The facts about heart disease and stroke High Blood Pressure PROTECT YOUR HEALTH The facts about heart disease and stroke High Blood Pressure

Millions of Canadians at risk of cardiovascular disease Over 4.7 million people still smoke Over 60% of Canadians are above a healthy weight 19% have high blood pressure “Ninety percent of Canadians have at least one risk factor for cardiovascular disease – which makes it more important than ever for the Heart and Stroke Foundation to support research into the root causes of  the  heart disease risk factors AND discovery of successful strategies to prevent the development of these risk factors.”  Heart and Stroke Foundation Researcher Dr. Sonia Anand MD PhD FRCPc Professor of Medicine, McMaster University

Topics for today How the heart works Warning signs of heart attack How the brain works Warning signs of stroke Risk factors, high blood pressure What the Heart and Stroke Foundation is doing

How the Heart Works

The heart Is a muscle the size of a clenched fist Is located behind the breastbone Pumps about 100,000 times a day Pumps about 7,600 litres of blood per day

Anatomy of the heart

Atherosclerosis Plaque

Heart attacks Blood flow through coronary arteries is blocked Vital blood supply to heart muscle is cut off About 70,000 heart attacks each year Victims can often recover if treated immediately

Warning signs of a heart attack Chest discomfort (uncomfortable chest pressure, squeezing, fullness or pain, burning or heaviness) Discomfort in other areas of the upper body (neck, jaw, shoulders, arms, back)

Warning signs of a heart attack Shortness of breath Sweating Nausea Light-headedness

Warning signs of a heart attack If you are experiencing any of the warning signs of a heart attack …. Call 9-1-1 or your local emergency number IMMEDIATELY Stop all activity Take your normal dose of nitroglycerin (if prescribed) If you are experiencing chest pain, take one dose of 160-325mg of ASA. Rest until the EMS arrive

Cardiopulmonary resuscitation (CPR) Most important factor in reducing pre-hospital deaths from cardiac arrest CPR courses teach lifesaving skills The Heart and Stroke Foundation collaborated on Resuscitation Guidelines in the US and Canada “It only takes a few minutes to save a life. CPR and defibrillation if administered early can triple or quadruple a person’s chance of survival.” Heart and Stroke Foundation researcher Ian G. Stiell, MD, MSc, FRCPC Professor and Chair, Department of Emergency Medicine, University of Ottawa Distinguished Professor and University Health Research Chair, University of Ottawa

Automated external defibrillator (AED) Automatically analyses heart rhythm Delivers controlled shock if needed to restore normal heart rhythm Now found in public places such as sports arenas and airports For course information, please call 1-888-HSF-INFO

How the Brain Works

The brain

A stroke is… An injury to a part of the brain caused by interruption of blood flow “Research has shown us that when blood flow is reduced, the brain tries to protect itself by releasing certain chemicals. In the short term, these chemicals can be protective but if blood flow is not restored quickly, they can actually contribute to brain damage. These insights have opened up new possibilities for developing drugs to protect the brain—agents that we call neuroprotectives.”  Heart and Stroke Foundation Researcher Yu Tian Wang, PhD Heart and Stroke Foundation of British Columbia and Yukon Chair in Stroke Research Professor, Department of Medicine, University of British Columbia

Ischemic strokes

Hemorrhagic strokes

Warning signs of a stroke Stroke can be treated. That’s why its so important to recognize and respond to the warning signs. Weakness - Sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary Trouble speaking – Sudden difficulty speaking or understanding or sudden confusion, even if temporary Vision problems – Sudden trouble with vision, even if temporary

Warning signs of a stroke Headache – Sudden severe and unusual headache Dizziness – Sudden loss of balance, especially with any of the above signs React immediately If you experience any of these symptoms, Call 9-1-1 or your local emergency number IMMEDIATELY

Risk Factors for Heart Disease and Stroke

Risk factors you can’t control Age Gender Family history Ethnicity Prior stroke or TIA

What you can do to lower your risk Know and control your blood pressure Know and control your blood cholesterol Manage your diabetes Maintain a healthy weight Eat a healthy diet Limit alcohol consumption Be physically active Be smoke-free Reduce stress

Know and control your high blood pressure High blood pressure has no visible symptoms Should be checked at least every two years by a healthcare professional Visit heartandstroke.ca/bp

What is high blood pressure “Blood pressure measures how hard blood pushes against the blood vessel walls.” Copyright 1996 Tim Peters and Company, Inc. All rights reserved.

Blood pressure has TWO numbers Top number = pressure when heart contracts (systolic) Bottom number = pressure when heart relaxes (diastolic) Example: healthy BP = 120 80

Classifications of hypertension Category Systolic Diastolic Optimal <120-129 <80-85 mm Hg High blood pressure 140 90 mm Hg or higher High normal 130-139 80-89 mm Hg or higher Note: High blood pressure for diabetics remains 140/90. However when trying to control hypertension, the target level should be 130/80 or less as recommended by their physician. In case of a direct question, this information given is in the slide notes for easy reference. Shadab Rana 9/25/2012 Canadian Hypertension Education Program (CHEP), 2012

High blood pressure can: Increase risk of stroke Increase risk of heart disease Damage kidneys and eyes Cause impotence Disrupt circulation

Risk factors you can’t change Age Family history Ethnic background South Asian Aboriginal Peoples People of African Descent

Risk factors you can change Take your blood pressure medication as prescribed Understand and monitor your blood pressure Be smoke-free Maintain a healthy weight Maintain a balanced diet Get active Limit alcohol intake Manage stress

How often should I check my blood pressure? Category Frequency Optimal At least every two years by a healthcare provider 130-139 85-89 Every year or as recommended by your doctor Above 139 89 Check often – your doctor will tell you just how often

If using a home blood pressure monitor: Ask doctor’s advice Record results and show to doctor Select monitor endorsed by Hypertension Canada Ensure correct cuff size Check monitor for accuracy Learn and use proper measurement technique

“White coat hypertension” A few people have high blood pressure when they visit the doctor’s office but have normal blood pressure when they go about their usual daily activities. Regular monitoring is required, as many people with WCH may develop high blood pressure over time.

Preparing to take your blood pressure: Wait 2 hours after a big meal or heavy exercise Wait 30 minutes after exercising, smoking or drinking caffeine Don’t measure if you are in pain or upset Be in calm warm environment Empty your bladder or bowel Sit quietly with your arm and back supported for 5 minutes prior

When taking your blood pressure: Do not speak Be seated Keep back supported Keep legs uncrossed Keep feet flat on the floor Ensure arm is supported Place cuff on bare arm, 3 cm above fold of elbow, at heart level

Know and control your blood cholesterol Ask your doctor if you are at risk and should be tested Can be lowered by reducing your fat intake and being physically active May be controlled with medication

Manage your diabetes Damages blood vessels, causes circulation problems Reduce risk of diabetes by healthy diet, activity, weight control Control diabetes to reduce your risk of heart disease and stroke

Maintain a healthy weight Achieve and maintain a healthy body weight by enjoying regular physical activity and healthy eating Small weight loss can significantly reduce risk Visit heartandstroke.ca/healthyliving “With over 60% of Canadians being over-weight or obese, we are faced with a serious public health problem.” Heart and Stroke Foundation Researcher Bruce A. Reeder MD, MHSc, FRCPC Department of Community Health and Epidemiology University of Saskatchewan

Eat a balanced healthy diet Enjoy a variety of foods from the four food groups Choose lower fat dairy products, leaner meats and watch your portion size Find delicious recipes and helpful cooking tips at heartandstroke.ca/recipes

Reduce dietary salt Choose fresh foods Prepare home cooked meals Season foods with herbs, salt-free spices, lemon, vinegar, garlic and onion Limit intake of salty condiments Avoid salty processed foods Look for products with the Health Check™ symbol

Limit alcohol consumption Women—no more than 2 drinks/day to a maximum of 10 drinks/week Men—no more than 3 drinks/day to a maximum of 15 drinks/week These guidelines do not apply if you are driving a vehicle, taking medications or other drugs that interact with alcohol, pregnant or are trying to get pregnant or breastfeeding, making important decisions, doing any kind of dangerous physical activity, living with alcohol dependence or mental or physical health problems, or responsible for the safety of others. I f you are concerned about how drinking may affect your health, talk to your doctor

Be physically active Adults aged 18-64 should accumulate at least 150 minutes of moderate-to-vigorous intensity aerobic physical activity per week in bouts of 10 minutes or more Be active most days of the week Consult a healthcare professional before starting an activity program

Be smoke-free Smoking cessation programs improve the chances of quitting Visit heartandstroke.ca for tips on quitting successfully “After you quit smoking, your risk of heart attack begins to decrease within just two days. Within a year it’s cut in half. And within 10 to 15 years, your risk of heart disease is almost the same as a non-smoker’s.” Heart and Stroke Foundation researcher Paul W. McDonald, PHD Professor and Chair, Health Studies and Gerontology University of Waterloo

Reduce stress Recognize sources of stress Consider relaxation exercises Ask for help from family, friends, or a healthcare professional

What the Heart and Stroke Foundation is doing

The Heart and Stroke Foundation at work in your community World class research Advocating for social change CPR/AEDs Promoting healthy living

Interested in volunteering? Visit heartandstroke.ca Call 1-888-HSF-INFO Contact your local area office

Visit heartandstroke.ca and sign up today!

What can YOU do? Learn about your risk factors and how to reduce their impact Know the warning signs of heart disease and stroke and what to do Learn CPR Become a volunteer Sign up for He@lthline Visit heartandstroke.ca

Thank you!