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Cardiovascular health

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Cardiovascular health Will examine what we know re CV health and Coronary heart disease (CHD) American and Canadian info & resources, mostly allopathic, some web-based – PowerPoint PPT presentation

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Title: Cardiovascular health


1
Cardiovascular health
  • Will examine what we know re CV health and
    Coronary heart disease (CHD)
  • American and Canadian info resources, mostly
    allopathic, some web-based
  • Then look at integrative approaches relying on
    text chapter 18 as framework

2
Cardiovascular health
  • CV disease is now the major cause of death and
    disability and of rising health care costs in
    Canada
  • In groups of 5, record what you know about CV
    disease / health and what you know re treatment /
    prevention allopathic less conventional or
    alternative

3
CHD what is it ?
  • Narrowing of coronary arteries
  • Atherosclerosis vs arteriosclerosis
  • Angina (lack of oxygen induced) to full blown
    heart attack
  • Cholesterol, vital to hormone vitamin D
    production, bile to digest fat etc present
    everywhere
  • Excess cholesterol is issue re athero etc

4
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5
CV Disease Deaths by sex, Stats Can, 1994
6
Risk Factors in General
  • smoking
  • high blood pressure
  • high cholesterol
  • physical inactivity
  • obesity
  • diabetes

7
Risk Factors and CHD
  • The risk factors that you cannot  control
    include
  • Age (45 years or older for men 55 years or older
    for women)
  • Family history of early heart disease (father or
    brother affected before age 55 mother or sister
    affected before age 65)

8
Risk Factors and CHD
  • The risk factors that you can control include
  • High blood cholesterol (high total cholesterol
    and high LDL ("bad") cholesterol)
  • Low HDL ("good") cholesterol
  • Smoking
  • High blood pressure
  • Diabetes -- if you have diabetes, your risk for
    developing heart disease is high, as high as a
    heart disease patient's risk for having a heart
    attack need to lower cholesterol under medical
    supervision, in much the same way as a heart
    disease patient, in order to reduce high risk of
    getting heart disease.
  • Obesity/overweight
  • Physical inactivity

9
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10
What makes cholesterol hi or low ?
  • Your blood cholesterol level is affected not only
    by what you eat but also by how quickly your body
    makes LDL ("bad") cholesterol and disposes of it
  • In fact, your body makes all the cholesterol it
    needs, and it is not necessary to take in any
    additional cholesterol from the foods you eat

11
Benefits of cholesterol - lowering
  • Huge risk reducer (lots of evidence) both for
    people with high cholesterol those with avg
    levels
  • Studies use statins (discussed in your text) as
    cholesterol lowering drugs longitudinal studies
    in Scotland etc showed dramatic reductions in
    incidences of CHD, 20-37 reductions
  • See notes re studies in Handout format
    below this slide

12
What makes cholesterol hi or low ? Factors re
LDL levels
  • Heredity
  • What you eat
  • Weight
  • Physical activity/exercise
  • Age and sex
  • Alcohol
  • Stress
  • see definitions in Handout format below this
    slide

13
Framingham Heart Study
  • huge study, best one re mass of data on
    cholesterol reductions
  • 0n web site see material below this slide
    re Framingham

14
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15
Types of Blood Pressure Medications
  • Diuretics
  • Beta-blockers
  • ACE inhibitors
  • Angiotensin antagonists
  • Calcium channel blockers (CCBs)
  • Alpha-blockers
  • Alpha-beta-blockers
  • Nervous system inhibitors
  • Vasodilators
  • see definitions of each below this slide

16
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20
Integrative medicine re CHD
  • when applied to CV disease, preventative
    medicine in Western society is a concept most
    people accept, few people practice, and almost no
    one pays for text 409
  • Most of the 200 billion annual US price tag is
    spent on the treatment of symptomatic disease
    end-organ failure

21
Integrative medicine re CHD
  • Reliance on therapeutic vs preventative
    strategies fosters a magic bullet mentality in
    N America
  • No single strategy, medication, or intervention
    program guarantees avoidance of negative cardiac
    events

22
Integrative medicine re CHD
  • Huge sums of to conquer a largely behavioural
    disease thru pharmacology, surgery,
    catheterization-based interventions genetic
    engineering
  • So, what are the integrative suggestions from
    your text and elsewhere ???

23
Integrative CV Health
  • CHD as a complex of genetic, environmental,
    cultural, and behavioural factors
  • Text notes that genetic markers, that is, risk
    factors we cant control, are important (lipid
    metabolism, diabetes, hypertension), CV health /
    prevention of CHD is remarkably variable
  • Non-allopathy here is predominantly diet and
    lifestyle interventions - consider these as
    primary or at least adjunctive treatments for CHD
    and CV health

24
Text CV Health
  • Diet goes thru studies re epidemiological
    links, avocados, Mediterranean-style diets
    (mono-unsat fats), and serial monitoring of types
    of fat intake body weight/BMI
  • Exercise evidence also strong here
  • Alcohol red wine vs beer vs hard liquor what
    does evidence say ?

25
Text CV Health
  • Dietary Supplements Herbs digoxin (also
    called digitalis, both derived from plant
    foxglove) vs angiotensin inhibitors
    plant-based diets re antioxidants and
    antiinflammatories purslane garlic and
    teas, hawthorn berries rich in flavinoids
    (anti-inflam), folic acid, Vitamin E-rich foods

26
Text CV Health
  • Note the crystal clear summary pp 410-411 esp
    tables 18-1, 18-2, and 18-3 what makes this
    alternative is the element of informed,
    evidence-based choice
  • Also, difference betw choices in acute coronary
    syndromes vs chronic stable CHD vs at-risk
  • Emphasis is on delay and avoid

27
Last 3 classes
  • Tuesday chronic fatigue GI system
  • Thursday oncology start wrap-up
  • Tuesday 11th, last class, synthesis yes,
    chapters 31 33 are required re this unit

28
Evidence MC Exams
  • Multiple multiples NOT when theyre logic, dont
    test knowledge
  • So, no more than 8 on exam, and only if content,
    not logic-based
  • of alternatives evidence 4 good ones better
    than 5th bad one so Im going to do that too
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