EXSC 301 Final Exam/ heart disease & obesity (pt. 1)

Adiposity located in the abdominal region is strongly linked with chronic disease risk; therefore, a WC of _____________ in men or ___________ in women is used to classify individuals with abdominal obesity.

102 cm (40 in.); 88 cm (35 in.)

Waist circumferences greater than _____ and _____ cm indicate abdominal obesity in men and women, respectively.

102;88

The U.S. prevalence of obesity rose from less than ___% in the early 1960s to _____% in 2011-2012.

15; 34.9

Stage III hypertension is classified as a persistent SBP reading that is greater than __________ mmHg or a persistent DBP reading that is greater than _________ mmHg

180;110

If a cardiac patient has an end-diastolic volume (EDV) of 140 ml and an end-systolic volume (ESV) of 90 ml, the ejection fraction is

36%

Which of the following best describes the initial exercise intensity that is used in exercise programming for outpatient cardiac rehabilitation?

40% to 75% of or HRR

Health gains such as lower blood pressure (BP) and improvements in the lipid profile are often realized with only a ___________ reduction in body weight in those who are currently obese.

5%

A well-planned diet with a caloric deficit of ______ to _______ kcal per day gradually reduces weight without sacrificing nutrition needs.

500; 1000

Which of the following best represents a normal ejection fraction?

55% to 70%

Of those experiencing a heart attack, ___% will survive.

80%

Which of the following is NOT true regarding the link between mortality, morbidity, and obesity?

A 2008 review indicated that overweight and obesity accounted for 20% to 25% of health care spending.

An exercise program that does not result in weight loss does little to protect an obese person against premature death.

False

The criteria for terminating a graded exercise test (GXT) done for diagnostic purposes is the achievement of 75% of age-adjusted maximal HR.

False

To maximize caloric expenditure when the primary goal of exercise is to reach duration goals to help with weight loss, exercise should not be divided into shorter bouts.

False

Unlike normal-weight individuals, overweight individuals must reduce their weight to have exercise-related benefits of improved blood lipid profile and lower BP.

False

List the three classes of obesity and the BMI (body mass index) thresholds or ranges (in kg · m2) that identify them.

grade 1 obesity: 30 to 34.9 kg*m^-2 grade 2 obesity: 35 to 39.9 kg*m^-2 grade 3 (extreme) obesity: 40kg* m^-2 or higher

The double product is a function of SBP and heart rate (HR).

True

Which of the following is NOT true regarding exercise and hypertension?

Weight loss is likely to result in a larger systolic blood pressure (SBP) and diastolic blood pressure (DBP) decrease than endurance training.

Reasons for ending a GXT diagnostic test for detecting CHD include all but which of the following?

achieving >75% of age-adjusted maximal HR

The most definitive tests for CHD are

coronary angiography and positron emission tomography (PET)

Cardiovascular disease (CVD) is the leading cause of death in the United States. Which of the following types of CVD accounts for the largest portion of these deaths?

coronary heart disease (CHD)

In regard to the atherosclerotic process, it is likely that the _________________ cells, which line the artery, become damaged as a result of exposure to various risk factors associated with CVD.

endothelial

In 2004, the FDA banned ___________ in over-the-counter products because of the reported occurrence of tachycardia, hypertension, strokes, and heart attacks.

ephedra

Although no universally agreed-on standards exist regarding what body fat percentage constitutes obesity, what body fat percentages are commonly considered obese for men and women, respectively?

females: >38% Males: >25%

Which of the following procedures involves putting a balloon-tipped catheter into a coronary artery and inflating the balloon to embed a metal mesh in the artery?

intracoronary stent

Stage 3 hypertension refers to a persistent elevation in BP (SBP of >180 mmHg or DBP of >110 mmHg) and is associated with damage to all the following organs except for the

liver

Which of the following is NOT one of the elements of the program designed by Ornish and colleagues to reverse coronary heart disease?

low carb diet

Which of the following is NOT true?

Atherosclerosis is a disease that starts late in life.

The clinically preferred method of assessing obesity is

BMI

What lifestyle changes are associated with lowering blood pressure and by how much?

Dietary change includes reducing sodium intake, which has been shown to independently lower SBP and DBP by 5 and 3 mmHg, respectively. Obesity is linked to hypertension, and research shows that a loss of 1 kg of body weight decreases SBP and DBP by 1.6 and 1.3 mmHg, respectively. Also, participating in an endurance exercise program has been shown to decrease SBP and DBP by 7 and 6 mmHg, respectively, in hypertensive individuals.

Outline a general exercise prescription for an obese client. Specifically, include the guidelines for frequency of exercise, specific intensity range in terms of heart rate reserve (HRR), and appropriate duration for this population.

F: 5 or more days per week I: moderate (40-60% HRR) with progression to higher intensity (greater than 60 HRR) T: Begin with short and easily tolerated bouts of 30 mins per day and then progressing to 60 minutes per day. Eventually to multiple daily bouts can be used with duration of 10 minutes or longer T: aerobic exercise targeting large muscle groups with resistance (2 to 3 days per week) and flexibility (2 to 3 days per week)

An atherosclerotic plaque that occurs in a femoral artery is likely to lead to ________________, which is a term that describes intermittent muscle pain on exertion.

claudication

Weight-loss guidelines indicate that weight should be lost at a rate of ______ to ________ kg per wk.

0.5;1

List four populations of people who would likely be referred to a cardiac rehabilitation program.

1.) angina pectoris 2.) myocardial infarction (MI) 3.) coronary artery bypass graft (CABG) 4.) angioplasty

List two commonly reported barriers to exercise for people who are obese.

1.) feeling too fat to exercise 2.) believing that their health is too poor for exercise

List at least four physiological changes that occur in the body or improvements that result from these changes in support of the use of exercise training in a person with established heart disease.

1.) higher VO2 max values after training 2.) higher work rates achieved without ischemia 3.) increased capacity for prolonged submaximal work 4.) moderate reduction in BP

List any two of the three possible sites of target-organ damage from chronic stage III hypertension.

1.) kidney 2.) eyes

Name two areas of safety that should be addressed with an obese exerciser.

1.) thermoregulation 2.) orthopedic injuries

List two special considerations that should come into play when screening obese clients before exercise testing.

1.) type 2 diabetes 2.) hypertension

Research studies demonstrate that patients with CVD who participate in a cardiac rehabilitation exercise program show a _________ reduction in all-cause and cardiovascular mortality.

20% to 25%

The 2008 U.S physical activity guidelines encourage __________ min per wk of moderate exercise to facilitate weight loss or prevent weight regain.

200 to 300

Successful weight loss is possible. Approximately 5,000 people participate in the NWCR, with an average weight loss of _____ kg maintained for _____ yr.

30; 5.5

Approximately _________ of the U.S. adult population in 2011 to 2012 met the criteria for obesity.

35%

The National Weight Control Registry (NWCR), established in 1994, currently lists approximately 5,000 people who have lost an average of 30 kg and kept it off for 5.5 yr. Which of the following is NOT true regarding some of the facts that have been gathered from these individuals?

A typical exercise routine was 30 min per day of vigorous activity.

Because it typically does not result in a large caloric expenditure, resistance training is not generally part of the exercise prescription when weight loss is the primary goal.

False

Ischemia is considered a permanent condition because it will not subside even when the oxygen demand of the heart returns to normal.

False

Certain biologic factors have been identified as factors that may predispose an individual to obesity. Name one of the biologic factors, and briefly state its role in obesity.

Genetics is a biological factor where the role in obesity deals with lowering RMR below normal RMR levels

Which of the following is NOT true regarding the atherosclerotic process?

It is a process that starts around the age of 50.

A test that diagnoses the presence of atherosclerotic lesions by using a radioactive substance to distinguish areas of the heart muscle that are not receiving good perfusion from those that are is called

PET scan

_____________can result in claudication, or intermittent muscle pain that occurs with exertion.

Peripheral artery disease

Which of the following is NOT true regarding exercise testing in the obese population?

Physiological response patterns—heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP)—during exercise differ from those of normal body weight.

Which of the following is a valid way of determining training intensity for a patient who is on a beta-blocker?

RPE ratings around somewhat hard, which correspond to 11 to 14 on the Borg RPE scale

Which of the following represents a sign (rather than a symptom) of CHD?

ST-segment depression on an ECG

Which of the following is the most appropriate method of prescribing exercise intensity in a person with CHD who is currently taking beta-blockers?

THR method when the measured HRmax is determined while the patient is on beta-blocking medications

Which of the following is NOT true regarding the current trends in the prevalence of overweight and obesity in the United States?

The current prevalence of obesity is almost 1.5 times that in the early 1960s.

Which of the following is or are part of a suitable exercise prescription for an individual in an outpatient cardiac rehabilitation program?

all of these ( frequency: 3 to 4 days per wk, intensity: 40% to 75% of or HRR, duration: 20 to 40 min per day, 5 to 10 min of warm-up and cool-down exercises)

Fitness professionals should be aware that _______________ may be a special concern for obese individuals participating in an exercise program.

all of these (orthopedic injury thermoregulation, hydration)

Suggested pathways through which biological factors work to predispose a person to obesity include all but which of the following?

altering thermoregulation

A test that diagnoses the presence of atherosclerotic lesions by using a dye injected into the coronary arteries (via introduction of a catheter through the femoral artery) is called

coronary angiography

Which is not considered primarily responsible for the rapid increase in obesity in the United States over the last four decades?

genetics

Reduced blood flow in any coronary artery reduces blood flow to the myocardium and creates a condition called ________________ _______________.

myocardial ischemia

Explain the difference between myocardial ischemia and a myocardial infarction (MI).

myocardial ischemia: blockages in coronary arteries reduce blood flow and oxygen to heart myocardial infarction (MI): severe case of myocardial ischemia

Which of the following is NOT one of the biological factors identified as a possible mechanism that predisposes a person to obesity?

none of these (all are possibly linked to obesity)

An individual with a BMI of 36.4 kg · m-2 falls in which subclass of obesity?

obesity class 2

Which of the following best describes the phase of cardiac rehabilitation in which patients are given well-thought-out exercise programs in an outpatient setting, have their cardiac rhythms monitored by ECG, receive BP and sometimes glucose monitoring during exercise, and receive education and instruction for home exercise and lifestyle modification?

phase II

What is meant by secondary prevention of CHD?

reduce the occurrence of subsequent MIs

If arteries in the brain become occluded, a ____________ will result.

stroke

Which of the following is NOT one of the well-known advantages to percutaneous transluminal coronary angioplasty (PTCA), compared to coronary bypass surgery?

very low risk of reocclusion