“ hypertension follows closely behind lipids W r i t i n g

Prior to beginning work on this assignment, examine the relationship between cardiovascular health status and wellness by reading Chapter 10 in the course text.

Cardiovascular disease (CVD) is the number one killer of both men and women in the United States (American Heart Association, 2013). Many risk factors are associated with CVD. A risk factor is a variable which can increase a person’s risk of developing a disease such as family history, obesity, high blood pressure, or high cholesterol. Chronic diseases, such as heart disease, can have a direct impact on a person’s wellness. Making healthy lifestyle changes can decrease a person’s risk of heart disease and other chronic diseases.

Carmen, from the Week 1 Dimensions of Wellness Case Study discussion and the Week 3 Weight and Body Composition Self-Check, did not heed your suggestions for improving her wellness. As a result, Carmen, now 58 years old, has developed cardiovascular disease. Due to her continued diet of fast food and sedentary behavior, she has gained 20 pounds and has a BMI of 28; her blood pressure is 152/80 mmHg; her total cholesterol level is 230 mg/dL, and she does not meet the physical activity guidelines for adults. Recently, she has also been diagnosed with Type 2 diabetes and is determined to make a behavior change.

For this discussion address the following in your response:

• Summarize Carmen’s controllable risk factors for heart disease.
• Discuss the relationship between the lifestyle factors of poor diet and sedentary behavior to heart disease (particularly discuss the formation of plaque within the arteries). Use a reference to support your explanation.
• Explain the current recommendations for healthy levels of BMI, cholesterol, blood pressure, and physical activity.
• Devise a plan for Carmen to reduce her risk factors. The plan should include detailed dietary guidelines (recommendations for specific amounts of fat, cholesterol, caloric intake, etc.) and physical activity guidelines to include each of the FITT principles.

Include the text and one additional scholarly reference correctly cited in APA style as outlined in the Ashford Writing Center to help support your response. See the Citing Within Your Paper and Formatting Your References List resources and the Scholarly, Peer-Reviewed, and Other Credible Sourcesdocument for additional guidance.

• To assist you in completing the library research required for this assignment, view the How Do I Begin? tutorial, which provides an overview of conducting searches in the library, generating keywords, and understanding your assignment prompt.

Guided Response: Respond substantially to two classmates by Day 7. Compare and contrast your recommendations for Carmen with your classmates. Are your classmate’s recommendations specific enough? Are your recommendations specific enough? If not, what information can you provide to improve clarity? If they are specific, what other suggestions can you provide for Carmen to improve her health?

Kathryn- Carmen has several controllable risk factors. Carmen’s major controllable risk factors include her high blood pressure, high cholesterol, sedentary lifestyle, diabetes, and BMI. Carmen also has a contributory risk factor that can be controlled which is her fast food diet and lack of proper nutrition. There is also a non-controllable risk factor in her increasing age.

Two of Carmen’s lifestyle factors, poor diet and sedentary behavior, are major contributors to risk associated with heart disease. According to Sharifi et al. (2020), “a sedentary lifestyle increases insulin resistance, induces obesity, increases blood glucose levels, plasma lipids and prothrombotic factors” (p.4). Additionally a diet high in low-density lipoprotein (LDL) contributes to the risk of heart disease by promoting fatty plaque buildup in the arteries (Powers & Dodd, 2017). Both of these risk factors lead to additional health problems such as diabetes and high blood pressure. These additional health issues also increase Carmen’s risks of heart disease.

The American Heart Association (AHA) has published a set of healthy recommendations for reducing risks of heart disease for people that already have diabetes. The AHA (2015) recommends maintaining a BMI between 18.6 and 24.9 and blood pressure lower than 130/80 mm Hg. The AHA (2018) also recommends “at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week” (para. 3). Cholesterol levels should be monitored as well. Powers and Dodd (2017) suggests that healthy cholesterol levels include LDL levels below 100 mg/dl and HDL levels greater than 60 mg/dl. Considering Carmen’s high consumption of LDL rich fast food and total cholesterol of 230 mg/dl, it can be assumed that Carmen’s LDL levels are much higher than recommended.

For Carmen to reduce her risk factors, it is important that she adopt a healthier diet and begin an exercise prescription that will work for her. Taking into consideration that Carmen is 58 years old and has already developed cardiovascular disease and Type 2 diabetes, she should first consult her doctor before beginning an exercise regimen. Once Carmen has consulted her doctor, she can begin setting goals that take into account her physical limitations. Carmen should work to incorporate a safe form of moderate intensity exercise, for at least 30 minutes a day, three or four days a week. Since Carmen has been sedentary for so long, a lower intensity workout will still benefit her. Aspects of her diet should also be changed.

Carmen’s BMI falls into the overweight category. Do determine her caloric needs, she should first determine her current needs. For this calculation, we will assume that Carmen weighs 160 lbs. To maintain her current weight with a sedentary lifestyle, she would need to consume approximately 2080 kcals a day. Since her current lifestyle is contributing to her poor health, Carmen needs to adjust her caloric intake. To loose one pound per week, Carmen would need to reduce her caloric intake to 1580 kcals a day. If Carmen achieves a moderate level of physical activity, then her daily caloric expenditure could increase to 2400 kcals a day and a reduction to 1900 to lose a pound a week.

To maintain balance in her diet, Carmen needs to pay attention to how her caloric needs are consumed. Powers and Dodd (2017) explains that 58% should be in the form of carbohydrates, 30% should be from fat, and 12% should be from protein. Carmen should avoid saturated and trans fat and consume less than 300mg of cholesterol. A simple guideline that Powers and Dodd (2017) offer is to fill half of your plate with fruits and vegetables.

American Heart Association. (2015). Know your health numbers. Total fitness & wellness, the Mastering Health edition (7th ed.). Retrieved from https://redshelf.com

Sharifi-Rad, J., Rodrigues, C. F., Sharopov, F., Docea, A. O., Can Karaca, A., Sharifi-Rad, M., Kahveci Karıncaoglu, D., Gülseren, G., Şenol, E., Demircan, E., Taheri, Y., Suleria, H. A. R., Özçelik, B., Nur Kasapoğlu, K., Gültekin-Özgüven, M., Daşkaya-Dikmen, C., Cho, W. C., Martins, N., & Calina, D. (2020). Diet, Lifestyle and Cardiovascular Diseases: Linking Pathophysiology to Cardioprotective Effects of Natural Bioactive Compounds. International Journal of Environmental Research & Public Health, 17(7), 2326

Amber-

• Summarize Carmen’s controllable risk factors for heart disease.

Carmen has control over high blood pressure, high cholesterol, sedentary lifestyle, overweight/obesity, diabetes, stress diet/nutrition, and alcohol consumption (Powers & Dodd, 2017, p.230).

• Discuss the relationship between the lifestyle factors of poor diet and sedentary behavior to heart disease (particularly discuss the formation of plaque within the arteries). Use a reference to support your explanation.

When exercise and diet are neglected, one of the consequences is heart disease. When a person’s diet consists only of processed, low nutrient dense, and salty foods, plaque begins to develop in the arteries around the heart. Eventually, this can stop blood flow to the heart causing a heart attack or could cause a blockage of arteries to the brain causing a stroke. Hypertension is another form of cardiovascular disease. “Chronic high blood pressure increases the workload on the heart, which may eventually damage heart muscle and reduce the heart’s ability to pump blood effectively throughout the body. It damages the lining of arteries, resulting in atherosclerosis” (Powers & Dodd, 2017, p. 279). Physical exercise can help prevent CVD because it helps to maintain healthy body weight and blood pressure, is part of stress management, and overall is great for the heart and lungs. “A lack of physical activity and inadequate nutrition act synergistically and in part additively, and they operate largely through the same pathways”(Ignarro, 2007, para. 4).

• Explain the current recommendations for healthy levels of BMI, cholesterol, blood pressure, and physical activity.

For Carmen’s age range, she needs to have a BMI of at least 24 or less (she will need to lose at least 20 lbs), she needs to have blood pressure of 120/80 mm Hg. It is recommended that Carmen have a total cholesterol level of 200 mg/dL, and not the 230 she currently has. Lastly, Carmen needs to be including low impact physical exercise at least 3-4 days per week.

Devise a plan for Carmen to reduce her risk factors. The plan should include detailed dietary guidelines (recommendations for specific amounts of fat, cholesterol, caloric intake, etc.) and physical activity guidelines to include each of the FITT principles.

First Carmen will need to fill out the PAR-Q to determine if she can begin an exercise program of if she will need to consult her Physician first (Powers & Dodd, 2017,pg. 30). Due to her age and lack of physical activity I would start Carmen off doing low impact activities like swimming or biking for 20-30 mins, 3-5 times per week. I would ensure she is equipped with proper warm up and cool down exercises and stretches to prevent injury. I would also recommend strength training exercises that would include high resistance and low repetitions. After about five weeks of consistency, Carmen would be reevaluated to see if she needs to keep to her current program or if she is ready to progress.

Some guidelines that I would recommend to Carmen is to first set up an account at myfitnesspal.com or myplate.gov to monitor her food and beverage intake as well as macro and micronutrients. That will let her see specifically in real time what is entering her body and keep goals more attainable. I would encourage her to replace soda and juices with flavored or seltzer water and consider adding fruit as a replacement for desserts after a meal. I think it is the gradual changes that make a big difference, one step at a time. The goal would be to reach a well balanced diet, to include fruits and vegetables, protein, carbohydrates, and healthy fats. As stated by Powers & Dodd, Carmen should consume less than 300 mg of cholesterol per day, 58% carbs, 30% fat, and 12% protein (pg.222).

Louis J. Ignarro, Maria Luisa Balestrieri, Claudio Napoli, Nutrition, physical activity, and cardiovascular disease: An update, Cardiovascular Research, Volume 73, Issue 2, January 2007, Pages 326–340, https://doi.org/10.1016/j.cardiores.2006.06.030

Powers, S. K., & Dodd, S. L. (2017). Total fitness & wellness, the Mastering Health edition (7th ed.). Retrieved from https://redshelf.com

Danielle Belfon- Summarize Carmen’s controllable risk factors for heart disease. Carmen cannot control her age or her race/ethnicity, but she can control her diet and weight. Her blood pressure is 152/80 mmHg. Her high blood pressure has put her at risk for heart disease. I am concerned because with a blood pressure this high, she could have a stroke. This is mentioned in the journal, Journal of Cerebral Blood Flow & Metabolism,

Hypertension has numerous effects upon the brain, notably, compromise of blood-brain barrier, distributed damage to the white matter, and post-stroke edema. Such physiologic changes create a different milieu for the ischemia-challenged brain. With the high prevalence of hypertension as both a risk factor and sequelae of stroke, it is an important consideration in acute stroke management. (O’Collins, 2017, p. 1146).

Carmen should cut out fast food out of her life and her kids’ lives. They will model after her because she is their mother. Fast food has a high concentration of salt and sugar. This is a risk factor for heart disease. Fast food also has a lot of saturated fats. Her body mass index shows that she is overweight and awfully close to being obese. Her gaining weight, has put her at risk for CVD and Type 2 diabetes. According to Powers and Dodd (2017),”Obesity increases the risk of developing at least 26 diseases. Cardiovascular disease, colon cancer, hypertension (high blood pressure), kidney disease, arthritis, and diabetes among the most serious” (p. 161). She could have controlled her weight, blood pressure, and cholesterol by exercising and eating healthy meals.

Discuss the relationship between the lifestyle factors of poor diet and sedentary behavior to heart disease (particularly discuss the formation of plaque within the arteries). Use a reference to support your explanation. A poor diet and not being physically active, can lead to heart disease. The body needs to move and get rid of unnecessary fat. Essential fat is good because it cushions the organs. It is needed when a woman is pregnant and when she is giving birth. However, storage fat can lead to clogged blood vessels. “Hypertension follows closely behind lipids on a list of classical risk factors for atherosclerosis” and “Angiotensin II (AII), in addition to its vasoconstrictor properties, can instigate intimal inflammation” (Riccioni et al., 2003, p. 27). Plague builds up in the blood vessels which then reduces proper blood flow. (Lechner et al., 2020, p. 395-400).

Explain the current recommendations for healthy levels of BMI, cholesterol, blood pressure, and physical activity. The current recommendation for physical activity is 150 minutes per week. A person should exercise five days out of the week for 30 minutes. A normal blood pressure should be around 120/80 mmHg. The upper number (systolic) should always be higher than the lower number (diastolic). A person’s HDL cholesterol should be between 40 and 60 mg/dL. The LDL cholesterol should be less than 100 mg/dL. The triglyceride level should be less than 150 mg/dL. The non-HDL cholesterol level should be less than 130 mg/dL. The cholesterol level should be less than 200 mg/dL. A normal BMI is 18-25.

Devise a plan for Carmen to reduce her risk factors. The plan should include detailed dietary guidelines (recommendations for specific amounts of fat, cholesterol, caloric intake, etc.) and physical activity guidelines to include each of the FITT principles. Carmen should consume more vegetables and fruits. However, she has to remember that fruits have sugar in them, so it is best to not eat too much at a time. She should watch her dietary intake as well. Her diet should consist of carbohydrates such as complex sugars. Because she is diabetic, she must watch her carbohydrate and fat intake. If she is going to consume bread or pasta, it should be wheat pasta and multigrain bread. Multigrain bread is also great for fiber. She also must watch her portion and serving size. She should cut back on red meat such as burgers and steaks because those tend to have a high amount of saturated fats. She should cut back on the meat and poultry for now until she can get her cholesterol levels and A1C down. Fish is a great alternative because it is rich in omega-3 fatty acids. She should cut out most, if not all, simple sugars. Her calorie intake should be around 2,000 calories a day. Her carbohydrate intake should be 325 grams a day. Her fat intake should be 50 grams a day. Her fiber intake should be 25 grams a day. Her cholesterol intake should be less than 200 grams a day. Her protein intake should be 46 grams a day. Carmen needs to exercise, but she has to engage in a physical activity that makes her feel good physically and emotionally. For now, Carmen should exercise for about 30 minutes a day for 2-3 days. It is best to start out slow. She should warm up and cool down every time. She also has a heart condition which means that she should not over do it when it comes to her exercise regimen. She should start walking or she can go on a treadmill. She can also go bike riding with her daughters which would be a fun and healthy activity for all of them to enjoy.

References

Lechner, K, von Schacky, C., McKenzie, A. L., Worm, N., Nixdorff, U., Lechner, B., Kränkel, N., Halle, M., Krauss, R. M., & Scherr, J. Lifestyle factors and high risk atherosclerosis: Pathways and mechanisms beyond traditional risk factors. European Journal of PreventiveCardiology, 27(4), 394 – 406. https://doi-org.proxy-library.ashford.edu/10.1177/2047487319869400

O’Collins, V. E., Donnan, G. A., Macleod, M. R., & Howells, D. W. (2013). Hypertension and experimental stroke therapies. Journal of Cerebral Blood Flow & Metabolism, 33(8), 1141-1147. https://doi-org.proxy-library.ashford.edu/10.1038/jcbfm.2013.88

Powers, S. K., & Dodd, S. L. (2017). Total fitness & wellness, the mastering health edition (7^th edition). Pearson. Retrieved from https://redshelf.com

Riccioni, G., De Santis A., Cerasa, V., Menna, C., Di llio, C., Schiavone, C., Ballone, E., & D’Orazio, N. (2003). Atherosclerotic plaque formation and risk factors. International Journal of Immunopathology and Pharmacology, 25-31. https://doi-org.proxy-library.ashford.edu/10.1177/039463200301600104