1. CONTROLLING YOUR RISK FACTORS Taking the Steps to a Healthy Heart

2. The Uncontrollable Risk Factors Increasing Age Increasing Age Male Gender Male Gender Family History Family History

3. What Are Your Controllable Risk Factors For Heart Disease? Smoking Smoking Abnormal Cholesterol Abnormal Cholesterol High Blood Pressure High Blood Pressure Diabetes Diabetes Sedentary Lifestyle (Inactivity) Sedentary Lifestyle (Inactivity) Unhealthy Body Weight Unhealthy Body Weight Unmanaged Stress Unmanaged Stress

4. Tobacco Use Smoking is the #1 preventable cause of premature death in US Smoking is the #1 preventable cause of premature death in US Risk of CAD is 2-4 times higher than nonsmokers Risk of CAD is 2-4 times higher than nonsmokers Types of tobacco Types of tobacco Secondhand smoke Secondhand smoke Take Action! Call 1-800-Quit-Now Take Action! Call 1-800-Quit-Now

5. Quit for Good S - Set a quit date S - Set a quit date T - Tell people T - Tell people A - Anticipate challenges A - Anticipate challenges R - Remove tobacco R - Remove tobacco T - Talk to your doctor T - Talk to your doctor

6. CHOLESTEROL Heredity and lifestyle Heredity and lifestyle Fatty deposits collect in arteries Fatty deposits collect in arteries Reduced blood flow Reduced blood flow Increased risk of heart attack, stroke, aortic aneurysm, & PAD. Increased risk of heart attack, stroke, aortic aneurysm, & PAD.

7. What are ideal cholesterol (lipid) values? LDL Cholesterol “bad” < 70 mg/dL LDL Cholesterol “bad” < 70 mg/dL HDL Cholesterol “good” HDL Cholesterol “good” –40 mg/ dL or higher for men –50 mg/dL or higher for women Triglycerides < 150 mg/dL Triglycerides < 150 mg/dL

8. How can you control your cholesterol? Follow a heart healthy eating plan Follow a heart healthy eating plan Eat more fiber Eat more fiber Take your medications as prescribed Take your medications as prescribed Exercise regularly Exercise regularly Maintain an ideal body weight Maintain an ideal body weight Control blood sugars Control blood sugars

9. OBESITY 127 Million adults are overweight, 60 M obese, 9 M severely obese 1. 127 Million adults are overweight, 60 M obese, 9 M severely obese 1. Obesity accounts for 280,000-350,000 deaths per year Obesity accounts for 280,000-350,000 deaths per year 2 nd leading cause for preventable deaths in U.S. 2 nd leading cause for preventable deaths in U.S. Waist Measurement and the Body Mass Index are the recommended ways to estimate body fat. Waist Measurement and the Body Mass Index are the recommended ways to estimate body fat. Body Mass Index (BMI) > 25 kg/m 2 Waist Circumference > 40” (102 cm) in men Waist Circumference > 35” (89 cm) in women Booth, F.W., et al., J Appl. Physiol. 88:774-787,2000.

10. Body Mass Index (BMI) BMI 18 to 24.9 is Normal BMI 18 to 24.9 is Normal BMI 25.0-29.9 is Overweight BMI 25.0-29.9 is Overweight BMI >30 is Obese BMI >30 is Obese BMI >40 is Extremely Obese BMI >40 is Extremely Obese To Calculate…Multiply your weight by 703, divide by your height in inches, then divide again by your height in inches To Calculate…Multiply your weight by 703, divide by your height in inches, then divide again by your height in inches Body Mass Calculator-americanheart.org/bodymass. Body Mass Calculator-americanheart.org/bodymass.

11. How Can You Help to Control Your Weight? Follow a heart healthy diet low in saturated fat Follow a heart healthy diet low in saturated fat Watch portion sizes Watch portion sizes Do not skip meals Do not skip meals Make sure you are getting enough fiber Make sure you are getting enough fiber Drink plenty of water Drink plenty of water Exercise daily Exercise daily Set realistic goals – weight loss should be gradual (1-2 pounds per week) Set realistic goals – weight loss should be gradual (1-2 pounds per week)

12. EFFECTS OF OBESITY ON HEART DISEASE RISK Raises blood cholesterol and triglyceride levels Raises blood cholesterol and triglyceride levels Lowers HDL “good” cholesterol Lowers HDL “good” cholesterol Raises blood pressure levels Raises blood pressure levels Increases your risk of developing diabetes Increases your risk of developing diabetes

13. HYPERTENSION=Silent Killer Blood pressure ≥ 120/80 mm Hg on at least 2 separate occasions OR on antihypertensive medication. When left uncontrolled, it can damage blood vessels leading to problems such as heart and vascular disease, stroke and peripheral arterial disease.

14. What can you do to lower your blood pressure? Eat healthier: Limit the amount of fat and salt in your diet Eat healthier: Limit the amount of fat and salt in your diet Lose weight if you need to Lose weight if you need to Begin a regular exercise program Begin a regular exercise program Learn to manage stress Learn to manage stress If you smoke, QUIT If you smoke, QUIT Drink alcohol in moderation Drink alcohol in moderation

15. Diabetes 20.8 million people have Diabetes, 6.2 million people are undiagnosed. 1. 20.8 million people have Diabetes, 6.2 million people are undiagnosed. 1. Diabetes is equivalent to having the diagnosis of Heart Disease. Diabetes is equivalent to having the diagnosis of Heart Disease. Insulin resistance is a characteristic of Type 2 Diabetes. Diabetes cause many metabolic abnormalities causing vascular changes leading to heart disease. Insulin resistance is a characteristic of Type 2 Diabetes. Diabetes cause many metabolic abnormalities causing vascular changes leading to heart disease. Diagnostic Criteria - Diagnostic Criteria - –Fasting blood sugars >126 mg/dL X 2 tests

16. “Pre-Diabetes” Also called impaired fasting glucose. Also called impaired fasting glucose. A person with “pre- diabetes” will have a fasting blood sugar of 100-125 mg/dL. A person with “pre- diabetes” will have a fasting blood sugar of 100-125 mg/dL. Increases a person’s risk for developing Type 2 Diabetes, heart disease and stroke. Increases a person’s risk for developing Type 2 Diabetes, heart disease and stroke. A 5-10% reduction in body weight will produce a 58% reduction in developing Diabetes. A 5-10% reduction in body weight will produce a 58% reduction in developing Diabetes.

17. What can you do to lower blood sugars? Exercise daily Exercise daily Take your medications as directed Take your medications as directed Eat a diet rich in fiber and low in refined carbohydrates Eat a diet rich in fiber and low in refined carbohydrates Weight loss Weight loss

18. Physical Inactivity ¼ of all adults have completely sedentary lifestyles. ¼ of all adults have completely sedentary lifestyles. More than 60% of all adults are not regularly physically active and 60% are overweight. More than 60% of all adults are not regularly physically active and 60% are overweight. The Surgeon General’s Report recommends we are to accumulate 30 minutes or more of physical activity on most days of the week. The Surgeon General’s Report recommends we are to accumulate 30 minutes or more of physical activity on most days of the week.

19. Benefits of Exercise- Exercise…… is the only treatment that improves all risk factors for Heart Disease!!!!!

20. Numbers that Count for a Healthy Heart Ideal Blood Pressure <120/80 mm Hg Fasting Blood Sugars<100 Body Mass Index<25 Waist Circumference Women < 35” Men < 40” Physical Activity-30 minutes of moderate intensity all days of the week. Strength Training at least 2 days per week Cholesterol –LDL cholesterol<70 –HDL cholesterol >50 for women HDL cholesterol >40 for men -Triglycerides<150

21. Other Contributing Factors…. Stress/Anxiety/Depression -Will increase heart rate and blood pressure. Stress/Anxiety/Depression -Will increase heart rate and blood pressure. Alcohol - Increases Triglyceride, body weight and blood pressure. Excessive alcohol can cause enlargement of the heart. Alcohol - Increases Triglyceride, body weight and blood pressure. Excessive alcohol can cause enlargement of the heart. –Women: NO more than 1 drink per day –Men: NO more than 2 drinks per day 1 drink= 5 oz. wine, 1 oz. liquor or 12 oz. beer 1 drink= 5 oz. wine, 1 oz. liquor or 12 oz. beer

22. FINAL THOUGHTS… “Our understanding of Heart Disease has expanded enormously over the past 30 years. We know that combining necessary medications with important lifestyle choices dramatically decreases future risk of a heart attack. You have the power to make these choices every day of your life and to teach the next generation the importance of heart-healthy living !!” “Our understanding of Heart Disease has expanded enormously over the past 30 years. We know that combining necessary medications with important lifestyle choices dramatically decreases future risk of a heart attack. You have the power to make these choices every day of your life and to teach the next generation the importance of heart-healthy living !!” Dr. Pearson, Dean/St. Mary’s Preventive Cardiology