Cardiac rehab lect 1

• LOW RISK - 1 or less RF (risk factors)
• MODERATE RISK - two or more RF (no signs or symptoms of systemic disease) can be overweight, hypertensive, inactive

HIGH RISK - if you have or show S/Sx of disease (dyspnea on min exertion, palpitation, syncope)(Systemic: diabetes (DM), thyroid disease, kidney, etc)

• -family hx (first degree male relative less or = to 55 yrs old when died or suffered from CVD)
• - first degree female relative less or = 65 yrs old (due to estrogen being cardiac protective)
• -age (men > 45, female > 55 or post menopausal)
• - gender as we get older (70) CRF in both women and men are pretty much equal

cigarette smoking (quit- more than 6 months- the risk for further cardiac event lessens but doesnt account for the damage already done in terms of pulmonary system (pressure); risk for coronary artery disease declines)

• hypertension (> or equal 140/90)ACSM (american  2 levels, 4 levels of BP, always label by the highest # (1 33)
• I 140 -159/90-99
• II 160-179/100-109
• III 180-199/110-119
• IV > or equal 200/ > or equal 120
• diastolic (1/3 of time we spend) has greater impact on ave BP then systolic contraindications for exercising
• REST: if BP reaches stage IV (resting cystolic BP), exercise is contraindicated except for diabetic pts (cut off is180)
• REST: if BP reaches phase III (resting dyastolic BP)EXERCISE: ????/115 is allowed (230/110 limit for most CR programs) by ACSM in a stressful situation (during exercising, never 100% intensity)

-hypercholesterolemia (ACSM)total cholesterol (above 200 is a risk factor)/

• HDL the dif btw 200 and 220 doubles the riskunder 5 avg riskunder 3 less then avg risk LDL no CVD <130LDL CVD < 100 (newer data70)HDL > 60 mg/dL -negative riskHDL < 40 -RF (exercise help to inc HDL)  
• triglycerides (mark a predesposition for diabetes, associate with inc carbohydrates ingestion) > 150 mg/dL

fasting glucose < or equal 100 mg/dL (normal), everything above is a risk factor110-125 impaired fasting glucose control (precursor)>125- diabetes-

• obesity - BMI = body mass (kg)/height(m2)
• BMI < 25 Normal 
• overweight: 25-29.9
• obese stage I: 30-34.9
• obese stage II: 35-39.9
• obese stage III: BMI >40
• ACSM uses waist circumference (measure at the widest point)
• male > 40 inches - positive RF
• female > 35 inches - positive RF
• ppl who have visceral fat have a greater impact on not even cardiac but general diseases

-sedentary lifestyle - mod intensity exercise 30 min on most days of the week>10000 steps a day = active