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## Calculating Coronary Artery Disease Risk

Author(s): Nancy P. Moreno, PhD, Ronald L. McNeel, DrPH, Barbara Z. Tharp, MS, Gregory L. Vogt, EdD, and James P. Denk, MA
• 6-8 9-12
• Length: 60 Minutes

### Overview

Students learn about risk factors for coronary artery disease (CAD) and heart attack, strategies for lowering those risks, and the importance of doing so. They use an interactive online tool from the American Heart Association to calculate the cardiovascular health score for Arturo, Brian and Angela, the three fictitious characters being followed through the Scientific Decision-making unit.

This activity is from the Scientific Decision-Making Teacher's Guide, part of a teaching unit which includes the publication, Scientific Decision-making: Supplementary Activities on the Cardiovascular System.

### Teacher Background

Arturo, Brian and Angela are in the emergency room. By now, students will have surmised that all three may be experiencing some type of heart-related crisis. One condition that may have contributed the three patients’ current health problems is coronary artery disease (CAD). As students discovered in Activity 2, risk is the possibility of damage, injury or other harm. It often is represented as the probability of a negative outcome. Students learned that in the United States, a person has a one-in-six lifetime risk of dying from heart-related illness.

Not everyone has the same risk for CAD or a heart attack, so it is important to understand (1) behaviors that increase the risk for developing heart disease, and (2) which behaviors or other factors can be modified to decrease the risk. Three important risk factors for developing heart disease cannot be modified: gender (sex), age, and heredity (family history and genetics). You cannot control the genes you inherit, and the chances for heart attack increase with age.

However, we can control, to more or less extent, many health factors that influence risk for heart disease. Personal choices about diet, exercise and smoking can affect cholesterol levels, blood pressure, body weight and blood sugar levels. In fact, smoking and diabetes (uncontrolled blood sugar) rank among the most important factors known to increase risk for heart attack. Teenage smoking causes immediate and long-term cardiovascular damage, and smoking into adulthood dramatically increases a person’s chances of dying prematurely. Diabetes interacts with other risk factors, such as high blood pressure, to cause additional harm to the heart and circulatory system. By understanding our personal risks and making lifestyle decisions to lower risks that may be modified, we can take steps, even at an early age, to reduce the chances for CAD or a heart attack.

### Materials and Setup

#### Teacher Materials (See Setup)

• Interactive white board or video projector and computer

• Internet access

• Copies of “Risky Business” activity sheet (one per student)

• Copies of “Heart Disease and Risk Factors” (enough for a classroom set, to be added to each team’s reference folder when the activity is completed)

• Copies of “Patient Information Sheet” (enough for a classroom set, to be added to each team’s reference folder when the activity is completed)

#### Materials per Student

• “Personal Data Sheet” completed in the activity, “Heart: Basic Measurements”

• Copy of “Risky Business” activity sheet

• Copy of the “Patient Information Sheet”

#### Setup

1. Be sure students have their “Personal Data Sheets” from the previous activity. Each student also will require access to his/her own computer, either in a computer lab or the classroom. Students will work individually unless there is a need to share computers.

2. Write the Internet address for My Life Check - Life’s Simple 7 Success Plan on the board or overhead (http://mylifecheck.heart.org/AssessmentTools2/main_en_US.html). It also is possible to access My Life Check - Life’s Simple 7 Success Plan by clicking the “Get Your Assessment” tab at the top of home page for My Life Check (http://mylifecheck.heart.org). This pathway will require each user to register.

3. In a computer lab setting, the first class to conduct the activity should bookmark the link for the classes that follow. If bookmarked, have the students title the bookmark “Heart Score.” At the end of the activity, have students return the reference materials.

### Procedure and Extensions

1. Begin by asking students, Do you think we can change our risks for certain diseases? Allow time for student comments. Alternately, create a T-chart on the board and list risk factors that students believe CAN and CANNOT be changed. Ask, Do you think lifestyle decisions may have made Arturo, Brian or Angela more or less likely to have medical problems? Have students name some of the risk factors for Arturo, Brian, and Angela. Tell students that they are going to learn how these factors impact each character.

2. Make the article, “Heart Disease and Risk Factors,” available for students in the reference folder or notebook. You may want to review this material with the class.

3. Use a interactive white board or computer and projector to access the Internet and demonstrate the American Heart Association’s My Life Check - Life’s Simple 7 Success Plan web site (http://mylifecheck.heart.org/AssessmentTools2/main_en_US.html). As an example, you may want to work through Arturo’s case with students.

4. Provide each student with a copy of the “Patient Information Sheet” and “Risky Business” activity sheet. Explain that the “Patient Information Sheet” includes some of the results from blood tests conducted on each patient while he or she was in the emergency room. As you work through the My Life Check process for Arturo, have students provide the answers for each question. Even if you conduct this as a demonstration, have each student record the scores for Arturo in Table 1.

5. Students should work independently to answer all questions on the “Risky Business” activity sheet.

6. As a final step, have students enter as much of information as possible to compute their own Heart Scores. They can find their blood pressure measurements on their “Personal Data Sheets.” Students should not guess at other information, such as cholesterol. Unless they know the values, students should leave those spaces blank.

7. Discuss students’ answers on the “Risky Business,” sheet. A summary of the risk factors for each character is given in “Character Info” (see sidebar, PDF).

#### Extensions or Homework

Have students visit the Healthy Eating Plate online to learn what constitutes a healthy diet (http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/). Direct students to work in pairs to create menus for meals that would meet the Healthy Eating
Plate guidelines.

• ### Scientific Decision-making

Teacher Guide

Students learn about evidence-based decision-making as they act as health care providers working to solve three patient cases, one of which may be a heart attack. (7 activities)

• ### Scientific Decision-making: Supplementary Activities on the Cardiovascular System

Teacher Guide

Students explore the cardiovascular system, build a model of coronary artery disease, create a poster of a heart attack, and learn about signs and symptoms of a heart attack. (3 activities)

### Agency for Healthcare Research and Quality

AHRQ's Ischemic Heart Disease Products Translated for High School Populations
Grant Number: 1R18HS019248