Transcript Heart Disease Primer Part 2

What is Heart Disease?
• Changes in the blood vessels leading to
Angina (heart pain), Heart Attack, CHF, A
Fib, Heart Block, Arrythmia.
Non-modifiable Risk Factors for
HD
•
•
•
•
Gender
Age
Family History
Race
Symptoms of Heart Disease
• Angina--pain caused by reduced blood flow to
the heart through the heart’s own blood vessels.
• Location--chest, near sternum (and anywhere
from jaw/teeth, between shoulder blades, down
arm to fingers.
• Character--pressure, tight, heavy, constricting,
heavy or burning. May include SOB, faintness,
nausea, sense of impending doom
Symptoms of Heart Disease
• Duration--Brief--usually less than 5
minutes.
• Exacerbating Factors--Worse with
exertion, emotional stress, brought on by
heavy meal or present first thing in the AM
• Women have a higher chance of having
few symptoms.
Silent Killer
• Studies show that
silent ischemia is
more common than
symptomatic
ischemia. HD usually
develops for many
years before
symptoms are
noticed.
Moderate Atherosclerosis
Saturated fats result in high
cholesterol and clogging of arteries
as seen above.
What are the types of
cholesterol?
Cholesterol
HDL
LDL
Unsaturated Fats and Health
• Unsaturated fats are essential to health and
when used moderately:
– Reduce blood cholesterol levels
– Help maintain HDL levels
– Are protective against heart disease and stroke
• Unsaturated fats are found mostly in plants,
primarily in the seeds
– Polyunsaturated fats
– Monounsaturated fats
Saturated Fats and Health
• Saturated fats come mostly from animal fats and
all cholesterol is from animal sources
• Diets low in saturated fats and cholesterol help
reduce the risk for:
– Heart disease
– High blood pressure
– Certain cancers
• Bowel, prostate, and breast cancer
– Obesity
Trans Fats and Health
• Recently it’s been discovered that “trans” fatty
acids are also damaging to the body
• Trans fats come from hydrogenating vegetable
oils
• Primary sources include:
–
–
–
–
Hard stick margarine
Vegetable shortenings
Most baked goods and deep fried foods
Processed foods (to increase shelf life)
Summary
We observed positive associations between the
incidence of coronary heart disease and the
intake of:
1. Saturated fat (p=0.10)
2. Trans unsaturated fat (p<0.001)
And an inverse associations with:
1. Monounsaturated fat (p=0.05)
2. Polyunsaturated fat (p=0.003)
NEJM, Nov. 20, ‘97
What can I do to reduce my
risk?
How does risk reduction
work?
Reduce My Cholesterol Levels
• High Cholesterol-- Increases risk--recommended
blood levels reduced for those at higher risk.
• Managing diet is key to reducing cholesterol.
• Increased fruit and vegetables, reduced meat
and dairy. (Reduces saturated fats)
• Medications
Fat Choices
• The goal for good health is not to eliminate
all fats but rather eat less of those that are
damaging to the body:
– Saturated fats
– Trans fats
• And eat moderately of healthier fats:
– Vegetable oil (unhydrogenated)
– And plant foods containing healthy fats:
• Nuts, seeds, olives, avocado, flax meal,
soy, and others
Stop Smoking
• One year after quitting,
the risk of MI decreases
by half. After several
years it approaches that
of the non-smoker.
• Quitting is difficult, seek
support
• No smoking, one of 4
health behaviors resulting
in a four-fold decreased
risk of dying (14 years
younger) per EPIC Study.
Control My Blood Pressure
• Blood Pressure-Studies show even
slight elevation
increases risk. 120/80
or lower.
• Pre-hypertension
associated with
increased risk.
Control my Blood Pressure
• There is evidence that
prehypertensives who
practice weight loss,
exercise and salt
restriction have
significantly reduced rate
of developing
hypertension.
• Ways to control blood
pressure? Medication,
Salt restriction, Exercise,
Dietary Changes, Weight
loss
Become more physically active.
• Studies show, the greater the degree of physical
activity the lower the risk of coronary events. You
can reduce your risk of dying by exercising daily!
• Minimum recommended exercise to accrue
health benefits is 20 minutes 4-6 times per week
of brisk walking as indicated by breathlessness,
fatigue, sweating.
Control my weight.
• Obesity--raises risk for heart disease--raises BP.
• Framingham and Nurses Health Study showed
that increased BMI increased risk of heart
disease.
• Distribution is important--abdominal obesity=
greater risk.
• Diet and exercise are key to controlling weight.
Manage my blood sugar levels.
• Increased blood glucose levels are
associated with increased risk.
• Keeping blood sugar levels well-controlled
reduces risk of cardiovascular disease in
those with both Type 1 and Type 2
Diabetes.
Eat a nutritious diet
• I can affect many of the previous risk reducers
(BP, Weight loss, Cholesterol) by eating a
healthy diet.
• Increased fruits and veggies in diet = EPIC
Study one of 4 factors that reduced mortality.
• Vegetarian Diet--Avoiding meat and dairy,
reduces dietary cholesterol and saturated fat.
Helps with weight control. 25% reduced risk of
dying of heart dz for vegetarians.
Eat a nutritious diet
• Whole grains--increases
fiber intake
• High fiber intake
associated with 40-50%
reduction in the risk of
HD compared with low
fiber intake (JAMA 1999).
• Oats and Barley--soluble
fiber decreases
cholesterol
Whole Grains
• What are whole grains?
Dark breads (not
molasses), whole grains
on label, breakfast
cereals, oatmeal,
popcorn, brown rice,
bran.
• What are NOT whole
grains? White bread,
refined breakfast cereal,
pasta, muffins, white rice,
pancakes, pizza
Eating a nutritious diet
• Nuts--Frequent consumption of nuts (5
times per week) associated with 50% risk
reduction of HD.
• Don’t forget to drink water--6 or more
glasses a day also associated with almost
50% reduction.
Diet Factors in Heart Disease
• Even one soda per day increases your risk of developing
metabolic syndrome by about 50%," says
Ramachandran Vasan, MD, professor of medicine at
Boston University School of Medicine and the senior
author of the study, published in the July 31 issue of the
American Heart Association's journal Circulation.
• Metabolic syndrome-a large waistline, elevated blood
pressure, elevated fasting blood sugar, elevated fasting
triglycerides, or reduced HDL or "good" cholesterol.
Chocolate and heart disease
•
•
•
•
Antioxidant effect
Very small amounts
Dark chocolate
Large amounts associated with weight
gain and increased risk for heart disease.
Red wine and heart disease
• Increased risk hypertension, obesity,
stroke, breast cancer, suicide and
accidents.
• Risk of 1:6 becoming an alcoholic.
• American Heart Association
recommends abstaining from alcohol.
Red wine and heart disease
• Studies are controversial.
• A diet high in fruits and vegetables
• Antioxidants found in red wine called flavonoids (which are
also found in other foods such as grapes and red grape
juice)
• More physical activity in countries that drink wine regularly
• Resveratrol-helped in rats not people.
• No study with just alcohol.
How it all works together…
• Healthy lifestyle can contribute to risk reduction
through many different risk factors for heart
disease.
• It reduces risk for a multiple other conditions.
• Other benefits? Increased energy, new
experiences.
• Role modeling--what habits do you want to
model for your kids, grandkids.
OK, I’m convinced…How do I
really make these changes?
• Set small goals.
• Establish rewards for yourself. (Don’t Shoot the
Dog)
• Find a partner or a team.
• Remember, progress is a spiral.
• When you miss the mark, assess the situation,
learn from it and keep moving.
• Enlist God’s help. None of us can make longlasting change on our own.
Words of Wisdom
The grains, with fruits, nuts,
and vegetables, contain all the
nutritive properties necessary to
make good blood. These elements
are not so well or so fully supplied
by a flesh diet. Had the use of flesh
been essential to health and
strength, animal food would have
been included in the diet appointed
man in the beginning. {MH 316.2}
A merry heart maketh a cheerful
countenance: but by sorrow of the
heart the spirit is broken.
Proverbs 15:3