it's time for a heart to heart

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Women of Summa: It’s Time for a Heart to Heart Vivian von Gruenigen, BSN, MD Chair Obstetrics and Gynecology Women’s Service Line Director Summa Akron City Hospital

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Page 1: It's Time for a Heart to Heart

Women of Summa: It’s Time for a Heart to Heart

Vivian von Gruenigen, BSN, MDChair Obstetrics and Gynecology

Women’s Service Line Director

Summa Akron City Hospital

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5 Leading Cause of Death in All Females, All ages

Heart Disease 27%

Cancer 22%

Stroke 8%

Respiratory Disease 5%

Alzheimers 4%

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Differences in gender

Women get heart disease later in life

Symptoms more subtle Women are much more likely to die from their first heart

attack than men Women hesitate to call 911, and get to the hospital ~60

minutes later than men In the past, CV research was done in men Women experience a unique increase in lipids after

menopause

Matthews KA et al. J Am Col Cardio 2009

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Differences in Gender

The signs and symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks

This may be because women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease.

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What Is Heart Disease?

Coronary Heart Disease

High Blood Pressure Heart Failure Valve Disease Diseases of

Pulmonary Circulation

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What Have We Learned?

Risk Factors Factors leading to heart disease can start in young

women and develop over time

The Disease Heart disease can strike women at any age

Prevention and Treatment Healthy lifestyle changes can prevent or postpone

heart disease

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Why Is It Important?

Cardiovascular disease kills 1 in 3 women Tens of millions

64% of women who die suddenly from coronary heart disease have no previous symptoms

80% of cardiovascular disease is preventable

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What is a heart attack?

A heart attack occurs when the blood flow to a part of the heart muscle is blocked

Most heart attacks start slowly, with mild pain or discomfort

Interrupted blood flow to your heart can damage or destroy a part of the heart muscle.

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What Is A Heart Attack?

Warning Signs Chest discomfort Discomfort in upper body Shortness of breath Cold sweat Nausea Lightheadedness

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Signs

Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue

Women also have more symptoms compared to men (2.6 on average vs 1.8 symptoms in men)

Approximately one quarter of all myocardial infarctions are silent, without chest pain or other symptoms.

The onset of symptoms in myocardial infarction (MI) is usually gradual, over several minutes, and rarely instantaneous.

Emergency

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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

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Am I at risk?

Vascular injury accumulates from adolescence, making primary prevention efforts necessary from childhood.

Risk factors can be modified, treated or controlled and some can’t

The more risk factors you have, the greater your chance of developing coronary heart disease

“Deadly quartet” of chronic conditions that includes Diabetes, Obesity, Blood pressure Cholesterol

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Am I At Risk?

If you have any of these risk factors, you are at risk for heart disease.

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Your Risk: High Blood Cholesterol

Cholesterol is a soft, fat-like substance found in the bloodstream and in all your body’s cells

The saturated fats, trans fats and cholesterol you eat may raise your blood cholesterol

Cholesterol can build up in the walls of arteries, narrowing the flow

If a narrowed artery gets blocked by a clot or other particle, the heart or brain loses its blood supply, resulting in a heart attack or stroke

www.3dchem.com

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Your Risk: High Cholesterol- Lipid Profile

Includes: Total Cholesterol LDL [low-density

lipoprotein] (bad) HDL Cholesterol

(good) Triglycerides

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Your Risk: High Blood Cholesterol

Total Cholesterol Level

Desirable = Less than 200

Borderline high = 200 to 239

High = 240 and above

~ 50% of women have a total cholesterol of 200 mg/dL

and above, which puts them at risk for heart disease.

www.nhlbi.nih.gov

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Your Risk: High Blood Cholesterol

HDL – the higher your HDL, the better

HDL Cholesterol Risk Levels Less than 50 mg/dL for women

Therefore, want > 50

LDL – is the main carrier of harmful cholesterol

LDL Cholesterol Risk Levels > 130 mg/dL Borderline, >160 high, > 190 very high

Therefore, want between 100-130

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Your Risk: High Blood Pressure

High blood pressure = hypertension (HTN) Blood pressure, is simply the pressure of the blood as it

circulates No one knows exactly what causes most cases of HTN HTN is called the “silent killer,” because it increases the

risk for heart attack, angina, stroke, kidney failure , heart failure and

peripheral artery disease (PAD)

1 in 3 adults has HTN, tens of millions

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Your Risk: High Blood Pressure

Risk Factors Genetics

African Americans

Over age 35 Overweight Physical inactivity Nutrition

Salt, alcohol

Diabetes, kidney disease Pregancy

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Your Risk: High Blood Pressure

Normal Blood Pressure

Around 120/80

Hypertension

Above 140/90

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Classification of Blood Pressure in Adults

OPTIMAL: <120 systolic and <80 diastolic PREHYPERTENSION

120-139 systolic or 80-89 diastolic STAGE 1 HYPERTENSION

140-159 systolic or 90-99 diastolic STAGE 2 HYPERTENSION

>160 systolic or >100 diastolic

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Your Risk: Diabetes

Incidence is increasing Type I Diabetes – also called juvenile

The body fails to make insulin Type II

The most common 95% of Americans Middle-aged. Linked with obesity and physical inactivity. The body doesn’t make enough.

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Your Risk: Diabetes

Complications of Diabetes Stroke, TIA Blindness Heart attack, angina Kidney disease High blood pressure Erectile dysfunction Loss of legs or feet Nerve disease

People with diabetes are two to four times more likely to develop cardiovascular disease.

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Your Risk: Diabetes

Prevention and Control

Control your weight and cholesterol (low-saturated fat and low-cholesterol diet)

If you take medicine, take it exactly as directed Discuss exercise with your physician Nutritionist consult/team

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Your Risk: Obesity & Overweight

The majority of Americans are overweight

Excess Weight: Strains your heart Raises blood pressure

and cholesterol Can lead to diabetes

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Your Risk: Obesity & Overweight

Set goals, potential roadblocks Lifestyle change, not a diet You may need help or support

Team approach Keeping weight off can be as challenging

as losing it

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Your risk: Physical inactivity

Regular, moderate-intensity physical activity can lower your risk of

Heart disease and heart attack HTN High cholesterol Overweight or obesity Diabetes Stoke Cancer

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Your risk: Physical inactivity

Inactive women:

White females – 38%

Black females – 52%

Hispanic females – 54%

All healthy adults ages should be getting at least 30 minutes of moderate intensity activity 5 days a week

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Your risk: physical inactivity

Most Americans favor walking as their favorite physical activity

Many places - at home, local parks, YMCAs, travel…

Many types – swim, resistance, ski, golf… Find your sole-mate or mates

Family, friends, colleagues Stay motivated

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Your Risk: Smoking

Benefits of Quitting Within 1 to 2 years of quitting, the risk of coronary

heart disease is substantially reduced A smoker’s cough will go away It is easier to be physically active Second hand smoke is real

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Your risk: Nutrition Quality

Be aware of calories Low fat Lean meats Fiber, whole grains Low fat dairy Fruits and veggies

Diversify your colors

Whole foods versus processed White food…sugar Limit fast foods

Super size me

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Decreasing your sodium intake: where is salt found in our diets?

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Your risk: Depression

Depression is twice as common in women as in men, and it increases the risk of heart disease by 2-3 times

Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment

Talk to your doctor if you're having symptoms of depression

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Your risk: HRT

Can estrogen replacement therapy reduce my risk for heart disease?

No. Estrogen replacement therapy, also called hormone replacement therapy (HRT

New studies have shown that when it comes to heart health, HRT may do more harm than good.

If you’re taking HRT to help prevent heart disease, talk to your doctor about whether you should stop.

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First aid

Call for help Aspirin Oxygen Nitroglycerin Automated external defibrillator (AED) Opiod painkillers Air travel kits

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Women in Recovery andRehabilitation after a Heart Attack

The first year following a heart attack, women tend to

have a higher rate of disability and death, and show

poorer psychological adaptation than men. Social support and mood were the best predictors

of overall quality of life at one year for women Those with more social support tended to have a higher rate

of persistency, while a belief in the positive health benefits of exercise increased the amount of exercise undertaken by the participant.

• Moore SM et al J Cardio Rehab 2003

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What Can I Do To Prevent Heart Disease?

Eat a healthy diet low in saturated fat, trans fat, cholesterol and sodium.

Keep your weight under control. Be physically active at least 30 minutes on most or all

days of the week. Control your blood pressure and cholesterol levels. Manage your blood sugar if you have diabetes. Don’t smoke, and avoid tobacco smoke. Taking your medicines as directed by your physician

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What Can I Do To Prevent Heart Disease?

You are here You are an advocate You are educated Teach those who are not as fortunate Lead by example Grass roots

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“Women, whether subtly or vociferously, have always been a

tremendous power in the destiny of the world.”

Eleanor Roosevelt

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Be the kind of woman that when your feet hit the floor

each morning the devil says~~

"Oh crap , She's up!“

Email from Aunt Jeanette 

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Questions?

YOU are beautiful, smart and have the power to

make a difference