Cardiovascular risk factors

Published on: 10/12/2014
Cardiovascular risk factors

1. Introduction

Cardiovascular diseases

The most significant ones for their severity and frequency are:

  • Cerebral vascular accident
  • Angina pectoris
  • Acute heart attack

The arteries are the conducts where the blood circulates transporting the oxygen and nutrients necessary so that all the organs and muscles of the human body work properly.

Any disorder of the arteries will cause disorders to the corresponding area of the blood supply. A blockage in an artery means that the food does not reach the cells and they can die. If it ruptures, this causes internal bleeding. If it hardens, this causes an increase in blood pressure, etc.

The heart is the engine that drives all of this transport essential for life. It cannot stop as blood circulation is constant in order to exchange the products that it contains.

A heart beats nearly 3 billion times in an average lifetime of 80 years and we don't think about it until it pains us and it is then too late. It is a machine that we must take care of so that it can give us the best quality of life possible.

Disorders of the arteries

Cholesterol accumulates between the layers of the arteries, forming atheromatous plaque. As this deposit increases, the arterial lumen narrows which means that there is a steady decrease in the amount of blood reaching its destination. The body starts to suffer as it needs more food. When this happens in the heart, this causes a heart attack or angina pectoris. To brain level you can produce a taponamiento for a thrombus that is given off of a plate of atheroma or you can break the artery causing a hemorrhage, in both cases a vascular brain accident will be produced.

The same process is observed here. The difference between angina pectoris and a heart attack is that the artery is not entirely blocked during angina pectoris so some blood can arrive.

 Brain vascular accident (acute appearance symptoms)

  • Paralysis of a limb or of all the hemicuerpo
  • Difficulty to talk
  • Memory loss
  • Facial paralysis
  • Loss of consciousness
  • Loss of view of an eye
  • Difficulty for gait (lateralización)

Angina pectoris

  • Chest pain of varying intensity
  • It can radiate to the left arm, back or jaw, or not
  • It usually occurs after doing exercise, making an effort, stress, copious food, extreme cold
  • It goes away with rest
  • It goes away with nitroglycerin
  • It can happen unnoticed

Acute heart attack

  • Intense chest pain, heavy weight
  • It can radiate to the left arm, back or jaw, or not
  • There may be nausea, vomiting, breathing difficulties
  • It happens very suddenly
  • It does not go away with rest
  • It improves but does not go away with nitroglycerin
  • Sense of severity and immediate hospitalisation

2. What to do in the event of angina pectoris, heart attack and cardiopulmonary arrest

What to do in the event of angina pectoris or heart attack

  • Notify the emergency service: 112
  • Reassure
  • Make sure the person is lying down comfortably
  • Loosen any tight fastenings: tie, belt, etc.
  • If you have nitroglycerin sublingual available, give them some
  • Give aspirin 500 if the person is not allergic to it

What to do in the event of cardiopulmonary arrest

  • Notify the emergency service: 112
  • Initiate cardiopulmonary resuscitation manoeuvres (CPR)
  • Start with 30 chest compressions and two rescue breaths repeatedly
  • If you have a defibrillator, you must use it as soon as possible as the chance of survival decreases the longer you wait to apply it. In the first minute, the survival rate is > 95%. After 5 minutes, it is < 40%.

3. Risk factors

Risk factors are the causes that are known scientifically to directly affect the occurrence of these diseases. We usually talk about uncontrollable and controllable factors. There are other factors, the so-called emerging risks that affect at cell level, such as the C reactive protein, intima thickness (inner wall of artery), fibrinogen, levels of calcium in the intima, etc.

Uncontrollable

  • Age
  • Family history
  • Gender

Controllable

  • Cholesterol
  • Blood pressure
  • Tobacco
  • Sedentary lifestyle
  • Obesity
  • Diabetes

4. Uncontrollable risks

Uncontrollable risks

Uncontrollable risks do not depend on the person:

  • Age:

    To more advanced age, major risk owing to the fact that the heart and arteries age and, if we do not have them care, start to alter.
  • Genetics:

    In cases where parents have had these diseases, it is more likely that the children will suffer them as well.
  • Gender:

    Men suffer more cardiovascular diseases that women. However in recent years, cardiovascular diseases that suffer women are graver.

The fact that women have started smoking means that they are more affected by cardiovascular diseases than ever before. The menopause also increases the possibility of cardiovascular diseases due to a decrease in the effect of oestrogens, the female hormone with cardioprotective effects.

The takeover of oral contraceptives, in women of more than 35 years with risk factors, increases the probability of suffering a cardiovascular disease. Is had to consult with its practitioner.


5. Controllable risks

Benefits of quitting smokingDegree of obesityMediterranean Diet Pyramid

Controllable risk factors are those that a person can control by themselves or with the help of their doctor. Adopting good habits can control all these factors and will reduce the probability of suffering heart disease by more than 30%.

Cholesterol

Cholesterol is a substance that is found in both humans and animals and it is essential for life because it is a precursor to vitamin D and synthesises various hormones, among other functions.

Cholesterol levels depend on the body's own production and external intake through food.

Cholesterol mainly travels through the body in two ways. With high density lipoproteins (HDL), or good cholesterol because of to protect of cardiovascular diseases, and low density lipoproteins (LDL), or bad cholesterol because of to promote vascular diseases and cardiac.

We know that LDL cholesterol forms atherosclerotic plaques.

Total cholesterol values include two types of cholesterol, so it is important to always know what proportions we have of each one. A high HDL reduces the risk.

Correct values of lipids in blood:

Total Cholesterol: < 200 mg/dl
* Cholesterol - LDL: < 130 mg/dl
* Cholesterol - HDL: >50 mg/dl
Triglycerides: < 150 mg/dl

Foods rich in saturated fatty acids are those that contain most cholesterol.

Classification of fatty acids:

Saturated (high in cholesterol): bacon, butter and animal fat (skin of the chicken).
Unsaturated (low in cholesterol): olive oil, white, fished and walnuts meat.

Tobacco

More than 4,000 substances have been identified in cigarette smoke with the following characteristics: antigenic, pharmacologically active, carcinogenic, cytotoxic and mutagenic.

The nicotine alters vascular walls, increases the coagulation of the blood and it causes narrowing of the glasses.

Passive smoking:

It has been proven that the smoke that comes from the burning tip of the cigarette contains the most toxic substances and this is what passive smokers breathe in.

There are studies that demonstrate that in cases of couples where the husband smokes daily at home, his non-smoking wife has effectively smoked half of the same amount and is therefore exposed to the same diseases.

Children are great imitators: parent smokers = children smokers. It is necessary to start teaching good habits to our children in order to have healthier adults and elderly, with a better quality of life.

Tobacco in pregnant women is a known cause of miscarriages, children with low birth weight and other disorders.

High blood pressure

Pressure made by the blood against the artery walls:

  • It increases for several factors, many of them strangers but it is known that increases for the intake of salt, canned foods and carbonated drinks.
  • It produces alterations in different bodies and systems.
  • It can cause the slippage of a plate of atheroma and breakage of a vessel.
  • Standard values: maximum pressure < 130, minimum < pressure 85.

Sedentary lifestyle

The World Health Organization (WHO) defines it as follows: when less than 2.5 hours of moderate exercise or less than 1 hour weekly of intense exercise is carried out.

A lack of physical activity causes: excess of diet, rise of cholesterol, muscular and smaller decrease contributes of Or2.

A sedentary lifestyle is related directly with cardiovascular diseases, diabetes, osteroporosis, high blood pressure, colon cancer, breast cancer, etc.

We can correct it by simply doing some exercise. What can we do?

  • Walk quickly for 60 minutes every day
  • Walk up and down the stairs
  • Use public transport
  • Do moderate sport at least 3 times a week
  • Avoid intense sport at the weekend with a big feast afterwards

Obesity

  • Increase in the volume of fat: there is a higher calorie intake than energy expenditure. This excess of energy is deposited as fat and carbohydrates.
  • Fat is a deposit of toxic substances. Many contaminants are stored in the fat cells that act as a reservoir.
  • Repercussion on organs. Weight gain has repercussions on all our organs which means that they have to work harder.
  • Increase in cholesterol. When you do not burn calories, fat is stored and muscle mass is reduced.

Indexes for calculating obesity:

Body mass index: BMI (20-25 Kg/m2)

Abdominal perimeter: AP: <102 / 88 cm

Levels of obesity:

The Body mass Index (BMI) just takes into account the relationship of the weight with the height, not the amount of fat.

For this reason, it is not useful for people who do sport regularly as muscle weighs more than fat and the result would be incorrect. Two people with the same height and same weight would have the same BMI, however only one is obese and the other is an athlete. This is owed to that the muscle weighs more than the fat.

Abdominal perimeter: Abdominal fat is known to be the fat that is related directly with cardiovascular diseases, which is why the abdominal perimeter measurement is a more trustworthy value than the BMI with regard to this type of disease.

It is considered that men should have an abdominal perimeter of less than 102 and women less than 88.

As you can observe, the diet is very significant as good habit since it influences in the majority of checkable risks. A good diet is basic to improve our health and quality of life.

Food

It is the conscious act of eating. We often eat because of what we see, not because we are hungry. We have replaced good eating habits for fast food and convenience foods.

Nutrition

It is the unconscious act, which the body really needs to live. In order to repair itself and work properly. What the body needs from everything that we eat is what it is formed of. Everything else is eliminated or accumulated in the form of fat or carbohydrates.
The use of nutrients corresponds to the energy expenditure of each person. The greater the activity, the higher the energy intake.

Food groups:

  1. Bread, cereals, rice and pasta
  2. Fruits and vegetables
  3. Milk, meat, fish and pulses
  4. Fats and sugars

It is recommended that a third of the dish is formed from group 1, another third from group 2, less than a third from group 3 and very little from group 4. AND drink between 1.5 and 2 litres of liquid a day.

The Mediterranean diet has been proven to be cardioprotective due to its ingredients. In 2011, it was appointed an Intangible Cultural Heritage of Humanity by UNESCO due to its important benefits in cardiovascular protection. Olive oil, pulses, fruit, fish and nuts are some of the foods in this diet.

Olive oil:

  • 80% unsaturated acids 
  • 14% saturated acids
  • Virgin and unrefined 
  • Rich in carotenoids and vitamin E, which are antioxidants, and in fatty acids low in cholesterol 
  • A soup spoon of crude olive oi is recommended every day

Fish:

  • Omega 3: Fat that increases the HDL and has cardioprotective effects. Is found mostly in the blue fish (sardine, anchovy, salmon, etc.)

Fruit, vegetables, pulses, pasta, cereals and nuts:

  • Low glycaemic index: they release sugar slowly into the blood stream which helps to avoid diabetes. 
  • High in fibre: the fibre is one of the better preventions of Columbus's cancer, promotes drags the of all substances towards the exterior.

It came:

  • Tannins: are found in the black grape and they have a stock anticoagulant and antinflamatoria. 
  • Resveratrol: substance that acts as a,natural anti-fungal agent for grapes. It is cardioprotective and is related with rejuvenation mechanisms.
  • Moderate use of wine and beer in people that are usually drink has cardioprotective effects. Once the recommended doses are exceeded, the harmful effects outweigh the beneficial effects. People that do not drink should continue not to drink.

Antioxidants:

These are substances that eliminate the free radicals produced in metabolic reactions due to excess calories and which are toxic for the cell. They are found in colourful fruits and vegetables.

  • Carotenoids: carrot, spinach, tomato, melon, etc. 
  • Selenium: walnut, garlic and brócoli
  • Vitamin E: cucumber, melon, strawberry, orange and lemon
  • Zinc: pumpkin and nuts
  • Quercetin: Green tea and grape
  • Tannins: wine

As indicated by the International Agency for Research on Cancer (WCRF):

A good diet can prevent:

  • 50% of breast cancers 
  • 75% of stomach cancers
  • 75% of colon cancers

Eating between 3 and 4 servings of fruit and vegetables a day reduces the incidence of cancer by 20%.

A change in diet combined with giving up smoking means that between 60 and 70% of cancers will be avoidable.


6. Other cardiovascular risk factors

Vascular risk

Alcohol

  • The moderate consumer spending of came or beer, less than 30 gr. per day, increases HDL.
  • The over-consumption, more than 30 gr. per day, promotes various illnesses' appearance.
  • Is measured for units of drink (UB).
  • One alcohol unit is equal to 8-10 gr. of raw spirit.
  • The danger limit is 30 gr. of alcohol per day, 3 alcohol units for men, and 20 gr. of alcohol per day, 2 alcohol units for women.
  • For people who like drinking, it is recommended not to drink more than two or three glasses of wine or beer per day. To the not drinkers, it is recommended that are still it. A glass of wine or beer is equal to 10 gr. of alcohol. A glass of distilled spirits is equivalent to 20 gr. of alcohol.

Stress

  • Permanent tension state.
  • Is not achieved to go out.
  • It causes dysfunctional reactions.
  • Demands exceed the capacity of response.
  • Stress is a physiological reply of the body to what each person considers to be an external aggression or stressor. When we have a response for this aggression, the stress disappears. The problem is that stressors get increasingly difficult to find a solution for and not being able to find a solution is very tiring. As a result, we enter a phase of permanent stress that causes organic alternations such as tiredness, headache, depression, etc.
  • Within our world, we live in several subworlds such as the family, work, society and the individual. Each subworld has its stressors and each one forces us to find solutions to overcome them.
  • Illness, children, mortgage, a move, work load, etc. they are examples of causes of stressors.

7. Set of rules for good habits

Cardiovascular risk factors
  1. Have a varied diet, rich in vegetables, cereals, legumes and fruits
  2. Drink milk and derivatives skimmed
  3. Drink daily 1.5 litres of water
  4. Fats should not exceed 30% of total calories
  5. Use crude olive oil
  6. Consume moderately meat, to predominate the white meat on the red one, and to increase the consumer spending of fish
  7. Avoid intake of alcohol > 30 gr/day.
  8. Avoid tobacco and stress
  9. Do physical exercise
  10. Sleep between 6 and 8 hours daily