Evidence based practice for prevention and treatment of cardiovascular disease across the lifespan

106 Pages·2016·6.31 MB·English

by  Barbara Cross

Evidence based practice for
prevention and treatment of
cardiovascular disease
across the lifespan
Shane A. Phillips, PT, PhD, FAHA
Sharon A. Martino, PT, PhD
Disclosure
Presenters have no financial interests to disclose.
Session Learning Objectives
• Review the epidemiology of cardiovascular disease in the American
population
• Identify risk factors associated with heart disease and discuss
guidelines and recommendations for prevention of heart disease
• Discuss the importance of peripheral vascular endothelium in the
pathophysiology of CV disease.
• Highlight the pertinent exercise intervention trials with peripheral
vascular function as a primary outcome.
• Begin to organize an exercise intervention strategy for patients with
cardiovascular risk based on the current research.
• Identify the inter-professional and multi-disciplinary roles needed to
develop evidence based programs of CVD prevention and
treatment.
• Discuss the role of technology in prevention and treatment of
cardiovascular disease and obesity
Coronary Heart Disease
Worldwide variation
Most recent data
available, revised 2006
Cardiovascular Disease
Mortality
WHO, 2014.
Diabetes Mortality World Wide
WHO, 2014.
U.S.
Non-communicable Diseases
WHO, 2014.
Pathogenesis of Atherosclerosis
• Definition: Formation of fibrofatty lesions in the
intimal lining of large and medium sized vessels
• Insidious
• Clinical evidence may appear not appear for 20-30
years
• Sites of severe atherosclerosis in order of
frequency
– Abdominal aorta & iliac arteries
– Proximal coronary arteries
– Thoracic aorta, femoral & popliteal arteries
– Internal carotid arteries
– Vertebral, basilar, and middle cerebral arteries
ACRM 2015
Overview of the Pathophysiology of
Atherosclerosis
1. Endothelial dysfunction
2. Inflammatory process involving many
cellular markers within the lesion
3. Deposits of fatty streaks initiating event
4. Lesions occur in large and medium sized
vessels
5. May be present throughout a person’s life-
time
Endothelium and Vascular
Control