1. The risk of dying as a result of cardiovascular disease increases with advancing age. Approximately what percent of persons who die of coronary heart disease are older adults – age 65 or older? About 81% of people who die of CHD are age 65 or older. Modifiable risk factors – cigarette smoking,
abnormal blood lipid levels, hypertension, diabetes, abdominal obesity, a lack of physical activity, and alcohol over-consumption account for more than 90% of the risk of an initial acute MI. 87% of strokes are ischemic, 3% result from subarachnoid hemorrhage, and 10% are due to intracerebral hemorrhage. Because strokes tend to occur in older persons and women live longer than men, more women die of strokes. The AHA reports that more than 60% of stroke
deaths in 2006 occurred in women. According to the Framingham Heart Study, women with early menopause (before age 42) have twice the stroke risk of other women in different age groups.
2. Modifiable risk factors that increase the risk of acute myocardial infarction (MI) include all of
the following except:
3. The overwhelming majority of strokes are ischemic. The percentage of strokes attributable to intracerebral hemorrhage is:
4. More than 60% of stroke deaths occur in:
5. Risk of ischemic
stroke is reduced among women with all of the following characteristics except:
6. Transient ischemic attacks (TIA) are associated with all of the following except:
7. High blood pressure is less common among women who:
8. By definition, prehypertension is untreated systolic or diastolic pressure ranging from:
9. The most commonly occurring congenital cardiovascular defect is:
10. Among postmenopausal women with coronary heart disease the strongest risk factor for heart failure is:
11. Heart disease is the leading cause of death among men and women of all races and ethnic groups, however mortality varies by ethnicity. The group with the lowest mortality is:
12. Reducing cholesterol and blood pressure may reduce all of
the following except:
13. The most commonly occurring arrhythmia is:
14. Symptoms such as shortness of breath, fatigue, weakness, difficulty breathing when recumbent, weight gain, and
swelling in the lower extremities may indicate:
15. To reduce the risk of heart disease total cholesterol levels should be less than:
16. Which condition has a 95% risk of death?
17.
Atrial septal defect is:
18. Which of the following groups is not at increased risk of developing endocarditis?
19. Which of the following statement about mitral valve prolapse is false?
20. The risks associated with stents include all of the following except:
Answers and Explanations1. A
The risk of stroke is highest in the 30 days following TIA, and the 90-day risk ranges from 3-17.3%. In the year following TIA, 25% of patients die.
7. AMore men than women suffer from high blood pressure until age 45. From ages 45-64, the rates are comparable for men and women. After age 65, many more women than men have high blood pressure. Women who are older, obese, or take oral contraceptives are at higher risk for high blood pressure.
8. AAn estimated 25 -37% of persons age 20 and older in the U.S. are prehypertensive.
9. BVentricular septal defects are the most common. Many close spontaneously; however, approximately 15% require intervention during the first year of life.
10. DAmong postmenopausal women with CHD, those with diabetes are at greatest risk of heart failure.
Native Americans or Alaska Natives have the lowest reported death rates from heart disease, followed by Asians or Pacific Islanders, Hispanics/Latinos, African Americans, and whites.
12. DLowering elevated cholesterol levels and blood pressure may prevent the development of heart disease and reduce the incidence of nonfatal MI and overall heart disease mortality.
13. AAtrial fibrillation is the most common problematic cardiac arrhythmia. An estimated 3-5% of Americans, most age 65 or older, suffer from atrial fibrillation. It is an electrical disturbance that causes the atria to quiver rather than pump effectively. As a result, blood may remain in the atrium and it may clot. Blood clots can cause a stroke if they block an artery that supplies blood to the brain.
14. BHeart failure occurs when the heart is unable to pump sufficient quantities of blood to supply the organs with oxygen. Coronary artery disease, hypertension, and diabetes are common causes of heart failure.
15. CFor persons at risk for heart disease, LDL cholesterol should be <100 mg/dL and triglycerides should be < 150 mg/dL. HDL cholesterol, which is considered protective against heart disease, should be 60 mg/dL or higher.
Although immediate defibrillation to restore normal rhythm may be lifesaving, 95% of persons with sudden cardiac arrest die within minutes.
17. BAtrial septal defect is a congenital heart defect; a hole between the atria that allows blood to pass from the left side of the heart to the right side. As a result, oxygen-rich blood may be pumped to the lungs rather than throughout the body. Some atrial septal defects close spontaneously; however, many require surgical repair.
18. DEndocarditis is an infection of the lining of the heart’s chambers and valves. It is more common in men than women, and in addition to the groups identified above, injection drug users are also at increased risk of developing endocarditis.
19. DEven people with symptoms attributable to mitral valve prolapse such as palpitations, shortness of breath, cough, dizziness and fatigue may not have significant backflow through the mitral valve. Mitral valve backflow may be more significant among persons with high blood pressure and persons with backflow sufficient to provoke serious symptoms such as arrhythmias or endocarditis may require surgery to repair the valve.
20. DAn estimated 1-2% of people who have stents placed develop a blood clot at the insertion site. The risk of blood clots is greatest in the months following stent placement. Most patients are prescribed aspirin or other anticlotting agents to prevent clot formation.