Question

1. A 62 year-old woman believes that heart disease and poor circulation are inevitable consequences of growing older and is resistant to altering her ADLs and dietary regimen. How would you respond?

Answer 1

QUESTION:

1. A 62 year-old woman believes that heart disease and poor circulation are inevitable consequences of growing older and is resistant to altering her ADLs and dietary regimen. How would you respond?

ANSWER:

• Give health education to the patient on following points.

Heart disease

Intoduction

People age 65 and older are much more likely than younger people to suffer a heart attack, to have a stroke, or to develop coronary heart disease (commonly called heart disease) and heart failure. Heart disease is also a major cause of disability, limiting the activity and eroding the quality of life of millions of older people.

Changes in the heart and blood vessels due to aging

• Aging can cause changes in the heart and blood vessels. For example, as get older, the heart can't beat as fast during physical activity or times of stress as it did when person were younger. However, the number of heart beats per minute (heart rate) at rest does not change significantly with normal aging.
• The most common aging change is increased stiffness of the large arteries, called arteriosclerosis (ahr-teer-ee-o-skluh-roh-sis), or hardening of the arteries.

Heart disease

Heart disease is caused by atherosclerosis ,which is the build-up of fatty deposits, or plaques, in the walls of the coronary arteries over many years. The coronary arteries surround the outside of the heart and supply blood nutrients and oxygen to the heart muscle. When plaque builds up inside the arteries, there is less space for blood to flow normally and deliver oxygen to the heart. If the flow of blood to heart is reduced by plaque buildup or is blocked if a plaque suddenly ruptures, it can cause angina (chest pain or discomfort) or a heart attack. When the heart muscle does not get enough oxygen and blood nutrients, the heart muscle cells will die (heart attack) and weaken the heart, diminishing its ability to pump blood to the rest of the body.

Cause of heart disease

• Changes that happen with age may increase a person's risk of heart disease.
• A major cause of heart disease is the buildup of fatty deposits in the walls of arteries over many years. The good news is there are things person can do to delay, lower, or possibly avoid or reverse the risk.
• The most common aging change is increased stiffness of the large arteries, called arteriosclerosis or hardening of the arteries. This causes high blood pressure, or hypertension, which becomes more common as we age.
• High blood pressure and other risk factors, including advancing age, increase the risk of developing atherosclerosis.

Pathology

Because there are several modifiable risk factors for atherosclerosis, it is not necessarily a normal part of aging. Plaque builds up inside the walls of arteries and, over time, hardens and narrows your arteries, which limits the flow of oxygen-rich blood to organs and other parts of body. Oxygen and blood nutrients are supplied to the heart muscle through the coronary arteries. Heart disease develops when plaque builds up in the coronary arteries, reducing blood flow to heart muscle. Over time, the heart muscle can become weakened and/or damaged, resulting in heart failure. Heart damage can be caused by heart attacks, long-standing hypertension and diabetes, and chronic heavy alcohol use.

Signs of Heart Disease

Early heart disease often doesn't have symptoms or the symptoms may be barely noticeable. That's why regular checkups are important.

Contact doctor right away if patient feels any chest pain, pressure, or discomfort. However, chest pain is a less common sign of heart disease as it progresses, so be aware of other symptoms. Tell doctor if patient has:

• Pain, numbness, and/or tingling in the shoulders, arms, neck, jaw, or back
• Shortness of breath when active, at rest, or while lying flat
• Chest pain during physical activity that gets better when you rest
• Light-headedness
• Dizziness
• Confusion
• Headaches
• Cold sweats
• Nausea/vomiting
• Tiredness or fatigue
• Swelling in the ankles, feet, legs, stomach, and/or neck
• Reduced ability to exercise or be physically active
• Problems doing your normal activities

Prevention of heart disease

There are many steps to keep heart healthy.

• Try to be more physically active.
• Talk with your doctor about the type of activities that would be best.
• If possible, aim to get at least 150 minutes of physical activity each week. Every day is best. It doesn't have to be done all at once.
• Start by doing activities person enjoys—brisk walking, dancing, bowling, bicycling, or gardening, for example.
• Avoid spending hours every day sitting.
• If you smoke, quit. Smoking is the leading cause of preventable death. Smoking adds to the damage to artery walls. It's never too late to get some benefit from quitting smoking. Quitting, even in later life, can lower risk of heart disease, stroke, and cancer over time.
• Follow a heart-healthy diet. Choose foods that are low in trans and saturated fats, added sugars, and salt. As we get older, we become more sensitive to salt, which can cause swelling in the legs and feet.
• Eat plenty of fruits, vegetables, and foods high in fiber, like those made from whole grains. Keep a healthy weight. Balancing the calories you eat and drink with the calories burned by being physically active helps to maintain a healthy weight. Some ways you can maintain a healthy weight include limiting portion size and being physically active.
• Keep your diabetes, high blood pressure, and/or high cholesterol under control.
• Follow doctor's advice to manage these conditions, and take medications as directed.
• Don't drink a lot of alcohol.
• Men should not have more than two drinks a day and women only one. One drink is equal to:
• Manage stress. Learn how to manage stress, relax, and cope with problems to improve physical and emotional health.
• Consider activities such as a stress management program, meditation, physical activity, and talking things out with friends or family.

Conclusion

Heart disease risk factors that person can have some control over include high blood pressure, cholesterol levels, diabetes, obesity, and smoking. Eat a heart-healthy diet with reduced amounts of saturated fat and cholesterol, and control your weight. Follow your health care provider's recommendations for treating high blood pressure, high cholesterol or diabetes. Reduce or stop smoking. Persons between the ages of 65 to 75 who have ever smoked should be screened for aneurysms in their abdominal aorta.