It is important for women to talk to their nurse or doctor about their heart health It is important for women to talk t

2. Why am I �Telling A Friend�?

3. Heart disease is the #1 cause of death in women Stroke is the #3 cause of death in women Know the symptoms of heart attack and stroke, and seek medical attention promptly Prevention is important for everyone! Key Messages for Women

4. CVD & Other Causes of Death

5. Women are getting the message It is not enough for the women in the audience to leave the session knowing that heart disease is the leading cause of death in women. We want them to think about themselves and their own heart health and risk factors when they hear this information. It is not enough for the women in the audience to leave the session knowing that heart disease is the leading cause of death in women. We want them to think about themselves and their own heart health and risk factors when they hear this information.

6. Death After a Heart Attack

7. Always Know Your Numbers!

8. Risk Factors for Heart Disease

9. What are the Risk Factors?

10. Signs You�re at High Risk for Heart Disease

11. Signs You�re at Moderate Riskfor Heart Disease

12. Signs You�re at Low Riskfor Heart Disease

13. Tackling a Risk Factor:HIGH BLOOD PRESSURE

14. Recognizing High Blood Pressure Hypertension is common in women as they get older. Many women who have had normal or even low blood pressure throughout their lives can expect to develop high blood pressure in later years. A person who has a normal blood pressure at age 55 has a 90% lifetime chance of developing hypertension.Hypertension is common in women as they get older. Many women who have had normal or even low blood pressure throughout their lives can expect to develop high blood pressure in later years. A person who has a normal blood pressure at age 55 has a 90% lifetime chance of developing hypertension.

15. Know Your Numbers:Classification of Blood Pressure Blood pressure is another risk factor with new guidelines. An optimal or ideal blood pressure is now considered < 120 on the top number (systolic blood pressure) over <80 on the bottom number (diastolic blood pressure) People with blood pressures ranging between 120 and 139 (systolic) or between 80 and 89 (diastolic) are now considered �prehypertensive.� Although in most cases they will not leave the physician�s office with a new prescription, people with prehypertension should receive advice about simple things they can do to avoid developing high blood pressure. Blood pressure is another risk factor with new guidelines. An optimal or ideal blood pressure is now considered < 120 on the top number (systolic blood pressure) over <80 on the bottom number (diastolic blood pressure) People with blood pressures ranging between 120 and 139 (systolic) or between 80 and 89 (diastolic) are now considered �prehypertensive.� Although in most cases they will not leave the physician�s office with a new prescription, people with prehypertension should receive advice about simple things they can do to avoid developing high blood pressure.

16. Lowering Your Blood Pressure: Good Things Can Happen! Keeping blood pressure in the recommended range is important not only for heart disease prevention but also for stroke prevention. High blood pressure is a major factor in the development of congestive heart failure, a serious problem for women.Keeping blood pressure in the recommended range is important not only for heart disease prevention but also for stroke prevention. High blood pressure is a major factor in the development of congestive heart failure, a serious problem for women.

17. Lowering Your Blood Pressure: What Can You Do?

18. Tackling a Risk Factor:HIGH CHOLESTEROL

19. Know Your Numbers:The Cholesterol (Lipid) Profile Beginning at age 20, all adults should have a cholesterol profile done. The best test is a fasting test where you will receive all 4 numbers. You can also have a non-fasting test that will only check your cholesterol and HDL levels. Ask your doctor about ordering these tests. A finger stick blood cholesterol test is often available at grocery and drug stores.Beginning at age 20, all adults should have a cholesterol profile done. The best test is a fasting test where you will receive all 4 numbers. You can also have a non-fasting test that will only check your cholesterol and HDL levels. Ask your doctor about ordering these tests. A finger stick blood cholesterol test is often available at grocery and drug stores.

20. Lowering Your Cholesterol:What Can You Do? After evaluating the research on cholesterol, expert panels have determined that LDL should be the primary target of treatment. LDL stands for low density lipoprotein cholesterol- some people remember this as the bad cholesterol by thinking of it as the �Low Down Lousy� component. If the LDL is elevated, lifestyle changes in the diet and exercise patterns will be recommended. If lifestyle changes do not achieve the targeted goals, there are many safe and effective medications that can be used. These medications can be started immediately in persons at high risk or who already have signs of heart disease or diabetes.After evaluating the research on cholesterol, expert panels have determined that LDL should be the primary target of treatment. LDL stands for low density lipoprotein cholesterol- some people remember this as the bad cholesterol by thinking of it as the �Low Down Lousy� component. If the LDL is elevated, lifestyle changes in the diet and exercise patterns will be recommended. If lifestyle changes do not achieve the targeted goals, there are many safe and effective medications that can be used. These medications can be started immediately in persons at high risk or who already have signs of heart disease or diabetes.

21. Tackling a Risk Factor:DIABETES

22. Women and Diabetes Diabetes is more likely associated with elevations of both systolic and diastolic BP in women. Anti-hypertensive therapy should be initiated in women with diabetes with a persistent BP >130 / 80 mm Hg. Both the NCEP III and ADA recommend an LDL cholesterol <100 mg /dl as a primary target for women with diabetes.Diabetes is more likely associated with elevations of both systolic and diastolic BP in women. Anti-hypertensive therapy should be initiated in women with diabetes with a persistent BP >130 / 80 mm Hg. Both the NCEP III and ADA recommend an LDL cholesterol <100 mg /dl as a primary target for women with diabetes.

23. Know Your Numbers:Diabetes Guidelines* *American Diabetes Association Guidelines Guidelines for diabetes are reviewed and updated regularly. An optimal level for fasting blood sugar to be <100 mg./dL. A blood sugar that measures 126 or higher (confirmed on a repeat test) meets the criteria for diabetes. A level of 100-125 is termed impaired fasting glucose. This group is at risk for developing diabetes.Guidelines for diabetes are reviewed and updated regularly. An optimal level for fasting blood sugar to be <100 mg./dL. A blood sugar that measures 126 or higher (confirmed on a repeat test) meets the criteria for diabetes. A level of 100-125 is termed impaired fasting glucose. This group is at risk for developing diabetes.

24. Lowering Your Risk for Diabetes:What can you do? Two research trials, in Finland and the United States, have shown that diabetes can be prevented in those with �pre-diabetes� by making diet changes, and increasing exercise. People in these studies who were part of the group following exercise and diet programs reduced their chance of getting diabetes by *%, even though they lost only a modest amount of weight, average of ten pounds over a few years. Lifestyle changes were superior to even a very powerful diabetic medication in preventing the progression to diabetes. Tuomilehto: N Engl J Med, Volume 344(18).May 3, 2001.1343-1350N Engl J Med, Volume 346(6).February 7, 2002.393-403Two research trials, in Finland and the United States, have shown that diabetes can be prevented in those with �pre-diabetes� by making diet changes, and increasing exercise. People in these studies who were part of the group following exercise and diet programs reduced their chance of getting diabetes by *%, even though they lost only a modest amount of weight, average of ten pounds over a few years. Lifestyle changes were superior to even a very powerful diabetic medication in preventing the progression to diabetes. Tuomilehto: N Engl J Med, Volume 344(18).May 3, 2001.1343-1350N Engl J Med, Volume 346(6).February 7, 2002.393-403

25. OTHER RISK FACTORS

26. Smoking: The #1 Preventable Risk 1. In the Framingham Heart Study, smoking was associated with an increase in CAD death in pre-menopausal women. 2. Fastest growing group of new smokers are young adolescent females. 3. The Nurses Health study demonstrated that angina, MI and CAD deaths were cigarette-dose related. Smoking as few as 1-4 cigarettes per day raised the relative risk of fatal CAD and nonfatal MI to 2.4 4. Cessation of smoking can normalize relative risk after 2 years of abstinence. (Redberg, Rita, M.D. Women�s Health E Journal 3 (5) 5. Health benefits of smoking cessation begin immediately. 1. In the Framingham Heart Study, smoking was associated with an increase in CAD death in pre-menopausal women. 2. Fastest growing group of new smokers are young adolescent females. 3. The Nurses Health study demonstrated that angina, MI and CAD deaths were cigarette-dose related. Smoking as few as 1-4 cigarettes per day raised the relative risk of fatal CAD and nonfatal MI to 2.4 4. Cessation of smoking can normalize relative risk after 2 years of abstinence. (Redberg, Rita, M.D. Women�s Health E Journal 3 (5) 5. Health benefits of smoking cessation begin immediately.

27. Overweight and Obesity You have probably heard or read about the concern among public health officials about the epidemic of obesity. In every state in the U.S., more than 15% of the population is 30# or more overweight. This epidemic, caused by taking in too many calories and expending too few, is associated with the growing number of people with diabetes. Obesity also increases blood pressure, and cholesterol disorders. If you cannot get to the park or the gym to take a 30 minute walk, there is evidence that you can expend calories while walking and moving around more during your daily activities � called incidental exercise-which over time can burn enough calories to achieve at lease a small weight loss, or at least curb weight gain.You have probably heard or read about the concern among public health officials about the epidemic of obesity. In every state in the U.S., more than 15% of the population is 30# or more overweight. This epidemic, caused by taking in too many calories and expending too few, is associated with the growing number of people with diabetes. Obesity also increases blood pressure, and cholesterol disorders. If you cannot get to the park or the gym to take a 30 minute walk, there is evidence that you can expend calories while walking and moving around more during your daily activities � called incidental exercise-which over time can burn enough calories to achieve at lease a small weight loss, or at least curb weight gain.

28. Easy Ways to �Cut� and �Spend� Calories

29. The Metabolic Syndrome Multiple abnormalities in the cholesterol profile, overweight, and high blood pressure are part of the metabolic syndrome. People with metabolic syndrome often go on to develop Type 2 diabetes. Even when they do not, this group carries a high risk for developing heart disease. Changes in lifestyle which increase activity and achieve weight loss are the key to improving these parameters. Multiple abnormalities in the cholesterol profile, overweight, and high blood pressure are part of the metabolic syndrome. People with metabolic syndrome often go on to develop Type 2 diabetes. Even when they do not, this group carries a high risk for developing heart disease. Changes in lifestyle which increase activity and achieve weight loss are the key to improving these parameters.

30. Risk Factors Add Up! If we woke up to a story on the radio or in the newspaper that told of a treatment that could lower the risk of heart disease by 83%, we would certainly take notice. Many people don�t realize that we already have evidence from the Nurses� Health Study that those who were non-smokers, had good blood pressure, desirable cholesterol levels, ate a healthy diet, and drank alcohol in moderation were 83% less likely to suffer from heart disease. In the Nurses� Health Study (80,000 women monitored for 14 years), 82% of the coronary events were attributed to the lack of adhering to lifestyle guidelines involving diet, exercise and smoking.If we woke up to a story on the radio or in the newspaper that told of a treatment that could lower the risk of heart disease by 83%, we would certainly take notice. Many people don�t realize that we already have evidence from the Nurses� Health Study that those who were non-smokers, had good blood pressure, desirable cholesterol levels, ate a healthy diet, and drank alcohol in moderation were 83% less likely to suffer from heart disease. In the Nurses� Health Study (80,000 women monitored for 14 years), 82% of the coronary events were attributed to the lack of adhering to lifestyle guidelines involving diet, exercise and smoking.

31. Exercise is Key! Exercise helps women stay healthy in a number of ways. Add: 30 minutes of exercise almost every day is recommended - this can be broken into smaller increments.Exercise helps women stay healthy in a number of ways. Add: 30 minutes of exercise almost every day is recommended - this can be broken into smaller increments.

32. What About Postmenopausal Hormone Therapy? For many years, it was generally thought that the use of hormone therapy after menopause lowered a woman�s risk of heart disease. More recent studies have not shown this, and in fact, have shown that the risk of hormone therapy outweighs the benefits in terms of disease prevention. Short term hormone therapy still has a place for the management of the symptoms of menopause. This is a decision that should be made after careful consultation between a woman and her health care provider. Research continues in this area.For many years, it was generally thought that the use of hormone therapy after menopause lowered a woman�s risk of heart disease. More recent studies have not shown this, and in fact, have shown that the risk of hormone therapy outweighs the benefits in terms of disease prevention. Short term hormone therapy still has a place for the management of the symptoms of menopause. This is a decision that should be made after careful consultation between a woman and her health care provider. Research continues in this area.

33. When Prevention Fails:HAVING A HEART ATTACK

34. How Do You Know:Symptoms of a Heart Attack

35. How Do You Know:Symptoms of a Heart Attack

36. When Prevention Fails:HAVING A STROKE

37. How Do You Know:Symptoms of a Stroke

38. How Do You Know:Symptoms of a Stroke

39. KEY TAKE-AWAYS

40. Key Take-Aways 1 Basically, heart disease prevention falls into two categories: lifestyle or behavior modification and pharmacological intervention. 2 Because there�s no advance warning for as many as two thirds of the women who die suddenly of heart disease, the importance of prevention cannot be overemphasized. 3 Know about the symptoms and causes. 4 Risk factors such as heredity, age, race, and gender cannot be controlled, but you can help prevent heart disease simply by maintaining a healthy lifestyle. 5 Be sure to discuss your risk factors with your healthcare provider and ask questions about your heart tests every time you visit. 1 Basically, heart disease prevention falls into two categories: lifestyle or behavior modification and pharmacological intervention. 2 Because there�s no advance warning for as many as two thirds of the women who die suddenly of heart disease, the importance of prevention cannot be overemphasized. 3 Know about the symptoms and causes. 4 Risk factors such as heredity, age, race, and gender cannot be controlled, but you can help prevent heart disease simply by maintaining a healthy lifestyle. 5 Be sure to discuss your risk factors with your healthcare provider and ask questions about your heart tests every time you visit.

41. Key Take-Aways We hope you will take this message and share it with a friend. Heart disease is a woman�s disease and can be prevented with early identification of risk factors and often simple lifestyle changes. We hope you will take this message and share it with a friend. Heart disease is a woman�s disease and can be prevented with early identification of risk factors and often simple lifestyle changes.

42. Online Resources Many of the Internet resources have tracking documents that you can use to �track� your risk reduction progress and personal heart health data. Here are just a few pertinent sites to assist you as you begin to identify your personal risk and start your journey towards �Heart Health�.Many of the Internet resources have tracking documents that you can use to �track� your risk reduction progress and personal heart health data. Here are just a few pertinent sites to assist you as you begin to identify your personal risk and start your journey towards �Heart Health�.