please see attached doc
After reading chapter 12 and watching the videos in module week 12. Please answer the following questions. Your paper should be double spaced size 12 font. You should write a minimum of 2 pages and a maximum of 3 pages. Please write your response in complete sentences. You must reference at least once where you received your information, Example: ch 12 3.33 or in the video titled obesity author states………
Define Cardiovascular Disease (CVD) in your own words. Name three risk factors for CVD. Do you have any of these risk factors? If so, what lifestyle changes can make to improve your heart health? How can physical activity improve heart health?
Define Diabetes; type 1 and type 2 in your own words. How are they different? How can a person treat type 1 diabetes Vs how does a person treat type 2?
Lastly with most CVD and type 2 diabetes being largely preventable please give your opinion as to why you believe CVD is the # 1 killer in the U.S. and why type 2 diabetes is on the rise in the U.S. What ways can you reduce your chances of developing type 2 diabetes or CVD.
CHAPTER 12: Cardiovascular Disease, Diabetes, and
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood
vessels. Cardiovascular disease includes coronary artery diseases (CAD) such
as angina and myocardial infarction (commonly known as a heart attack). Other
CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart
disease, cardiomyopathy, heart arrhythmia, congenital heart disease, valvular heart
disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic
disease, and venous thrombosis.
The underlying mechanisms vary depending on the disease. Coronary artery
disease, stroke, and peripheral artery disease involve atherosclerosis, which is the
narrowing of the inside of an artery due to the build up of plaque. This may be
caused by high blood pressure, smoking, diabetes, lack of exercise, obesity, high
blood cholesterol, poor diet, and excessive alcohol consumption, among others. High
blood pressure results in 13% of CVD deaths, while tobacco results in 9%, diabetes
6%, lack of exercise 6% and obesity 5%. Rheumatic heart disease may follow
untreated strep throat. It is estimated that 90% of CVD is preventable.
Coronary heart disease (CHD), also commonly referred to as just heart disease, is a
common term for the buildup of plaque in the heart’s arteries that could lead to
heart attack. But is there a difference between coronary heart disease and coronary
artery disease? The short answer is often no — health professionals frequently use
the terms interchangeably. However, coronary heart disease, or CHD, is actually a
result of coronary artery disease, or CAD. With coronary artery disease, plaque first
grows within the walls of the coronary arteries until the blood flow to the heart’s
muscle is limited. View an illustration of coronary arteries below:
The Coronary Arteries are the blood vessels that supply blood to your heart. They
branch off of the aorta at its base. The right coronary artery, the left main coronary, the
left anterior descending, and the left circumflex artery, are the four major coronary
arteries. Blockage of these arteries is a common cause of angina, heart disease, heart
attacks and heart failure.
This restriction of the blood supply to the tissues is also called ischemia. It may be
chronic, narrowing of the coronary artery over time and limiting of the blood supply
to part of the muscle. Or it can be acute, resulting from a sudden rupture of a plaque
and formation of a thrombus or blood clot.
Anatomy of the Cardiovascular System
To fully understand Cardiovascular Diseases, it may be helpful to understand the
anatomy of the cardiovascular system. It includes the following:
o Heart: the pump, divided into four chambers (R/L atria, R/L ventricles)
o Arteries: large vessels carrying oxygen-rich blood away from heart; have
thick, muscular wall
o Arterioles: smaller arteries
o Capillaries: smallest vessels where gas exchange takes place, oxygen is
delivered to tissues and carbon dioxide is carried away
o Veinuoles: smallest veins, which carry carbon dioxide-rich blood, back to
o Veins: biggest vessels that carry carbon dioxide-rich blood back to heart;
have one-way valves to prevent gravity from pulling blood backward (away
o Atria: the collecting chambers of the heart, located on top
o Ventricles: the pumping chambers of the heart, located on the bottom
o Aorta: the largest vessel (artery) in the body; all arteries branch from it
The right side of the heart (right atrium and right ventricle) takes CO2-rich blood
and sends it to the lungs for oxygenation. The left side of the heart (left atrium and
ventricle) takes O2-rich blood and delivers it to the body. The right side is said to be
responsible for pulmonary circulation; the left side is said to be responsible for
systemic circulation. Because of the distances involved, pulmonary circulation is a
relatively low-pressure system, while systemic circulation is a relatively high-
pressure system. In fact, when we measure blood pressure we’re measuring
Heart Disease and Stroke Facts
Heart Disease Facts
• Heart disease is the leading cause of death for both men and women.
• About 610,000 Americans die from heart disease each year—that’s 1 in every
• Coronary heart disease is the most common type of heart disease, killing about
365,000 people in 2014.
• In the United States, someone has a heart attack every 42 seconds. Each
minute, someone in the United States dies from a heart disease-related event.
• Heart disease is the leading cause of death for people of most racial/ethnic
groups in the United States, including African Americans, Hispanics, and whites.
For Asian Americans or Pacific Islanders and American Indians or Alaska
Natives, heart disease is second only to cancer.
• Heart disease costs the United States about $207 billion each year. This total
includes the cost of health care services, medications, and lost productivity.
High blood pressure, high LDL cholesterol, and smoking are key risk factors for
heart disease. About half of Americans (49%) have at least one of these three risk
Several other medical conditions and lifestyle choices can also put people at a higher
risk for heart disease, including:
• Overweight and obesity
• Poor diet
• Physical inactivity
• Excessive alcohol use
• Stroke is the fifth leading cause of death in the United States, killing more
than 130,000 Americans each year—that’s 1 of every 20 deaths.
• A stroke, sometimes called a brain attack, occurs when a clot blocks the blood
supply to the brain or when a blood vessel in the brain bursts.
• Someone in the United States has a stroke every 40 seconds. Every four
minutes, someone dies of stroke.
• Every year, about 795,000 people in the United States have a stroke. About
610,000 of these are first or new strokes; 185,000 are recurrent strokes.
• Stroke is an important cause of disability. Stroke reduces mobility in more
than half of stroke survivors age 65 and over.
• Stroke costs the nation $33 billion annually, including the cost of health care
services, medications, and lost productivity.
• You can’t control some stroke risk factors, like heredity, age, gender, and
ethnicity. Some medical conditions—including high blood pressure, high
cholesterol, heart disease, diabetes, overweight or obesity, and previous
stroke or transient ischemic attack (TIA)—can also raise your stroke risk.
Avoiding smoking and drinking too much alcohol, eating a balanced diet, and
getting exercise are all choices you can make to reduce your risk.
Common Stroke Warning Signs and Symptoms
• Sudden numbness or weakness of the face, arm, or leg—especially on one
side of the body.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance or coordination.
• Sudden severe headache with no known cause.
Coronary Artery Disease (CAD)
Coronary artery disease (CAD) is the most common type of heart disease in the
United States. For some people, the first sign of CAD is a heart attack. Therefore,
taking steps to reduce your risk for CAD is essential.
Research suggests that CAD (also referred to as coronary heart disease, abbreviated
CHD) starts when certain factors damage the inner layers of the coronary arteries.
These factors include:
• High levels of certain fats and cholesterol in the blood
• High blood pressure
• High levels of sugar in the blood due to insulin resistance or diabetes
Causes of CAD
When damage occurs, your body starts a healing process. The healing may cause
plaque to build up where the arteries are damaged. Plaque is made up of deposits of
cholesterol and other substances in the artery. This progression of plaque build up
is called atherosclerosis.
The buildup of plaque in the coronary arteries may start in childhood. Over time,
plaque can narrow or block some of your coronary arteries. This reduces the flow of
oxygen-rich blood to your heart muscle.
Eventually, an area of plaque can rupture (break open). If this happens, blood cell
fragments called platelets will stick to the site of the injury and may clump together
to form blood clots. Blood clots narrow the coronary arteries even more and worsen
angina (chest discomfort or pain) or cause a heart attack.
Over time, CAD can weaken the heart muscle. This may lead to heart failure, a
serious condition where the heart can’t pump blood the way that it should. An
irregular heartbeat, or arrhythmia, also can develop.
Other Conditions Related to Heart Disease
Coronary artery disease is the most common type of heart disease, but there are
many other conditions that affect the heart:
• Acute coronary syndrome is a term that includes heart attack and unstable
• Angina, a symptom of coronary artery disease, is chest pain or discomfort that
occurs when the heart muscle is not getting enough blood. Angina may feel like
pressure or a squeezing pain in the chest. The pain also may occur in the
shoulders, arms, neck, jaw, or back. It may feel like indigestion. There are two
forms of angina—stable or unstable:
o Stable angina happens during physical activity or under mental or
o Unstable angina is chest pain that occurs even while at rest, without
apparent reason. This type of angina is a medical emergency.
• Aortic aneurysm and dissection are conditions that can affect the aorta, the
major artery that carries blood from the heart to the body. An aneurysm is an
enlargement in the aorta that can rupture or burst. A dissection is a tear in the
aorta. Both of these conditions are medical emergencies.
• Arrhythmias are irregular or unusually fast or slow heartbeats. Arrhythmias
can be serious. One example is called ventricular fibrillation. This type of
arrhythmia causes an abnormal heart rhythm that leads to death unless treated
right away with an electrical shock to the heart (called defibrillation). Other
arrhythmias are less severe but can develop into more serious conditions, such
as atrial fibrillation, which can cause a stroke.
• Atherosclerosis occurs when plaque builds up in the arteries that supply blood
to the heart (called coronary arteries). Plaque is made up of cholesterol
deposits. Plaque buildup causes arteries to narrow over time.
• Atrial fibrillation is a type of arrhythmia that can cause rapid, irregular
beating of the heart’s upper chambers. Blood may pool and clot inside the heart,
increasing the risk for heart attack and stroke.
• Cardiomyopathy occurs when the heart muscle becomes enlarged or stiff. This
can lead to inadequate heart pumping (or weak heart pump) or other problems.
Cardiomyopathy has many causes, including family history of the disease, prior
heart attacks, uncontrolled high blood pressure, and viral or bacterial
• Congenital heart defects are problems with the heart that are present at birth.
They are the most common type of major birth defect. Examples include
abnormal heart valves or holes in the heart’s walls that divide the heart’s
chambers. Congenital heart defects range from minor to severe.
• Heart failure is often called congestive heart failure because of fluid buildup in
the lungs, liver, gastrointestinal tract, and the arms and legs. Heart failure is a
serious condition that occurs when the heart can’t pump enough blood to meet
the body’s needs. It does not mean that the heart has stopped but that muscle is
too weak to pump enough blood. The majority of heart failure cases are chronic,
or long-term heart failures.
• The only cure for heart failure is a heart transplant. However, heart failure can
be managed with medications or medical procedures.
• Peripheral arterial disease (PAD) occurs when the arteries that supply blood
to the arms and legs (the periphery) become narrow or stiff. PAD usually results
from atherosclerosis, the buildup of plaque and narrowing of the arteries. With
this condition, blood flow and oxygen to the arm and leg muscles are low or
even fully blocked. Signs and symptoms include leg pain, numbness, and
swelling in the ankles and feet.
• Rheumatic heart disease is damage to the heart valves caused by a bacterial
(streptococcal) infection called rheumatic fever.
Risk Factors for Coronary Heart Disease
Coronary heart disease risk factors are conditions or habits that raise your risk
of coronary heart disease (CHD) and heart attack. These risk factors also increase
the chance that existing CHD will worsen.
There are many known CHD risk factors. You can control some risk factors, but not
others. Risk factors you can control include:
• High blood cholesterol and triglyceride levels (a type of fat found in the
• High blood pressure
• Diabetes and prediabetes
• Overweight and obesity
• Lack of physical activity
• Unhealthy diet
The risk factors you can’t control are age, gender, and family history of CHD.
Many people have at least one CHD risk factor. Your risk of CHD and heart attack
increases with the number of risk factors you have and their severity. Also, some
risk factors put you at greater risk of CHD and heart attack than others. Examples of
these risk factors include smoking and diabetes. Many risk factors for coronary
heart disease start during childhood. This is even more common now because many
children are overweight and don’t get enough physical activity. Researchers
continue to study and learn more about CHD risk factors.
Section 12.1 Stroke
A stroke is a medical condition in which poor blood flow to the brain results in cell
death. This results in part of the brain not functioning properly. The main types of
• Ischemic stroke.
• Hemorrhagic stroke.
• Transient ischemic attack (a warning or “mini-stroke”).
Most strokes (85%) are ischemic strokes. If you have an ischemic stroke, the artery
that supplies oxygen-rich blood to the brain becomes blocked.
Blood clots often cause the blockages that lead to ischemic strokes.
A hemorrhagic stroke occurs when an artery in the brain leaks blood or ruptures
(breaks open). The leaked blood puts too much pressure on brain cells, which
High blood pressure and aneurysms—balloon-like bulges in an artery that can
stretch and burst—are examples of conditions that can cause a hemorrhagic stroke.
There are two types of hemorrhagic strokes:
• Intracerebral hemorrhage is the most common type of hemorrhagic stroke.
It occurs when an artery in the brain bursts, flooding the surrounding tissue
• Subarachnoid hemorrhage is a less common type of hemorrhagic stroke. It
refers to bleeding in the area between the brain and the thin tissues that
Transient Ischemic Attack (TIA)
A transient ischemic attack (TIA) is sometimes called a “mini-stroke.” It is different
from the major types of stroke because blood flow to the brain is blocked for only a
short time—usually no more than 5 minutes.
It is important to know that:
• A TIA is a warning sign of a future stroke.
• A TIA is a medical emergency, just like a major stroke.
• Strokes and TIAs require emergency care. Call 9-1-1 right away if you feel
signs of a stroke or see symptoms in someone around you.
• There is no way to know in the beginning whether symptoms are from a TIA
or from a major type of stroke.
• Like ischemic strokes, blood clots often cause TIAs.
• More than a third of people who have a TIA end up having a major stroke
within 1 year if they don’t receive treatment, and 10%-15% will have a major
stroke within 3 months of a TIA.
A health care team can usually find the cause and take steps to prevent a major
stroke. Recognizing and treating TIAs can reduce the risk of a major stroke.
Recognizing a Stroke – Think FAST!
During a stroke, every minute counts! Fast treatment can lessen the brain damage
that stroke can cause. By knowing the signs and symptoms of stroke, you can take
quick action and perhaps save a life—maybe even your own.
Signs of Stroke in Men and Women
• Sudden numbness or weakness in the face, arm, or leg, especially on one
side of the body
• Sudden confusion, trouble speaking, or difficulty understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance, or lack of coordination
• Sudden severe headache with no known cause
Call 9-1-1 right away if you or someone else has any of these symptoms.
Acting F.A.S.T. can help stroke patients get the treatments they desperately need.
The stroke treatments that work best are available only if the stroke is recognized
and diagnosed within 3 hours of the first symptoms. Stroke patients may not be
eligible for these if they don’t arrive at the hospital in time.
If you think someone may be having a stroke, act F.A.S.T. and do the following
F—Face: Ask the person to smile. Does one side of the face droop?
A—Arms: Ask the person to raise both arms. Does one arm drift downward?
S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or
T—Time: If you see any of these signs, call 9-1-1 right away.
Note the time when any symptoms first appear. This information helps health
care providers determine the best treatment for each person. Do not drive to the
hospital or let someone else drive you. Call an ambulance so that medical personnel
can begin life-saving treatment on the way to the emergency room.
Section 12.2 Metabolic Syndrome
Metabolic syndrome is the name for a group of risk factors that raises your risk for
heart disease and other health problems, such as diabetes and stroke.
The term “metabolic” refers to the biochemical processes involved in the body’s
normal functioning. Risk factors are traits, conditions, or habits that increase your
chance of developing a disease.
In this article, “heart disease” refers to coronary heart disease (CHD). CHD (also
called coronary artery disease, abbreviated CAD) is a condition in which a waxy
substance called plaque builds up inside the coronary (heart) arteries.
Plaque hardens and narrows the arteries, reducing blood flow to your heart muscle.
This can lead to chest pain, a heart attack, heart damage, or even death.
Metabolic Risk Factors
The five conditions described below are metabolic risk factors. You can have any
one of these risk factors by itself, but they tend to occur together. You must have at
least three metabolic risk factors to be diagnosed with metabolic syndrome.
A Large Waistline
Having a large waistline means that you carry excess weight around your waist
(abdominal obesity). This is also called having an “apple-shaped” figure. Your doctor
will measure your waist to find out whether you have a large waistline.
A waist measurement of 35 inches or more for women or 40 inches or more
for men is a metabolic risk factor. A large waistline means you’re at increased risk
for heart disease and other health problems.
A High Triglyceride Level
Triglycerides are a type of fat found in the blood. A triglyceride level of 150
mg/dL or higher (or being on medicine to treat high triglycerides) is a metabolic
risk factor. (The mg/dL is milligrams per deciliter—the units used to measure
triglycerides, cholesterol, and blood sugar.)
A Low HDL Cholesterol Level
HDL cholesterol sometimes is called “good” cholesterol. This is because it helps
remove cholesterol from your arteries.
An HDL cholesterol level of less than 50 mg/dL for women and less than 40
mg/dL for men (or being on medicine to treat low HDL cholesterol) is a metabolic
High Blood Pressure
A blood pressure of 130/85 mmHg or higher (or being on medicine to treat high
blood pressure) is a metabolic risk factor. (The mmHg is millimeters of mercury—
the units used to measure blood pressure.)
If only one of your two blood pressure numbers is high, you’re still at risk for
High Fasting Blood Sugar
A normal fasting blood sugar level is less than 100 mg/dL. A fasting blood sugar
level between 100–125 mg/dL is considered prediabetes. A fasting blood sugar level
of 126 mg/dL or higher is considered diabetes.
A fasting blood sugar level of 100 mg/dL or higher (or being on medicine to treat
high blood sugar) is a metabolic risk factor.
About 85 percent of people who have type 2 diabetes—the most common type of
diabetes—also have metabolic syndrome. These people have a much higher risk for
heart disease than the 15 percent of people who have type 2 diabetes without
What Is Cholesterol?
To understand high blood cholesterol, it helps to learn about cholesterol.
Cholesterol is a waxy, fat-like substance that’s found in all cells of the body. Your
body needs some cholesterol to make hormones, vitamin D, and substances that
help you digest foods. Your body makes all the cholesterol it needs. However,
cholesterol also is found in some of the foods you eat. Cholesterol travels through
your bloodstream in small packages called lipoproteins. These packages are made of
fat (lipid) on the inside and proteins on the outside.
Two kinds of lipoproteins carry cholesterol throughout your body: low-density
lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of
both types of lipoproteins is important.
LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a
buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood
from your heart to your body.)
HDL cholesterol sometimes is called “good” cholesterol. This is because it carries
cholesterol from other parts of your body back to your liver. Your liver removes the
cholesterol from your body.
What Is High Blood Cholesterol?
High blood cholesterol is a condition in which you have too much cholesterol in your
blood. By itself, the condition usually has no signs or symptoms. Thus, many people
don’t know that their cholesterol levels are too high.
People who have high blood cholesterol have a greater chance of getting coronary
heart disease, also called coronary artery disease. (In this article, the term “heart
disease” refers to coronary heart disease.) The higher the level of LDL cholesterol in
your blood, the GREATER your chance is of getting heart disease. The higher the
level of HDL cholesterol in your blood, the LOWER your chance is of getting heart
Coronary heart disease is a condition in which plaque builds up inside the coronary
(heart) arteries. Plaque is made up of cholesterol, fat, calcium, and other substances
found in the blood. When plaque builds up in the arteries, the condition is called
What Causes High Blood Cholesterol?
Many factors can affect the cholesterol levels in your blood. You can control some
factors, but not others.
Factors You Can Control
Cholesterol is found in foods that come from animal sources, such as egg yolks,
meat, and cheese. Some foods have fats that raise your cholesterol level.
For example, saturated fat raises your low-density lipoprotein (LDL)
cholesterol level more than anything else in your diet. Saturated fat is found in
some meats, dairy products, chocolate, baked goods, and deep-fried and processed
Trans fatty acids (trans fats) raise your LDL cholesterol and lower your high-density
lipoprotein (HDL) cholesterol. Trans fats are made when hydrogen is added to
vegetable oil to harden it. Trans fats are found in some fried and processed foods.
Limiting foods with cholesterol, saturated fat, and trans fats can help you control
your cholesterol levels.
Physical Activity and Weight
Lack of physical activity can lead to weight gain. Being overweight tends to raise
your LDL level, lower your HDL level, and increase your total cholesterol level.
(Total cholesterol is a measure of the total amount of cholesterol in your blood,
including LDL and HDL.) Routine physical activity can help you lose weight and
lower your LDL cholesterol. Being physically active also can help you raise your HDL
Factors You Can’t Control
High blood cholesterol can run in families. An inherited condition called familial
hypercholesterolemia causes very high LDL cholesterol. (“Inherited” means the
condition is passed from parents to children through genes.) This condition begins
at birth, and it may cause a heart attack at an early age.
Age and Sex
Starting at puberty, men often have lower levels of HDL cholesterol than women. As
women and men age, their LDL cholesterol levels often rise. Before age 55, women
usually have lower LDL cholesterol levels than men. However, after age 55, women
can have higher LDL levels than men.
How Is High Blood Cholesterol Diagnosed?
Your doctor will diagnose high blood cholesterol by checking the cholesterol levels
in your blood. A blood test called a lipoprotein panel can measure your cholesterol
levels. Before the test, you’ll need to fast (not eat or drink anything but water) for 9
to 12 hours.
The lipoprotein panel will give your doctor information about your:
• Total cholesterol. Total cholesterol is a measure of the total amount of
cholesterol in your blood, including low-density lipoprotein (LDL)
cholesterol and high-density lipoprotein (HDL) cholesterol.
• LDL cholesterol. LDL, or “bad,” cholesterol is the main source of cholesterol
buildup and blockages in the arteries.
• HDL cholesterol. HDL, or “good,” cholesterol helps remove cholesterol from
• Triglycerides (tri-GLIH-seh-rides). Triglycerides are a type of fat found in
your blood. Some studies suggest that a high level of triglycerides in the
blood may raise the risk of coronary heart disease, especially in women.
If it’s not possible to have a lipoprotein panel, knowing your total cholesterol and
HDL cholesterol can give you a general idea about your cholesterol levels.
Testing for total and HDL cholesterol does not require fasting. If your total
cholesterol is 200 mg/dL or more, or if your HDL cholesterol is less than 40 mg/dL,
your doctor will likely recommend that you have a lipoprotein panel. (Cholesterol is
measured as milligrams (mg) of cholesterol per deciliter (dL) of blood.)
The tables below show total, LDL, and HDL cholesterol levels and their
corresponding categories. See how your cholesterol numbers compare to the
numbers in the tables below.
Total Cholesterol Level Total Cholesterol Category
Less than 200 mg/dL Desirable
200–239 mg/dL Borderline high
240 mg/dL and higher High
LDL Cholesterol Level LDL Cholesterol Category
Less than 100 mg/dL Optimal
100–129 mg/dL Near optimal/above optimal
130–159 mg/dL Borderline high
160–189 mg/dL High
190 mg/dL and higher Very high
HDL Cholesterol Level HDL Cholesterol Category
Less than 40 mg/dL A major risk factor for heart disease
40–59 mg/dL The higher, the better
60 mg/dL and higher Considered protective against heart disease
Triglycerides also can raise your risk for heart disease. If your triglyceride level is
borderline high (150–199 mg/dL) or high (200 mg/dL or higher), you may need
How Is High Blood Cholesterol Treated?
High blood cholesterol is treated with lifestyle changes and medicines. The main
goal of treatment is to lower your low-density lipoprotein (LDL) cholesterol level
enough to reduce your risk for coronary heart disease, heart attack, and other
related health problems.
Your risk for heart disease and heart attack goes up as your LDL cholesterol level
rises and your number of heart disease risk factors increases.
Some people are at high risk for heart attacks because they already have heart
disease. Other people are at high risk for heart disease because they have diabetes
or more than one heart disease risk factor.
Talk with your doctor about lowering your cholesterol and your risk for heart
disease. Also, check the list to find out whether you have risk factors that affect your
LDL cholesterol goal:
• Cigarette smoking
• High blood pressure (140/90 mmHg or higher), or you’re on medicine to
treat high blood pressure
• Low high-density lipoprotein (HDL) cholesterol (less than 40 mg/dL)