Effect of Habitual Physical Activity on Important Cardiovascular Disease Risk Factors

FACTOR REPORTED EFFECT OF HABITUAL PHISYCAL ACTIVITY

Serum Lipids Increase in HDL cholesterol
Decrease in triglycerides, LDL cholesterol
Improved LDL subfractions (less atherogenic)
Possible improvement in apolipoprotein A
No change in apolipoprotein B or lipoprotein (a)

Decrease in incidence of diabetes mellitus, type II

Glucose metabolism Increase in insulin sensitivity

Decrease in incidence of hypertension

Blood pressure Decrease in resting systolic and diastolic blood pressure

Decrease in hemostatic factors (fibrinogen, factor VII, platelet

aggregability)
Clotting factors Improvement in fibrinolytic factors (increased tissue
plasminogen activator decreased plasminogen activator
inhibitor-I)

Improved free fatty acid and total fat oxidative capacity

Fat metabolism
Dietary Advice for Cardiovascular Disease Reduction of Risk

FOODS TO CHOOSE FOODS TO AVOID

Fruit Pies, cookies, doughnuts, pastries

Fried meats
Vegetables Hamburger, meatloaf, beef burritos
Soy products Hot dogs
Fish, baked, broiled, or grilled Bologna, salami
Poultry, skinless, baked, broiled, or grilled Bacon, sausage
Margarine, low-fat, or fat-free Margarine
Vegetable spray Butter
Olive or canola oil (sparingly) Cream cheese
Cheese, low-fat or fat-free Lard, bacon fat, shortening
Milk, skim or 1% fat Whole milk, cream, half-and-half
Mayonnaise, low-fat or fat-free Salad dressing, regular
Pretzels, air-popped popcorn, low fat chips Potato chips, french fries
Bagels, low-fat muffins Ice cream
Bread, whole grain
Sherbet, fruit ice, low-fat frozen yogurt
Nuts (sparingly)
Drug Therapy for Selected Lipid Abnormalities

LIPID ABNORMALITY DRUG OPTION AEXAMPLE

Elevated LDL cholesterol Nicotinic acid (NA) NA (niacin)

HMG Co-A reductase inhibitors
(statins)
Atorvastatin, fluvastatin,
lovastatin, pravastatin,
simvastatin
Cholestyramine, colestipol,
psylium fiber

Elevated triglycerides NA
NA (niacin)
Fibrates
Fenofibrate, gemfibrozil

Elevated LDL and triglycerides NA

NA (niacin)
Statin
Atorvastatin (most potent)
Combination therapy
NA + statina
NA + BAR
NA + fibrateb
Statin + fibrate
Statin + BAR
Statin + NAa
Blood Pressure Screening Guidelines

1. Patients should be seated for at least 5 minutes and should refrain

from smoking or drinking caffeinated products for the 30 minutes
before the measurement.

2. The cuff used should be large enough so that the air bladder
ancircles at least 80 % of the arm.

3. Because considerable measurement error can occur with different

blood pressure measurement

4. The first appearance of sound (Korotkoff phase 1) is the value for

systolic blood pressure, and the disappearance of sound (phase 5)
is the value for diastolic blood pressure.

5. Two or more readings at least 2 minutes apart should be taken and

averaged.
Classification of Blood Pressure Levels for Adults as Recommended in The Sixth Report of the
Join National Committee on Detection, Evaluation, and Treatment of High Blood Pressure

SYSTOLIC BLOOD DIASTOLIC BLOOD

BLOOD PRESSURE PRESSURE PRESSURE
CATEGORY
(MM HG) (MM HG)

Optimal <120 <80

Normal <130 <85

High normal 130-139 85-89

Stage 1 hypertension 140-159 90-99

Stage 2 hypertension 160-179 100-109

Stage 3 hypertension >180 >110

Recommendation for Follow-up Blood Pressure Measurements

INITIAL BLOOD
FOLLOW-UP RECOMMENDATION
PRESSURE (MM HG)

<130/<85 Rechek in 2 yr

130-139/85-89 Rechek in 1 yr

140-159/90-99 Confirm within 2 mo

160-179/100-109 Evaluate within 1 mo

>180/>110 Evaluate immediately or within 1 wk

depending on the clinical situation
Recommendations for Management of High Blood Pressure,
According to Patient Risk Status

Risk Group C
Risk Group B
Blood Pressure Risk Group A (TOD, CCD, or
Stage (At Least 1 Risk
(No Risk Factors, Diabetes, with or
Factor, No TOD,
(MM HG) TOD or CCD) without Other Risk
CCD, or Diabetes)
Factors)
High normal Lifestyle modification Lifestyle modification Lifestyle modification
(30-139/85-89) and drug therapy

Stage 1 Lifestyle modification Lifestyle modification Lifestyle modification

(140-149/90-199) (up to 12 mo) (up to 6 mo) and drug therapy

Stages 2 and 3 Lifestyle modification Lifestyle modification Lifestyle modification

and drug therapy and drug therapy and drug therapy
( ≥160 / ≥100 )