fall 2007-lecture 3,4

fall 2007-lecture 3,4 - Health Screening and CVD Risk...

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Unformatted text preview: Health Screening and CVD Risk Stratification Lectures #3 and #4 September 4 and 6, 2007 Professional Responsibility Do benefits outweigh risk? 1. Is medical clearance necessary? 2. What precautions should be taken before starting? 3. Is the individual ready? 4. What is the safest and most effective program? Medical Clearance?? Health History Physical Activity Readiness Questionnaire (PAR­Q) – – – – Series of Yes or No Questions Opportunity to include additional conditions Administered in front of client Must include ALL contraindications to exercise See laboratory 2.1 on page 49 Defining CVD #1 cause of death in U.S. Atherosclerosis­hardening of the arteries – – – – – Hypertension­high blood pressure May lead to atherosclerosis Silent killer Associated w/ angina pectoris during exercise Precedes Myocardial Infarction Precedes Stroke CVD Risk Factors 1. Family History MI, coronary revascularization, sudden death in father/male first degree relative or mother/female first degree relative ACSM’s Guidelines for Exercise Testing and Prescription, 7th Ed. 2006 CVD Risk Factors 1. Cigarette Smoking − − − − CHD 2X of non­smoker #1 risk factor for sudden cardiac death 2nd hand smokers also at risk Risk eliminated w/i ~10­15 years ACSM’s Guidelines for Exercise Testing and Prescription, 7th Ed. 2006 CVD Risk Factors 1. Hypertension Systolic ≥ 140 mm Hg or Diastolic ≥ 90 mmHg ACSM’s Guidelines for Exercise Testing and Prescription, 7th Ed. 2006 CVD Risk Factors 1. Dyslipidemia LDL > 130 mg/dL (3.4 mmol/L) HDL < 40 mg/dL (1.03 mmol/L) TC > 200 mg/dL (5.2 mmol/L) ACSM’s Guidelines for Exercise Testing and Prescription, 7th Ed. 2006 CVD Risk Factors 1. Impaired Fasting Glucose Fasting blood glucose ≥ 100 mg/dL (5.6 mmol/L) ACSM’s Guidelines for Exercise Testing and Prescription, 7th Ed. 2006 CVD Risk Factors 1. Obesity OR BMI > 30 kgm2 men and women Waist girth > 102 cm for men > 88 cm for women Waist/hip ratio: ≥ 0.95 for men ≥ 0.86 for women OR ACSM’s Guidelines for Exercise Testing and Prescription, 7th Ed. 2006 CVD Risk Factors 1. Sedentary Lifestyle No regular exercise program or minimal physical activity recommendations from the U.S. Surgeon General’s Report ACSM’s Guidelines for Exercise Testing and Prescription, 7th Ed. 2006 CVD NEGATIVE Risk Factor 1. HDL cholesterol (reverse cholesterol transport) > 60 mg/dL (1.6 mmol/L) ( 1)!!!! ̶ ACSM’s Guidelines for Exercise Testing and Prescription, 7th Ed. 2006 Impact of Risk Factors See lab 11A ACSM Risk Stratification Guidelines Low Risk Moderate Risk High Risk – men < 45, women < 55 AND – ≤ 1 threshold – men ≥ 45 and women ≥ 55 OR – ≥ 2 thresholds – ≥ 1 signs and symptoms of cardiovascular, pulmonary, metabolic disease OR – known disease ACSM Risk Stratification Guidelines Low Risk Moderate Risk High Risk – medical examination NOT necessary – medical supervision NOT necessary – medical examination recommended – medical supervision recommended (max) – Medical examination recommended – Medical supervision recommended (max & submax) See guidelines on page 20 Stress Test AKA: maximal exercise tolerance test ECG, BP, HR monitoring Recommended for: men ≥ 45, women ≥ 55 – TC > 240 mg/dl, LDL > 160 mg/dl, HDL < 40mg/dl – hypertensive and diabetic patients – symptomatic individuals ...
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