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Eliminating Risk Factors for Heart Disease

Eliminating Risk Factors for Heart Disease. Healthy Transitions Summer 2014. Corrine Benacka , RN, BSN Bluhm Cardiovascular Institute July 21, 2014. Presented to: Insert relevant presenter information Calibri 16pt Presented on: Month day, Year

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Eliminating Risk Factors for Heart Disease

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  1. Eliminating Risk Factors for Heart Disease Healthy Transitions Summer 2014 Corrine Benacka, RN, BSN Bluhm Cardiovascular Institute July 21, 2014 Presented to: Insert relevant presenter information Calibri 16pt Presented on: Month day, Year Presented by: Insert relevant presenter information here

  2. Eliminating Risk Factors for Heart Disease Review the evidence Define heart disease Identify the unavoidable and avoidable risk factors for heart disease Discuss lifestyle changes to decrease your risk of cardiovascular disease Review the AHA Life’s Simple 7 Identify resources at NMH to help you achieve your health goals Objectives

  3. Eliminating Risk Factors for Heart Disease Heart Disease is a broad term which refers to any disease that affects the heart. Atherosclerotic cardiovascular disease (ASCVD) Valvular heart disease Congenital heart disease Arrhythmias Heart failure Heart infections Tumors of the heart What is heart disease?

  4. Eliminating Risk Factors for Heart Disease A glance at the evidence

  5. Eliminating Risk Factors for Heart Disease Risk Factors Variable associated with an increased risk of disease Risk factors you can’t control Age, gender, genetics Risk factors you CAN control Being physically inactive Unhealthy diet Being overweight Smoking High blood cholesterol High blood pressure Diabetes Risk Factors

  6. Eliminating Risk Factors for Heart Disease Age Genetics Family history of premature CVD Coronary disease in male first-degree relative < 55 years Coronary disease in female first-degree relative < 65 years “Health behaviors can trump a lot of your genetics. Research shows people have control over their heart health. The earlier they start making healthy choices, the more likely they are to maintain a low-risk profile for heart disease.” Donald Lloyd-Jones, MD Accept the things we can not change……or can we? • For men, risk begins to climb around age 45 • For women, the risk begins to climb around 55 and especially with the onset of menopause. Gender • Men are more likely to develop cardiovascular disease. • The difference beings to disappear after women go through menopause. • Cardiovascular disease is the number one killer of men and women in the United States

  7. Eliminating Risk Factors for Heart Disease Primary Prevention Secondary Prevention After the disease has occurred All patients who have had a CV event should receive secondary prevention Lifestyle changes Medications Primary and Secondary Prevention • Aims at preventing the disease • Reduces incidence and prevalence of a disease • The majority of know CVD risk factors are preventable!

  8. Eliminating Risk Factors for Heart Disease Benefits of Exercise • Improvement in lipid profile • Reduction in blood pressure • Less insulin resistance • Weight loss Secondary Prevention Reduction in mortality Reduction in recurrent MI Physical Activity

  9. Eliminating Risk Factors for Heart Disease Recommendations • Moderate-intensity aerobic exercise for 150 minutes every week AND muscle-strengthening activities involving all major muscle groups at least two days per week, OR • Vigorous-intensity aerobic exercise for 75 minutes every week AND muscle-strengthening activities involving all major muscle groups at least two days per week, OR • An equivalent mix of moderate-intensity and vigorous-intensity aerobic exercise AND muscle-strengthening activities involving all major muscle groups at least two days per week Questions/concerns about starting an exercise program? Talk to your physician first! Physical Activity Getting Started Short intervals Several times a day=30min/day Walking, dancing, active yard work Free weights 10-15 repetitions/2-3 times a week

  10. Eliminating Risk Factors for Heart Disease Foods LOW in: • Saturated and trans fats • Cholesterol • Sodium • Added sugars Quick Tips Keep a food journal Keep healthy foods on hand Bring your own healthy dish to family parties Eat fish at least twice a week Fish rich in omega 3 fatty acids like salmon, trout and herring Heart-healthy Diet Foods HIGH in: Whole grain fiber Lean protein Fruits and vegetables!

  11. Eliminating Risk Factors for Heart Disease Dietary Approaches to Stop Hypertension Key foods Fruits Vegetables Low fat/nonfat dairy The DASH Diet http://dashdiet.org/what_is_the_dash_diet.asp

  12. Eliminating Risk Factors for Heart Disease Obesity • Overweight is defined as a BMI between 25 and 29.9 kg/m2 • Obesity as a BMI of 30 kg/m2 or greater • In the U.S. • 34 percent of US adults aged 20 years and over are overweight • 34 percent are obese • 6 percent are extremely obese • The American Heart Association has named obesity as an independent risk factor Weight Management

  13. Impact of Weight Loss on Risk Factors Wing RR et al. Arch Intern Med. 1987;147:1749-1753; Blackburn G. Obes Res. 1995;3 (Suppl 2):211S-216S. Mertens IL, Van Gaal LF. Obes Res. 2000;8:270-278; Ditschuneit HH et al. Eur J ClinNutr. 2002;56:264-270.

  14. Prevalence* of Self-Reported Obesity Among U.S. AdultsBRFSS, 2012 *Prevalence reflects BRFSS methodological changes in 2011, and these estimates should not be compared to those before 2011. 15%–<20%20%–<25% 25%–<30% 30%–<35% ≥35% http://www.cdc.gov/obesity/data/adult.html

  15. Eliminating Risk Factors for Heart Disease How does obesity contribute to CVD?

  16. Eliminating Risk Factors for Heart Disease STOP SMOKING! • Smoking is an independent risk factor • Smoking is associated with a higher risk of: • Stroke • Atherosclerosis • Heart Attack • Aortic Aneurysm Smoking

  17. Eliminating Risk Factors for Heart Disease It’s never too late to quit • Cardiac risk diminishes shortly after quitting and continues to decrease • Mortality benefit • Risk of stroke reduces after quitting Smoking

  18. Eliminating Risk Factors for Heart Disease Smoking

  19. Eliminating Risk Factors for Heart Disease Know Your Numbers HDL ≥ 50mg/dl LDL <100mg/dl, if CAD < 70 mg/dl Triglycerides <100 mg/dl Non HDL <130 mg/dl Total Cholesterol= HDL + LDL + 20% of your triglyceride level. A total cholesterol score of less than 180 mg/dL is considered optimal. Cholesterol • Cholesterol is a fat-like substance that lines the blood vessels. • Cholesterol is carried in the blood by carries = lipoproteins • LDL - Low density lipoprotein or “Bad” cholesterol • HDL - high density lipoprotein or ”Good” cholesterol • Non-HDL cholesterol - Non-HDL cholesterol is your total cholesterol minus your HDL cholesterol. • Triglycerides- type of fat found in your blood; high levels may signify metabolic syndrome

  20. Eliminating Risk Factors for Heart Disease • Why Cholesterol Matters • Major controllable risk factor • If you have other risk factors such as high blood pressure, DM or you smoke-your risk increases even further • Cholesterol can form thick deposits called plaque in artery walls=atherosclerosis • CAD • Stroke • Peripheral vascular disease • Aortic atherosclerosis and aneurysms of the aorta Cholesterol

  21. Eliminating Risk Factors for Heart Disease Cholesterol Prevention • Healthy diet • Ideal body weight • Activity • DON’T SMOKE Treatment • Lifestyle change is first line treatment of hyperlipidemia for all patients • Diet • Exercise • Don’t smoke • Simplified into 4 groups to treat for both primary and secondary prevention • Clinical Atherosclerotic CVD • LDL-cholesterol levels ≥ 190 mg/dL • Diabetes Mellitus aged 40-75 yo • 10 year risk of ASCVD ≥ 7.5% • No LDL targets • Patient-Physician discussion is key to making informed decisions about treatment Stone NJ, et al Circulation: Nov. 12 2013

  22. Eliminating Risk Factors for Heart Disease Cholesterol Cholesterol Lowering Medications Statins Most effective agents to lower LDL-C Clinically proven to reduce mortality & recurring CV events Change composition of plaques (especially in vulnerable plaques) Stabilize atherosclerotic plaques May result in partial regression Can be well tolerated

  23. This chart reflects blood pressure categories defined by the American Heart Association. Eliminating Risk Factors for Heart Disease High Blood Pressure Hypertension- The Silent Killer Often no symptoms 1 in 3 adults have high blood pressure Hypertension can cause: stroke heart attack heart failure peripheral artery disease kidney failure Defined as ≥ 140/90 mmHg Blood Pressure= Systolic BP Diastolic BP www.heart.org

  24. Eliminating Risk Factors for Heart Disease High Blood Pressure Prevention and Treatment • Diet • Low Na • DASH • Don’t Smoke • Maintain a healthy weight • Exercise • Coping with stress • Take your medication

  25. Eliminating Risk Factors for Heart Disease Diabetes • Heart disease and stroke are the #1 cause of death for type 2 diabetics • DM can lead to atherosclerosis • DM can cause damage to your heart, eyes, nerves and kidneys Why is DM a risk factor? • AHA considers DM one of the controllable risk factors for heart disease • When blood sugars are within normal range, you protect vital organs • Diabetics often have other risk factors • HTN • High cholesterol and triglycerides • Obesity and lack of exercise • Poorly controlled blood sugars • Smoking

  26. Eliminating Risk Factors for Heart Disease Diabetes Prevention • Control weight • Be active • Control blood pressure • Control cholesterol Treatment • Lifestyle • Medications • Oral medications • Insulin You and your doctor can discuss the best treatment plan for you! Who should be tested? • Overweight and over 45 yrs/old • High cholesterol • Family history of DM • African-American, Asian-American, Latino/Hispanic-American, Native American or Pacific Islander descent • A history of gestational diabetes (diabetes during pregnancy) or delivering a baby over 9 lbs.

  27. Eliminating Risk Factors for Heart Disease Metabolic Syndrome Metabolic Syndrome Cluster of risk factors that put a person at greater risk of cardiovascular disease

  28. Eliminating Risk Factors for Heart Disease Metabolic Syndrome Who’s at risk? • Obesity/overweight • Insulin resistant • Physically inactive Treatment • Eat better • Get moving • Lose weight • Medications

  29. Eliminating Risk Factors for Heart Disease Life’s Simple 7 Assess your risk! • My life check assessment www.heart.org

  30. Eliminating Risk Factors for Heart Disease Bluhm Cardiovascular Institute The Bluhm Cardiovascular Institute is proud of our U.S. News & World Report rankings – a reflection of the leading edge cardiac and vascular services we offer and the results we obtain for our patients, their families and the community. #1 in the Chicago metro region #1 in Illinois for the seventh straight year #13 in the nation out of 708 cardiac programs Highest ranked cardiac program in the region: Indiana, Michigan, Wisconsin, Missouri and Iowa Bluhm Cardiovascular Institute www.heart.nm.org

  31. Eliminating Risk Factors for Heart Disease Know your numbers! BMI or body mass index- goal 18-24.9 Waist circumference- goal < 35 inches Blood pressure- goal < 120/80 Cholesterol Total cholesterol- goal < 200 mg/dL HDL- goal ≥ 50 mg/dl LDL- goal < 100 mg/dL, if CAD < 70 mg/dL Triglycerides- goal < 100 mg/dL non-HDL- goal < 130 mg/dL Fasting Blood Sugar < 100 mg/dL Summary www.heart.nm.org

  32. Thank You

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