Cardiovascular disease

Risks factors for cardiovascular disease that can and can not be changed.


The risks factor for cardiovascular disease have been categorize by the American Heart Association (AHA) as the following: (1) Major risks factors that can not be changed (increasing age, male gender, and heredity). (2) Major risk factors that can be changed (cigarette/tobacco smoke, high blood cholesterol, high blood pressure, and physical inactivity).(3) Other factors diabetes, Obesity, and stress.
Physiological Benefits of physical Activity
Research shows that moderate, not necessarily extensive exercise is sufficient for good health. For example, for both women and men, the chance of dying from cancer and several other diseases is greater for individuals with sedentary life-styles than those who engage in a daily brisk walk of 30 to 60 minutes (Cufman, 1993). Moderate regular exercise, lasting say 15 to 30 minutes, five times a week also has been found to improve health. In fact, high levels of exercise increase the risk of injuries (Edlin p.130 ).

If you exercise regularly, your overall risk of a heart attack is about 50 percent less than if you are inactive and out of shape. With routine exercise you can reach a level of physical fitness comparable to an active person ten to twenty years younger. Regular exercise may also lower your cholesterol and blood pressure, and reduce the risk of diabetes.

Exercise increases the size of coronary arteries and reduce clogging due to atherosclerosis. Exercise also increases the efficiency of your blood’s oxygen-carrying capacity and your muscles’ uptake of oxygen.
Exercise has been linked to increased levels of high density lipoprotein (good) cholesterol and decreases low-density lipoprotein (bad) cholesteroland triglyceride levels. After exercising for 6 to 12 months, lowered cholesterol levels can mean as much as a 30 percent reduction in the risk of coronary artery disease (Edlin p.130).


Psychological Benefits of physical Activity
Regular physical activity can result in periods of relaxed concentration, characterized by reduced physical and psychic tension, regular breathing rhythms, and increased self-awareness. This effect is often compared to meditation and is the aim of all eastern body workouts, including Hatha yoga, t’aichi ch’uan, and many martial arts.
Moderate exercise for middle-aged and older adults is emerging as an important aide to the treatment of many diseases. These include diabetes, osteoporosis, osteoarthritis, insomnia, deconditioning, and (to a degree) obesity. A recent report from the United States Surgeon General recommends that most adults exercise most if not all days of the week, accumulating 180 minutes of moderate intensity exercise weekly. If a person have been previously sedentary, encourage them to start a slow, stepwise exercise program. Ongoing support, encouragement, and follow-up can help them commit to and maintain a program of regular exercise.
Exercise has long been recognized as a key component of a healthy lifestyle. In the past decade, increasing emphasis has been placed on exercise to improve health and reduce morbidity and mortality. Until recently, most exercise studies have focused on younger adults. However, we now have convincing data that regular exercise lowers morbidity and mortality rates, even when we start exercising relatively late in life.
Middle-aged and older men and women who engage in regular physical activity have significantly higher high-density lipoprotein cholesterol levels than those who are sedentary(Edlin p.130). Most studies of endurance exercise training of individuals with normal blood pressure and those with hypertension have shown decreases in systolic and diastolic blood pressure. Insulin sensitivity is also improved with endurance exercise. A number of factors that affect thrombotic function, including hematocrit, fibrinogen, platelet function, and fibrinolysis, are related to the risk of CVD (Edlin p.130). Regular endurance exercise lowers the risk related to these factors. The burden of CVD rests most heavily on the least active. In addition to its powerful impact on the cardiovascular system, physical inactivity is also associated with other adverse health effects, including osteoporosis, diabetes, and some cancers.
Discussion
Our bodies were designed to be used. We were not designed to sit around behind desks or computers all day. But we often do. Life has become so filled with conveniences that we tend to sit back and “let our fingers do the walking.” We slouch in our sofas and channel surf rather than getting up and changing the TV channel. We drive our cars just a few blocks rather than walking the distance. We have become a nonphysical society (Edlin p.129 ).

The belief that exercise is good for one’s health has been the topic of scientific debate for several years. Serious scientific research designed to examine the role of exercise on mortality and morbidity was started in the 1950s, and data now show that suitable amounts of aerobic exercise not only reduce the risk of coronary heart disease, but also extend life expectancy. These data initially came by studying occupations that in degrees of physical activity, and more recently, by the energy expenditure (i.e., calorie expenditure) of various groups of people.
Occupation and coronary Heart Disease Study
A common method used to examine the role of exercise on health was to study occupations that varied in physical activity and compare heart disease rates of the various groups of workers. In general, these studies have shown that individuals who had the most physically demanding jobs suffered fewer fatal heart attacks than their sedentary counterparts. For example, conductors who walked up and down the stairs of double-decker buses in London had fewer heart attacks than the more sedentary bus drivers. In the United States, postal workers who walked and delivered the mail had a lower incidence of heart disease than those who just stood and sorted it.

One of the classical studies of the role of occupation physical activity on heart disease was conducted by medical scientists from the University of Minnesota. They studied more than 191, 000 American railroad workers. Because of union rules and benefits, railroad workers had excellent medical records, which provided the data for the study. In addition, union rules discouraged shifting from one occupations class to another. A 55-year-old person with 20 years of service was likely to have spent all 20 years at the same job.
The occupational groups studied were clerks, switchmen, and section men. The clerks represented men in jobs requiring little physical activity, while the work of the section men was the most physically demanding, and the work of the switchmen were moderate. The trends show the well established influence of age on heart disease, and that it was independent of occupation group. For each age group, the most physically active workers had the lowest heart disease rate while the least physically active clerks had the highest rates. The section men were between the two extremes.


Harvard Alumni Study
In a second study, Paffenbarger and associates surveyed the health and physical activity of nearly 17,000 Harvard alumni who entered college in the years 1916 to 1950. A questionnaire data were used to quantify exercise expenditure in terms of caloric expenditure. The forms of physical activity included various types of sports, stair climbing and walking.
The researchers showed that calorie expenditure was related to the heart attack rate. The risk of heart attack declined and then leveled off when energy expenditure reached about 2,000 kilocalories per week. It was discovered that common forms of physical activity such as walking, climbing stairs, and/or playing strenuous sports on a regular basis provided a degree of protection against a heart attack; however, being a college athlete did not reduce risk less the person remained physically active. In fact the alumni at highest risk of heart attack were those former athletes who led a sedentary post-college life.
Treatment of cardiovascular disease
When medical tests such as an angiocardiography, a procedure for visualizing the flow of blood through the coronary arteries and chambers of the heart, confirm that one or several coronary arteries are blocked and that blood flow to the heart is restricted, various kinds surgery are usually recommend. In coronary bypass surgery, the diseased segment of an artery is cut out and a segment of healthy vein or artery is grafted onto the damaged artery to restore normal flow of blood to the heart. If one graft is made into a blocked artery, the surgery is called a single coronary bypass; if four graphs are made it is called a quadruple bypass (Edlin p.145).

Coronary bypass surgery is a form of open-heart surgery and usually requires several months of recuperation. In open heart surgery, while the heart is exposed and being repaired, the blood stream is diverted through a heart-lung machine. More than 350,000 bypass surgeries are performed every year in the United States at an average cost of approximately 50,000. Although bypass surgeries are successful and save many lives, as many as half bypass patients experience another arterial blocking age within five years, especially if they do not modify their life- style to reduce the risk factors contributing to heart disease( Edlin p.145 ).

An alternative surgical approach to opening a blocked artery is balloon angioplasty. In this procedure a thin wire is threaded from the femoral artery in the thigh up to the point of blockage in a coronary artery. Another thin tube containing a deflated balloon is then slipped over the wire and threaded up to the area of the arterial plaque. The balloon is inflated and pushes the plaque back into the wall of the artery thereby opening it up. Angioplasty costs much less than a bypass operation, but the frequency with which the blockage recurs is quite high, making a repeat procedure necessary. About 300,000 angioplasty operations are performed in the United States each year.

Other high-technology devices for opening clogged arteries are being developed and clinically tested. These include high-speed rotary scrapes that grind away plaque and lasers that are threaded into the artery to melt or burn away plaque . Although these techniques for opening blocked arteries are valuable, in many instances heart and artery surgery may not be necessarily.

Until recently, it was universally believed that atherosclerosis was a progressive and irreversible disease. However, an experiment with a small group of volunteers who had partial blockage of their arteries showed that this long-standing conviction is not necessarily correct. The study showed that over a period of a year, life-style changes could significantly reduce arterial blockage in over 90 percent of the experimental group (Ornish,1990). While this study has been criticized for its methodology by some cardiologist, it does show that healthy life-style changes can halt or reverse the effects of heart disease (Edlin p.297).
Design of the study
I compared three different studies on the effect of exercise on cardiovascular disease. These studies were performed by three different legitimate organizations. I took in consideration the number of people participating in each investigation. The number of participants was close in all three Studies . The size of each group varied. The approach taken in the studies was also similar in each groups. The investigating topic was the same. The population being investigated were also taken in consideration. The average age of all participants in each group ranged between 35 and 57 years of age. The studies focused on different population ranging from different social economic status, race, and culture. I examined the result of each study, they were comparable to each other. All three outcome yielded the same result. The percentage of each result were computed and averaged. The results supported the investigating hypothesis. All three studies were approved by the U.S. Department of Health and Social Services.

Analysis of the Data
In the review of studies conducted on cardiovascular disease and exercise. All of the data collected suggested that there is a definite link between cardiovascular disease and exercise. Individuals that were leading active lives were at a lower risk than sedentary individuals. The data collected through the studies also strongly supports the conclusion that physically active individuals have higher survival rates and live longer.
Summary
All the studies reviewed allude to one thing, the risks for cardiovascular disease can be reduced by adopting a active lifestyle. In each of the studies the majority of the population at risk have stationary jobs and live sedentary lifestyles. The studies also show that exercise improves quality of life, relieves depression, enhances self-image, relieves stress and anxiety, slows the aging process, improves quality of sleep, and improves mental sharpness.

Findings
Exercise is an important factor in controlling and preventing heart disease. The advantages of exercise far out-weigh the disadvantages. Exercise is the key, less active individuals are more at risk for cardiovascular disease.


Conclusions
Heart and blood vessel disease is the number one health problem in this country, but the incidence has declined by 36 percent in the last twenty years (Hoeger p.147). The primary cause for this dramatic decrease has been health education. More people are now aware of the risk factors for cardiovascular disease and are making significant changes in their lifestyles to lower their own potential risk of suffering from this disease. Although genetic inheritance plays a role in the development of cardiovascular disease, the most important determinant in whether an individual will suffer from this disease is the person’s own lifestyle.
Although specific recommendations can be followed to improve each individual risk factor, engaging in a regular aerobic exercise program has been shown to control most of the major risk factors associated with cardiovascular disease.