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Reducing Risk of Heart Disease & Stroke - A Life Long Quest

Reducing Risk of Heart Disease & Stroke - A Life Long Quest. Jeffrey P. Gold, M.D. University of Toledo Medical Center. Reducing Risk of Heart Disease & Stroke - A Life Long Quest. Coronary Artery Disease. Coronary Artery Disease. Where will you be in 33 seconds?.

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Reducing Risk of Heart Disease & Stroke - A Life Long Quest

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  1. Reducing Risk of Heart Disease & Stroke - A Life Long Quest Jeffrey P. Gold, M.D. University of Toledo Medical Center

  2. Reducing Risk of Heart Disease & Stroke - A Life Long Quest

  3. Coronary Artery Disease

  4. Coronary Artery Disease

  5. Where will you be in 33 seconds?

  6. Heart Disease & Stroke in 2007 A Few Facts & Figures

  7. Heart Disease in 2007 15.8 Million Americans have CAD 0.45 Million Americans die of CAD 1234 Americans die of CAD every day Lifetime Risk for American Male @ 40 - 40% Lifetime Risk for American Female @ 40 - 25%

  8. Coronary Heart Disease Heart Failure Diseases of the ArteriesDefects Rheumatic Fever/Rheumatic Heart Disease Stroke High Blood Pressure Congenital Cardiovascular Other Percentage breakdown of deaths from cardiovascular diseases (United States:2004) Source: NCHS and NHLBI.

  9. 0 Cardiovascular disease mortality trends for males and females (United States: 1979-2004). Source: NCHS and NHLBI.

  10. Deaths from diseases of the heart (United States: 1900–2004.) Note: See Glossary for an explanation of “Diseases of the Heart. Total CVD data are not available for much of the period covered by this chart. Source: NCHS and NHLBI.

  11. Hospital discharges for cardiovascular diseases. (United States: 1970-2004). Note: Hospital discharges include people discharged alive, dead and status unknown. Source: NCHS and NHLBI.

  12. Trends in the age-adjusted prevalence of health conditions, U.S. adults ages 20-74 (NHANES:1971-74 to 1999-2000). Source: Briefel and Johnson. Annu Rev Nutr. 2004;24:401-431. Printed with permission from the Annual Review of Nutrition.

  13. Age-adjusted death rates for coronary heart disease, stroke, and lung and breast cancer for white and black females(United States: 2004). Source: NCHS and NHLBI.

  14. Prevalence of cardiovascular diseases in adults age 20 and older by age and sex (NHANES: 1999-2004). Source: NCHS and NHLBI. These data include coronary heart disease, heart failure, stroke and hypertension.

  15. A B C D Blood Pressure (mm Hg) 120/80 140/90 140/90 140/90 Total Cholesterol (mg/dL) 200 240 240 240 HDL Cholesterol (mg/dL) 50 50 40 40 Diabetes No No Yes Yes Cigarettes No No No Yes mm Hg = millimeters of mercury. mg/dL = milligrams per deciliter of blood Estimated 10-Year CHD risk in 55-year-old adults according to levels of various risk factors (Framingham Heart Study).Source: Wilson et al., Circulation. 1998;97:1837-47.

  16. Annual number of Adults having diagnosed heart attack by age and sex (ARIC: 1987-2000). Source: Extrapolated from rates in the NHLBI’s ARIC surveillance study, 1987-2000. These data don’t include silent MIs.

  17. Prevalence of coronary heart disease by age and sex (NHANES :1999-2004). Source: NCHS and NHLBI.

  18. Hospital discharges for coronary heart disease by sex (United States: 1970-2004). Source: NHDS, /NCHS and NHLBI. Note: Hospital discharges include people discharged alive, dead, and status unknown.

  19. Prevalence of high blood pressure in Adults by age and sex (NHANES: 1999-2004). Source: NCHS and NHLBI.

  20. Extent of awareness, treatment and control of high blood pressure by age (NHANES : 1999-2004.) Source: NCHS and NHLBI.

  21. Prevalence of heart failure by age and sex (NHANES: 1999-2004). Source: NCHS and NHLBI.

  22. Hospital discharges for heart failure by sex (United States: 1979-2004). Source: NHDS, NCHS and NHLBI. Note: Hospital discharges include people discharged alive, dead and status unknown..

  23. Incidence of Heart Failure* by age and sex. (FHS: 1980-2003).Source: NHLBI. * HF based on physicians review of medical records and strict diagnostic criteria.

  24. Prevalence of high school students in grades 9-12 reporting current cigarette smoking by race/ethnicity and sex. (YRBS:2005).Source: MMWR. 2006;55:SS-5. June 9, 2006. . NH – non-Hispanic.

  25. Prevalence of current smoking for Adults age 18 and older by race/ethnicity and sex (NHIS:2004). Source: MMWR. 2004;54:1121-24. NH – non-Hispanic.

  26. Trends in mean total blood cholesterol among adolescents ages 12-17 by race, sex, and survey (NHES: 1966-70; NHANES: 1971-74 and 1988-94). Source: NCHS and NHLBI.

  27. Age-adjusted prevalence of Adults age 20 and older with LDL cholesterol of 130 mg/dL or higher, by race/ethnicity and sex (NHANES: 2003-2004). Source: NCHS and NHLBI. NH – non-Hispanic.

  28. Age-adjusted prevalence of Adults age 20 and older with HDL cholesterol <40 mg/dL, by race/ethnicity and sex (NHANES: 2003-2004). Source: NCHS and NHLBI. NH – non-Hispanic.

  29. Trends in cardiovascular risk factors in the U.S. population ages 20-74 (NHES: 1960-62, NHANES:1971-75 to 1999-2000). Source: Gregg et al., JAMA 2005;293:1868-74.In this study, high total cholesterol was defined as greater than or equal to 240 mg/dL; high blood pressure was defined as greater than or equal to 140/90 mm Hg.

  30. Prevalence of students in grades 9-12 who met currently recommended levels of physical activity during the past 7 days by race/ethnicity and sex (YRBS: 2005). Source: MMWR. 2006;55:No. SS-5. NH – non-Hispanic.

  31. Prevalence of leisure-time physical inactivity among adults age 18 and older by race/ethnicity, and sex. (BRFSS: 1994 and 2004). Source: MMWR, 2005;54:No. 39. NH – non-Hispanic.

  32. Prevalence of overweight among students in grades 9-12 by race/ethnicity and sex (YRBS: 2005). Source: BMI 95th percentile or higher. MMWR. 2006 55: No. SS-5. NH – non-Hispanic.

  33. Age-adjusted prevalence of obesity in Adults ages 20-74 by sex and survey (NHES, 1960-62; NHANES, 1971-74, 1976-80, 1988-94 and 2001-2004). Source: Health, United States, 2006, unpublished data. NCHS. Note: Obesity is defined as a BMI of 30.0 or higher.

  34. Trends in prevalence of overweight among U.S. children and adolescents by age and survey (NHANES, 1971-74, 1976-80, 1988-94 and 2001-2004). Source: Health, United States, 2006, unpublished data. NCHS.

  35. Trends in Heart Transplants (UNOS: 1970-2005). Source: United Network for OrganSharing (UNOS), scientific registry data.

  36. Trends in Cardiovascular Operations and Procedures (United States: 1979-2004). Source: NCHS and NHLBI. Note: Inpatient procedures only.

  37. Estimated direct and indirect costs of major cardiovascular diseases and stroke(United States: 2007). Source: NHLBI.

  38. Reducing Risk of Heart Disease & Stroke - A Life Long Quest • Recognize: Heart Attack & Stroke • Number 1 Killer in Western World • Prevention is more effective than treatment • Progression of Atherosclerosis • Age & Gender Related Issues • Concept of Risk Factors • Prevention = Risk Factor Control

  39. Reducing Risk of Heart Disease & Stroke - A Life Long Quest • Understand: Risk Factors for Heart Disease & Stroke • Genetics & Related Issues • Gender, Ethnicity • Diet & Related Issues • Lipids, Calories, Body Weight • Exercise & Related Issues • Types, Duration, Frequency • Blood Pressure Control • Normal, Diet, Medications • Tobacco & Drugs • Metabolic Conditions • Diabetes, SLE, etc.

  40. Reducing Risk of Heart Disease & Stroke - A Life Long Quest • Medical Care: Detect & Prevent Heart Disease & Stroke • History of Patient & Family • Physical Examination • Blood Pressure & Cardiac Exam • Blood Lipid Measurements • Exercise Stress Tests • Radionucleide Scans • Echocardiography • MRI & PET Scans • CTT, Cath & Angiography • Education

  41. Reducing Risk of Heart Disease & Stroke - A Life Long Quest • Five Steps to Prevention • Diet- Lipids • Exercise - Weight • Hypertension - Diabetes • Tobacco - Drugs • Medical Screening

  42. Reducing Risk of Heart Disease & Stroke - A Life Long Quest • Four Steps of Therapy • Risk Factor Control • Education • Medical Care • Pharmaceuticals • Angioplasty • Surgery • Gene Therapy, etc.

  43. Reducing Risk of Heart Disease & Stroke - A Life Long Quest • More Information? • Ask Your Physician, Nurse, Parent • The American Heart Association • 1-800-AHA-USA1 • http://www.amhrt.org • Ask University of Toledo Medical Center • 1-800-383-5454 • http://www.utoledo.edu

  44. Reducing Risk of Heart Disease & Stroke - A Life Long Quest Where will you be in 33 seconds?

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