1. WENDY WRAY RN BSCN MSCN DIRECTOR MUHC WOMEN'S HEALTHY HEART INITIATIVE FEBRUARY 2016 Heart Disease by the Numbers

2. Important Numbers Blood pressure Cholesterol Diabetes BMI; Alcohol Age; Family History ; Smoking Waist circumference Physical Activity

3. Blood Pressure Normal values- 140/80; 130/70 High Blood pressure risks- stroke, heart failure “Silent killer” Accurate measurement challenging Lifestyle- salt, physical activity, alcohol, weight loss SPRINT study- 2015- 120/80- stay tuned

4. Cholesterol Total cholesterol ( TC): calculated using the following equation: HDL + LDL + 20 percent of your triglyceride level. 5.1 mmol/l -desirable -6.2 high Triglycerides ( TG): the most common type of fat in the body. 1.50 elevated High Density Lipoprotein (HDL) good chol.-higher levels are better; HDL removes excess cholesterol from cells Genetic factors, type 2 diabetes, smoking, being overweight and being sedentary can all result in lower HDL cholesterol. protective

5. Cholesterol cont’d Low density Lipoprotein (LDL-C) bad chol.-low LDL cholesterol level is considered good for your heart health; a diet high in saturated and trans fats raises LDL cholesterol. 2.5mmol/l optimal 4.1 -4.8 high apoA: is the main protein component in HDL. 1.20-2.28 g/l apoB : is the main protein constituent of lipoproteins such as very low-density lipoprotein (VLDL) and low- density lipoprotein (LDL). 0.80-1.20 g/l>1.20 high

6. Diabetes Random sugar- 3.9-11.0 AC sugar PC sugar HGBA1C- normal is 6.0 or less: Diabetes- 6.5+ 50% higher risk of heart disease Worse in women Type 11- diet and physical activity

7. Case Study 60 y.o.woman Non-smoker, diabetic, BMI- 27; no family history TC- 6.2; TG- 0.50;HDL- 2.00;LDL-C- 3.6;apoB-1.10

8. BMI and Alcohol Body Mass Index- weight in kg. x height M2 Normal- 18.5-24.9; overweight- 25-29.9 obesity- >30 Muscle versus fat Alcohol- empty calories; sugar women- 1 ½, men- 2

9. Age, Family History and Smoking 50 years of age- heart disease develops over time Prevention requires earlier start- proactive prevention vs reactive disease oriented approach Premature Family History- women- <60; men- 50’s Smoking- Zero- more potent risk in women Vaping- long term effects; stepping stone to quitting

10. Waist Circumference Normal: men- 40” ; women- 35” Tape measure Abdominal obesity- adipose tissue, visceral fat Secretes hormones – acts like a organ

11. Physical Activity 150 minutes per week or more; personal preference Aerobic, muscle strengthening and resistance combo Sitting is the new smoking – move at least hourly Any physical activity is better than no physical activity

12. Making Change Creating new behaviors is a process 6 months to create a new habit Cheating is probably part of success- realistic expectations- 80/20 The Art of Negotiation

13. Take Home Message Become more engaged in your heart knowledge – Numbers Count!! AHA 2016- “women are underdiagnosed and undertreated. Heart disease is largely a preventive disease. Be a friend- Tell a friend !

14. Resources www.whhionline.ca - Facebook www.whhionline.ca Wear Red Day- February HeartBeat event 2017 Red Dress Campaign- Heart and Stroke Foundation