Environmental Determinants of Cardiovascular DiseaseLinks to an external site.
Taking Action for Circulatory Health and Sustainable DevelopmentLinks to an external site.
For this discussion, you are assigned a case scenario based on the first initial of your last name (see table below). Based on your assigned topic, create an initial discussion post that is a minimum of 250 words and addresses the topics listed below in the table. All referenced materials must include citations and references in APA format. Please see directions for including APA Style elements on these Writing Center pages: APA: Citing Within Your PaperLinks to an external site. and Formatting Your References ListLinks to an external site..
Patient D:
Althea—Thea—is a 67-year-old female who is a retired nurse and widowed. Thea is 5′8″and weighs 192 pounds. Her weight is evenly distributed. Thea smokes and drinks heavily, though very few people know how much alcohol she consumes. Her husband died three years ago from pancreatic cancer. She has two children who are in their 40s. One of her children died from leukemia five years ago.
Thea lives in a 200-unit independent-living senior apartment building. She moved in two years ago after selling the house she and her husband lived in for 42 years. Thea gets little to no physical activity. She spends most of her day watching television or playing games online. She does not actively engage with her neighbors and she has a very limited social life. Her children have busy lives with their careers and family, so they see her once every few months. Her weekly outings are usually to the grocery store. She rarely goes anywhere else .
In your discussion,
Describe the genetic, lifestyle, and cultural-social risk factors in the assigned scenario. Explain how these increase the risk of cardiovascular and respiratory disorders.
Discuss environmental factors that increase the risk of cardiovascular disease as identified in the scenario.
Identify at least two environmental factors that contribute to the onset of disease processes described in the scenario.
Discuss how the environmental factors change the system function leading to cardiovascular disease.
Sample Answer
Case Study Analysis: Thea
Based on the case of Thea, a 67-year-old retired nurse, several genetic, lifestyle, and cultural-social risk factors significantly increase her risk of cardiovascular and respiratory disorders.
Genetic, Lifestyle, and Cultural-Social Risk Factors
From a genetic standpoint, Thea's family history is concerning. Her husband died of pancreatic cancer and one of her children died from leukemia. While these are not directly linked to cardiovascular disease (CVD), they point to a potential genetic predisposition to certain diseases, which can sometimes co-exist with or exacerbate other health conditions. It is also important to note that the loss of her loved ones likely contributes to her emotional and mental state.
Her lifestyle risk factors are significant and highly detrimental. Her weight, at 192 pounds and a height of 5'8", places her in an overweight category, which is a major risk factor for hypertension, diabetes, and high cholesterol—all precursors to CVD. Thea's heavy smoking and drinking are two of the most critical risk factors. Smoking damages the lining of blood vessels, leading to atherosclerosis and increasing the risk of heart attack and stroke. It also causes chronic obstructive pulmonary disease (COPD) and other respiratory illnesses. Heavy alcohol consumption can lead to high blood pressure, cardiomyopathy, and stroke. Her sedentary lifestyle, spending most of her day watching television or playing games online, further increases her risk of obesity and related metabolic disorders. This lack of physical activity weakens the heart muscle and reduces cardiovascular fitness.
The cultural-social factors are also pronounced. Thea is widowed and has a very limited social life. Her children see her infrequently, and she does not engage with her neighbors. This social isolation and lack of social support can lead to chronic stress, anxiety, and depression. These mental health conditions are increasingly recognized as independent risk factors for CVD, as they can lead to an increase in cortisol and other stress hormones, which contribute to inflammation and heart strain (American Heart Association, 2017).
Environmental Factors Increasing Risk
While Thea's personal habits are the primary drivers of her risk, her environment also plays a role. The two key environmental factors that contribute to her health risks are:
The built environment and lack of access to exercise: Although she lives in an independent-living senior apartment building, the scenario suggests a lack of facilities or a personal inclination towards physical activity. Her weekly trips are only to the grocery store, indicating a limited sphere of mobility. A neighborhood or living situation that promotes walking, social interaction, and outdoor activity would encourage a healthier lifestyle.
Indoor air quality: As a heavy smoker, Thea's living space is likely filled with secondhand smoke, which exposes her to a multitude of toxins that contribute to respiratory disease and heart conditions. Even in an independent-living building, the indoor air can be a source of pollutants that exacerbate her health issues.
How Environmental Factors Change System Function
These environmental factors alter the body's system function in ways that lead to CVD. A sedentary environment and lack of physical activity lead to a deconditioning of the cardiovascular system. The heart muscle becomes weaker, blood circulation is less efficient, and the body's ability to regulate blood sugar and lipids is impaired. This contributes to the buildup of plaque in arteries, a process known as atherosclerosis, which is the root cause of many cardiovascular events.
Furthermore, exposure to indoor air pollutants, specifically from smoking, introduces fine particulate matter and other toxins into the respiratory system. These particles can pass from the lungs into the bloodstream, where they cause inflammation and oxidative stress to the blood vessels. This continuous inflammation damages the endothelium—the inner lining of the blood vessels—making it more susceptible to plaque formation and leading to hypertension and a higher risk of blood clots. In essence, the environmental factors create a perfect storm of systemic inflammation and physiological dysfunction that directly contributes to the onset and progression of cardiovascular disease.