- 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)?
- >80%
- 55%
- 66%
- 75%
About 81% of people who die of CHD are age 65 or older.
- Modifiable risk factors that increase the risk of acute myocardial infarction (MI) include all of the following except:
- Hypertension
- Smoking
- Food allergies
- Lack of physical activity
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.
- The overwhelming majority of strokes are ischemic. The percentage of strokes attributable to intracerebral hemorrhage is:
- 25%
- 18%
- 10%
- <6%
87% of strokes are ischemic, 3% result from subarachnoid hemorrhage, and 10% are due to intracerebral hemorrhage.
- More than 55% of stroke deaths occur in:
- Native Americans
- Women
- Mexican Americans
- Persons age 45-64
Because strokes tend to occur in older persons and women live longer than men, more women die of strokes. The AHA reports that 56.6% of stroke deaths in 2022 occurred in women.
- Risk of ischemic stroke is reduced among women with all of the following characteristics except:
- Low BMI
- Regular exercise
- Healthy diet
- Menopause before age 42
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.
- Transient ischemic attacks (TIA) are associated with all of the following except:
- Increased risk of stroke in the first 30 days following the TIA
- Increased risk of stroke in the first 90 days following the TIA
- Increased risk of death within one year of the TIA
- Increased risk of congenital heart disease
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, 4%-8% of patients die.
- High blood pressure is less common among women who:
- Are age 45 and younger
- Are obese
- Use oral contraceptives
- Are African American
More men than women suffer from high blood pressure until age 45. From ages 45–64, rates are comparable; after age 65, more women than men have high blood pressure. Women who are older, obese, or take oral contraceptives are at higher risk for hypertension.
- According to current ACC/AHA guidelines, elevated blood pressure is defined as:
- SBP 120–129 mm Hg, DBP < 80 mm Hg
- SBP 130–139 mm Hg, DBP 80–89 mm Hg
- SBP ≥ 140 mm Hg, DBP ≥ 90 mm Hg
- SBP < 120 mm Hg, DBP < 80 mm Hg
Elevated blood pressure is defined as a systolic reading of 120–129 mm Hg with a diastolic below 80 mm Hg. Stage 1 hypertension begins at SBP 130–139 or DBP 80–89 mm Hg per the 2017 ACC/AHA update.
- The most commonly occurring congenital cardiovascular defect is:
- Tetralogy of Fallot
- Ventricular septal defects
- Coarctation of the aorta
- Hypoplastic left heart syndrome
Ventricular septal defects are the most common. Many close spontaneously; however, approximately 15% require intervention during the first year of life.
- Among postmenopausal women with coronary heart disease the strongest risk factor for heart failure is:
- First child after age 30
- No children
- Diet low in fruit and vegetables
- Diabetes
Among postmenopausal women with CHD, those with diabetes are at greatest risk of heart failure.
- 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:
- African Americans
- Native Americans or Alaska Natives
- Hispanics/Latinos
- Asian or Pacific Islanders
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.
- Reducing cholesterol and blood pressure may reduce all of the following except:
- Heart disease mortality
- Incidence of nonfatal myocardial infarction
- Risk of developing heart disease
- Risk of congenital heart disease
Lowering 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.
- The most commonly occurring arrhythmia is:
- Atrial fibrillation
- Ventricular tachycardia
- Bradycardia
- Ventricular fibrillation
Atrial fibrillation is the most common problematic cardiac arrhythmia. An estimated 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, potentially leading to clot formation and stroke.
- Symptoms such as shortness of breath, fatigue, weakness, difficulty breathing when recumbent, weight gain, and swelling in the lower extremities may indicate:
- Atrial fibrillation
- Heart failure
- Cardiac arrest
- Stroke
Heart failure occurs when the heart is unable to pump sufficient blood to supply the organs with oxygen. Coronary artery disease, hypertension, and diabetes are common causes of heart failure.
- To reduce the risk of heart disease total cholesterol levels should be less than:
- 100 mg/dL
- 60 mg/dL
- 200 mg/dL
- 150 mg/dL
For persons at risk for heart disease, total cholesterol should be <200 mg/dL. LDL cholesterol should be <100 mg/dL and triglycerides <150 mg/dL; HDL cholesterol should be ≥60 mg/dL.
- Which condition has a 95% risk of death?
- Myocardial infarction
- Atrial fibrillation
- Heart failure
- Sudden cardiac arrest
Although immediate defibrillation to restore normal rhythm may be lifesaving, around 90% of persons with sudden cardiac arrest die within minutes.
- Atrial septal defect is:
- A congenital heart defect in which there is a hole between the heart’s two lower chambers
- A congenital heart defect in which there is a hole between the heart’s two upper chambers
- A nonfatal cardiac arrhythmia
- Enlargement of the atria
Atrial septal defect is a congenital heart defect; a hole between the atria allows oxygen-rich blood to pass from the left side of the heart to the right, potentially overloading the pulmonary circulation. Some close spontaneously; others require surgical repair.
- Which of the following groups is not at increased risk of developing endocarditis?
- Patients with artificial heart valve or implanted medical devices in the heart or blood vessels
- Patients with congenital heart defects
- Persons with poor dental hygiene and gum disease
- Persons with elevated cholesterol levels
Endocarditis is an infection of the heart’s lining and valves. Risk factors include artificial valves or implanted devices, congenital heart defects, and poor dental hygiene; elevated cholesterol is not a risk factor.
- Which of the following statement about mitral valve prolapse is false?
- It is generally asymptomatic and requires no treatment
- It affects less than 3% of the population
- It is more common in persons with connective tissue disorders such as Marfan syndrome
- All people with mitral valve prolapse require immediate medical or surgical treatment
Most cases of mitral valve prolapse are benign and asymptomatic. While symptomatic patients may require treatment if significant regurgitation or complications occur, not all patients need immediate intervention.
- The risks associated with stents include all of the following except:
- Blood clot at the stent site
- Rupture of an aneurysm
- Blocked blood flow to the lower body
- Elevated cholesterol or triglyceride levels
An estimated 1%–2% of patients with stents develop a blood clot at the insertion site. There is also risk of aneurysm rupture or distal embolization, but stent placement does not affect cholesterol or triglyceride levels.