women's heart smarts: top ten list for a heart healthy life
DESCRIPTION
A presentation for women or men on how to live a heart-healthy life. By cardiologist Shawn Patrick, M.D., Portland, Oregon.TRANSCRIPT
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Heart Disease Number one killer of women.
Kills 1 in 2 women (1 in 3 men).
Often undiagnosed and undertreated.
A very dangerous, but very preventable problem.
"Women are like teabags; you never know how strong they are until they're put in hot water." — Eleanor Roosevelt
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Top Ten List
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Women’s Heart Smarts:Top Ten List for aHeart-Healthy Life
Shawn Patrick, MD
April 29, 2011
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10. Get a Good Night’s Sleep
Risk of high blood pressure increases when you sleep less than 7 hours per night.
The risk doubles when you get less than 5 hours per night. If you have high blood pressure and sleep less than 7 hours per night,
your risk for heart attack is increased. REM sleep is responsible for reducing stress. Muscle tissue repair increases during sleep. Have good sleep habits. If you have sleep apnea, TREAT IT!
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Sleep Apnea
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Sleep Apnea Associated with… Coronary artery disease
Atrial fibrillation
Pulmonary hypertension
Hypoxic brain injury
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Sleep Apnea An estimated 20 to 30 percent of Americans have some degree of
sleep apnea.
If you have sleep apnea, wear your CPAP.
Weight loss is often curative.
Sleep apnea affects men and women.
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Sleep Apnea
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Get plenty of sleep
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9. Know and Manage Your Blood Pressure
The risk for stroke is decreased 30% by lowering the systolic blood pressure from greater than 140 mmHg to 130 mmHg.
Only 30% of patients being treated for high blood pressure in the United States actually have control.
The ideal is less than 120/80.
Blood pressure higher than 130/80 should be treated.
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Prevalence of High Blood Pressure in Americans Age 20 and Older by Age and Sex NHANES IV: 1999-2000
p18
Source: Health, United States, 2003, CDC/NCHS.
Note: NA = data not available. Prevalence estimates for women ages 20-34 are considered unreliable.
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Hypertension Prior to 1990 the incidence of hypertension was declining. Data from 1999-2002 showed that the incidence had risen to
28.6% of the US population. As of 2006, only one-third of Americans with hypertension had
control of their blood pressure.
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Treating Hypertension Weight loss
Medications
Diet changes
Exercise
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8. Eat a Smart, Healthy Diet
Always eat breakfast, it can save you from a heart attack.
Avoid processed foods, especially foods with High Fructose Corn Syrup (HFCS).
When in season, shop at a farmer’s market at least twice per month or join a Community Sponsored Agriculture.
Avoid fast food.
Avoid saturated and trans-fats.
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Fast Food Fast food is designed to be fast, not nutritious.
Fast food is often cooked in oil and the amount of sugar, salt, and fat is maximized to increase flavor.
Fast food is usually eaten by hand and is quickly consumed allowing customers to eat greater quantities (supersize) before they realize they are full.
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Processed Food Many foods are now processed to contain corn products such as HFCS,
which increase caloric load.
Processing often introduces chemicals designed to trigger parts of the brain to crave that particular food.
Many foods are predigested with enzymes or are tumbled to make them easier to eat.
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7. Know and Manage Your Cholesterol Weight loss Medications Diet changes Exercise Know your numbers
> Total> Triglycerides <150> HDL >40 men, >50 women> LDL <70 with DM CAD, <100> Total/HDL <5.0
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Cholesterol LDL particles cause atherosclerosis. LDL concentration (gm/dl) is measured. LDL particles may be large or small, so the concentration does not
tell the number of particles present. If LDL is mostly small particles, more particles are present, greater
risk for atherosclerosis.
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6. Make Three Little Choices Every Day
Conscious decisions to do something good for your health.
Simple choices: walking, taking the stairs, turning off the TV earlier, fruit for dessert, extra 30 minutes of exercise.
These little choices add up to have a huge impact.
They also confirm your dedication to good health.
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5. Maintain a Healthy Weight
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Age-Adjusted Prevalence of Obesity in Americans Ages 20-74 by Sex and Survey NHES, NHANES I, NHANES II, NHANES III, NHANES IV: 1960-62, 1971-74, 1976-80, 1988-94 and 1999-2000
Note: Obesity is defined as a BMI of 30.0 or higher.
p33Source: CDC/NCHS.
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Prevalence of Overweight Among Students in Grades 9-12 by Sex and Race/Ethnicity United States: 2001
p33
Note: Overweight is defined as BMI 95th percentile or higher by age and sex of the CDC growth chart.
Source: YRBS, MMWR, Vol. 51, No. SS-4, June 28, 2002, CDC/NCHS.
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Weight For thousands of years, weight had been stable with no significant
change. In 1960, the average weight of the American woman aged 20-29
was 128 lbs. By 2000, the average weight was 157 lbs. As of 2007, 74.1% of Americans were overweight or obese. WHY???
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WHY??? Fast food
Processed food
Lack of exercise
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Prevalence of High School Students Using any Tobacco Product Within the Last 30 Days by Race/Ethnicity and Sex United States: 2001
p27
Source: YRBS, MMWR, Vol. 51, No. SS-4, June 28, 2002, CDC/NCHS.
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A Smoking Problem Approximately 25% of Americans smoke (27% men, 22.6%
women). 1 in 2 chance of smoking-related death. Average life years lost from smoking: 12 Cancers: lung, mouth, larynx, throat, oral, esophagus, urinary
tract, kidney, pancreas, and cervix. Most smokers die of heart disease first.
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Smoking Quit
Use whatever means is necessary
Replace the activity
If not for you, for those around you
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3. Avoid or Cure Diabetes
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Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1990
No Data Less than 4% 4% to 6% Above 6%
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Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1991-92
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data Less than 4% 4% to 6% Above 6%
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Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1993-94
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data Less than 4% 4% to 6% Above 6%
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Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1995-96
No Data Less than 4% 4% to 6% Above 6%
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Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1995
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data Less than 4% 4% to 6% Above 6%
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Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1997-98
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data Less than 4% 4% to 6% Above 6%
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Source: Mokdad et al., Diabetes Care 2001;24:412.
Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1999
No Data Less than 4% 4% to 6% Above 6%
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Source: Mokdad et al., J Am Med Assoc 2001;286(10).
Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 2000
No Data Less than 4% 4% to 6% Above 6%
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Source: Mokdad et al., J Am Med Assoc 2001;286(10).
Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 2002
No Data Less than 4% 4% to 6% Above 6%
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Diabetes Now and in the Future 2010 National Incidence: 14%
Projected Incidence 2050: 33%
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Normal Type 2 Diabetes
Courtesy of Wilfred Y. Fujimoto, MD.
Visceral Fat DistributionNormal vs Type 2 Diabetes
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Diabetes Do you have diabetes?
Are you sure?
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Metabolic Syndrome: “Pre-Diabetes”3 of These 5 Risk Factors
Risk Factor Defining Level
Abdominal obesityMenWomen
Waist Circumference>102 cm (>40 in)>88cm (>35 in)
Triglycerides >150 mg/dl
HDL-CMenWomen
<40 mg/dl<50 mg/dl
Blood Pressure >130/>85 mmHg
Fasting Glucose >110 mg/dl
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Diabetes If you have metabolic syndrome, high probability of developing
diabetes within 5 years.
Metabolic syndrome and diabetes have the same cardiovascular risk as established coronary artery disease.
Are you still sure?
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Treating (and Curing!) Diabetes Weight loss
Medications
Diet changes
Exercise
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2. Drink Plenty of Water
Americans far under-consume water.
Water is essential for every system in the body to function normally.
Consuming alcohol or sweetened soft drinks often defeats the purpose of drinking and adds empty calories.
Water helps us maintain normal body weight.
Rule of thumb: eight 8oz glasses per day, more with exercise, warm weather, altitude, or thirst.
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1. Exercise
5 to 7 days per week.
Minimum of 30 minutes, more is better.
Exercise: Aerobic activity and strength.
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Leisure-time Physical Activity (PA) Patterns Among Overweight Adults by Race/Ethnicity and Sex BRFSS: 1998
p31Source: MMWR, Vol. 49, No. 15, April 21, 2000, CDC/NCHS.
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Walking the dog
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Exercise Lowers blood pressure.
Improves cholesterol, lowers LDL and raises HDL.
Can help treat/cure diabetes.
Can help weight control.
Improves endothelial function and reduces risk of heart attack and stroke.
Improves lean muscle mass and bone density.
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Design an Exercise Program Pick activities you enjoy
Start slow, build as you go
Do it more days than you don’t
Sequester your exercise time
Get a partner, if you need one
Follow your progress
If it helps, think of exercise as medicine
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Check Your Progress Compare objective data
> Weight, BP, cholesterol, glucose control
> Speed, strength, endurance
Compare subjective data> How do you feel?
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Conclusion
10. Get plenty of sleep.
9. Know and manage your blood pressure.
8. Eat a smart, healthy diet.
7. Know and manage your cholesterol.
6. Make 3 little choices every day.
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Conclusion
5. Maintain a healthy weight.
4. Quit smoking.
3. Avoid or cure diabetes.
2. Drink plenty of water.
1. Exercise
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"I am what I am today because of the choices I made yesterday" — Eleanor Roosevelt
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For more tips and information
www.theactiveheart.blogspot.com
Coming in May 2011 www.theactiveheart.com