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Heart DiseaseEffects of lifestyle on coronary heart diseaseSara Quale ∙ Concordia University-Nebraska

2

What is heart disease?

• Heart disease kills more people each year than anything else.

• It strikes people of different race, age, and gender.• It becomes more prevalent with age.• It is caused by both genetic and lifestyle factors.

3

Epidemiological Factors

Causes of disease

Trends in the population

Results of treatments

4Annually, heart disease kills more people than anything else.

Heart

Diseas

e

Cance

r

Resp.

Diseas

e

Stroke

Accid

ents

Alzheim

er's

Diseas

e

Diabete

s Mell

itus

Nephr

itis

Influ

enza

& P

neum

onia

Suicid

e0

100,000200,000300,000400,000500,000600,000700,000

10 Leading Causes of Death, United States - 2010

5Heart disease becomes more prevalent with age.

<1

5--9

15-24

35-44

55-64

0 100000 200000 300000 400000 500000 600000

Deaths

Deaths

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Heart Disease Age-adjusted death rates by Race/Ethnicity

Black

Whi

te

Amer

ican I

ndian

Two or m

ore r

aces

050

100150200250300350

2005200620072008

MenWomen

Heart Disease death rates by gender, all races

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Non-modifiable Risk Factors• Age• Genetics

Modifiable Risk Factors• High cholesterol• High blood pressure• Diabetes• Smoking• Obesity• Physical Inactivity

8Biostatistical Factors

Data collected

How it’s used

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Framingham Heart Study

Researchers followed a large group of Framingham, Mass., residents who did not have cardiovascular disease or previous heart attacks. Each person received a physical every 2 years to track changes in heart health.

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Heart Disease

High Blood Pressure

High Cholesterol

Smoking

Obesity

Diabetes

Physical Inactivity

Through the study, researchers learned the major risk factors for developing heart disease.

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• In 1913 Nikolai Anichkov found that cholesterol caused changes in the vascular wall – atherosclerosis. This led to better understanding of the role between cholesterol and heart disease.

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With information, public health advocated for primary and secondary preventions measures.

Primary prevention is eating healthy and avoiding the main sources of cholesterol. Secondary prevention is taking steps to monitor your health.

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After decades of research on ways to treat high cholesterol, Merck offered the first commercial statin in 1987. That type of drug in 2010 was given to about 30 million people worldwide.

14Biomedical Basis

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Atherosclerosis – hardening of the arteries – is a major cause of heart disease.

Plaque from cholesterol and other material builds up around the arterial wall. The artery narrows and restricts blood and oxygen flow.

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When the flow is blocked entirely because the artery becomes too narrow or a clot breaks off and lodges in the artery, the person may have a heart attack.

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Cigarette smoking damages blood cells and arteries, which also contributesto plaque buildup. Smoking and second hand smoke can lower good cholesterollevels, raise blood pressure and damage heart tissue.

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Social/behavioral factors

Belief in risk

Belief in severity

Belief that there’s hope

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Barriers to overcoming heart disease• Lack of access to healthy food options• Easy access to unhealthy fast foods and tobacco

in poor urban areas• Lack of access to recreational places for

physical activity• Poor access to healthcare resources and

screenings• Even if those are overcome, people still don’t

feel they can be successful.

20Steps to improve

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• Intrapersonal: Get to know your family physician. Participate in regular screenings.

• Interpersonal: Eat healthy and exercise as a family. If an emergency arises, be prepared.

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• Institutional: Strong continuity of care in healthcare systems will help patients who have heart disease manage their illness better.

• Community: Increase community and home gardening opportunities to increase access to healthy foods.

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• Public Policy: Continued efforts to enforce tobacco laws, policies to limit access to fast foods and sugary drinks. Encourage participation by private businesses in educational outreach.

24References

1. Atherosclerosis (February 2013). American Heart Association. Retrieved from http://www.heart.org/HEARTORG/Conditions/Cholesterol/WhyCholesterolMatters/Atherosclerosis_UCM_305564_Article.jsp

2. Framingham Heart Study, (Dec. 10, 2012). Risk score profiles. Retrieved from http://www.framinghamheartstudy.org/

3. Freeman, M., MD; Jung, C. (2005). The Harvard Medical School Guide to Lowering Your Cholesterol, McGraw-Hill Companies, Retrieved from http://www.health.harvard.edu/newsweek/Understanding_Cholesterol.htm

4. Heart Disease Fact Sheet, (Oct. 18, 2012). Centers for Disease Control. Retrieved from http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_disease.htm

5. How does smoking affect the heart and blood vessels? (Dec. 20, 2011). National Heart, Lung, and Blood Institute. Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/smo/

6. Lower heart disease risk (Feb. 29, 2012). National Heart Lung and Blood Institute. Retrieved from http://www.nhlbi.nih.gov/educational/hearttruth/lower-risk/risk-factors.htm

7. Million HeartsTM (2013). About heart disease & stroke. Retrieved from http://millionhearts.hhs.gov/abouthds/overview.html

8. Outcome measures, Centers for Medicare and Medicaid (Jan. 19, 2013). CMS.gov. Retrieved from http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/OutcomeMeasures.html

9. Proceedings of the Japan Academy, Series B Physical and Biological Sciences, (May 10, 2010). U.S. National Library of Medicine, Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108295/

10. Roger, MD, Veronique; et al, (2012). AHA statistical update. Retrieved from http://circ.ahajournals.org/content/125/1/e2.full

11. Schneider, Mary-Jane, (2011). Introduction to public health 3rd ed., p. 18012. State smoke-free laws (April 22, 2011). Morbidity and Mortality Weekly Report, CDC, Retrieved from

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6015a2.htm 13. Texas Heart Institute Journal, (2006). U.S. National Library of Health Medicine. Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764970/