It's Time for a Heart to Heart

Download It's Time for a Heart to Heart

Post on 07-May-2015

1.687 views

Category:

Health & Medicine

1 download

Embed Size (px)

TRANSCRIPT

<ul><li>1.Women of Summa:Its Time for a Heart to Heart Vivian von Gruenigen, BSN, MD Chair Obstetrics and Gynecology Womens Service Line Director Summa Akron City Hospital</li></ul> <p>2. 5 Leading Cause of Death in All Females, All ages </p> <ul><li>Heart Disease 27% </li></ul> <ul><li>Cancer 22% </li></ul> <ul><li>Stroke 8% </li></ul> <ul><li>Respiratory Disease 5% </li></ul> <ul><li>Alzheimers 4% </li></ul> <p>3. Differences in gender </p> <ul><li>Women get heart disease later in life </li></ul> <ul><li>Symptoms more subtle </li></ul> <ul><li>Women are much more likely to die from their first heart attack than men </li></ul> <ul><li>Women hesitate to call 911, and get to the hospital ~60 minutes later than men </li></ul> <ul><li>In the past, CV research was done in men </li></ul> <ul><li>Women experience a unique increase in lipids after menopause </li></ul> <p>Matthews KA et al. J Am Col Cardio 2009 4. Differences in Gender </p> <ul><li>The signs and symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks </li></ul> <ul><li>This may be because women tend to have blockages not only in their main arteries,but also in the smaller arteries that supply blood to the heart a condition called small vessel heart disease.</li></ul> <p>5. What Is Heart Disease? </p> <ul><li>Coronary Heart Disease </li></ul> <ul><li>High Blood Pressure </li></ul> <ul><li>Heart Failure </li></ul> <ul><li>Valve Disease </li></ul> <ul><li>Diseases of Pulmonary Circulation </li></ul> <p>6. What Have We Learned? </p> <ul><li>Risk Factors </li></ul> <ul><li><ul><li>Factors leading to heart disease can start in young women and develop over time </li></ul></li></ul> <ul><li>The Disease </li></ul> <ul><li><ul><li>Heart disease can strike women at any age </li></ul></li></ul> <ul><li>Prevention and Treatment </li></ul> <ul><li><ul><li>Healthy lifestyle changes can prevent or postpone heart disease </li></ul></li></ul> <p>7. Why Is It Important? </p> <ul><li>Cardiovascular disease kills 1 in 3 women </li></ul> <ul><li><ul><li>Tens of millions </li></ul></li></ul> <ul><li>64% of women who die suddenly from coronary heart disease have no previous symptoms </li></ul> <ul><li>80% of cardiovascular disease ispreventable </li></ul> <p>8. What is a heart attack? </p> <ul><li>A heart attack occurs when the blood flow to apartof the heart muscle isblocked </li></ul> <ul><li>Most heart attacks startslowly , with mild pain or discomfort </li></ul> <ul><li>Interrupted blood flow to your heart can damage or destroy a part of theheart muscle . </li></ul> <p>9. What Is A Heart Attack? </p> <ul><li>Warning Signs </li></ul> <ul><li>Chest discomfort </li></ul> <ul><li>Discomfort in upper body </li></ul> <ul><li>Shortness of breath </li></ul> <ul><li>Cold sweat </li></ul> <ul><li>Nausea </li></ul> <ul><li>Lightheadedness </li></ul> <p>10. Signs </p> <ul><li>Women may experience fewer typical symptoms than men, most commonlyshortness of breath, weakness, a feeling of indigestion, and fatigue </li></ul> <ul><li>Women also havemore symptomscompared to men (2.6 on average vs 1.8 symptoms in men) </li></ul> <ul><li>Approximatelyone quarterof all myocardial infarctions aresilent , without chest pain or other symptoms. </li></ul> <ul><li>The onset of symptoms in myocardial infarction (MI) isusually gradual , over several minutes, and rarely instantaneous. </li></ul> <ul><li>Emergency</li></ul> <p>11. Stroke Warning Signs </p> <ul><li>Suddennumbness or weaknessof the face, arm or leg, especially onone sideof the body</li></ul> <ul><li>Suddenconfusion , trouble speaking or understanding</li></ul> <ul><li>Sudden troubleseeingin one or both eyes</li></ul> <ul><li>Sudden troublewalking , dizziness, loss of balance or coordination</li></ul> <ul><li>Sudden, severeheadach e with no known cause</li></ul> <p>12. Am I at risk? </p> <ul><li>Vascular injury accumulatesfrom adolescence , making primary prevention efforts necessary from childhood. </li></ul> <ul><li>Risk factors can be modified, treated or controlled and some cant </li></ul> <ul><li>The more risk factors you have, the greater your chance of developing coronary heart disease </li></ul> <ul><li> Deadly quartet of chronic conditions that includes </li></ul> <ul><li><ul><li>Diabetes,</li></ul></li></ul> <ul><li><ul><li>Obesity,</li></ul></li></ul> <ul><li><ul><li>Blood pressure</li></ul></li></ul> <ul><li><ul><li>Cholesterol </li></ul></li></ul> <p>13. Am I At Risk? If you have any of these risk factors,you are at risk for heart disease. 14. Your Risk:High Blood Cholesterol </p> <ul><li>Cholesterol is a soft,fat-like substancefound in the bloodstream and in all your bodys cells </li></ul> <ul><li>The saturated fats, trans fats and cholesterol youeatmay raise your blood cholesterol </li></ul> <ul><li>Cholesterol can build up in the walls of arteries,narrowing the flow </li></ul> <ul><li>If a narrowed arterygets blocked by a clot or other particle , the heart or brain loses its blood supply, resulting in a heart attack or stroke </li></ul> <p>www.3dchem.com 15. Your Risk:High Cholesterol- Lipid Profile </p> <ul><li>Includes: </li></ul> <ul><li>Total Cholesterol </li></ul> <ul><li>LDL [low-density lipoprotein](bad) </li></ul> <ul><li>HDL Cholesterol (good) </li></ul> <ul><li>Triglycerides </li></ul> <p>16. Your Risk:High Blood Cholesterol </p> <ul><li>Total Cholesterol Level</li></ul> <ul><li>Desirable = Less than 200 </li></ul> <ul><li>Borderline high = 200 to 239 </li></ul> <ul><li>High = 240 and above </li></ul> <ul><li>~ 50% of women have a total cholesterol of 200 mg/dL </li></ul> <ul><li>and above, which puts them at risk for heart disease. </li></ul> <p>www.nhlbi.nih.gov 17. Your Risk:High Blood Cholesterol </p> <ul><li>HDL the higher your HDL, the better </li></ul> <ul><li>HDL Cholesterol Risk Levels </li></ul> <ul><li>Less than 50 mg/dL for women </li></ul> <ul><li>Therefore, want &gt; 50 </li></ul> <ul><li>LDL is the main carrier of harmful cholesterol </li></ul> <ul><li>LDL Cholesterol Risk Levels </li></ul> <ul><li>&gt; 130 mg/dL Borderline, &gt;160 high, &gt; 190 very high </li></ul> <ul><li>Therefore, want between 100-130 </li></ul> <p>18. Your Risk: High Blood Pressure </p> <ul><li>High blood pressure = hypertension (HTN) </li></ul> <ul><li>Blood pressure, is simply the pressure of the blood as it circulates </li></ul> <ul><li>No one knows exactly what causes most cases of HTN </li></ul> <ul><li>HTN is called the silent killer, because it increases the risk for</li></ul> <ul><li><ul><li>heart attack, angina, stroke, kidney failure , heart failure and peripheral artery disease (PAD) </li></ul></li></ul> <ul><li>1 in 3 adults has HTN, tens of millions </li></ul> <p>19. Your Risk: High Blood Pressure </p> <ul><li>Risk Factors </li></ul> <ul><li>Genetics </li></ul> <ul><li><ul><li>African Americans </li></ul></li></ul> <ul><li>Over age 35 </li></ul> <ul><li>Overweight </li></ul> <ul><li>Physical inactivity </li></ul> <ul><li>Nutrition </li></ul> <ul><li><ul><li>Salt, alcohol </li></ul></li></ul> <ul><li>Diabetes, kidney disease </li></ul> <ul><li>Pregancy</li></ul> <p>20. Your Risk: High Blood Pressure </p> <ul><li>Normal Blood Pressure </li></ul> <ul><li>Around120/80 </li></ul> <ul><li>Hypertension</li></ul> <ul><li>Above140/90 </li></ul> <p>21. Classification of Blood Pressure in Adults </p> <ul><li>OPTIMAL: 100 diastolic </li></ul> <p>22. Your Risk: Diabetes </p> <ul><li>Incidence is increasing </li></ul> <ul><li>Type I Diabetes also called juvenile </li></ul> <ul><li><ul><li>The body fails to make insulin </li></ul></li></ul> <ul><li>Type II </li></ul> <ul><li><ul><li>The most common</li></ul></li></ul> <ul><li><ul><li>95% of Americans Middle-aged.</li></ul></li></ul> <ul><li><ul><li>Linked with obesity and physical inactivity.</li></ul></li></ul> <ul><li><ul><li>The body doesnt make enough.</li></ul></li></ul> <p>23. Your Risk: Diabetes </p> <ul><li>Complications of Diabetes </li></ul> <ul><li>Stroke, TIA </li></ul> <ul><li>Blindness </li></ul> <ul><li>Heart attack, angina </li></ul> <ul><li>Kidney disease </li></ul> <ul><li>High blood pressure </li></ul> <ul><li>Erectile dysfunction </li></ul> <ul><li>Loss of legs or feet </li></ul> <ul><li>Nerve disease </li></ul> <p>People with diabetes aretwo to four times more likelyto developcardiovascular disease. 24. Your Risk: Diabetes </p> <ul><li>Prevention and Control </li></ul> <ul><li>Control your weight and cholesterol (low-saturated fat and low-cholesterol diet) </li></ul> <ul><li>If you take medicine, take it exactly as directed </li></ul> <ul><li>Discuss exercise with your physician </li></ul> <ul><li>Nutritionist consult/team </li></ul> <p>25. Your Risk: Obesity &amp; Overweight </p> <ul><li>The majority of Americans are overweight </li></ul> <ul><li>Excess Weight : </li></ul> <ul><li>Strains your heart </li></ul> <ul><li>Raises blood pressureand cholesterol </li></ul> <ul><li>Can lead to diabetes </li></ul> <p>26. 27. Your Risk: Obesity &amp; Overweight </p> <ul><li>Set goals, potential roadblocks </li></ul> <ul><li>Lifestyle change, not a diet </li></ul> <ul><li>You may need help or support </li></ul> <ul><li><ul><li>Team approach </li></ul></li></ul> <ul><li>Keeping weight off can be as challenging as losing it </li></ul> <p>28. Your risk: Physical inactivity </p> <ul><li>Regular, moderate-intensity physical activity can lower your risk of</li></ul> <ul><li>Heart disease and heart attack </li></ul> <ul><li>HTN </li></ul> <ul><li>High cholesterol </li></ul> <ul><li>Overweight or obesity</li></ul> <ul><li>Diabetes </li></ul> <ul><li>Stoke </li></ul> <ul><li>Cancer </li></ul> <p>29. Your risk: Physical inactivity </p> <ul><li>Inactive women: </li></ul> <ul><li>White females 38% </li></ul> <ul><li>Black females 52% </li></ul> <ul><li>Hispanic females 54% </li></ul> <ul><li>All healthy adults ages should be getting at least30 minutes of moderate intensity activity 5 days a week </li></ul> <p>30. Your risk: physical inactivity </p> <ul><li>Most Americans favor walking as their favorite physical activity </li></ul> <ul><li>Many places - at home, local parks, YMCAs, travel </li></ul> <ul><li>Many types swim, resistance, ski, golf </li></ul> <ul><li>Find your sole-mate or mates </li></ul> <ul><li><ul><li>Family, friends, colleagues </li></ul></li></ul> <ul><li>Stay motivated </li></ul> <p>31. 32. Your Risk: Smoking </p> <ul><li>Benefits of Quitting </li></ul> <ul><li>Within 1 to 2 years of quitting, the risk of coronary heart disease is substantially reduced</li></ul> <ul><li>A smokers cough will go away </li></ul> <ul><li>It is easier to be physically active </li></ul> <ul><li>Second hand smoke is real </li></ul> <p>33. Your risk: Nutrition Quality </p> <ul><li>Be aware of calories </li></ul> <ul><li>Low fat </li></ul> <ul><li>Lean meats </li></ul> <ul><li>Fiber, whole grains </li></ul> <ul><li>Low fat dairy </li></ul> <ul><li>Fruits and veggies </li></ul> <ul><li><ul><li>Diversify your colors </li></ul></li></ul> <ul><li>Whole foods versus processed </li></ul> <ul><li>White foodsugar </li></ul> <ul><li>Limit fast foods </li></ul> <ul><li><ul><li>Super size me </li></ul></li></ul> <p>34. Decreasing your sodium intake: where is salt found in our diets? 35. Your risk:Depression </p> <ul><li>Depression is twice as common in women as in men, and itincreases the risk of heartdisease by 2-3 times </li></ul> <ul><li>Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment </li></ul> <ul><li>Talk to your doctorif you're having symptoms of depression </li></ul> <p>36. Your risk:HRT </p> <ul><li>Can estrogen replacement therapy reduce my risk for heart disease? </li></ul> <ul><li>No. Estrogen replacement therapy, also called hormone replacement therapy (HRT </li></ul> <ul><li>New studies have shown that when it comes to heart health, HRT may do more harm than good.</li></ul> <ul><li>If youre taking HRT to help prevent heart disease, talk to your doctor about whether you should stop. </li></ul> <p>37. First aid </p> <ul><li>Call for help </li></ul> <ul><li>Aspirin</li></ul> <ul><li>Oxygen </li></ul> <ul><li>Nitroglycerin </li></ul> <ul><li>Automated external defibrillator (AED) </li></ul> <ul><li>Opiod painkillers </li></ul> <ul><li>Air travel kits</li></ul> <p>38. Women in Recovery and Rehabilitation after a Heart Attack </p> <ul><li>The first year following a heart attack, women tend to </li></ul> <ul><li>have ahigher rate of disability and death , and show </li></ul> <ul><li>poorer psychological adaptationthan men. </li></ul> <ul><li>Social support and moodwere the best predictors </li></ul> <ul><li>of overall quality of life at one year for women </li></ul> <ul><li>Those with more social support tended to have a higher rate of persistency, while abelief in the positive health benefitsof exercise increased the amount of exercise undertaken by the participant. </li></ul> <ul><li><ul><li><ul><li><ul><li><ul><li>Moore SM et al J Cardio Rehab 2003 </li></ul></li></ul></li></ul></li></ul></li></ul> <p>39. What Can I Do To Prevent Heart Disease? </p> <ul><li>Eat ahealthy dietlow in saturated fat, trans fat, cholesterol and sodium.</li></ul> <ul><li>Keep yourweightunder control. </li></ul> <ul><li>Bephysically activeat least 30 minutes on most or all days of the week. </li></ul> <ul><li>Control yourblood pressureandcholesterollevels.</li></ul> <ul><li>Manage your blood sugar if you havediabetes . </li></ul> <ul><li>Dont smoke , and avoid tobacco smoke. </li></ul> <ul><li>Taking yourmedicinesas directed by your physician </li></ul> <p>40. What Can I Do To Prevent Heart Disease? </p> <ul><li>You are here </li></ul> <ul><li>You are an advocate </li></ul> <ul><li>You are educated </li></ul> <ul><li>Teach those who are not as fortunate </li></ul> <ul><li>Lead by example </li></ul> <ul><li>Grass roots </li></ul> <p>41. Women, whether subtly or vociferously, have always been a tremendouspowerin the destiny of the world. Eleanor Roosevelt 42. Be the kind of womanthat when your feethit the floor eachmorning the devil says~~ "Oh crap, She's up! Email from Aunt Jeanette 43. </p> <ul><li>Questions? </li></ul> <p>YOU are beautiful, smart and have the power to make a difference </p>