Heart Disease in the Bluegrass State

1. Heart Disease in the Bluegrass State

2. HEART DISEASE IS DEADLY IN KENTUCKY : • Kentucky ranks 6th in heart disease death rates for 2003, behind Mississippi, Oklahoma, DC, Alabama, and West Virginia. • Diseases of the heart accounted for 23% (11,291) of all deaths in Kentucky in 2003. • The death rate for heart disease was 281.3 per 100,000 in 2003. Source: Kentucky Department for Public Health (KDPH). Death Certificate Files. Frankfort, Kentucky: Cabinet for Health and Family Services, 1960-2003 Cabinet for Health and Family Services

3. HEART DISEASE IS COSTLY IN KENTUCKY • Diseases of the heart accounted for 11% (67,239) of all hospitalizations in Kentucky in 2004. • The hospitalization rate for heart disease was 164.8 per 100,000 in 2004, a 12% increase from 147.4 per 100,000 in 2000. • In Kentucky, inpatient hospitalizations for cardiovascular-related diagnoses for 2004 totaled over $2,106,997,000. Source: Kentucky Inpatient Hospitalization Claims Files, Frankfort, KY, 2004; Cabinet for Health and Family Services, Kentucky Department for Public Health, Office of Health Policy Cabinet for Health and Family Services

4. Alarming Disparities • More than half of the heart disease deaths in Kentucky and the United States are women. • More women die of heart disease than all cancers combined. • Only 13 percent of women identify heart disease as the greatest health problem facing women today. • Most women fail to make the connection between heart disease risk factors and their personal risk of developing heart disease. Source: American Heart Association, American Stroke Association. Heart Disease and Stroke Statistics – 2007 Update Cabinet for Health and Family Services

5. What isHeart Disease? • Heart disease is a broad term that includes several more specific heart conditions: • The most common heart condition in the United States is coronary heart disease, which can lead to heart attack. Cabinet for Health and Family Services

6. Coronary Heart Disease- CHD • CHD is the most common type of heart disease. • CHD occurs when the coronary arteries, that supply blood to the heart muscle, become hardened and narrowed due to the plaque buildup. • The plaque buildup and the narrowing and hardening of the arteries is called atherosclerosis. Cabinet for Health and Family Services

7. Coronary Heart Disease- CHD (cont.) • Plaques are a mixture of fatty substances including cholesterol and other lipids. • Blood flow and oxygen supply to the heart can be reduced or even fully blocked with a growing plaque. • Plaques may also rupture and cause blood clots that block arteries. Cabinet for Health and Family Services

8. Heart Attack • A heart attack is also called a myocardial infarction. • If the blood supply to the heart is severely reduced or completely blocked, heart muscle cells may not receive enough oxygen and begin to die. • The more time that passes without treatment to restore blood flow, the greater the damage to the heart. • This damage can cause irregular heart rhythms or even sudden cardiac arrest or stopping of the heart beat. Death can result. • Coronary artery disease is the chief underlying cause of a heart attack. • A less common cause of a heart attack is a severe spasm of a coronary artery that reduces the blood supply to the heart. Cabinet for Health and Family Services

9. Risk Factors • Modifiable (we can control) • High blood pressure • Cigarette smoking • High blood cholesterol • Overweight and obesity • Physical inactivity • Diet low in fruits and vegetables • Diabetes • Alcohol Cabinet for Health and Family Services

10. Risk Factors • Non-modifiable (we cannot control) • Increasing age • Gender • Family history • Race • Diabetes Cabinet for Health and Family Services

11. Warning Signs of a Heart Attack • If the blood supply to the heart muscle is cut off, a heart attack can result. • Cells in the heart muscle do not receive enough oxygen and begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart. • Having high blood pressure or high blood cholesterol, smoking, and having had a previous heart attack, stroke, or diabetes can increase a person's chances of having a heart attack. Cabinet for Health and Family Services

12. Warning Symptoms of a Heart Attack • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain. • Discomfort in other areas of the upper body. This can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach. • Shortness of breath. This often comes along with chest discomfort. But it also can occur before chest discomfort. • Other symptoms. These may include breaking out in a cold sweat or feeling nausea or light–headedness. • If you think that you or someone you know is having a heart attack, you should call 9–1–1 immediately. Cabinet for Health and Family Services

13. What Can You Do? • Know your risk factors • Change/improve the risk factors you can change • Regular check ups with your physician • Know your numbers (Blood Pressure, Cholesterol, weight) • Healthy lifestyle choices – diet, exercise • Smoking cessation programs Cabinet for Health and Family Services

14. What Can You Do? • Prevent and control high blood cholesterol • High blood cholesterol is a major risk factor for heart disease. • Preventing and treating high blood cholesterol includes eating a diet low in saturated fat and cholesterol and high in fiber, keeping a healthy weight, and getting regular exercise. • All adults should have their cholesterol levels checked once every five years. • If yours is high, your doctor may prescribe medicines to help lower it. Cabinet for Health and Family Services

15. What Can You Do? • Prevent and control high blood pressure • Lifestyle actions such as healthy diet, regular physical activity, not smoking, and healthy weight will help you to keep normal blood pressure levels. • All adults should have their blood pressure checked on a regular basis. Blood pressure is easily checked. • If your blood pressure is high, you can work with your doctor to treat it and bring it down to the normal range. • A high blood pressure can usually be controlled with lifestyle changes and with medicines when needed. Cabinet for Health and Family Services

16. What Can You Do? Prevent and control diabetes • People with diabetes have an increased risk of heart disease. • People with diabetes can take steps to reduce their risk for diabetes through weight loss and regular physical activity. • For more information about diabetes, see CDC’s Diabetes Program website @ http://www.cdc.gov/diabetes/ Cabinet for Health and Family Services

17. What Can You Do? Maintain a healthy weight • Healthy weight status in adults is usually assessed by using weight and height to compute a number called the "body mass index" (BMI). • BMI usually indicates the amount of body fat. • An adult who has a BMI of 30 or higher is considered obese. • Overweight is a BMI between 25 and 29.9. • Normal weight is a BMI of 18 to 24.9. • Proper diet and regular physical activity can help to maintain a healthy weight. Cabinet for Health and Family Services

18. What Can You Do? Regular physical activity • Adults should engage in moderate level physical activities for at least 30 minutes on most days of the week. Cabinet for Health and Family Services

19. What Can You Do? Diet and nutrition • Along with healthy weight and regular physical activity, an overall healthy diet can help to lower blood pressure and cholesterol levels and prevent obesity, diabetes, heart disease, and stroke. • This includes eating lots of fresh fruits and vegetables, • Lowering or cutting out added salt or sodium, and • Eating less saturated fat and cholesterol. Cabinet for Health and Family Services

20. What Can You Do? Do Not Smoke • Smoking increases the risk of high blood pressure, heart disease, and stroke. • Never smoking is one of the best things a person can do to lower their risk. • Quitting smoking will also help lower a person’s risk of heart disease. A person's risk of heart attack decreases soon after quitting. • If you smoke, your doctor can suggest programs to help you quit smoking. Cabinet for Health and Family Services

21. What Can You Do? Moderate alcohol use • Excessive alcohol use increases the risk of high blood pressure, heart attack, and stroke. • People who drink should do so only in moderation and always responsibly. Cabinet for Health and Family Services

22. Prevention • In principle, all people can take steps to lower their personal risk of heart disease and heart attack by addressing their risk factors. • People who already have heart disease especially need to control their risk factors. Cabinet for Health and Family Services

23. Prevention is the KEY…to the future health of Kentucky Cabinet for Health and Family Services

24. Sources of Information • Center for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention http://www.cdc.gov/dhdsp/ • American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=1200000 Cabinet for Health and Family Services

25. Web Resources Web Links/Resources • CDC’s Heart Disease and Stroke Prevention Program • http://www.cdc.gov/dhdsp/ • National Heart, Lung and Blood Institute, for the medical professional • http://www.nhlbi.nih.gov/health/prof/heart/index.htm • National Heart, Lung and Blood Institute, for the public • http://www.nhlbi.nih.gov/health/public/heart/index.htm • American Heart Association • http://www.americanheart.org/presenter.jhtml?identifier=1200000 Cabinet for Health and Family Services

26. Provided by: Kentucky Department for Public Health Heart Disease and Stroke Prevention Program 502-564-7996 Cabinet for Health and Family Services