Kimberly A. Rogers, BSN, RNAugust 2013 HEART DISEASE Risk Factors & Prevention Heart Disease Risk Factors & Prevention

Section I: U.S. Disease Statistics Heart Disease Risk Factors & Prevention

U.S. Disease Statistics 25% of all deaths in the U.S. for all ethnic groups are caused by heart disease 600,000 people in the U.S. die each year of heart disease Over ½ of all heart disease deaths in the U.S. annually (385,000) are caused by coronary heart disease There are 935,000 heart attacks each year in the U.S. (Hillsborough County Population is 1.2 million) Coronary heart disease costs the U.S. economy $1.89 billion each year (Centers for Disease Control, 2013) Heart Disease Risk Factors & Prevention

1.Epidemiological & Statistical Data 2.Health Status Section II: Hillsborough County Statistics Heart Disease Risk Factors & Prevention

Epidemiological & Statistical Data: Hillsborough County vs. State of Florida Coronary Disease Death Rates (Florida Charts.com, 2013) Heart Disease Risk Factors & Prevention Deaths per 100,000 Population

Epidemiological & Statistical Data Summary Hospitalizations and deaths from Coronary Heart Disease have dropped in Hillsborough County and statewide since the early 1990’s The rate of deaths from Coronary Heart Disease is still higher in Hillsborough County than the state for males The rate of deaths from Coronary Heart Disease is higher for men than women, in Hillsborough County and statewide Heart Disease Risk Factors & Prevention

Health Status: Percentage of People with Cardiovascular Disease (Florida Department of Health, 2013) Heart Disease Risk Factors & Prevention

Health Status: Percentage of Adults Who Smoke, Hillsborough County vs. Florida Statewide (Floridacharts.com, 2013) Heart Disease Risk Factors & Prevention

Health Status: Percentage of Adults Who Are Overweight or Obese in Hillsborough County vs. Florida Statewide (Floridacharts.com, 2013) Heart Disease Risk Factors & Prevention

Health Status: Percentage of Adults with High Cholesterol in Hillsborough County vs. Florida Statewide (Floridacharts.com, 2013) Heart Disease Risk Factors & Prevention

Health Status: Percentage of Adults with Hypertension in Hillsborough County vs. Florida Statewide (Floridacharts.com, 2013) Heart Disease Risk Factors & Prevention

Health Status Summary The health status data discussed in these slides all represent known risk factors for coronary artery disease (American Heart Association, 2013) Heart Disease Risk Factors & Prevention

Heart Disease Risk Factors & Prevention Section III: Heart Disease Risk Factors

Non-Modifiable Heart Disease Risk Factors Age (Increased Risk Above 65 Years of Age) Gender (Increased Risk for Males) Heredity (Increased Risk for African Americans, Mexican Americans, Native Americans, Native Hawaiians, and Some Asian Americans) Heart Disease Risk Factors & Prevention (American Heart Association, 2013)

Modifiable Heart Disease Risk Factors Tobacco Smoke (Increases 2X – 4X above non-smokers) Second-hand Smoke Also Increases Risk High Blood Cholesterol Total Cholesterol Should be <200 mg/dL LDL Should be 100 mg/dL – 160 mg/dL depending on other risk factors High Blood Pressure Heart Disease Risk Factors & Prevention (American Heart Association, 2013)

Modifiable Heart Disease Risk Factors (cont’) Physical Inactivity Overweight & Obesity Diabetes Stress Alcohol Consumption Diet/Nutrition Heart Disease Risk Factors & Prevention (American Heart Association, 2013)

Heart Disease Risk Factors & Prevention Section IV: Heart Disease Characteristics & Symptoms

Coronary Artery Disease & Anatomy (Drchandler.com, 2005) Heart Disease Risk Factors & Prevention

Coronary Artery Disease Progression (Bean et al, 2006) Heart Disease Risk Factors & Prevention

Signs & Symptoms of Coronary Heart Disease Chest Pain (squeezing, pressure, or heaviness) Pain in Shoulders, Arms, Neck, Jaw, or Back Persistent Indigestion or Nausea Fatigue and Weakness Shortness of Breath Sweating Lightheadedness (American Heart Association, 2013) Heart Disease Risk Factors & Prevention

Signs & Symptoms of Coronary Heart Disease in Diabetics Diabetic Nerve Damage Can Interfere with Pain Signals in the Body Diabetics Can Have Some or All of the Typical Symptoms Some Diabetics May Have a Heart Attack without Symptoms When in Doubt, Always Call (National Institutes of Health, 2011) Heart Disease Risk Factors & Prevention

Differences in Signs & Symptoms of Coronary Heart Disease in Women Women May Not Have Typical Symptoms Signs Can Be Subtle May Perceive as Flu-like Symptoms May Have Shortness of Breath without Chest Pain May Have Back Pain or Pressure May Have Dizziness, Light-headedness, or Fainting (American Heart Association, 2013) Heart Disease Risk Factors & Prevention

Heart Disease Risk Factors & Prevention Section V: Heart Disease Prevention

Prevention: Controlling Modifiable Risk Factors Hypertension Comply with medications Reduce salt intake Maintain a healthy weight Limit alcohol Manage stress (American Heart Association, 2013) Heart Disease Risk Factors & Prevention

Prevention: Controlling Modifiable Risk Factors Elevated Cholesterol & Triglycerides Adopt a heart healthy diet Increase physical activity Take any cholesterol medications as directed by your doctor Obesity & Sedentary Lifestyle Exercise at least 30 minutes a day – can be broken into three 10-minute sessions Adopt a heart healthy diet (American Heart & Dash Diet) (American Heart Association, 2013) Heart Disease Risk Factors & Prevention

Prevention: Controlling Modifiable Risk Factors Poorly Controlled Blood Sugar Perform blood sugar checks as recommended by doctor A1C Checks Medications: insulin or oral medications taken as directed Diet & Exercise Smoking There are many options & resources available for smoking cessation (American Heart Association, 2013) Heart Disease Risk Factors & Prevention

Heart Disease Risk Factors & Prevention Section VI: Heart Disease Diagnosis & Treatment

Diagnosis of Coronary Artery Disease History & Physical Exam Lab Work EKG Stress Test Echocardiogram Cardiac Cath Heart Disease Risk Factors & Prevention

Treatment of Coronary Artery Disease Medication Risk Factor Modification Cardiac Stent Coronary Artery Bypass Graft Surgery (CABG) Heart Disease Risk Factors & Prevention

Heart Attack Persistent Symptoms = Acute Event This is a Cardiac Emergency Early Activation of EMS is Important Call Rapid Intervention is Associated with Better Outcomes (Less than 120 Minutes from Onset of Symptoms) Treatment Cardiac Stent Coronary Artery Bypass Graft Surgery Heart Disease Risk Factors & Prevention

Heart Disease Risk Factors & Prevention Section VII: Florida Hospital Zephyrhills Heart Institute

Florida Hospital Zephyrhills Heart Institute Established in 2006 Award-winning Program Accredited Chest Pain Center Offers Comprehensive Cardiac Care Has Performed Thousands of Procedures Highly Skilled Staff – Board Certified Cardiologists, Cardiac Surgeons, and Specialized Cardiac Care Nurses & Technical Support Staff Heart Disease Risk Factors & Prevention

Florida Hospital Zephyrhills Heart Institute Services Offered Open-heart Surgery Coronary Bypass Grafting Cardiac Valve Repair/Replacement Minimally Invasive Valve Surgery Thoracic Aneurysm Repair Cardiac Catheterization Diagnostic Heart Caths Coronary Angioplasty & Stenting Radial Catheterization Heart Disease Risk Factors & Prevention

Florida Hospital Zephyrhills Heart Institute Services Offered (Cont’) Other Catheterization Procedures Valvuloplasty Renal Artery Stenting Peripheral Artery Stenting Electrophysiology Procedures Electrophysiology Studies 3D Mapping Cardiac Ablations, Including Atrial Fibrillation Pacemakers/Defibrillators Heart Disease Risk Factors & Prevention

Florida Hospital Zephyrhills Heart Institute Services Offered (Cont’) Other Cardiac Testing Procedures & Services Stress Tests Echocardiograms Tilt Table Tests Cardiac Rehabilitation Program Congestive Heart Failure Support Group Device Support Group Heart Disease Risk Factors & Prevention

Florida Hospital Zephyrhills Heart Institute Services Offered (Cont’) Other Services State of the Art Cardiovascular Operating Room (CVOR) Cardiac Intensive Care Unit (CVICU) Cardiac Step-down Unit (CSDU) Cardiac Procedure Recovery Unit (CRU) Heart Disease Risk Factors & Prevention

References The American Heart Association (2013). Retrieved from Bean, C.A., et al (2006). Image. ACC Atlas of Pathophysiology, 2 nd Edition. Philadelphia: Lippincott & Wilkins. Centers for Disease Control and Prevention (2013). Heart Disease Facts. Retrieved from Florida Department of Health. (2013) Retrieved from Heart Disease Risk Factors & Prevention

References Drchandler.com (2005). Image. Retrieved from National Institutes of Health (2011). What Are the Signs and Symptoms of Diabetic Heart Disease? Retrieved from topics/topics/dhd/signs.html. topics/topics/dhd/signs.html U.S. Census Bureau (2010). American Fact Finder. Retrieved from Heart Disease Risk Factors & Prevention