HEART DISEASE AND YOU
Latino Americans
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WHAT IS HEART DISEASE?
2
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What is Heart Disease?
Heart disease is a broad term used
to describe a range of diseases that
affect your heart
Coronary Artery Disease
(heart attack & stroke)
Arrhythmias
Conditions & Infections
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Coronary Artery Disease
• Your heart is a pump that
circulates blood, oxygen and
nutrients throughout your body
• Coronary artery disease is
a disease of the heart, and
can lead to:
–
–
–
–
–
Chest pain
Shortness of breath
Heart failure
Heart attack
Stroke
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Coronary Artery Disease
(heart attack & stroke)
Heart Arrhythmias
• Electrical impulses cause your
heart to beat
• When your heart beats too fast, too
slow or irregularly, you have an
arrhythmia
• Most are harmless. However,
some heart arrhythmias may cause
bothersome — sometimes even
life-threatening — signs and
symptoms
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Arrhythmias
The Heart of the Matter
Heart disease is the leading cause of death
for women and men, regardless of race and ethnicity
82.6 Million American Adults Have Heart Disease1
African American Females2
47.3%
African American Males
44.8%
37.4%
White Males
White Females3
33.8%
30.9%
Hispanic/Latino Females4
Hispanic/Latino Males
0.0%
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1.
2.
3.
4.
30.7%
10.0%
20.0%
30.0%
American Heart Association. Heart Disease and Stroke Statistics-2012 Update
American Heart Association. African Americans and CVD – 2012 Statistical Fact Sheet
American Heart Association. Whites and CVD – 2012 Statistical Fact Sheet
American Heart Association. Hispanics/Latinos and CVD – 2012 Statistical Fact Sheet
40.0%
50.0%
The Heart of the Matter: Major Causes of Death
LATINO MEN
LATINO WOMEN
Heart Disease (26.7% )
Heart Disease (30.4% )
Cancer (19.9% )
Cancer (21.8% )
Accidents (10.9% )
Accidents (4.4% )
Homocide (3.6% )
Homocide (.9% )
Diabetes (4.3% )
Diabetes (5.2% )
CLRD (2.6% )
CLRD (3.1% )
American Heart Association. Hispanics/Latinos and CVD – 2012 Statistical Fact Sheet
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The Heart of the Matter
• Heart disease, being overweight or
obese and having diabetes are
prevalent among Latino Americans
• Some people have simply accepted
this is a way of life
• This doesn’t have to be true for you
• Heart disease and most risk factors
can be prevented or treated
Take responsibility for
your heart’s health
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WHAT YOU NEED TO KNOW
ABOUT HEALTH CARE
DISPARITIES
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Disparities in Health Care
Racial or ethnic differences in the quality of health care that are
not due to access-related factors, clinical needs, preferences,
Over 65
Ethnic Groups
or appropriateness of intervention
Non-English
Women
Racial
Groups
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Smedley BD, Stith AY, Nelson AR. Institute of Medicine. Committee on Understanding and Eliminating Racial and Ethnic
Disparities in Health Care, Board on Health Policy, Institute of Medicine. Washington, DC: National Academy Press; 2002.
Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Accessed:
http://www.nap.edu/openbook.php?record_id=12875&page=R1
Reasons Are Complex
Insurance
Culture
Refusal
Time
Stereotypes
Language
Geography
Bias
Language
Uncertainty
Behavior
Preference
Health System
Provider
Patient
Henry J. Kaiser Family Foundation. Why the Difference Power Point Presentation, slide # 26. Unequal Treatment Confronting Racial
and Ethnic Disparities in Healthcare: March 2000.
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WHAT CAN I DO?
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Know Your
Risk Factors
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Talk to Your
Doctor
Take Charge of
Your Heart
Health
Know Your
Risk Factors
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Risk Factors Lead to Heart Disease
Risk Factors You Can NOT Control
• Increasing Age
• Family History
Risk Factors You CAN Control
•
•
•
•
•
•
•
•
Diabetes
High Blood Pressure
High Cholesterol
Physical Inactivity
Overweight/Obesity
Smoking
Stress
Alcohol
National Heart Lung and Blood Institute. “Your Guide to a Healthy Heart.” 2005. NIH Publication No. 06-5269
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Age and Family History
Increasing Age
• For men, are you over 45?
• For women, are you over
55?
Family History
• Does anyone in your
immediate family have a
history of heart disease
or diabetes?
National Heart Lung and Blood Institute. “Your Guide to a Healthy Heart.” 2005. NIH Publication No. 06-5269
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Diabetes
What is it?
• A lifelong disease in which there are high
levels of sugar (glucose) in the blood
Why a major risk factor?
• Heart disease and stroke account for
about 65% of deaths in people with
diabetes1
How many Latino Americans affected? 2
• Over 11% of men and women have
diagnosed diabetes
• 6% of men and almost 4% of women have
undiagnosed diabetes
• 45% of men and 34% of women have
pre-diabetes
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Good diabetes
management can help
reduce your risk
Many people are not
even aware that they
have diabetes
1. American Heart Association. Cardiovascular Disease and Diabetes. Accessed:
http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/Cardiovascular-DiseaseDiabetes_UCM_313865_Article.jsp
2. American Heart Association. Hispanics/Latinos and CVD – 2012 Statistical Fact Sheet
High Blood Pressure (Hypertension)
What is it?
• Blood pressure (the force of blood against
the walls of arteries) that stays high and
damages the heart over time
Why a major risk factor?
• About 69% of people who have a first heart
attack, 77% who have a first stroke, and 74%
who have congestive heart failure have high
blood pressure, i.e. higher than 140/90 mm
Hg.1
How many Latino Americans affected?
• More women (28.9%) than men (27.8%)
have the condition1
1. American Heart Association. High Blood Pressure– 2012 Statistical Fact Sheet
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High Blood Cholesterol
What is it?
• The body needs cholesterol — a waxy, fat-like
substance in your blood — but too much bad
(LDL) cholesterol can lead to plaque build up in
arteries and veins
• Your LDL cholesterol level is a better gauge of
risk than total blood cholesterol1
Why a major risk factor?
• When levels of bad (LDL) cholesterol are 130
mg/dl or higher there is a higher risk of
developing coronary heart disease1
How many Latino Americans affected? 2
• Over 32% of women have high bad cholesterol
• Nearly 42% of men have high bad cholesterol
1.
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2.
American Heart Association. What Your Cholesterol Levels Mean. Accessed:
http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-LevelsMean_UCM_305562_Article.jsp
American Heart Association. High Blood Cholesterol– 2012 Statistical Fact Sheet
Physical Inactivity
What is it?
• Lack of regular moderate physical activity
Why a major risk factor?
• Exercise helps to prevent or reduce high blood
pressure, diabetes and being overweight or
obese
How many Latino Americans affected?1
• Nearly 45% of men and women are inactive
Moderate exercise for 30 minutes/day
•
•
•
•
•
Improves physical wellness
Decreases risk of developing heart disease
Boosts mental wellness
Relieves tension, anxiety, depression
Improves mental alertness
1.
2.
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Key Guidelines Snapshot2
Adults (aged 18–64)
Moderate-intensity aerobic
exercise; 2 hours and
30 minutes /week;
Muscle-strengthening;
2+days per week
Older Adults (aged 65+)
Follow adult guidelines
(as abilities allow)
Inactivity should be avoided
American Heart Association. Physical Inactivity– 2012 Statistical Fact Sheet
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans.
http://www.health.gov/paguidelines/factsheetprof.aspx
Overweight & Obesity
What is it?
• When your weight exceeds what is generally
considered healthy for your height
• A waist measurement greater than 40 inches
for men and 35 inches for women
Why a major risk factor?
• Leads to many diseases and conditions,
including high blood pressure and Type 2
diabetes which can cause heart disease
How many Latino Americans affected?1
• 78% of men are overweight or obese
• 75% of women are overweight or obese
1.
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American Heart Association. Overweight & Obesity– 2012 Statistical Fact Sheet
Cigarette and Tobacco Smoke
What is it?
• Inhalation of the smoke of burning tobacco
encased in cigarettes, pipes, and cigars
Why a major risk factor?
• Cigarette smoking and secondhand smoke
further raises risk of heart disease when
combined with high cholesterol, high blood
pressure, and being overweight or obese
How many Latino Americans affected? 1
• 18% of men smoke
• 9% of women smoke
1.
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American Heart Association. Hispanics/Latinos & CVD– 2012 Statistical Fact Sheet
Stress and Heart Disease
What is it?
•
Stress affects each of us in different ways — you
may have physical signs, emotional signs or both
Why a major risk factor?
•
Stress sets off a chain of events
– Stressful situation
– Breathing and heart rate speed up; blood
pressure rises
– Body experiences “fight or flight” response
– When it lasts days/weeks = chronic stress
– Chronic stress increases heart rate and
blood pressure
How many Americans affected?
•
•
22% of Americans reported extreme stress in
2010
Top reasons: money, work, economy,
relationships, family responsibilities
American Psychological Association. Stress in America report. http://www.apa.org/news/press/releases/2012/01/chronicdisease.aspx
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Alcohol Beverages and Heart Disease
What is it?
• The relation between alcohol and heart
disease is complex
• Some say no alcohol at all, but
• Moderate-alcohol use has been shown to
reduce coronary heart disease
• Excessive or binge drinking can lead to high blood
pressure, heart failure and a higher calorie intake
How many Latino Americans affected? 2
• In 2010, rates of alcohol use among Latino persons
12 and older was 42%
• Rates of excessive/binge alcohol use among Black
persons was 25%
1.
2.
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American Heart Association. Alcoholic Beverages and Heart Disease. Accessed
http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Alcoholic-Beverages-and-Cardiovascular-Disease_UCM_305864_Article.jsp
Substance Abuse and Mental Health Services Administration, Results from the 2010 National Survey on Drug Use and Health: Summary of
National Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services
Administration, 2011.
4
oz.
The Multiplier Effect
Risk Factors Don’t Add Their Potential Danger
Like 1 + 1 = 2  They Multiply It1
Woman over 55
Overweight
+ High Blood Cholesterol
3
= 10
more likely to
develop heart disease
1.
2.
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National Heart Lung and Blood Institute “The Heart Truth” speaker’s guide. 2010. Publication No. 10-520B, p. 17
National Heart, Lung, and Blood Institute (2006), HEART DISEASE RISK FACTOR "MULTIPLIER EFFECT“ IN MIDLIFE
WOMEN infographic
Talk to Your
Doctor
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Talk to Your Doctor
• Being honest will get you
the most realistic
assessment
– Help your doctor develop a
plan to lower your overall
risk
• Visit your doctor regularly
and bring 2–3 questions
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Talk to Your Doctor
• Do I have heart disease? What tests
should I have?
• What do my test results mean?
• Are my blood pressure numbers
within a normal range? Cholesterol
numbers?
• Can you help me plan a safe weight
loss and exercise program?
• What are the possible side effects of
the medications I’ve been
prescribed?
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Your doctor is your
partner — working
together you can live a
longer, healthier and
happier life
Take Charge of
Your Heart
Health
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Enjoy Regular Physical Activity
Recommendation
• Pick a physical activity that you like
(brisk walking, dancing, swimming)
• Make the time!
• Do it for 30+ minutes 5X per week
Why?
– 70% of Americans do not get the
physical activity they need1
– Daily physical activity will guarantee
you a healthier and more satisfying
life while lowering your risks for
heart disease, stroke and diabetes1
– Studies show that for every hour of
walking, life expectancy may
increase by 2 hours2
1.
2.
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American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=8&CultureCode=en-US
American Heart Association: Get Moving. Where Do I Start
http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/StartWalking/Get-moving-Where-do-Istart_UCM_307978_Article.jsp
Eat a Heart-Healthy Diet
Recommendation:
• Stock up on healthy foods
• Eat a lot of vegetables and fruits
• Eat unrefined fiber-rich whole-grain foods
• Eat fish at least twice a week
• Choose skinless lean meats and poultry
• Select fat-free, 1% fat, and low-fat
dairy products
• Cut back on saturated/trans fats,
cholesterol, salt and added sugars
• Remember candy, cakes, cookies, ice
cream, etc. are occasional special treats!
Why?
One of your best weapons for
fighting heart disease
Over 90% of us fail to eat a hearthealthy diet
Poor eating can lead to heart
disease, stroke, diabetes and
obesity
American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=10&CultureCode=en-US
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Maintain a Healthy Weight
Recommendation
• Know your Body Mass Index or
BMI
• Understand your caloric needs
• Track your calories
• Only eat at restaurants/fast food
1-2 times per week
Why?
• When you shed extra fat and
unnecessary pounds, you reduce
the burden on your heart, lungs,
blood vessels and skeleton
American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=11&CultureCode=en-US
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Body Mass Index (BMI) Chart
Weight-control Information Network: an information service of the National Institute of Diabetes and Digestive and Kidney Diseases:
Web page, “Understanding Adult Obesity.” Accessed http://win.niddk.nih.gov/publications/understanding.htm#bodymass
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Stop Smoking (please!)
Recommendation
• Do whatever it takes to quit!
• Talk with your health-care provider
or look for a quit-smoking program
Why?
• Cigarette smokers have a higher risk of
developing cardiovascular disease 1
• Smoking is one of our nation’s top
causes of early death1
• Smoking will only add to your stress by
taking away your good health and
shortening your life1
• On average, smokers die 13–14 years
earlier than nonsmokers 2
1.
2.
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American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=14&CultureCode=en-US
Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/.
Reduce Your Blood Sugar
Recommendation
• Reduce consumption of simple
sugars that are found in soda, candy
and sugary desserts
• Get regular physical activity!
• Take medications or insulin, if
prescribed for you
Why?
• High levels of blood sugar can
damage your heart, kidneys, eyes
and nerves
• When you reduce excessive sugars
you help protect your vital organs
American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=13&CultureCode=en-US
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Control Your Cholesterol
Recommendation
• Eat healthy foods low in cholesterol,
trans fats and saturated fats and lots of
fiber
• Schedule a cholesterol screening
• Get active
• Maintain a healthy weight
• Take your prescribed medication
Why?
• When you control your cholesterol, you
are giving your arteries their best
chance to remain clear of blockages
that can lead to heart disease and
stroke
American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=9&CultureCode=en-US
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Manage Your Blood Pressure
Recommendation:
•
•
•
•
•
•
•
Eat a heart-healthy diet with less sodium
Enjoy regular physical activity
Maintain a healthy weight
Take your prescribed medication
Managing stress
Limit alcohol
Avoid tobacco smoke
Why?
• High blood pressure is the single most
significant risk factor for heart disease
• Managing it is common sense for
good health
American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=12&CultureCode=en-US
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Stress and Heart Disease
Recommendation for Stress
•
•
•
•
•
•
Exercise
Maintain a positive attitude
Do not smoke or drink too
much coffee
Enjoy a healthy diet
Maintain a healthy weight
Talk to your doctor or other
healthcare professionals
Why?
•
•
Managing stress is good for your
overall health
After a heart attack or stroke,
people can feel depressed,
anxious or overwhelmed by stress
American Heart Association/American Stroke Association: webpage, “Stress and Heart Health” Accessed
http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Stress-and-Heart-Health_UCM_437370_Article.jsp
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Alcohol Beverages and Heart Disease
Recommendation
• Talk to your doctor about benefits and
risks based on your own family history and
health
• If you drink alcohol, do so in moderation
4 oz.
4% 80
– 1 to 2 drinks per day for men
– 1 drink per day for women
Why?
• Alcohol use may be harmful for anyone
with:
–
–
–
–
–
–
Standard Drink
Equivalents
Personal/family history of alcoholism
Hypertriglyceridemia
Certain blood disorders
Heart failure
Uncontrolled hypertension
Taking certain medications
American Heart Association. Alcohol Beverages and Cardiovascular Disease.
http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Alcoholic-Beverages-and-CardiovascularDisease_UCM_305864_Article.jsp
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DISCUSSION
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How Heart Healthy Are You?
Raise your hand if you….
• Have immediate family members who have heart
disease/diabetes
• Smoke or live with someone who does
• Have been tested for type 2 diabetes in the last 2 years
• Had your blood pressure checked in the last year
• Know your cholesterol numbers, i.e., total, LDL and
HDL
• Exercise for 30 minutes a day at least 4 days a week
• Know how many calories you should eat in a day
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Know Your Numbers
Risk Factor
Goal
Total cholesterol
less than 200 mg/dL
LDL “Bad”
less than 160 mg/dL; < 130; <100, <70
HDL “Good”
women > 50 mg/dL; men > 40 mg/dL
Triglycerides
less than 150 mg/dL
Blood Pressure
less than 120/80 mmHg
Fasting Glucose
less than 100 mg/dL
Body Mass Index (BMI)
less than 25
Waist Circumference
women < 35 inches; men < 40 inches
Exercise
30 minutes ≥ 5 X week of moderate-intensity aerobic AND muscle
strengthening ≥ 2 X week
Diet and Nutrition
with your doctor, determine how many calories you need each day
and eat healthy, low sodium/sugar and high fiber foods
Tobacco and Alcohol
Stop smoking and exposure to secondhand smoke; women: one
drink or less per day; men: 2 drinks or less per day
American Heart Association; webpage, “Numbers That Count for a Healthy Heart.” Accessed
http://www.heart.org/HEARTORG/Conditions/Numbers-That-Count_UCM_305427_Article.jsp
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QUESTIONS?
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Thank You!
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Heart Attack Signs in Women
• Uncomfortable pressure, squeezing, fullness or pain in center of
chest
• Pain or discomfort in one or both arms, the back, neck, jaw or
stomach
• Shortness of breath with or without chest discomfort
• Breaking out in a cold sweat, nausea or lightheadedness
• Most common heart attack symptom is chest pain or discomfort
• Shortness of breath, nausea/vomiting and back or jaw pain are likely
If you have any of these signs,
don’t wait more than five minutes
before calling 9-1-1 and get to a hospital right away
American Heart Association. Heart Attack Symptoms in Women. Accessed
http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Heart-Attack-Symptoms-inWomen_UCM_436448_Article.jsp
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Stroke Warning Signs
• Sudden numbness or weakness of the face, arm or
leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or
coordination
• Sudden severe headache with no known cause
If one or more of these signs is present,
don’t delay — call 9-1-1
American Stroke Association: home page. Accessed:
http://www.strokeassociation.org/STROKEORG/WarningSigns/Warning-Signs_UCM_308528_SubHomePage.jsp
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CVD Risk and American Women
More women die of CVD than all forms of cancer combined1
Women experience some of the highest risk factors for CVD:
•
•
•
Black (71%), Latina (75%) and White (59%) women are overweight/obese2
Black (27%), Latina (34%) and White (28%) women are pre-diabetic2
Black (46%), Latina (29%) and White (31%) women have HBP3
Women can lower their heart disease risk by as much as 80% just by
leading a healthy lifestyle1
However, in a 2006 study of women3:
•
•
•
Only 57% knew heart disease is leading cause of death among women
Awareness was lower among Black (31%) and Latina women (29%) compared
with White women (68%)
Majority (≥ 50%) reported confusion related to heart disease prevention
More outreach and education clearly is warranted
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1. American Heart Association/Go Red for Women. “Women and Heart Disease: Myths vs. Realities” PDF 2012
2. American Heart Association . Women & CVD– 2012 Statistical Fact Sheet
3. Christian, A. et al. Nine-Year Trends and Racial and Ethnic Disparities in Women’s Awareness of Heart Disease and Stroke:
An American Heart Association Study. Journal of Women’s Health. Volume 16, Number 1. 2007
CVD Risk and Latinas
• Latinas have high rates of: diabetes
(13%)1, overweight and obesity
(75%)1 and physical inactivity (60%)2
• However, in a 2006 study of women3:
– Only 57% knew heart disease is leading
cause of death among women
– Awareness was lower among Black
(31%) and Latina women (29%)
compared with White women (68%)
– Majority (≥ 50%) reported confusion
related to heart disease prevention
• More Latina outreach and education
clearly is warranted
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1. American Heart Association/Go Red for Women. “Women and Heart Disease: Myths vs. Realities” PDF 2012
2. American Heart Association . Women & CVD– 2012 Statistical Fact Sheet
3. Christian, A. et al. Nine-Year Trends and Racial and Ethnic Disparities in Women’s Awareness of Heart Disease and Stroke:
An American Heart Association Study. Journal of Women’s Health. Volume 16, Number 1. 2007
Diabetes, Heart Disease and Stroke
High blood glucose levels can lead to increased
deposits of fatty materials inside blood vessels,
affecting blood flow and increasing the chance
of clogging and hardening of blood vessels
If you have diabetes:
• You are 2X more likely to have heart disease or a
stroke than someone who does not
• And are a woman, you have an even greater risk of
heart disease
• And have already had one heart attack, you run an
even greater risk of having a second one
• Your heart attack may be more serious and more
likely to result in death than someone without
diabetes
National Diabetes Information Clearinghouse. Diabetes, Heart Disease and Stroke. Accessed:
http://diabetes.niddk.nih.gov/dm/pubs/stroke/#connection
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