Heart Disease- The Silent Killer

Slide 1:Heart Disease- The Silent Killer

Created by: Tricia Fleming, University of Kansas Dietetic Intern Tammy Beason, MS, RD, Nutrition Education Specialist, Family Nutrition Education Program December 2001

Slide 2:What is Heart Disease?

A general term that covers a number of diseases which affect the heart, including coronary artery disease, heart-failure and angina. Heart Disease is the number one killer in the United States.

Slide 3:What Causes Heart Disease?

Atherosclerosis-fatty deposits of cholesterol Hypertension- we will discuss in detail later. What causes heart disease? Two major conditions contribute Atherosclerosis it involves deposits of fatty substances cholesterol, cellular waste and calcium in the lining of an artery. It starts due to elevated levels of cholesterol, high blood pressure, and tobacco smoke.What causes heart disease? Two major conditions contribute Atherosclerosis it involves deposits of fatty substances cholesterol, cellular waste and calcium in the lining of an artery. It starts due to elevated levels of cholesterol, high blood pressure, and tobacco smoke.

Slide 4:Coronary Artery Disease

Occurs when the coronary arteries that supply the heart muscle become blocked. Partially blocked it causes angina. Fully blocked it causes a myocardial infarction or a heart attack!

Slide 5:Myocardial Infarction or Heart Attack

Symptoms: uncomfortable pressure, fullness, squeezing pain, pain spreading to the shoulders, neck and arms. Chest discomfort and light headedness Anxiety/nervousness Paleness or pallor Increased irregular heart rate

Slide 6:Myocardial Infarction contd.

Feeling of impending doom If you or someone you know is having these symptoms call 911!

Slide 7:Congestive Heart Failure

Fits under the description of heart disease. Does not mean the heart has failed, simply means the heart is not doing an efficient job. It results from an injury or a reduction of function of the heart muscle. Can be due to arteriosclerosis, hypertension, myocardial infarction, rheumatic fever or birth defect. Congestive Heart Failure affects people of all ages from children to senior citizens, there is no cure. The heart has been weakened by an underlying problem. Clogged arteries, high blood pressure, a defect or some other medical condition. It does not mean the heart has failed, simply means the heart is not doing an efficient job.Congestive Heart Failure affects people of all ages from children to senior citizens, there is no cure. The heart has been weakened by an underlying problem. Clogged arteries, high blood pressure, a defect or some other medical condition. It does not mean the heart has failed, simply means the heart is not doing an efficient job.

Slide 8:Congestive Heart Failure

The right side of the heart collects the blood returning from the body and sends it to the lungs. If it is failing, the blood backs up into the veins, and there are signs of edema. The left side of the heart receives the blood from the lungs and pumps it out into the body. If it is failing the blood is not pumped effectively.

Slide 9:Cerebrovascular AccidentorStroke

Blood vessel in the brain becomes blocked by atherosclerosis- the tissue supplied by the artery dies. Embolus � which is a traveling blood clot. Cerebrovascular Accident � Every 53 seconds someone in America has a stroke. Stroke is the nation�s #3 killer and is the leading cause of long-term disability. People with heart disease have twice the risk of having a stroke. It is caused when a blood vessel in the brain become blocked by artherosclerosis and the tissue supplied b the artery dies. It can also be caused by a traveling blood clot known as an embolus.Cerebrovascular Accident � Every 53 seconds someone in America has a stroke. Stroke is the nation�s #3 killer and is the leading cause of long-term disability. People with heart disease have twice the risk of having a stroke. It is caused when a blood vessel in the brain become blocked by artherosclerosis and the tissue supplied b the artery dies. It can also be caused by a traveling blood clot known as an embolus.

Slide 10:Symptoms of Stroke

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body. Sudden confusion, trouble speaking, or understanding. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance or coordination.

Slide 11:Symptoms of Stroke

Sudden severe headache with no known cause. If you have any of these symptoms you need immediate medical attention!

Slide 12:Unchangeable Risk Factors

Age- the older you get, the greater the chance. Sex- males have a greater rate even after women pass menopause. Race- minorities have a greater chance. Family history- if family members have had CHD, there is a greater chance. Unchangeable Risk Factors: Age, the older you get the greater the chance of heart disease. Four out of five people who die of congestive heart disease are 65 years of age or older. Sex, males have a greater rate of congestive heart disease. Race, minorities have a greater chance of heart disease. African Americans have a greater chance of high blood pressure. The risk is also higher in Mexican Americans, America Indians, native Hawaiians and Asian Americans. Also included as unchangeable risk factors is your family history and your own personal medical history.Unchangeable Risk Factors: Age, the older you get the greater the chance of heart disease. Four out of five people who die of congestive heart disease are 65 years of age or older. Sex, males have a greater rate of congestive heart disease. Race, minorities have a greater chance of heart disease. African Americans have a greater chance of high blood pressure. The risk is also higher in Mexican Americans, America Indians, native Hawaiians and Asian Americans. Also included as unchangeable risk factors is your family history and your own personal medical history.

Slide 13:Unchangeable Risk Factors

Personal Medical History- other diseases such as Diabetes Mellitus can increase chances.

Slide 14:Changeable Risk Factors

Hypertension Serum cholesterol Obesity Diabetes Mellitus Physical Inactivity Cigarette Smoking Alcohol Intake Hypertension Serum Cholesterol: As cholesterol rises so does the risk of congestive heart disease, and obesity. It is unhealthy because excess weight puts more strain on your heart. It can raise blood pressure and blood cholesterol and lead to diabetes. Diabetes Mellitus, Physical Inactivity, and Cigarette Smoking along with Alcohol intake are the other changeable risk factors. A smoker�s risk of a heart attack is more than twice that of a non-smoker. Hypertension Serum Cholesterol: As cholesterol rises so does the risk of congestive heart disease, and obesity. It is unhealthy because excess weight puts more strain on your heart. It can raise blood pressure and blood cholesterol and lead to diabetes. Diabetes Mellitus, Physical Inactivity, and Cigarette Smoking along with Alcohol intake are the other changeable risk factors. A smoker�s risk of a heart attack is more than twice that of a non-smoker.

Slide 15:Cholesterol

Everybody needs cholesterol, it serves a vital function in the body. It is a component of the nerve tissue of the brain and spinal cord as well as other major organs. Frequently measured to promote health and prevent disease. A major component of the plaque that clogs arteries. Cholesterol is a soft waxy substance found among the lipids in the bloodstream and in all of your body�s cells. Everybody needs cholesterol, it serves a vital function in the body. It is a component of the nerve tissue of the brain and spinal cord as well as other major organs. We get cholesterol from two ways. Our bodies make it and the rest comes from animal products we eat. It is frequently measured to promote health and prevent disease. Desirable levels of total cholesterol levels should be at 200 or less. 240 is considered high but it will depend on the HDL and LDL levels if at this level there is a risk to your health. It is a major component of the plaque that clogs arteries. Cholesterol and other fats can�t dissolve in the blood. They have to be transported to and from cells by special carriers called lipoproteins. Cholesterol is a soft waxy substance found among the lipids in the bloodstream and in all of your body�s cells. Everybody needs cholesterol, it serves a vital function in the body. It is a component of the nerve tissue of the brain and spinal cord as well as other major organs. We get cholesterol from two ways. Our bodies make it and the rest comes from animal products we eat. It is frequently measured to promote health and prevent disease. Desirable levels of total cholesterol levels should be at 200 or less. 240 is considered high but it will depend on the HDL and LDL levels if at this level there is a risk to your health. It is a major component of the plaque that clogs arteries. Cholesterol and other fats can�t dissolve in the blood. They have to be transported to and from cells by special carriers called lipoproteins.

Slide 16:Types of Cholesterol

Lipoproteins- 4 main classes Chylomicrons Very low density lipoproteins (VLDL) Low Density Lipoprotein (LDL) High Density Lipoprotein (HDL)

Slide 17:Good vs. BAD

LDL is known as bad cholesterol. It has a tendency to increase risk of CHD. LDL�s are a major component of the atherosclerotic plaque that clogs arteries. Levels should be <130

Slide 18:Good vs. BAD

HDL is known as the good cholesterol. It helps carry some of the bad cholesterol out of the body. It does not have the tendency to clog arteries. Levels should be >35. High levels of HDL >60 can actually negate one other risk factor. HDL or high density lipoprotein is know as the good cholesterol, it helps to bind to some of the bad cholesterol and carry it out of the body. It does not have the tendency to clog arteries. The target level is greater than 35mg/dl. High levels of >60 can actually negate one other risk factor. Studies suggest that high levels of HDL cholesterol reduce your risk of a heart attack. HDL or high density lipoprotein is know as the good cholesterol, it helps to bind to some of the bad cholesterol and carry it out of the body. It does not have the tendency to clog arteries. The target level is greater than 35mg/dl. High levels of >60 can actually negate one other risk factor. Studies suggest that high levels of HDL cholesterol reduce your risk of a heart attack.

Slide 19:The Facts About Fat

Certain fats are essential for good nutrition and health. Fats provide essential fatty acids which the body can�t manufacture. Act as insulators to maintain body temperature. Improve the palatability of food and promote digestion. The Facts About Fat � Certain fats are essential for good nutrition and health. Fats provided essential fatty acids which the body can�t manufacture, they act as insulators to maintain body temperature and they improve the palatability of food and promote digestion. Knowing which fats raise LDL cholesterol and which ones don�t is very important. Saturated fat, trans fatty acids, and dietary cholesterol raise blood cholesterol. Some studies suggest that using monounsaturated and polyunsaturated may lower cholesterol levels slightly. The Facts About Fat � Certain fats are essential for good nutrition and health. Fats provided essential fatty acids which the body can�t manufacture, they act as insulators to maintain body temperature and they improve the palatability of food and promote digestion. Knowing which fats raise LDL cholesterol and which ones don�t is very important. Saturated fat, trans fatty acids, and dietary cholesterol raise blood cholesterol. Some studies suggest that using monounsaturated and polyunsaturated may lower cholesterol levels slightly.

Slide 20:The Facts About Fat

Provide the greatest energy output per gram of any food source. ( 9 cals) Carry fat soluble vitamins- A,D,E, and K.

Slide 21:The Skinny on Fat

Saturated fats- basically means the fat is saturated with hydrogen, they are solid at room temperature. Examples are lard and butter. Why are they bad for you? They increase levels of LDL , decrease HDL and increase total cholesterol. Saturated fats can cause an increase in cholesterol. What is saturated fat? It is fat that is saturated with hydrogen and is a solid at room temperature. Examples are lard and butter. Saturated fats increase levels of LDL, decrease levels of HDL and increases total cholesterol. The American Heart Association recommends you limit saturated fat intake to 7-10% of your total calories.Saturated fats can cause an increase in cholesterol. What is saturated fat? It is fat that is saturated with hydrogen and is a solid at room temperature. Examples are lard and butter. Saturated fats increase levels of LDL, decrease levels of HDL and increases total cholesterol. The American Heart Association recommends you limit saturated fat intake to 7-10% of your total calories.

Slide 22:The Skinny on Fat

What are polyunsaturated fats? They are unsaturated fats which are liquid at room temperature and in the refrigerator. Why are they good for us? They help the body get rid of newly formed cholesterol.

Slide 23:The Skinny on Fat

What are monounsaturated fats? They are liquid at room temperature but start to solidify in the refrigerator. Decrease total cholesterol and lower LDL levels. Monounsaturated fat includes canola, olive and peanut oils and avocados.Monounsaturated fat includes canola, olive and peanut oils and avocados.

Slide 24:The Skinny on Fat

What are trans fatty acids? They are unsaturated fats but they tend to raise total and bad cholesterol. Where do you find them? In fast-food restaurants Commercial baked goods. Examples: doughnuts, potato chips, cupcakes. Trans fatty acids have hydrogen added to them to give them a longer shelf life and they also tend to lower HDL levels.Trans fatty acids have hydrogen added to them to give them a longer shelf life and they also tend to lower HDL levels.

Slide 25:What about Omega 3?

Type of polyunsaturated fat. Consistently lowers serum triglycerides and may also have an effect on lowering blood pressure. Found in oily fish such as salmon, tuna, and herring. Is available as a supplement. The American Heart Association recommends eating fish two times per week. Mention other fish that contain Omega 3 fatting acids. Omega 3 fatty acids are available as a supplement but research is till being done to determine the supplements� effectiveness. The American Heart Association recommends eating fish two times per week. Mention other fish that contain Omega 3 fatting acids. Omega 3 fatty acids are available as a supplement but research is till being done to determine the supplements� effectiveness.

Slide 26:Obesity

People who are obese have 2 to 6 times the risk of developing hypertension. Location of the body fat is significant. Pears of apples? People who are obese have 2 to 6 times the risk of developing hypertension even if they have no other risk factors.People who are obese have 2 to 6 times the risk of developing hypertension even if they have no other risk factors.

Slide 27:Diabetes Mellitus

At any given cholesterol level, diabetic persons have a 2 or 3 x higher risk of atherosclerosis! Insulin is required to maintain adequate levels of lipoprotein lipase, an enzyme needed to break down bad cholesterols. About 2/3 of the people with diabetes die of some type of heart or blood vessel disease.About 2/3 of the people with diabetes die of some type of heart or blood vessel disease.

Slide 28:Physical Inactivity

Increasing physical activity has been shown to decrease blood pressure. Moderate to intense physical activity for 30-45 minutes on most days of the week is recommended. Exercise can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure.Exercise can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure.

Slide 29:Cigarette Smoking

Causes an increase in blood pressure Usually have lower levels of HDL Within 1 year of quitting, CHD risk decreases, within 2 years it reaches the level of a nonsmoker.

Slide 30:Alcohol Consumption

In small amounts it acts as a vasodilator-Good! 1-2 drinks In large amounts it acts as a vasoconstrictor-BAD! 3-4 drinks This is a very fine line! Alcohol Consumption: In small amounts alcohol acts as a vasodilator, this is good and usually occurs in 1-2 drinks. In large amounts it acts as a vasoconstrictor which is bad. The range this occurs is 3-4 drinks. This is a very fine line. Other risk factors that may contribute to a higher risk of heart disease is an individual�s response to stress, sex hormones, and the loss of natural estrogen as women age.Alcohol Consumption: In small amounts alcohol acts as a vasodilator, this is good and usually occurs in 1-2 drinks. In large amounts it acts as a vasoconstrictor which is bad. The range this occurs is 3-4 drinks. This is a very fine line. Other risk factors that may contribute to a higher risk of heart disease is an individual�s response to stress, sex hormones, and the loss of natural estrogen as women age.

Slide 31:Treatment

Cardiac Catherization - Dr. inserts a plastic tube into an artery or vein and injects a dye, this can help to determine where the blockages are. Also a good method to determine the amount of blood and oxygen the heart is receiving.

Slide 32:Treatment

Coronary Artery Bypass Surgery (CABG) The most frequently performed major surgery in the United States. Surgery reroutes or bypasses blood around clogged arteries.

Slide 33:Treatment

Angioplasty (PCTA) It involves creating a space in a blocker artery by inserting a small balloon and then inflating it. Now includes the placement of a mesh stent to improve effectiveness.

Slide 34:How can You Stop CVD?

Diet and Nutrition, there are several guidelines listed by the American Heart Association: Eat a variety of fruits and vegetables every day. ( 5 servings - they are naturally low in fat and high in vitamins and minerals) Eat a variety of grain products ( 6 a day) How can you stop cardiovascular disease? The heart healthy diet is designed to decrease sodium, saturated fat, including trans fatty acids which are all closely linked to high blood cholesterol and an increased risk of heart disease. It also encourages the increased intake of monounsaturated fat, Omega 3 fatty acids and soluble fiber which helps to lower blood cholesterol levels and reduce the risk of heart disease.How can you stop cardiovascular disease? The heart healthy diet is designed to decrease sodium, saturated fat, including trans fatty acids which are all closely linked to high blood cholesterol and an increased risk of heart disease. It also encourages the increased intake of monounsaturated fat, Omega 3 fatty acids and soluble fiber which helps to lower blood cholesterol levels and reduce the risk of heart disease.

Slide 35:Diet and Prevention of CVD

Choose nonfat or low-fat products. Use lean meats- choose chicken, fish, turkey and lean cuts of beef and pork. Switch to fat-free milk- gradually reduce the fat content of the milk you drink.

Slide 36:Dietary Guidelines

Choose fats with 2 gms or less of saturated fats per serving such as liquid and tub margarines, canola oil and olive oil. Balance the # of calories you eat with the number of calories you use each day. Maintain a level of physical activity that keeps you fit and matches the # of calories you eat.

Slide 37:Dietary Guidelines

Limit your intake of foods high in calories and low in nutrition, including foods like soft drinks and candy. Limit foods high in saturated fat, trans fat and cholesterol Eat less than 6 gms of salt a day Have no more than one alcoholic drink a day.

Slide 38:Step I and II Diets

The AHA and NCEP have developed these diets to treat high blood pressure and hypercholesterolemia They are designed to lower LDL levels, while at the same time promoting good nutrition. The American Heart Association and the National Cholesterol Education Program have developed these diets to treat high blood pressure and hypercholesterolemia. The main goal is to lower LDL levels to reduce the risk of cardiovascular heart disease. These guidelines help patients reduce saturated fat and cholesterol in their diets. The difference between Step 1 and 2 is that Step 1 is carried out in a medical setting. Step 1 is the starting point.The American Heart Association and the National Cholesterol Education Program have developed these diets to treat high blood pressure and hypercholesterolemia. The main goal is to lower LDL levels to reduce the risk of cardiovascular heart disease. These guidelines help patients reduce saturated fat and cholesterol in their diets. The difference between Step 1 and 2 is that Step 1 is carried out in a medical setting. Step 1 is the starting point.

Slide 39:Step I Step II

Total fat- 30% or less Sat fat- 7-10% Poly - up to 10% Mono Up to 15% Carb 55% or more Pro Approx 15% Chol. less than 300mg 30% or less 7% up to 10% up to 15% 55% or more Approx 15% less than 200 mg

Slide 40:Exercise and CVD

Serves several functions in preventing and treating those at high risk. Reduces incidence of obesity. Increases HDL Lowers LDL and total cholesterol Helps control diabetes and hypertension Those at high risk should take part in a specially supervised program.

Slide 41:Conclusion

Cardiovascular disease is the number one killer. It is highly preventable and controllable with diet and exercise. Good resource: www.americanheart.org 1-800-AHA-USA