Transcript Cholesterol, blood pressure, and heart disease

Cholesterol, blood pressure,
and heart disease
By Melissa Bess
Nutrition and Health Education
Specialist
University of Missouri Extension
FNEP STAFF TRAINING ONLY, DO NOT USE
WITH FNEP PARTICIPANTS
06/2007
Introduction
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About cholesterol
LDL vs. HDL
Triglycerides
Healthy levels
Common misconceptions
What affects cholesterol?
Why does it matter?
Prevention of high cholesterol
Introduction (continued)
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About blood pressure
Common misconceptions
Controlling high blood pressure
Heart disease risk factors
About cholesterol
• Soft, fat-like, waxy substance
• Bloodstream and cells
• Needed for cell membranes and
hormones and to make vitamin D
• Comes from 2 sources
– Body produces it (mostly genetic) in liver
(1000 mg day)
– Food sources (animal products – meats,
poultry, fish, eggs, butter, whole milk, and
cheese, not from plant sources) (100 – 500
mg day)
– Foods with trans fats or saturated fats may
cause the body to produce more
cholesterol
About cholesterol
• Must be transported through
blood
• Carriers are called lipoproteins
– Low-density lipoprotein (LDL)
– High-density lipoprotein (HDL)
• Lipoprotein = protein + fat
– LDL, more fat, less protein
– HDL, more protein, less fat
LDL vs. HDL
• LDL = “bad”
• Too much can clog arteries by
forming plaque
• Atherosclerosis can cause heart
attack or stroke
LDL vs. HDL
• HDL = “good”
• Tends to carry cholesterol away
from arteries and back to liver
• May also remove excess
cholesterol from plaque in
arteries, slows buildup
Triglycerides
• Form of fat
• Also made in body (body fat
stored as triglyceride) and from
food
• Help transport dietary fat,
metabolism
• Trigger liver to make more
cholesterol, rising LDL and total
cholesterol
Healthy Levels
• Total cholesterol
– Optimal – under 200 mg/dL
– Borderline high risk – 200-239 mg/dL
– High risk – 240 mg/dL and up
• LDL
– Optimal – less than 100 mg/dL
– Near/Above optimal – 100-129 mg/dL
– Borderline high – 130- 159 mg/dL
– High – 160 – 189 mg/dL
– Very high – 190 mg/dL
Source: National Cholesterol Education Program, National Heart,
Lung, and Blood Institute
Healthy Levels
• HDL
– Low - less than 40 mg/dL
– High – above 60 mg/dL (may lower
risk for heart disease)
– Women tend to have higher HDL due
to estrogen (needs to be over 50
mg/dL)
• Triglycerides
– Normal – less than 150 mg/dL
– Borderline high – 150 – 199 mg/dL
– High – above 200 mg/dL
Source: National Cholesterol Education Program, National Heart, Lung, and Blood
Institute
Common misconceptions
• Using margarine instead of butter
will help lower my cholesterol
• Thin people don’t have to worry
about high cholesterol
• If a label lists no cholesterol, it’s a
“heart-healthy” choice
• Eggs – good or bad?
• Women don’t need to worry about
cholesterol
• Only middle-aged people should
have their cholesterol checked
What affects cholesterol?
• Diet
– Poly and monounsaturated fats may help
lower cholesterol when used in place of
saturated fats, but still limit
– High carbs, excessive alcohol may
increase triglycerides
– Soluble fiber may lower LDL, not HDL
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Weight
Physical activity
Age
Gender
Heredity
Why does it matter?
• Coronary heart disease is caused
by atherosclerosis
• Single leading cause of death
• The higher LDL you have plus risk
factors increases risk for heart
attack
– Smoking
– High Blood pressure
– Low HDL
– Family history of early heart disease
– Age
Prevention of high cholesterol
• Get it checked
• Watch fats, eat healthy
• Consume less than 300 mg of
cholesterol a day
• Be active
• Quit smoking
• Some may need medication
– Lipitor, Crestor, Zocor
– Vytorin
– Zetia
Blood pressure
• 1 in 3 adults has hypertension
• No symptoms, nearly 1/3 of those
people don’t know they have it
• No known cause
• 2 forces
– Blood pumps to arteries and through
circulatory system
– Arteries resist blood flow
• Arteries elastic, stretchy
• Heart beats 60-80 times a minute
Blood pressure
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Systolic (top) – heart is beating
Diastolic (bottom) – heart resting
Normal – 120/80 mm Hg
Pre-hypertensive – 120-139/80-89 mm
Hg
Hypertensive – 140/90 mm Hg
May take several readings
“White coat hypertension”
Hypertension increases risk for heart
disease and stroke
Number 1 controllable risk factor for
stroke
Blood pressure
• Sodium/salt
– Holds excess fluid in body, heart has
to work harder
• Potassium
– Blunts effects of salt on blood
pressure
Common misconceptions
• Symptoms of high blood pressure
include nervousness, sweating,
and difficulty sleeping
• High cholesterol = high blood
pressure
• Everyone has high blood
pressure, I don’t need to worry
• Women don’t need to worry about
high blood pressure
Controlling hypertension
• Reduce fat (particularly saturated
fat)
• Stop smoking
• Cut back on alcohol
• Be active
• May need medication
• Stress management
Heart disease risk factors
• Uncontrollable
– Age
– Male gender
– Heredity (including race) – African
Americans = higher blood pressure.
Also higher among other races
• Controllable
– Smoking (2-4x higher than nonsmokers)
– High cholesterol (high HDL can be
positive risk factor)
– High blood pressure
Heart disease risk factors
• Controllable
– Physical inactivity
– Obesity/overweight (especially in
abdominal area)
– Diabetes
• Other factors
– Stress
– Too much alcohol
• Moderate drinkers = less risk than nondrinkers (may increase HDL cholesterol)
Phytonutrients
• Soy protein may reduce risk of heart
disease
– Especially when replacing foods high in
saturated fat
• Plant sterols/stanols
– Found naturally in fruits/veggies, plant oils
may lower LDL
• Omega-3 fatty acids
– Two weekly servings of fish may be heart
healthy
• Folic Acid
– May lower homocysteine levels
• Antioxidants
• Questions??
• Activity time!