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Heart Disease Prevention and Management

Heart Disease Prevention and Management. ,. Salil Midha, MD FACC Chief of Cardiology and  Director of Cardiac Cath and Rehabilitation programs Melrose Wakefield Hospital, Melrose, MA President, Boston Cardiac Foundation www.bostoncardiac foundation.org. Acknowledgements.

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Heart Disease Prevention and Management

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  1. Heart Disease Prevention and Management , Salil Midha, MD FACC Chief of Cardiology and  Director of Cardiac Cath and Rehabilitation programs Melrose Wakefield Hospital, Melrose, MA President, Boston Cardiac Foundation www.bostoncardiac foundation.org

  2. Acknowledgements • Thanks to the following web sites for the educational materials • American Heart Association • CADI Research foundation • Mayo Clinic • Cardiac Cath. Lab, Melrose, MA

  3. Heart Disease Overview • Number one cause of death in the world • More people die of heart disease than due to cancer and accidents combined • Recent treatments have lowered the mortality due to the heart disease

  4. Heart Disease Overview • Begins in childhood and slowly progresses • Causes plaque formation • Plaque rupture causes heart attacks and stroke • No relation of severity of disease and symptoms • Advanced warning of angina in 1/3 rd patients only • Half of the sudden deaths occur in undiagnosed • Good news – Can be detected by stress test, heart scan and cardiac Catheterization

  5. Heart Disease Prevalence Over Age 20

  6. Deaths Due To Heart Diseases

  7. Mortality Trends in USA

  8. Heart Disease Indian Overview • 1.2 Billion people • 33% below age 15 • 50% below age 25 • Life expectancy is 64 years in 2008 (USA 75 for men and 78 for females) • Only 5.5 % over 65( 65 million) vs. 13% in USA (41 million our of 300 million people) • 2.3 million died of heart disease in India vs. 404,000 in USA

  9. Coronary Artery Disease in Indians

  10. Mortality Ratios In UK Vs. Asia

  11. Ethnic Differences

  12. Cardiac Mortality in India

  13. Stroke Mortality Ethnic Difference

  14. Heart Disease Definitions • Coronary Artery Disease • Angina • Heart Attack/ Myocardial Infarction • Congestive Heart failure • Valular Heart disease • Arrhythmia like Atrial Fibrillation and Ventricular tachycardia • Congenital Heart disease

  15. Coronary artery Disease • Heart supplies the blood and Oxygen to the rest of the body. • Average heart rate is 70 and BP is 120/80 • Heart is supplied by three arteries which are known as coronary arteries. These are Left Anterior Descending, left Circumflex and the right coronary arteries

  16. Coronary Arteries and Atherosclerosis

  17. Heart Attack A heart attack occurs when one or more of the arteries supplying your heart with oxygen-rich blood (coronary arteries) become blocked. Coronary artery can become narrowed from the buildup of cholesterol. This buildup — collectively known as plaques — in arteries throughout the body is called atherosclerosis.

  18. Causes of Heart Attack • During a heart attack, one of these plaques can rupture and a blood clot forms on the site of the rupture. • If the clot is large enough, it can completely block the flow of blood through the artery and cause heart attack

  19. Atherosclerosis & Plaque Rupture

  20. Angina • Condition when patient complain of chest pain due to the lack of blood supply to the heart muscle • This generally happens slowly with some warning signs • However frequently there is sudden blockage of the vessel due to acute plaque rupture and closure of the artery with clot build up.

  21. Symptoms of Heart Disease • Pressure, a feeling of fullness or a squeezing pain in the center of your chest that lasts for more than a few minutes • Pain extending beyond your chest to your shoulder, arm, back, or even to your teeth and jaw • Increasing episodes of chest pain • Prolonged pain in the upper abdomen • Shortness of breath • Sweating • Impending sense of doom • Fainting • Nausea and vomiting

  22. Prevalence of Heart Disease

  23. Annual Rate of First Heart Attack

  24. Estimated 10 Risk of Heart Attack

  25. Deaths Due To Heart Disease In USA

  26. RISK FACTORS IN ASIAN INDIANS

  27. LDL Major risk factor

  28. Age Adjusted CAD Death Rates

  29. High Calcium Score and LDL

  30. Regional Differences In India

  31. Overview of Diet • Significantly modifiable risk • Change saturated and trans fats with poly and monounsaturated foods • Olive and Canola oils are monounsaturated • Soybean and sunflower oils are polyunsaturated • Total fat calories should be 25% of diet and saturated foods should be less than 7% • Omega 3 and 6 are found in oily fish, nuts and seeds. • Decrease salt intake and increase fruits and vegetables

  32. Corn Oil v Coconut Oil

  33. Metabolic Syndrome for Indians • Increased risk of Diabetes and heart attack • Abdominal obesity • High cholesterol • High Blood pressure • Low LDL( good cholesterol) • High triglycerides

  34. Metabolic Syndrome

  35. Prevalence of Obesity in USA

  36. Obesity Overview • Major modifiable risk • Over 400 million people are obese • Over 1.6 billion people are overweight • Caused by overeating and lack of physical activity • Incidence of Diabetes increased 3 fold in men and 5 fold in women • Preventable • Shortens life span by 3 years

  37. Progression of Obesity

  38. Prevalence of Hypertension

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