World Heart Day: September – 2011
Scientific seminar
Risk factor control and life style
modification for prevention of Ischemic
Heart Disease
Speaker:
Dr. R. C. Debnath
Chairperson:
Dr. M. Saiful Bari
Assistant professor
Associate Professor & Head
Department of cardiology
Department of cardiology Mymensingh
Medical college Mymensingh Medical college
Introduction:Every year 17.1 million lives are claimed
by the global burden of cardiovascular
disease, with 82% of deaths occurring in
low and middle income countries. This
excessive number of death is
particularly saddening, since through
steps such as eating a healthy diet,
regular physical activity and avoiding
tobacco, the majority of these death
could be prevented.
Continue
Introduction (cont…)
Over 70 % of all cardiac and
breathing emergencies occur in the
home when a family member is
present and available to help a
victim.
Risk factors
for
coronary Artery disease
Non modifiable risk factors
(Non controllable)
Heredity:- if parents / First degree relatives
have heart disease or sudden cardiac
death in early age
Gender & Age:- Men > 45 years
Women > 55years
After menopause incidence
of CAD is equal.
Modifiable risk factors
(controllable)
Smoking
Hypertension
Dyslipidemia
Diabetes & Pre diabetes
Over weight and obesity
Physical inactivity
Stress and Behavior
Unhealthy diet
Alcohol
Emerging risk factors
C-reactive protein (CRP)
Triglycerides
Lipoprotein (a)
Homocystine
Thrombogenic /Haemostatic factor
 Impaired fasting blood glucose
Ankle brachial index
Carotid intima- media thickness
Periodontal disease
Smoking
Smoking has a particularly large impact in the
third world.
Persons who consume 20 or more cigarettes
daily have a two to threefold increase in total
coronary heart disease.
Cigarette consumption directly relates to
increase rates of sudden cardiac death, PVD,
IHD, Ischemic CVD
Smokers have 20-30% increased risk than
non-smokers.
Smoking (cont..)
* Smoking Increases level of oxidized LDL &
reduces cardioprotective HDL
* These effect is produced direct effect of
carbon monoxides and nicotine
* Impaired endothelium dependent coronary
vasodilatation
* Directly dysfunction of endothelial nitric
oxide biosynthesis.
Smoking (cont)
*Chronic smoking increases level
of CRP, fibrinogen and
homocystine level
*Chronic smoking increases
platelets aggregation.
*Smokers have increase
prevalence of coronary stenosis
Hypertension: (BP Control)
Individual with
Systolic BP 120-139 mmHg
Diastolic BP 80-89 mmHg
*Pre hypertension needs life style
modification
Goal:- <140/90 mmHg
<130/85 mmHg (Renal failure)
<130/80 mmHg (DM)
Dyslipidemia
Improve cholesterol level, one healthy
adult should be:Goal:Total cholesterol <200 mg/dl
LDL <130 mg/dl
HDL above 40 mg/dl (men)
HDL above 50 mg/dl (women)
Diabetes & pre diabetes
Goal: Fasting glucose <110 mg/dl
HbA1c <7%
* Patient with DM have high risk for coronary
artery disease.
* ATP III has designated DM as CHD risk
equivalent
* More over, many patients, with DM type-2
present with silent MI, silent ischemia and
sudden cardiac death.
* So DM should be properly control, by Diet,
Exercise Weight Reduction & Appropriate Drugs.
Over weight and obesity: BMI= (Kg/m2)
* Normal: 18-24.9
* Over weight: 25-29.9
* Obese: >30
* Increase risk for
HTN, DM, Dyslipidemia
* Increase risk for IHD, COPD &
others chronic illness
* Appropriate lifestyle modification by diet,
exercise, best way to control weight gain.
Source: over weight and obesity article
Lack of physical Activity
*Inactive people are nearly twice as likely
to develop CHD as those who are active.
*A lack of physical activity can worsen
other CHD risk factors. e.g. Increased
cholesterol, TG, BP, DM, Pre diabetes,
overweight & obesity.
* It is important for children and adult to
make physical activity part of their daily
routines.
Lack of physical Activity (cont)
*Many American’s are not active enough is
because of hours spent in front of TV, and
computers doing work, schoolwork and leisure
activities.
*Some Experts advise that children and teens
should reduce screen time they recommended
that children age 2 and older should spend no
more than 2 hours a day watching TV or using
computer (except school work)
*Being physically active is one of the most
important way to keep your heart healthy
(Source:- 2008 physical activity guideline for Americans)
Unhealthy Diet
* An unhealthy diet can raise your risk of
CHD
* Foods that are high in saturated and trans
fat, and cholesterol raise LDL
* Saturated fats are found in some meats,
dairy products, chocolate, egg yolk, full
cream milk, coconut oil, deep fried and
processed foods
Life style modification: No Big Deal !
Unfortunately most of us live an
unhealthy life.
By adopting and practicing certain very
simple and convenient day to day life
style changes, we can lead a much better
and healthier life
Life style changes includes
Eating a healthy diet
Regular physical activity
Weight control
Stop smoking
Healthy diet
Cut salt:- Reduce dietary sodium intake
not more than 100 mmol per day (2.4 gm
sodium or 6 gm sodium chloride)
High sodium intake increases BP.
Avoid sugar:-Specially refined sugar (A
form of carbohydrate).
Healthy diet (Continued)
Diet:- American Guidelines for diet
to reduce CHD risk.
Reduced intake saturated fat <7%
Poly unsaturated fat up to 10%
Monounsaturated fat up to 20% of
total calories.
Total fat up to 25-35% of total
calories
Healthy diet (Continued)
Carbohydrate 50-60% of total calories
Protein 15-25% of total calories.
Inclusion of plant stanols, and sterol, (Found
fruits, vegetables, nut, cereals, vegetable oil,
seeds)
Inclusion of 20-30 gm per day fiber (found
oats, barley, soybean, citrus
fruits)
Recommended food
Avoid saturated fat:- Such as animal fat,
Ghee, egg yolks, coconut oil, full cream
milk, butter, cheese, Fatty fish and meat.
Should be taken:Plant protein: pulses (dal)
Animal protein: Low fat fish, meat, egg
(Except yolk.)
Recommended food
• Unsaturated fat: Sunflower oil, olive oil, mustard
oil Milk: Non fat milk, non fat curd, non fat
cheese
• Take more vegetable and fruits
(fruits should be taken 5 times in a day)
 Early dinner:-Eat an early and light dinner. Almost
an hour & half before bed time. To give ample
time to our stomach for proper digestion of food.
It is advisable to eat by end of the evening.
Exercise: (Physical activity)
Should be Aerobic exercise
At least 30 minutes of moderate
intensity of physical activity on most
(preferably all) days of the week.
Moderate intensity of activities (4060% of maximum capacity) are
equivalent to brisk walking (15-20 min
per mile)
Physical activity contd..
Out door exercise :
 Brisk walking
 Swimming 20 minute
 Jumping rope for 15 minute
Indoor exercise:
 Playing single tennis
 Stair climbing
 Stationary bicycle
 Tread mill
World Heart Day 2011
key message and theme
One world, One Home, One Heart
One world
Cardiovascular disease causes 29% of all death,
globally each year.
It’s the world number one killer
Global leaders have recognized the urgency to
control and prevent CVD with other non
communicable disease
It is important that efforts to fight CVD do not rest
only with policy makers and global leaders.
Individuals throughout the world can also reduce the
CVD burden by learning about risk factors and taking
vital step to reduce their own and their family’s risk.
One Home
This year on world heart day, the world heart
federation and its members challenge you to
take charge of your family's heart health.
To help you, the world heart federation
identified four action you and your family can
take
1.Ban smoking from your home:
Stop smoking tobacco in the home to
improve your own and your children heart
health.
Implement a new rule in your home, for
every cigarette smokers.
One Home (continue)
2. Stock your home with healthy food
options:
Start the day with a piece of fruits
or prepare your own lunch at home.
To ensure healthy options are taken.
Make sure every evening contain at
least two to three servings of
vegetable per persons.
One Home (continued)
• 3. Be active:
 Families should limit the amount of time
spent in front of the TV to less than two
hours per day.
 Organize outdoor activities for the family
such as cycling, walking, playing in the
garden.
 When possible , instead of using the car, take
your bicycle or walk from home to your
destination.
One Home (continue)
4. Know your numbers:
Visit a healthcare professional who
can measure your blood pressure,
cholesterol, and glucose levels,
together with waist circumference and
body mass index (BMI)
Once you know your overall CAD risk,
you can develop a specific plan of
action to improve your heart health.
One Heart
World heart day was created in 2000 to inform
people around the globe that heart disease &
stroke are leading cause of death, clamming
17.1 million lives each year.
The world heart federation together with its
members, spreads the news that at least 80%
premature death, from heart disease and stroke
could be avoided if main risk factors, tobacco,
unhealthy diet and physical inactivity are
controlled.
WORLD HEART DAY
It is a national
&
International awareness
day
Take care of your heart
World Heart Day
World Heart Day 29
September- 2011