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# 8.1: Cardiovascular Health

Difficulty Level: At Grade Created by: CK-12

How can I keep my heart strong and my arteries clean and clear?

More people in the United States die from heart disease than from any other cause. At least 70percent\begin{align*}70\;\mathrm{percent}\end{align*} of those deaths are due to heart attacks. The remaining deaths are due to strokes, high blood pressure, and other diseases of the circulatory system. Atherosclerosis is the main cause of heart disease and the leading cause of death in the United States. Heart disease is most common in the elderly. But it is also a leading cause of death in those under age 65\begin{align*}65\end{align*}.

Cardiovascular Diseases

Cardiovascular diseases affect the heart's blood vessels or blood supply. The most common cardiovascular disease is atherosclerosis. In atherosclerosis, fatty materials called plaque form on the interior of the artery walls. The buildup of plaque changes the walls of the arteries. The arteries become rigid and less springy. The plaque narrows the internal diameter of arteries. The narrowing of the arteries restricts the flow of blood and makes the heart work harder. Sometimes the arteries become so narrow that blood flow slows or stops.

Atherosclerosis can involve all major arteries, especially those leading to the heart, brain, kidneys, and legs. As the disease gets worse the internal diameters of the arteries get smaller and the artery walls get harder. A narrowed, harder artery cannot increase blood flow in times of increased demand, such as during exercise. A different condition is a localized weakening of the arterial wall leading to the artery bulging at that site. Such a bulge is called an aneurysm (ANN-yur-ism.) When an aneurysm gets very large and the walls of the vessel are very weak, it can burst. Then blood leaks out and a person can actually bleed to death inside.

Figure 7.2 When arteries that feed the heart get narrow, the heart muscle doesn't get enough oxygen.

Figure 7.2 A heart attack happens when a blocked artery prevents blood flow to the heart. Heart cells may die due to lack of oxygen.

Did You Know? Every day in the United States 4100\begin{align*}4100\end{align*} people have heart attacks and 1500\begin{align*}1500\end{align*} the as a result.

Did You Know? If a person has too little oxygen in the blood or not enough blood gets to the tissues, including the brain, the person may

• increase the rate and depth of breathing,
• have a swollen red neck and face,
• have blue face, lips, nails, and fingers,
• have noisy breathing with frothing at the mouth,
• lose consciousness,
• have a seizure or uncontrolled shaking,
• die.

A heart attack occurs when the coronary arteries that serve the heart become clogged with plaque and/or a blood clot. When the arteries get very narrow, there is the risk of a sudden complete blockage. Where plaque forms, the artery is damaged and its inner surface becomes rough. These changes in the artery wall can trigger the blood clotting process. After a small clot forms, it can break loose and get stuck “downstream” where the artery gets narrower. The result is that blood flowing to the heart muscle is suddenly blocked, depriving heart muscle cells of oxygen. Part of the heart muscle dies.

The part of the heart the artery goes to in Figure 7.2 can no longer pump well because parts of the muscles of the left and right ventricles don't get enough blood. Without enough blood, the muscle cells get too little nutrients and oxygen. Waste products are not carried away so they build up in the muscle cells.

Someone having a heart attack may have pain in the chest, sweat, and pass out when the heart stops pumping. If the heart cannot pump, the brain gets too little blood and oxygen, which would cause the person to pass out. The first aid for cardiac arrest is CPR, or cardiopulmonary resuscitation.

Some doctors treat atherosclerosis by widening the narrowed part of the artery. One method is called angioplasty (ANN-gee-oh-plass-tee). Doctors thread a balloon-like device attached to a long, slender tube into the artery. Then they inflate the “balloon” to flatten the plaque against the artery wall. This works to open up the artery. In some cases the widened artery can narrow again and may need to be reopened more than once.

A coronary bypass operation is another way to treat atherosclerosis. In this operation doctors sew part of a healthy blood vessel in place to allow the blood to bypass the narrowed parts of the coronary arteries. Part of a leg vein is usually removed for this purpose. If a person has a “triple bypass” that means that parts of three coronary arteries are bypassed. The operation may need to be repeated if the plaque builds up again.

Figure 7.3 A blocked artery in the brain causes impaired function called a stroke. Damage to the brain may be reflected in various parts of the body.

A stroke occurs when atherosclerosis causes narrowing in an artery that carries oxygen to the brain. Or a stroke can be caused when a piece of plaque or a blood clot breaks off and blocks an artery going to the brain. Damage to brain tissue occurs when too little oxygen-containing blood reaches one or more sections of the brain. Look at Figure 7.3. If part of the brain is damaged, such as the area controlling the left leg, the person may lose control of the leg. If the part of the brain controlling the face or part of the brain that is necessary for language is involved, the person may be unable to talk.

What Is Your Risk of Having Cardiovascular Disease?

Before we study how to lower the risk of heart disease, we need to talk about what risk is. Risk in this health context is the chance of injury or loss as a result of an activity or action. If you do something risky you run the risk of getting hurt or injured. For example, if you smoke you run the risk of getting lung cancer or heart problems. Smoking is risky. The more you smoke over longer periods of time, the more likely it is you will have health problems from smoking.

What Do You Think?

Do you think teenagers take more risks than other age groups? Why or why not?

Did You Know? More than twice as many smokers as nonsmokers die from cardiovascular disease. The earlier someone starts smoking, the more likely that person is to have heart problems later in life. Smokers who quit after a heart attack are much more likely to survive than those who keep smoking are. In general, people who don't smoke have a greater chance of a longer, healthier life.

What are risk factors for cardiovascular disease? Risk factors are conditions or habits that make getting cardiovascular disease more likely. People with cardiovascular disease often have a history of smoking. Other risks include eating habits. People who eat too much fatty food, are overweight, and exercise too little are at risk for getting cardiovascular disease. Other people may have high blood pressure and a history of heart disease in their families. Some people may cope poorly with stress. All of these are risk factors. Let's look at each one separately.

Risk Factors for Cardiovascular Disease Smoking

Cigarette smoke contains nicotine and other chemicals that damage the interior wall of the arteries. These chemicals also damage the lungs and other parts of the respiratory system. Cigarette smoke raises carbon monoxide levels in the blood. Blood with high carbon monoxide levels can't carry as much oxygen as usual, so the cells get less oxygen than they need. Smoking also narrows arterioles and raises the smoker's blood pressure. The narrowed arterioles limit the blood going into the capillaries. This also reduces the amount of oxygen going to smoker's cells. Smoking damages the inner lining of the blood vessels and makes the heart pump harder. And it's not just the smoker who is negatively affected. People near the smoker can be affected in the same way.

What can happen if cells don't receive enough oxygen?

Did You Know? Cholesterol is a waxy, whitish substance found in animal cells. It's true that the body needs some cholesterol to make other substances, but the body can make its own cholesterol. The liver can produce all the cholesterol the body needs. We do not have to eat any cholesterol at all. One third of the young people in the United States may be getting too much cholesterol in their diets.

Fat in the blood

There is evidence that eating a diet high in fats and cholesterol can contribute to blocking and hardening of the arteries. Fat buildup in the arteries tends to be slow, but it can start as early as age 10\begin{align*}10\end{align*}. There are no symptoms to warn you about this process until it is already well advanced. One way you can help protect yourself is to choose foods that are low in fats and cholesterol. The American Heart Association recommends that less than 30percent\begin{align*}30\;\mathrm{percent}\end{align*} of your total calories should come from fat.

High blood pressure

When a person has high blood pressure, it means that their blood pressure has been greater than normal over a period of time. Normal blood pressure for adults ranges from 10070mm Hg\begin{align*}\frac{100}{70}\;\mathrm{mm \ Hg}\end{align*} to 13090mm Hg\begin{align*}\frac{130}{90}\;\mathrm{mm \ Hg}\end{align*}. Most people have blood pressures that are close to 12080mm Hg\begin{align*}\frac{120}{80}\;\mathrm{mm \ Hg}\end{align*}. The normal blood pressure range for teens is from 9257mm Hg\begin{align*}\frac{92}{57}\;\mathrm{mm \ Hg}\end{align*} to 13487mm Hg\begin{align*}\frac{134}{87}\;\mathrm{mm \ Hg}\end{align*}. You can see in the table in Figure 7.5 that "normal" is a range and not an exact value.

Did You Know? The kidneys are the organs that keep your blood clean. Kidneys receive 20percent\begin{align*}20\;\mathrm{percent}\end{align*} of the blood flowing from the heart. It takes about 50minutes\begin{align*}50\;\mathrm{minutes}\end{align*} to cleanse all your blood. The kidneys work to maintain homeostasis in your blood-keeping the right balance of water, salt, and other chemicals. Doctors have figured out away to help people with kidney problems. People with kidney problems can go to a hospital and be hooked up to a machine that works as an artificial kidney. The artificial kidney is called a dialysis machine.

Figure 7.4 This food pyramid shows the recommended proportions of different types of foods in a healthy diet.

Age (years) Sex Systolic Diastolic Blood Pressure Blood Pressure
6\begin{align*}6\end{align*} M 78115\begin{align*}78-115\end{align*} 4878\begin{align*}48-78\end{align*}
6\begin{align*}6\end{align*} F 78113\begin{align*}78-113\end{align*} 4879\begin{align*}48-79\end{align*}
12\begin{align*}12\end{align*} M 95135\begin{align*}95-135\end{align*} 5888\begin{align*}58-88\end{align*}
12\begin{align*}12\end{align*} F 94133\begin{align*}94-133\end{align*} 5985\begin{align*}59-85\end{align*}
14\begin{align*}14\end{align*} M 98143\begin{align*}98-143\end{align*} 6090\begin{align*}60-90\end{align*}
14\begin{align*}14\end{align*} F 97139\begin{align*}97-139\end{align*} 6190\begin{align*}61-90\end{align*}
16\begin{align*}16\end{align*} M 103148\begin{align*}103-148\end{align*} 6095\begin{align*}60-95\end{align*}
16\begin{align*}16\end{align*} F 100143\begin{align*}100-143\end{align*} 6292\begin{align*}62-92\end{align*}

Figure 7.5 This chart shows a range of blood pressure for 6\begin{align*}6-\end{align*} to 16\begin{align*}16\end{align*}-year-olds.

High blood pressure contributes to cardiovascular disease. It increases the risk of a stroke or a heart attack by putting too much stress on the system. The high pressure can weaken the walls of the arteries and cause aneurysms. High blood pressure is a silent killer, because there are few symptoms that warn you about the problem. You don't know if you have high blood pressure unless your blood pressure is checked regularly.

The exact cause of most high blood pressure is not known. Blood pressure is largely controlled by genes inherited from your parents. It also is affected by choices you make about diet and exercise. Some people with high blood pressure are born with the disease, have it all their lives, and need medication to keep their blood pressure normal. Other people can develop high blood pressure due to unhealthy life styles. Changes in lifestyle can prevent high blood pressure or reduce blood pressure that is already high. Lowered blood pressure can decrease the chance of a heart attack or stroke.

Figure 7.6 Fat helps to cause plaque formation in the arteries that supply your heart. The plaque can partially block the arteries and cause high blood pressure. If the plaque totally blocks a coronary artery, the result is a heart attack. The photograph on the right shows a totally blocked artery.

Did You Know?

• blood pressures increase with age,
• high blood pressure can be inherited,
• African-Americans are more likely to have high blood pressure than many other ethnic groups in the United States.

Some controllable factors that raise blood pressure are

• obesity (overweight),
• too much salt in the diet,
• smoking,
• stress,
• atherosclerosis,
• lack of exercise.

Did You Know? For every pound (0.45kilograms\begin{align*}(0.45\;\mathrm{kilograms}\end{align*}) of excess weight, your heart has to push blood through several more miles (1.6kilometers\begin{align*}1.6\;\mathrm{kilometers}\end{align*} per mile) of blood vessels.

Obesity

Excess body weight puts stress on the cardiovascular system. The hearts of overweight people must work harder to supply nutrients and oxygen to all their cells. Obese, or overweight, people also have higher levels of fat and cholesterol in the blood. Obesity is common in children as well as adults. Middle-aged men who are overweight are about three times more likely to have a fatal heart attack than men of average weight are. Proper diet and exercise are important to avoid obesity.

Family history

Sometimes doctors joke that the best thing you can do for your health is to choose your biological parents. Of course that's impossible. But if you have a biological parent or close relative who died between ages 40\begin{align*}40\end{align*} and 60\begin{align*}60\end{align*} from cardiovascular disease, your chance of getting cardiovascular disease may be higher than normal.

What can you do if there is a history of heart disease in your family? The best thing you can do is live a healthy lifestyle by reducing the risk factors you do have control over. Don't smoke. Control what and how much you eat. Exercise wisely and monitor your blood pressure to keep it within a safe range. Minimize your chances for cardiovascular disease by making careful choices. It's true you can't control your family history, but you can control the choices in your life.

Not everyone has the same target heart-rate zone. To find yours, try the following.

1. Subtract your age from 220\begin{align*}220\end{align*}.
2. Multiply this number by 60percent (0.60)\begin{align*}60\;\mathrm{percent} \ (0.60)\end{align*}. This is the low end of your zone.
3. Multiply the number from step 1 by 85percent (0.85)\begin{align*}85\;\mathrm{percent} \ (0.85)\end{align*}. This is the high end of your zone.
4. Can you find the middle of your zone? Use 75percent\begin{align*}75\;\mathrm{percent}\end{align*} as an estimate of the middle.

Lack of exercise

Another risk factor for cardiovascular disease is lack of exercise. Exercising the heart, lungs, and circulatory system reduces the effects of other risk factors. Exercise lowers stress and the circulating fat and cholesterol levels. Therefore, a person who exercises regularly is less likely to become obese or develop high blood pressure. Besides the health and medical benefits of exercise, staying fit can be fun. You don't have to be a super athlete to enjoy and benefit from exercise. Walking is one of the simplest and the best exercises for the heart.

Cardiovascular activities raise your heart rate up to your target heart-rate zone. This zone is a specific range of heartbeats per minute that's best for an individual according to age. The zone is the heartbeats per minute when you can best increase the strength and efficiency of your circulatory and respiratory systems. The best kind of exercise for your cardiovascular system is aerobic (ayr-OH-bik) exercise. Aerobic means “with oxygen.” An activity that makes you breathe faster and deeper for 20minutes\begin{align*}20\;\mathrm{minutes}\end{align*} or more is an aerobic activity. Your heart and lungs supply your muscles with oxygen to keep up the activity at a steady pace. Aerobic activities such as walking quickly, running, and swimming develop muscles, coordination, and heart efficiency.

The target heart rate is not the only way to measure how hard you are exercising. Since everyone is different, it is important to listen to your body. When you exercise ask yourself how hard you are working on a scale of 1\begin{align*}1\end{align*} (easy) to 10\begin{align*}10\end{align*} (very hard). Always start an exercise program slowly and work your way up. That way you're working at around a \begin{align*}6\end{align*} or a \begin{align*}7\end{align*} on your personal exercise scale.

Notice the strap around this runner's stomach area. This strap is monitoring her heart rate.

Activity Cardiovascular Workout
Baseball Poor
Dancing Good
Football Fair
Gymnastics Fair
Hockey Good/excellent
Racquetball Good/excellent
Running/Jogging Excellent
Skating Good
Skiing (cross-country) Excellent
Skiing (downhill) Fair
Soccer Excellent
Softball Poor
Swimming Excellent
Tennis Fair/good
Volleyball Fair
Walking Good/excellent
Water-skiing Fair

The table in Figure 7.7 shows examples of aerobic activities that can help you maintain your cardiovascular health. What others can you name? The important thing is to choose an aerobic activity you like and follow these guidelines:

1. Warm up and stretch your muscles before you start.
2. Begin your activity slowly so that your heartbeat can be raised to your target heart-rate zone.
3. Keep your heart rate in this zone for at least \begin{align*}15\end{align*} to \begin{align*}30\;\mathrm{minutes.}\end{align*}
4. Exercise at least \begin{align*}3\;\mathrm{times}\end{align*} per week.

Some teenagers believe that they will live forever and show little concern for their health. They think that health concerns are only for old people. But some of the risk factors for cardiovascular disease can start very early in life, at your age or even earlier. By choosing to begin an exercise program now, you can increase your chances for good health for the rest of your life.

## Activity 7-1: Pulse Rate

Introduction

How does your pulse rate vary a a result of different activities? It's your turn to design your own investigation to answer till question. In this activity you work with a team to develop an experimental design.

Materials

• Clock or watch with a second hand
• Activity Report

Procedure

Step 1 Brainstorm with your team members an experiment that will help you explore the question, “How does your pulse rate vary as a result of different activities?” Predict how pulse rates will vary and record your predictions.

Step 2 Design the steps you'll follow in your experiment. Write up your experimental design following the style of other investigations that you've conducted in this unit.

Step 3 Identify only one variable for your experiment and incorporate it into your experimental design. Develop the tables and graphs you'll u e to record and graph data.

Step 4 List all the materials you'll need in order to conduct your experiment. Make sure all the materials you'll need to conduct each step are included in your materials' list.

Step 5 Your experimental design should include your predictions, materials, procedural steps, tables, and graphs. When you have completed your experimental design show it to your teacher. Make sure you get teacher approval of your experimental design before going any further.

Step 6 With your teacher's approval carry out your experiment and record the data.

Step 7 Summarize the results of your experiment using both a table and a graph. Include a written explanation with each.

Step 8 Share the results of your experiment with the class.

How does exercise help the body maintain good health?

Stress

Your body responds to stress in several different ways. Your liver releases glucose (sugar) into your blood for “instant” energy. Your heart pumps harder and faster. The pupils in your eyes dilate. Your muscles tense. The stress response helps you deal with short-term dangers.

Some stress can be stimulating and exciting. For example, riding a roller coaster i stressful, but it can be fun too! A certain amount of stress before a musical performance may help you concentrate better and play or sing better. Many athletes who have “butterflies in their stomach” before competitions finish as winners.

So stress responses such as increased heart rate can be good for sudden, short-term situations. But they are not healthy if maintained over long periods of time. Many people suffer from the stress of constant worries and nervous tension. Continued stress can cause high blood pressure and other health problems.

Sources of Stress - What are some sources of stress for you? Make a list of things that create stress. Then think about ways of handling each kind of stress. In making your lists consider which sources of stress come from inside you and which sources of stress come from outside you. Share your completed list with the class. Then your class can create a master list of stress creators and stress relievers.

Risk Profile - Review the risk factors for cardiovascular disease. Rate yourself on each of the risk factors on a scale from \begin{align*}1\end{align*} (low risk) to \begin{align*}10\end{align*} (high risk). If the average of all your scores is more than \begin{align*}7\end{align*}, you might want to consider some lifestyle changes. List some changes you could make to lower the risk of cardiovascular disease.

Stress management is an important part of cardiovascular fitness. You must decide what you can change and what you can't change. Then you need to act accordingly. Worrying about things you can't change creates even more stress. It is very important to learn how to relax in healthy ways.

• Eat a healthful diet.
• Get the rest you need each day.
• Keep a stress notebook. When you feel stressed write down the time, place, and type of situation that caused the stress. You may begin to see your stressful situations as a pattern. By becoming more aware of the situations that cause your stress, perhaps you can change your habits.
• Stop and relax when you feel stressed. Take a walk or just sit by yourself. You can reduce muscle tension in the following way. First contract muscles that are tight due to stress, such as the shoulder muscles. Then suddenly release the contraction and let the muscles go limp.
• Manage your time effectively. Set priorities. Write a list of the things you need to do.
• Exercise regularly. Exercise calms you down and gives you time to be yourself, away from other pressures.
• Find out more about things that cause you stress. Know the facts, even if they are unpleasant. Trying to ignore a stressful situation can be more stressful than understanding the situation and dealing with it.
• Seek creative solutions to your problems. Brainstorm with friends. Break down big problems into smaller parts that can be handled more easily. Make plans for resolving the problem and reward yourself for the solution.
Physical Emotional Relationships

Appetite change

Tension

Fatigue

Insomnia

Weight change

Colds

Pounding heart

Restlessness

Teeth grinding

Poor sleep

Others

Anxiety

Frustration

Mood swings

Nightmares

Irritability

Worrying

Easily discouraged

Depression

Isolation

Intolerance

Loneliness

Lashing out

Distrust

Using people

Hiding

“Clamming” up

Figure 7.8 Stress can show itself in many ways. Some symptoms of stress are listed in the table above. Have you noticed any of these symptoms in yourself or a friend lately?

## Review Questions

1. Describe the most common cardiovascular disease.
2. What happens during a heart attack?
3. What is risk?
4. Describe five risk factors for cardiovascular disease and what you can do to minimize them.
5. What kind of risk taker are you? How does your willingness to take risks affect who you are? What isn't so good about being a risk taker in certain situations? What might be the consequences of any risks you are taking?

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