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Cardiovascular Disease: Knowing the Risk Factors, Symptoms, and Prevention Arvi Grover M.D. Director of Cardiovascular Research, Director of Heart Health Program, KMH Cardiology Today’s presentation • The Heart Truth…………….. • What are heart disease and stroke? • What are the warning signs? • What are the risk factors? • How can you reduce your risks? • How to talk to your doctor? 2 Simple Stats , • 9 out of 10 Canadians over the age of 20 have at least one of the following risk factors: • smoking, • physical inactivity during leisure time, • less than recommended daily consumption of vegetables and fruit, • stress, • overweight or obesity, • high blood pressure, • or diabetes. • 2 in 5 have three or more of these risk factors • Addressing these risk factors will reduce the risk not only of CVD, but also of many other chronic diseases that share the same risk factors. AHA Heart Disease and Stroke Statistics 2010 Update. Circulation 2010;121:e41-e215. What is heart disease? • Damage to the heart • Most common type is coronary artery disease - angina caused by reduced blood supply and oxygen to the heart - heart attack caused by reduction or stoppage of blood supply/oxygen 4 Do you know the warning signs of a heart attack? 5 Heart Attack Symptoms - MEN Chest pain Discomfort in other areas of the upper body • • • One or both arms Back, neck or jaw Stomach Shortness of breath Other signs • • • • Cold sweat Nausea Lightheadedness Fatigue Heart Attack Symptoms - WOMEN As with men, chest pain or discomfort More likely- other symptoms: • • • • • • • • Shortness of breath Nausea/vomiting Back or jaw pain Not feeling right Fatigue Palpitations Musculoskeletal complaints Hot flashes Cardiovascular Disease Risk Factors History of CAD/PAD Male Sex History of TIA/CVA Smoking Hypertension(high blood pressure) Diabetes Mellitus Dyslipidemia (high cholesterol) – Low HDL < 1.0 – Elevated LDL / TG Family History - event in first degree relative > 55 male, > 65 female Chronic Kidney Disease Obesity Lack of regular physical activity Diet poor in fruits, vegetables, and fiber Age > 45 male, > 55 female Risk Factors that Can’t Be Changed ♥ ♥ ♥ ♥ ♥ Age Gender: Male Heredity – Family History Race Previous CAD, PVD or CVA Exercise is a Medicine Physicians should prescribe it, Patients should take it! • Instead of an allergy, exercise may be the long sought vaccine to prevent chronic disease and extend life Are we reaching a point where NOT prescribing physical activity should be consider patient neglect? Do You Really Think We have a Chance Without Exercise? • • • • • • • • • Obesity Coronary artery disease Diabetes Hypertension Cancer Depression and anxiety Arthritis Osteoporosis Etc, etc, etc… NO! Patients Physicians Physical Activity and Reduced Mortality (Lancet, Vol 378, Issue 9798, Pages 1244-1253, October 2011) • Those who exercised for at least 90 min / week or 15 min/day had a 14% reduction in mortality • Further extra 15 min/day reduced mortality even more by 4% and reduced cancer risk by another 1% • Inactive individuals had a 14% increased mortality risk Cardiovascular Diet Cardiovascular Care Smoking cessation – Cessation-class, medications, counseling Physical activity – Goal 30 - 60 minutes daily – Risk assessment prior to initiation Diet – DASH diet, Mediterranean diet, fiber, omega-3 fatty acids – <7% total calories from saturated fats Cardiac Screening – Heart Health Program • Know your personal and family history • Appropriate screening for your level of risk • Program consists of aprox. 6 visits over 1 year • Testing to determine current status • Multi-disciplinary approach to increase your education on proper lifestyle, including diet and exercise • Take charge of your health Prevention Begins with You Take one step at a time Replace unhealthy habits with healthier ones Eat for a healthy heart Start walking—try 10 minutes and add time gradually to reach 2 hours and 30 minutes each week How to Keep Going View changes as a new lifestyle, not quick fixes Set realistic goals Buddy up Don’t worry about slipping up—get back on track Reward your successes Be your own advocate—ask questions and seek information The Heart Truth® It’s up to you to protect your heart health—start today! Heart Health Program • Speak to your doctor to see if you could benefit from enrollment • No cost to patients • Services include regular Cardiology/Dietician assessment • 6 visits over 14 months • Multiple locations across GTA and Southeastern Ontario