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Coronary Heart Disease

Coronary Heart Disease. Leading Causes of Death. Middle age Sudden death due to heart attack or stroke Cancer Elderly Heart disease Cancer Stroke. Coronary Artery Disease. Atherosclerosis Arteriosclerosiss  Ischemia  Coronary Heart Disease

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Coronary Heart Disease

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  1. Coronary Heart Disease

  2. Leading Causes of Death • Middle age • Sudden death due to heart attack or stroke • Cancer • Elderly • Heart disease • Cancer • Stroke

  3. Coronary Artery Disease Atherosclerosis Arteriosclerosiss  Ischemia  Coronary Heart Disease   Angina Myocardial Pectoris Infarction

  4. Symptoms of a Heart Attack • Uncomfortable pressure or pain in the center of the chest that lasts for more than a few minutes • Pain spreading to shoulders, neck, or arms • Shortness of breath • Light-headed, fainting, sweating, nausea • In women, severe abdominal pain or indigestion

  5. When do heart attacks occur? • Less likely during sleep. • Among the employed, more often on a Monday between 6 and 11 am. • In part due to waking and becoming active shortly after dreaming which increases BP. • In part because of circadian rhythm effects, increases in arousal hormones and blood pressure.

  6. Biological Risk Factors • Age • Gender • Diabetes • Family history • Obesity

  7. Behavioural Risk Factors • Sociocultural • Hypertension • Cigarette smoking • Cholesterol levels • Diet • Physical inactivity • Stress • Type A behaviour • Hostility/anger

  8. Type A Behaviours • Achievement orientation • Time urgency • Anger/hostility Result = Coronary Prone Personality

  9. Why is Type A linked to heart disease? • Greater Physiological Reactivity • Behavioural Factors • Emotions

  10. Hostility/Anger • Cynicism • Mistrust • Denigration

  11. Depression/Anxiety • Evaluations of life • Hopelessness and helplessness

  12. Psychosocial Predictors of Sudden Cardiac Death 1.00 0.95 0.90 0.85 Proportion Surviving Placebo, BDI <10 Placebo, BDI >10 AMIO, BDI <10 AMIO, BDI >10 0 200 400 600 800 Survival in days

  13. Rehabilitation • Promote recovery • Reduce risk of another attack

  14. Rehabilitation • Reduce behavioural risk factors • Exercise • Stress management

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