Welcome to Health From Head to Toe: Vascular Risk Reduction Building Healthy Lifestyles

1. Welcome toHealth From Head to Toe:Vascular Risk ReductionBuilding Healthy Lifestyles

2. Objectives • ● Promote your knowledge of vascular risk factors • ● Learn chronic disease prevention strategies • ● Discuss healthy lifestyle interventions

3. As I see it, every day you do one of two things: build health or produce disease in yourself. • Adelle Davis (1904-1974)

4. MANAGEABLErisk factor  Metabolic Syndrome  High Blood Pressure  High Cholesterol  Pre-Diabetes/Diabetes MODIFIABLE risk factor  Smoking Abdominal Obesity  Physical Inactivity Nutrition/High sodium intake  Excessive Alcohol Consumption  Un-managed Stress  Insufficient Sleep 8 in 10 Canadians have at least one risk factorfor vascular disease (i.e. heart disease or stroke)

5. Steps to Reduce Your Risk • Know and control your risk factors! http://www.phac-aspc.gc.ca/ccdpc-cpcmc/index_e.html#extended www.heartandstroke.ca

6. Metabolic Syndrome • Diagnosed if you have 3 or more of the following conditions: • ● Blood pressure > 130/85 mmHg • ● Triglycerides >1.7 mmol/L • ● HDL (Healthy cholesterol) - Men< 1.0 ; Women < 1.3 mmol/L • ● Fasting Blood Glucose >5.6 mmol/L • ● Abdominal obesity – Waist circumference > 94 cm in men or > 80 cm in women

7. Leading Risk Factors for Death in Developed Countries 1 Blood Pressure Tobacco 2 3 High Cholesterol Overweight 4 Low Fruit & Vegetable intake 5 6 Physical Inactivity (World Health Organization 2002)

8. Why Treat Hypertension?

9. Cholesterol • ● About 40% of Canadians have high cholesterol • ● Ideal cholesterol levels vary individually based on other risk factors for heart disease or stroke • www.heartandstroke.ca

10. Lipid Panel • LDL (LOUSY) – promotes the buildup • of fatty plaque on the artery walls • HDL (HEALTHY) – helps clear the arteries • Triglycerides – not a type of • cholesterol, but are also a fat found in • the blood

11. Statins • In addition to current Canadian recommendations on management of dyslipidemia, statins are recommended in high-risk hypertensive patients with established atherosclerotic disease or with at least 3 of the following criteria: • LVH • ECG abnormalities • Microalbuminuria or Proteinuria • Family History of Premature CV disease • Male • age 55 or older • Smoking • Total-C/HDL-C ratio of 6 mmol/L or higher

12. Diabetes • ●More than 3 million Canadians have diabetes (90% are Type 2) • ● Fasting blood sugar should be tested every 3 years if over age 40 to screen for diabetes • www.diabetes.ca

14. Waist Circumference Measurement Last rib margin Mid distance Iliac crest Courtesy J.P. Després 2006

15. 45% Reductionin CVD 10% Reductionin BP + 10% Reductionin Total-C = 90% of Canadians have other cardiovascular risk factors! Emberson et al. Eur Heart J. 2004;25:484-491.

16. Lifestyle Modification

17. Healthy Lifestyles Really Make a Difference Reducing Stress -6.1/-4.3

18. Some Fantastic Effects of Smoking Cessation • Risk of heart attack and stroke drop < 24 hours • Breathing is easier < 3 days • Coughing is improved < 2 weeks • Risk of CAD is reduced by 20 – 50 % < one year • Risk of stroke normalizes < 5 years • Risk of dying is equal to a non smoker < 15 years. • Smoker Help Line 1-866-332-2322

19. Physical Activity • Physical Activity can: • Decrease risk of heart disease and stroke • Help lower blood pressure • Help control blood sugar • Help to control weight. • Help to reduce stress levels • Increase HDL, decreases LDL and triglycerides.

20. Physical Activity Recommendations • Frequency: 4 - 7 times per week • Intensity: Moderate • Time: 30-60 minutes • Type: Cardiorespiratory Activity– • - walking, jogging • - cycling • - non-competitive swimming

21. Eat a Healthy Diet Follow Canada’s Food Guide Adequate fruit, vegetables, whole grains, low-fat dairy products. Foods low in saturated and trans fat, sugar & salt, and high in fiber. Have at least 3 meals a day and an afternoon snack. Space meals 4-6 hours apart. Eat breakfast each morning. Visit www.healthcanada.gc.ca/foodguide for more information.

23. Nutrient Density vs Calorie Density

24. What About the Food We Eat? The Amount of Fat and Sugar Is What’s Important!

26. Shake the Salt Habit • 1 in 3 Canadians with hypertension could have normal blood pressure if they lowered their sodium intake.

27. Health Issues Linked to High Sodium Intake • Excretion of calcium in the urine, may lead to osteoporosis • Stomach cancer • Water retention • Kidney stones • Enlargement of the heart • Increased severity of asthma symptoms

28. Adequate Sodium Intake For Adults

29. Sources Of Sodium

30. Sodium Content of Restaurant Foods

31. Processing Adds Sodium To Food

32. Salt – o - Meter • http://www.theglobeandmail.com/special-reports/hard-to-shake/ • www.sodium101.ca • - information on how to reduce dietary sodium • http://www.sodium101.ca/en/happening/news.html

33. Potential Benefits of Dietary Sodium Reduction in Canada • Reduction in average dietary sodium from about 3500 mg to 1700 mg • 1 million fewer hypertensives • 5 million fewer physicians visits a year for hypertension • Health care savings of $430 to $540 million • Improvement of hypertension treatment • & control rate • 13% reduction in CVD • Total health care cost savings of over $1.3 billion/year

34. Limit Alcohol Men: Maximum 14 drinks/week Women: Maximum 9 drinks/week No more than 0-2 drinks per day

35. Stress • Increases LDL and decreases HDL • Raises Blood pressure • Increases Blood sugars • Increases Clotting enzymes

36. What Can You Do? • Identify what is causing stress • Establish priorities • Can you change perspective??? • If able, modify your situation • Say “NO” more often?? • Make time for yourself!!

37. Sleep Reduces Vascular Damage • ● Adults need 7 – 8 hours of uninterrupted sleep tomaintain vascular health. • ● Sleep is a process of restoration and regeneration for the body and mind • ● Sleep allows the body to heal itself, suppress the appetite hormone, reduce cortisol (stress) which in turn will decrease blood pressure.

38. CONCLUSION UNDERSTAND – vascular protection KNOW – your stats! REDUCE – your risk VISIT - your doctor/health care provider DEVELOP – your action plan!!!

39. QUESTIONS?? • BHL Hypertension/Stroke Prevention