CHD Lab - Lab heart rate PDF

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Lab heart rate...

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Estimating the Risk of Coronary Heart Disease

Laboratory Activity

ESTIMATING RISK OF CORONARY HEART DISEASE – (CHD) INTRODUCTION In this activity you will do what doctors do when they see patients for heart problems. One of the main things they do is take a case history of their patients. A case history is all the information about a person’s habits, health, and background. This activity will show how certain factors can be used to help predict if a person will have CORONARY HEART DISEASE. We have periodically spoken of factors thought to be related to the occurrence of heart disease. For example, if all other factors are equal, a person with a poor diet with respect to CHD (too much fat, sugar, etc.), is thought to be more likely to end up with CHD than a person on a good diet (low fat, low sugar, etc). This does not say that either individual necessarily will or won’t have CHD as we are dealing with statistical relationships rather than with a simple cause and effect relationship. In general, the higher your total risk factor, the more likely that you will get CHD. In other words, the relative frequency of CHD will tend to be higher in a group of people with high risk factors. It is important to learn about the CHD risk factors to avoid loading the dice in favor of CHD. Avoiding unnecessary risks is an important part of preventative medicine. For our study of risk factors, we will use Table 1. This table is modified from one produced by the Michigan Heart Association. Similar tables of CHD risk factors have been produced by different groups. Some charts include a few different risk factors such as personal stress, vital lung capacity, and diabetes. In addition, charts of heart risk factors are not identical in the way they rate the relative importance of each factor. Some rate nutritional factors highest, others rate smoking or blood pressure highest. All of these charts are useful however since they tell people whether they should be concerned about the risk of CHD and they suggest ways for individuals to lower their risk. In Table 1, nine risk factors are listed. For each risk factor, the degree of risk increases from left to right. Note that for age 10-20 the risk is 1, but for age 61 and over the risk factor is 8. This means that people over 60 are considerably more likely to have CHD than those under 20. It does not necessarily mean the older individuals are eight times as likely to have CHD than the younger group. Look at the 9 factors in Table 1 that are related to coronary heart disease. Each factor is listed with numbers corresponding to the risk of having heart disease. For example a person with a poor diet is more likely to end up with coronary heart disease than a person with a good diet and will have a higher number on the chart. The higher a person’s total number for all of the risk factors, the higher their chance for heart disease.

PROCEDURE 1. Copy the data table below on to your own paper. Rose 2

Tom 4

Freddie 6

Maria 2

Mrs. Jones 3

1

5

5

1

2

1

2

3

0

5

1

3

4

4

4

2

4

4

2

4

1

3

4

1

3

1

10

6

10

0

1

8

8

2

8

7

4

2

1

4

17

43

42

23

33

Age Sex Weight Blood Cholesterol % Calories from saturated fat Systolic Blood Pressure Tobacco Smoking Exercise Family History TOTAL SCORE

TABLE 1

1. Age

2. Sex

3. Weight

10-20

21-30

31-40

41-50

51-60

61 and over

1

2

3

4

6

8

Female 40-50

Female over 50

Male

1

2

3

5

More than 2 kg below standard weight

Standard weight + 2 kg

3-10 kg overweight

11-30 kg overweight

31-40 kg overweight

40 or more kg overweight

1

2

3

4

5

Female < 40

0 4. Blood Cholesterol Level

< 180

181-205

206-230

231-255

256-280

281-300

0

1

2

3

4

5

5. % of total calories from saturated fat

< 10

11-20

21-30

31-40

41-50

> 50

0

1

2

3

4

5

6. systolic blood pressure

100-120

121-140

141-160

161-180

181-200

> 200

1

2

3

4

6

8

7. Smoking

Non-smoker

Cigar/pipe

< 10 cigarettes per day

11-20 cigarettes per day

21-30 cigarettes per day

0

1

> 30 cigarettes per day

2

4

6 10

8. Exercise

Intense regular exercise

Moderate regular exercise

Intense Recreational exercise only

Moderate recreational exercise

Light recreational exercise

Complete lack of exercise

1

2

3

5

6

8

No known family history

2 relatives had CHD after age 60

9. Family History

1

1 relative had CHD after age 60

3

1 relative had CHD before age 60

2 relatives had CHD before age 60

3 relatives had CHD before age 60

4 6 7 2 2. Use the following case histories and the accompanying RISK FACTOR CHART to fill in data table.

CASE #1 – Rose

CASE #2 – Tom

Age: 29

Age: 47

Weight: 1 kg over standard wt

Weight: 9 kg over standard wt

Blood Cholesterol: 200

Blood Cholesterol: 235

% Calories from Saturated Fat: 30%

Calories from Saturated Fat: 44

Blood Pressure: 120/80

Blood Pressure: 160/90

**Smoking: none

**Smoking: 2 packs/day

Exercise: exercises at work and for recreation

Exercise: none

Family History: both parents and grandfather had

Family History: 1 grandfather had early CHD

CHD in their 50’s

CASE #3 – Freddie

CASE #4 – Maria

Age: 52

Age: 29

Weight: 11 kg over standard wt

Weight: 2 kg below standard wt

Blood Cholesterol: 260

Blood Cholesterol: 185

% Calories from Saturated Fat: 44

Calories from Saturated Fat: 24

Blood Pressure: 170/100

Blood Pressure: 80/60

**Smoking: 1 ½ packs/day

**Smoking: 3 packs/day

Exercise: watching football on tv (NONE)

Exercise: occasional walking

Family History: father, brother, grandfather had

Family History: none

CHD in their 60’s

**A **Assume ssume there are 20 ci cigaret garet garettes tes per pack CASE #5 – Mrs. Jones Age: 40 Weight: 35 kg over standard wt Blood Cholesterol: 270 % Calories from Saturated Fat: 41 Blood Pressure: 160/100 **Smoking: none Exercise: none

Exercise: none

Family History: father died of heart attack in his 50's

EVALUATING TOTAL RISK FACTOR: TOTAL SCORE SCORE 5-11 12-18 19-24 25-31 32-40 41-63

RISK well below average below average average moderate high much too high

Copy the following questions on your own paper and write com complete plete sentence answers answers. 1. List each of the 5 case studies total score and risk for CHD. Use the TOTAL SCORE chart above. Rose: 17 Below Avg. Freddie:42 Much too high Mrs.Jones:33 High Tom: 43 Much too high Maria: 23 Average

2. For each individual at high risk, what SPECIFIC ADVICE would you give them to help them decrease their risk of CHD? Quit smoking, exercise at least once a day, change eating habits....