 3 rd leading cause of death  Leading cause of serious long term disability in the U. S.  Women more likely to die from a stroke than men  On average, every 40 seconds someone has a stroke

 Death of brain cells leading to loss of neurological function  Two types  Ischemic Stroke: blocked circulation to a part of the brain usually due a blood clot, often in a narrowed artery  Hemorrhagic Stroke: ruptured blood vessel, usually arterial, causing circulation loss to part of the brain  87% if strokes are ischemic and 13% hemorrhagic

 Temporary neurological symptoms in the distribution of a blood vessel that blocks, and then clears  Usually develop stroke like symptoms that resolve in 60 minutes or less  Similar to Angina preceding a heart attack

 F.A.S.T.  Face: facial droop on one side: ask the person to smile  Arms : Loss of coordination or weakness/numbness on one side- hold both arms straight out from the body- does one drift downward?  Speech: Ask the person to repeat a simple sentence- was it repeated normally?  Time: Get to the Hospital immediately if any of the above are abnormal: Time is Brain

 Less common, but potentially stoke symptoms:  New type of severe headache  Sudden Nausea/Vomiting  Sudden sleepiness or agitation  Ataxia- staggering while moving, clumsiness

 Blood pressure: increased risk for blood pressure above 120/80  Cholesterol: Should be less than 200 mg/dl  Diabetes  Smoking  Diet: know your Body Mass Index- BMI less than 24  Exercise: cardiovascular fitness reduces stroke risk  Family History: Increased risk if immediate family members with heart or cerebral vascular disease at an early age.

 Check blood pressure and work with a doctor to achieve BP less than 120/80  Have your cholesterol checked and work on reduction if elevated  Check for diabetes  If a smoker, work on smoking cessation  Drink alcohol in moderation

 Have an ECG or heart rhythm evaluation to check for Atrial Fibrillation  Develop an exercise habit  Enjoy a reduced fat and sodium diet

 Antihypertensives- reduce blood pressure  Antidysrhythmics- control Atrial Fibrillation  Anticoagulants- decrease clotting risk  Anticholesterol/lipid medications  Diabetic medications

 Affects 25% of the US population.  Each year:  Claims 1 million lives  Cost $290 billion

of every 5 deaths Every 26 seconds someone suffers a heart attack Every 1 minute someone will die from a heart attack

 Uncomfortable pressure, heaviness, squeezing or pain in the center of the chest lasting at least 2 minutes.  Pain the travels to the shoulders, arms, neck, jaw or back  Severe pain, lightheadedness, fainting, sweating, nausea or shortness of breath

 Women, diabetics, the elderly  Unusual fatigue  New, unusual shortness of breath with everyday activity or while a rest  Nausea or Dizziness  Stomach or lower chest pain; back pain

 Time is heart muscle  Treating heart disease:  Medications  Angioplasty and Stenting  Bypass  Implantable devices

 Age  Race  Gender  Family History  Diabetes

 Blood Pressure  Cholesterol  Smoking  Diabetes  Obesity  Physical Fitness

 Rarely causes symptoms  Strains Heart Muscle and increased heart oxygen use  Damages blood vessels

Class SBP DSP Normal <120 <80 Pre HTN Stage Stage 2 > 160 > 100

 Reduce weight  Keep salt intake to less than a teaspoon daily- both added and in foods  Assure eating plenty of fruits and vegetables; low-fat dairy products  Exercise  Reduce stress  Medications

 Single greatest risk factor predicting heart disease

 High Blood Pressure  High LDL cholesterol  High Triglycerides  Low HDL cholesterol  Irritates blood vessel walls

 Risk of developing heart disease:  Women: 5-7 times  Men: 2-3 times

 Good: HDL  Bad: LDL  Ugly: VLDL

 HDL  Women- 60 mg/dl or higher  Men- 50 mg/dl or higher  LDL  Normal mg/dl  Desire < 100 mg/dl  In heart disease or diabetics: goal < 70 mg/dl  VLDL- highest triglycerides  Desire below 20 mg/dl

 Extra weight adds strain to the heart and cardiovascular system  Since 1991 obesity has increased 75%  7 of ten adults are overweight  Body Mass Index: BMI

 Active persons reduce cardiovascular risk by 50%  Opportunity to Exercise: OTE  Walk stairs  Park farther from store front or walk/bike to store  Take walk breaks during the day  Partner up: walk/run/bike/gym

 Improves blood lipid profile  Burns calories and reduces weight  Improves blood pressure  Improves blood sugar control  Decreases depressed moods  Decreases stress  Improves energy and confidence

 Tobacco use increases the probability of Heart Disease  Nicotine:  Speeds development of atherosclerosis  Decreases HDL cholesterol levels  Binds carbon monoxide to Red Blood Cells, decreasing oxygen delivery tissue

 Polyunsaturated fats and Monounsaturated fats- healthiest  Saturated fats- less good  Trans fats- the worst

 Fruits and Vegetables  Whole grains  Brans  Unrefined cereals

 Healthy Habits  Maintain healthy weight- BMI < 24.  Physical activity  Non-smoker  Eating Habits:  Fruits and vegetables  Low fat dairy  Low total fat  Avoid saturated and trans fats

 Low salt  Control blood sugar  Know your numbers  Blood Pressure  Lipid Panel  Blood Glucose

Under 40: Blood Pressure Lipid Profile Blood Chemistry Over Age 40: Urinalysis EKG Stress Test

 No your numbers  Seek treatment for BP, DM, cholesterol  Eat right and get regular exercise  Watch your weight  Smoking cessation  Recognize symptoms  Seek immediate care

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