Transcript CARDIOVASCULAR DISEASE (CVD) CAN BE “RISKY BUSINESS”.

CARDIOVASCULAR
DISEASE (CVD)
“RISKY BUSINESS”
Rhonda Jones, RN, BSN, CHES, CCM
MESSA Health Promotion Consultant
THE LOSS
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Cardiovascular disease is the leading cause of death in
the United States and is a major cause of disability.
Almost 652,091 people die of heart disease in the U.S.
each year.
Someone dies of a heart attack or a stroke every 33
seconds.
Strokes are the 3rd leading cause of death in the U.S.
The cost of cardiovascular diseases and stroke in the
United States in 2009 is estimated to be………….
$475.3 BILLION
MAKE THE RIGHT
INVESTMENTS IN YOUR HEALTH
TO DECREASE YOUR RISK
FACTORS FOR
HEART DISEASE
$$$$$$$$$$$
BASELINE PORTFOLIO
NON-MODIFYABLE
RISK FACTORS
AGE
Advanced age significantly raises the risk of heart attacks or strokes.
For men, being 45 years or older and for women, being 55 years
or older. This doesn’t mean that younger people are immune.
GENDER
Women develop heart disease about 10 years later in life than men.
This difference is attributed o the protective effects of estrogen
before menopause. Women’s risk rises after menopause, but it
still remains lower than men’s in the same age group. Each year
more women than men have a stroke.
HEREDITY/ETHNICITY
If your parents have heart disease it is more likely that you will
develop it. African-Americans have more severe high blood
pressure than Caucasians and a higher risk of cardiovascular
disease. Risks are also higher for Mexican Americans, American
Indians and Pacific Islanders.
BAD INVESTMENTS
Modifiable risk factors
ABNORMAL CHOLESTEROL
LDL
HDL
TRIGLYCERIDES
>160
low risk
<40
>150
>130
moderate risk
>100
high risk
When there is excess LDL or Triglycerides in the blood it is deposited
in the arteries, causing them to become narrow, preventing
sufficient amounts of blood flow and oxygen. HDL provides for
“reverse cholesterol transport”. Insufficient HDL prevents adequate
amounts of cholesterol from being moved back to the liver and
eventually removed from the body.
BAD INVESTMENTS
Modifiable risk factors
HIGH BLOOD PRESSURE
High blood pressure is a condition when the pressure in the blood
flowing inside the arteries is too high. The high pressure causes the
arteries to become thick and less pliable and the heart muscle
begins to thicken and enlarge resulting in improper function.
BP CLASS
Normal
SYSTOLIC
DIASTOLIC
<120
AND
<80
Prehypertension
(HTN)
120 - 139
OR
80 – 89
Stage 1 HTN
140 - 159
OR
90 – 99
Stage 2 HTN
>160
OR
> 100
BAD INVESTMENTS
Modifiable risk factors
Tobacco Use
Cigarette smoking promotes hardening and narrowing of
the arteries. It increases the levels of blood clotting
factors causing the blood to become thick and sticky
increasing chances of blood clot formation. The carbon
monoxide being inhaled from the cigarette reduces the
amount of oxygen that the blood can carry. Exposure to
secondhand smoke narrows the arteries of non-smokers.
BAD INVESTMENTS
Modifiable risk factors
OBESITY and OVERWEIGHT
Excess weight especially around the waist increases the
work of vital organs. Inactivity and weight gain can
increase insulin resistance in the body’s cells. Insulin
resistance can lead to type II diabetes which is also a
condition that is a risk factor for CHD.
Body Mass Index
Waist Circumference
Underweight- Below 18.5
Women > 35
Normal - 18.5 - 24.9
Overweight - 25.0 - 29.9
Obesity - 30.0 and Above
Men > 40
BAD INVESTMENTS
Modifiable risk factors
PHYSICAL INACTIVITY
Inactivity is when someone sits in a chair more than walking or engaging in
physical activity (AHA). An inactive lifestyle can lead to a decrease in insulin
sensitivity, obesity and overweight. Excess body fat especially around the waist
(central adiposity) increases the work of vital organs. Adipose cells secrete
chemicals that increase systemic inflammation.
STRESS/DEPRESSION
Chronic stress, the type of stress that seems never-ending and inescapable.
Depression sometimes occurs due to a byproduct of cortisol released during
stress acts as a sedative that contributes to feelings of being blue or
depressed.
BAD INVESTMENTS
Modifiable risk factors
Poor Dietary Patterns
Processed food
Saturated fat/Animal fat
Inadequate vegetables/fruit
Excess Alcohol
Atherosclerosis
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Atherosclerosis is the underlying disease process.
Individuals can have atherosclerosis throughout the
arteries of the circulatory system.
When plaque leads to an occlusion of a coronary artery,
a myocardial infarction (MI) occurs.
When an occlusion blocks circulation to the brain, a
cerebral vascular accident (CVA) occurs.
Atherosclerosis in the legs is called peripheral artery
disease (PAD). This results in intermittent claudication,
which is described as pain in the legs when walking.
Atherosclerosis can also weaken part of the aorta and
contribute to abdominal aortic aneurysms (AAA).
HEALTHY ARTERY
A healthy artery consists of 3 layers:
–
1.) Intima
– 2.) Media
– 3.) Adventitia
The Atherosclerotic process
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Low Density Lipoprotein (LDL) particles similarly enter the intima.
Cholesterol in the LDL is modified by oxidation or glycation.
Foam cells are created by a combination of LDL and a type of white blood
cell (WBC) called macrophages.
Foam cells release cytokines prompting an immune response attracting
more WBC.
The accumulation of WBC, including the foams cells, forms the “fatty
streak” within the artery wall. Fatty streaks are the beginning of the
atherosclerotic lesion.
The fatty streaks develop a fibrous cap made up of smooth muscle cells
that originated in the media of the artery. This is now referred to as
plaque.
The Atherosclerotic process
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The process continues with accumulation of smooth muscle cells and
calcium, (causing calcification and hardening of the plaque) resulting
in a complicated lesion.
The artery can become completely occluded by either:
• Continued build-up of plaque
• Fibrous cap bursts, the lipid core enters the lumen and is attacked
as a foreign substance and a thrombus forms and blocks flow of
blood through lumen.
MEDICAL APPROACHES TO
LOWERING RISK
Cholesterol lowering medications
 Blood Pressure lowering medications
 ASA, PLAVIX, ETC
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ALTERNATIVE APPOACHES
Omega 3 Fatty Acids
 Red Yeast Rice
 Co-enzyme Q-10 (ubinque)
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LIFESTYLE APPROACHES
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CARDIOVASCULAR EXERCISE
– Assists with weight lose/maintenance efforts
– Improves cardiovascular endurance by
strengthening heart muscle
– Builds collateral circulation
– Decreases negative effect of stress by way of
beta-endorphin release (elevates mood).
– Improves insulin sensitivity
– Decreases systemic inflammation
LIFESTYLE APPROACHES
– Accumulate a minimum of 30 minutes moderateintensity physical activity, on most and preferably all,
days of the week.
– For weight loss or weight loss maintenance:
accumulate 60 to 90 minutes of moderate-intensity
physical activity.
LIFESTYLE INTERVENTIONS
Healthy Eating Pattern
– High intake of VEGETABLES and fruit.
 Ensure adequate vitamins, antioxidants and
minerals.
– High fiber foods
– Whole grains
– Consume fish at least 2x/week
LIFESTYLE INTERVENTIONS
– Limit saturated fat <7-10%
– Cholesterol <300 mg a day
– No more than 1 drink a day for Women, 2 for
Men.
– Less than 2.3 grams of sodium a day
– Low sugar
– Minimal processed food
LIFESTYLE INTERVENTIONS
Stress Management Techniques
– Optimism
– Laughter
– Altruism
– Hobbies
– Music
LIFESTYLE INTERVENTIONS
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Rhonda’s Remedy for Relief from Stress
– Embrace Your Faith
– Pray/Meditate
– Exercise (get your heart rate up!)
– Exercise some more (GET SWEATY)
– LOVE yourself
– Treat everyone with RESPECT