Welcome to Health From Head to Toe: Vascular Risk Reduction Building Healthy Lifestyles

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Welcome toHealth From Head to ToeVascular Risk
ReductionBuilding Healthy Lifestyles
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Objectives

• ? Promote your knowledge of vascular risk factors
• ? Learn chronic disease prevention strategies
• ? Discuss healthy lifestyle interventions

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• As I see it, every day you do one of two things
  build health or produce disease in yourself.
• Adelle Davis (1904-1974)

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8 in 10 Canadians have at least one risk
factor for vascular disease (i.e. heart disease
or stroke)

• MANAGEABLE risk factor
• ? Metabolic Syndrome
• ? High Blood Pressure
• ? High Cholesterol
• ? Pre-Diabetes/Diabetes

• MODIFIABLE risk factor
• ? Smoking
• Abdominal Obesity
• ? Physical Inactivity
• Nutrition/High sodium
• intake
• ? Excessive Alcohol
• Consumption
• ? Un-managed Stress
• ? Insufficient Sleep

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Steps to Reduce Your Risk

• Know and control your risk factors!
• http//www.phac-aspc.gc.ca/ccdpc-cpcmc/index_e.htm
  lextended
• www.heartandstroke.ca

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Metabolic Syndrome

• Diagnosed if you have 3 or more of the following
  conditions
• ? Blood pressure gt 130/85 mmHg
• ? Triglycerides gt1.7 mmol/L
• ? HDL (Healthy cholesterol) - Menlt 1.0 Women lt
  1.3 mmol/L
• ? Fasting Blood Glucose gt5.6 mmol/L
• ? Abdominal obesity Waist circumference gt 94 cm
  in men or gt 80 cm in women

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Leading Risk Factors for Death in Developed
Countries
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Blood Pressure
Tobacco
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High Cholesterol
Overweight
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Low Fruit Vegetable intake
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Physical Inactivity
(World Health Organization 2002)
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Why Treat Hypertension?
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Cholesterol

• ? About 40 of Canadians have high cholesterol
• ? Ideal cholesterol levels vary individually
  based on other risk factors for heart disease or
  stroke
• www.heartandstroke.ca

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Lipid Panel

• LDL (LOUSY) promotes the buildup
• of fatty plaque on the artery walls
• HDL (HEALTHY) helps clear the arteries
• Triglycerides not a type of
• cholesterol, but are also a fat found in
• the blood

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Statins

• In addition to current Canadian recommendations
  on management of dyslipidemia, statins are
  recommended in high-risk hypertensive patients
  with established atherosclerotic disease or with
  at least 3 of the following criteria

LVH ECG abnormalities Microalbuminuria or
Proteinuria Family History of Premature
CV disease
Male age 55 or older Smoking
Total-C/HDL-C ratio of 6 mmol/L or higher
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Diabetes

• ? More than 3 million Canadians have diabetes
  (90 are Type 2)
• ? Fasting blood sugar should be tested every 3
  years if over age 40 to screen for diabetes
• www.diabetes.ca

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Waist Circumference Measurement
Last rib margin
Mid distance
Iliac crest
Courtesy J.P. Després 2006
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90 of Canadians have other cardiovascular risk
factors!
Emberson et al. Eur Heart J. 200425484-491.
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Lifestyle Modification
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Healthy Lifestyles Really Make a Difference
Intervention Amount Change in SBP/DBP
Reduce daily sodium intake by 1800 mg -5.1 / -2.7
Weight loss of 4.5kg (lt10lb) -7.2/-5.9
Alcohol intake 0-2 drinks per day/day -3.9 / -2.4
Aerobic exercise 120-150 min/week -4.9 / -3.7
Dietary patterns DASH diet Hypertensive Normotensive -11.4 / -5.5 -3.6 / -1.8
Reducing Stress
-6.1/-4.3
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Some Fantastic Effects of Smoking Cessation

• Risk of heart attack and stroke drop lt 24 hours
• Breathing is easier lt 3 days
• Coughing is improved lt 2 weeks
• Risk of CAD is reduced by 20 50 lt one year
• Risk of stroke normalizes lt 5 years
• Risk of dying is equal to a non smoker lt 15
  years.
• Smoker Help Line 1-866-332-2322

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Physical Activity

• Physical Activity can
• Decrease risk of heart disease and stroke
• Help lower blood pressure
• Help control blood sugar
• Help to control weight.
• Help to reduce stress levels
• Increase HDL, decreases LDL and triglycerides.

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Physical Activity Recommendations

• Frequency 4 - 7 times per week
• Intensity Moderate
• Time 30-60 minutes
• Type Cardiorespiratory Activity
• - walking, jogging
• - cycling
• - non-competitive swimming

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Eat a Healthy Diet

• Follow Canadas Food Guide
• Adequate fruit, vegetables,
• whole grains, low-fat dairy products.
• Foods low in saturated and trans fat, sugar
  salt, and high in fiber.
• Have at least 3 meals a day and an afternoon
  snack. Space meals 4-6 hours apart.
• Eat breakfast each morning.
• Visit www.healthcanada.gc.ca/foodguide for more
  information.

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Nutrient Density vs Calorie Density
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What About the Food We Eat? The Amount of Fat and
Sugar Is Whats Important!
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Shake the Salt Habit

• 1 in 3 Canadians with hypertension could have
  normal blood pressure if they lowered their
  sodium intake.

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Health Issues Linked to High Sodium Intake

• Excretion of calcium in the urine, may lead to
  osteoporosis
• Stomach cancer
• Water retention
• Kidney stones
• Enlargement of the heart
• Increased severity of asthma symptoms

Osteoporosis is a disease characterized by low bone mass and weakening of bone tissue
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Adequate Sodium Intake For Adults
Age Sodium intake per day (mg)
9-50 years 1500
50-70 years 1300
Over 70 years 1200
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Sources Of Sodium
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Sodium Content of Restaurant Foods
Menu Item Sodium (mg)
Breakfast Egg Sandwich 840
Chicken Caesar Salad 570
12 Pepperoni Pizza 5960
Deluxe Cheeseburger Medium Fries 1910
Fried Chicken Dinner 2280
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Processing Adds Sodium To Food
Food Sodium (mg) Food Sodium (mg)
Plain pasta 5 Pasta sauce 800
Cucumber 2 Dill Pickle 385
Fresh salmon 56 Canned salmon 272
Cheddar cheese 176 Processed cheese 407
Coffee cream sugar 15 Cappuccino from mix 250
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Salt o - Meter

• http//www.theglobeandmail.com/special-reports/har
  d-to-shake/
• www.sodium101.ca
• - information on how to reduce dietary sodium
• http//www.sodium101.ca/en/happening/news.html

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Potential Benefits of Dietary Sodium Reduction in
Canada

• Reduction in average dietary sodium from about
  3500 mg to 1700 mg
• 1 million fewer hypertensives
• 5 million fewer physicians visits a year for
  hypertension
• Health care savings of 430 to 540 million
• Improvement of hypertension treatment
• control rate
• 13 reduction in CVD
• Total health care cost savings of over 1.3
  billion/year

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Limit Alcohol

• Men Maximum 14
• drinks/week
• Women Maximum 9
• drinks/week
• No more than 0-2 drinks per day

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Stress

• Increases LDL and decreases HDL
• Raises Blood pressure
• Increases Blood sugars
• Increases Clotting enzymes

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What Can You Do?

• Identify what is causing stress
• Establish priorities
• Can you change perspective???
• If able, modify your situation
• Say NO more often??
• Make time for yourself!!

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Sleep Reduces Vascular Damage

• ? Adults need 7 8 hours of uninterrupted sleep
  to maintain vascular health.
• ? Sleep is a process of restoration and
  regeneration for the body and mind
• ? Sleep allows the body to heal itself, suppress
  the appetite hormone, reduce cortisol (stress)
  which in turn will decrease blood pressure.

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CONCLUSION

• UNDERSTAND vascular protection
• KNOW your stats!
• REDUCE your risk
• VISIT - your doctor/health care provider
• DEVELOP your action plan!!!

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QUESTIONS??

• BHL Hypertension/Stroke Prevention