resistant to  How do you score? Take this assessment www.queendom.com/tests/personality/type_a_personality_access.html https://www.queendom.com/tests /testscontrol.htm?s=14&t=1  More CVD Risk Factors: Negative Affect, Depression, and Type D Personality ▹ Negative Affect: the tendency to experience negative emotions ▸ Hostility ▸ Depression is a risk related to CVD and MetS ▸ Social inhibition: A characteristic of people who have difficulty expressing their feelings driven by the need to avoid negative interactions. ▹ Type D (D is for distressed) ▸ Personality type found in people who tend to experience negative emotions and have difficulty expressing their feelings How Does Negative Affect Promote Cardiovascular Disease? ▹ Psychosocial Vulnerability Hypothesis ▹ Health Behavior Explanation ▹ Cardiovascular Reactivity Model ▹ Education, Income, and Work Environment ▹ Social Support ▹ Biopsychosocial Model Biopsychosocial Model of CVD  Reducing the Risk of Cardiovascular Disease ▹ Controlling hypertension by lowering sodium intake, reducing excess body weight, and exercising regularly ▹ Reducing cholesterol by limiting intake of animal fats and hydrogenated oils and engaging in moderate, regular physical activity ▹ Combining stress management, aerobic exercise, relaxation training, smoking cessation, and low-fat diet ▹ After CVD: Preventing Recurrence with stress management Managing Stress, Anxiety, and Hostility (part 1) ▹ Interventions aimed at reducing hostility are based on two premises ▹ Focus of Intervention Studies ▹ Engaging in Cognitive Intervention Strategies Diabetes ▹ Diabetes Mellitus ▹ Prediabetes ▹ Type 1 Diabetes (T1D) ▸ Symptoms ▹ Type 2 Diabetes (T2D) ▸ Symptoms  Diabetes and Blood Sugar ▹ In both types of diabetes, two types of blood sugar problems can develop ▹ Causes: ▸ Obesity ▸ Overactive immune system and genetic vulnerability ▸ Nutritional Westernization and poor diet ▸ Increased TV watching associated with reduced physical activity ▸ Stress  experiencing excessive thirst and urination, cravings for sweets, weight loss, and fatigue. Which disease is he most likely experiencing? a. prediabetes b. Type 1 diabetes c. Type 2 diabetes 25  Diversity and Healthy Living ▹ Cultural Adaptations to Evidence-Based Interventions for Type 2 Diabetes ▸ Prevalence of Type 2 diabetes for U.S. Latinas is almost twice that for non-Latina White women (National Diabetes Statistics Report, 2014) ▸ If current trends continue, over 20% of Latino population overall is expected to have diabetes by 2031 ▸ Successful Programs ⬩ Spanish-language public education campaign (¡Viva Bien!) launched to improve health through everyday choices ⬩ Extended and adapted for non-Latina women (Mediterranean Lifestyle Program) Health Psychology and Diabetes ▹ Health psychologists increasingly involved in diabetes primary care ▸ Patient’s knowledge, beliefs, and behavior affect the ability to manage diabetes ▸ Self-management is the cornerstone of treatment; based on glycemic control ▸ Smartphones/tablets may be used for Ecological Momentary Assessment (EMA) ▹ Promoting Adjustment to Diabetes Treating Diabetes-Related Psychological Disorders ▹ Treating diabetes-related depression, anxiety, and eating disorders ▹ Managing weight and stress ▹ Increasing adherence to diabetes treatment regimes ▹ Enhancing communication and increasing social support  29 Zena’s Story