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TRANSCRIPT
TM RY A H EE H A RR UT, O Y
TM RY A H EE H A RR UT, O Y
“Prevention is better than cure”
Prevention is by one rupee whereas cure is by one Lac rupees in Heart Disease (by Stent & Surgery)
This World Heart Day, we ask you to share how you power your heart and inspire
millions of people around the world to be heart healthy.
Cardiovascular disease (CVD), which includes heart disease and stroke, is the
world’s number one killer. Each year, it’s responsible for 175 lakhs premature
deaths and by 2030 this is expected to rise to 230 lakhs.
But the good news is that such Cardiovascular disease can be prevented by small
changes in lifestyle.
like...
World Heart Day
01
PROMISETO EAT WELL AND DRINK WISELY
PROMISETO SAY NO TO SMOKING
PROMISETO GET MORE ACTIVE
Risk Factors for Heart Disease
• • • Abnormal lipids Smoking Hypertension
• • • Diabetes Abdominal obesity Psychosocial stress
• Decreased consumption of fruits and vegetables
• • Moderate consumption of alcohol Physical inactivity
• • • Smoking / Tobacco Sedentary lifestyle Stress
• Type - A Personality
• • • High Blood Pressure Diabetes Dyslipidaemia (Bad Cholesterol)
Obesity Metabolic Syndrome Improper & High fat Diet• • •
• • • Lipoprotein (a) Hyper Homocys�nemia Hyper Uricemia
Hyper Fibrinogenemia HS-CRP An�phospholipid • • •
An�body Syndrome)
Oral Contracep�ve Pills Apolipoproteins• •
• • Gender-Male Post menopausal women
• Heredity (Family history of Heart Disease, Male < 55 years and
Female < 65 years)
• Collectively, following nine risk factors accounted for 90% of the population
attributable risk (PAR) in men and 94% in women in India.
02
Modifiable Risk Factors (by Lifestyle)
Non – Modifiable Risk Factors
New factors
03Know your ideal goals of Important Risk Factors for Prevention of Heart Attack
< 50 mg/100ml.
04
Abnormal lipids
• It increases the risk of Heart attack by 56%.
• LDL is the best established risk factor of Heart Attack.
• Total cholesterol to HDL ratio is also a very strong risk predictor for Heart Disease.
• For general population LDL>160 (mg/dl), TG>150 (mg/dl) and HDL<40 mg/dl are considered as abnormal.
• For people with risk factors of Heart Diseases mentioned before, LDL>100 is considered as abnormal.
• 1 unit(1 mmol/litre) reduction in LDL level reduces major coronary events and stroke by 25%.
• Target LDL should be less than 100 mg/dl (for general population) & less than 70 mg/dl (for heart patients).
• Low calorie, low fat diet
• Avoid fried foods and junk food.
• Consume more fruits and vegetables.
• Do Physical activity (Walking, Jogging, Cycling, Swimming etc.
• Lipid Lowering Drugs-Statins (only according to doctors advice).
Preventive Steps for Abnormal lipids
05
• It increases the risk for heart attack by 49%.
Prevention of Hypertension
Hypertension
• In addition, it also causes cerebrovascular stroke, Kidney failure, Peripheral vascular
diseases and retinal damage.
• Out of all diagnosed of Hypertension, 47% remain uncontrolled.
• Prehypertension also increases the risk of Heart Attack and Stroke.
• Research showed that lowering of the blood pressure by 5-6 mmhg results in 56%
reduction in the risk of heart attack.
• Symptoms of Hypertension :
- Headache
- Giddiness
- Blurring of vision, etc.
• Although majority of the patients are asymptomatic.
Grade Systolic (mm of Hg) Diastolic (mm of Hg)
Normal < 120 < 80
Pre-Hypertension 120 to 139 80 to 89
Stage-1 140 to 159 90 to 99
Stage-2 > 160 > 100
MedicationPhysical activityWeight ControlLow Salt Diet (DASH Diet - Dietary
Approach to stop Hypertension)
06
Diabetes
Preventive Steps of Diabetes
MedicationMonitoring of Fasting Blood
sugar/HbA1C levels
Low calorie, low fat diet
Weight Control
Physical activity
• In India, 61.3 million people are affected (largest proportion in world).
• >50% are undiagnosed (Silent killer).
• Every 1 of 10 heart patient has Diabetes.
Fasting Blood Sugar (FBS) > 126 mg/dl
Post Prandial Blood Sugar (PPBS) > 200 mg/dl
Random Blood Sugar (RBS) > 200 mg/dl
HbA1c > 6.0%
• Symptoms of Diabetes :
- Increased appetite and thirst,
- Increased frequency of urination,
- Weakness,
- Unexplained weight loss.
• Although majority of patients have no symptoms.
• In addition to Heart Diseases, it also increases the risk of Kidney failure, Peripheral Vascular Diseases, Retinal Damage, Stroke, Neuropathy etc.
Criteria for Diabetes
07
Obesity leads to high blood pressure, diabetes, High cholesterol, Heart diseases, Stroke,
Arthritis, Gallstones and Cancer etc.
• It increases the risk for heart attack by 20%.
Definition of Obesity
• Waist circumference > 90 cm (men), >80cm (women)
• BMI= [Weight (kg)/Height (m2)] = ≥ 25 denotes a person as Over Weight
Preventive steps for obesity
• Low calorie diet
1. 1200-1500 kcal/day for women and 1500-1800 kcal/day for men.
2. Avoid high carbohydrate foods and high fat foods.
3. Take high fiber food, fruits and vegetables.
• Do physical activity (Walking, Jogging, Cycling, Swimming etc.)
: 30 minutes for 5 day / week
• Practice Yoga & Shavasana
Obesity
08
Smoking / Tobacco
Intake of tobacco or smoking increases the possibility of heart diseases by 20-30 times.
• Among smokers/ tobacco users 35 years of age or older who die of smoking related
causes, 35% die due to heart disease.
By the consumption of tobacco and smoking...
• Nicotine in Tobacco is injurious to Heart & Other Organs.
• It Increases Vasoconstriction, Sympathetic tone and Endothelial dysfunction.
• It causes Oxidation of LDL.
• Decreases the good cholesterol (HDL) and increases the bad cholesterol (LDL).
• Increases the heart rate and blood pressure.
• Also increases the risk of oral and lung cancer.
• It increases the Blockage & Thrombus Formation in the arteries of leg.
What is Indirect (Passive) Smoke ?
• Cigarette smoke exhaled by smoker and inhaled by non-smoker is called passive
smoking.
• Others Exhaled smoke is also Hazardous.
• It increases the risk of heart attack 30% more, also the chances of lung cancer with
more than 30 times.
09
Advantages of stopping smoking
• Smokers/ tobacco users who quit, Reduce their excess risk of heart disease by 50%
within first 2 years after suggestion.
• 1 year : Risk of heart attack is decrease to 50% compared to smoker.
• 10 years : Risk of lung cancer decrease to 50% compared to smoker.
• 15 years : Risk of heart attack becomes Equal to a normal person.
Help to quit the smoking...
• Patient’s Willingness to quit.
• Strong Will power.
• Positive support of the family members.
• Awareness of diseases and its consequences.
• Behaviour counselling.
• You can use the alternatives :- Nicotine Patch, Chewing gum, lozenges, Micro tablets,
Inhaler, Bupropion Spray.
10
Physical inactivity
• It increases the risk for heart attack by 21%.
Exercise
• Reduces diabetes and heart attack by 52%
Exercise Programme
• Aerobic activity – walking , cycling, swimming etc.
Frequency-5 days /week
Duration- average 30 minutes
• Stretching and relaxation exercises leading to progressive deep relaxation
• Yoga and Meditation
• Padmasan
Siddhasan •
Halasan •
Shirshasan •
• Virasan
Janu shirasan •
Supt vajrasan •
Ardha matsyandrasan•
• Dhanurasan
Shavasan •
Pashchinotasan •
• Decrease bad cholesterol, high blood
pressure.
• Increase good cholesterol.
• It controls the diabetes & obesity.
• It can increase the enthusiasm,
Activeness and prolong healthy life.
• It increases the spirituality and happiness.
• We can also get sound sleep.
• It decreases mental stress and depression.
• It can prevent ageing.
Benefits from yoga and exercise...
11
Stress Control...
• Yoga, Meditation, Prayers
• Relaxation techniques, deep breathing
Regular Adequate & Sound sleep...
• Sleep for 6 to 8 hours at night time.
• Try to rest one hour in day time.
• Take dinner 2 to 3 hours before you
sleep.
• It increases the risk for heart a�ack by 15-20%.
Stress increases blood pressure and the viscosity of blood. It also increases bad
cholesterol and Blood sugar. Hence Increases Heart a�ack.
• Stress, anxiety and depression can contribute to coronary heart disease.
Psycho - Social Stress
Type-A Type-B
Type-A & Type-B Personality...
• Patience
One task at a time •
Enjoys peaceful eating•
Peaceful nature •
Competitive attitude only if required •
Works without time limit•
Jolly nature•
Value success as per circumstances•
Relaxes at proper time•
• Impatience
Multiple tasks at a time•
Fast eating & talking while eating•
Aggressive nature•
Always competitive attitude •
Always works time bound•
Pertinacity and malevolent nature•
Tries to quantify success•
No relaxation in the life•
P unctuality and Perfectness•
• Don't bother too much. Learn to say 'No'.
• Get peace of mind e.g. listen light music
12
Have Healthy Food
By Research, Following facts about diet are established
• Coconut oil
Palm oil •
Butter •
Ghee •
Cheese •
• Vanaspati
• Fatty food 83% Saturated harmful fat-avoid it
Healthy Eating Plan
Diet recommendations
• • Carbohydrates - Refined < 30% Whole grains - 50%
• • Proteins - > 15 % Fruit and vegetables-> 400gm /day
• • Poly unsaturated fat - > 15% Salt < 1gm /day
• • Saturated fat - < 5% Fiber - 30 - 45gm
• • Fast and Fried food - < 5% Dry fruit - 30gm /day
• Total calorie - 1500 -1800/day
Heart Attack can be prevented by taking a Balanced Diet About various fats
Poly unsaturated fat (PUFA) :Reduces LDL cholesterol
Example :Sunflower oil, corn, soybean, Cotton Seed oil and sesame seeds
Example :Olive oil, Peanut oil, Canola oil
Mono unsaturated fat (MUFA) : Can lower LDL (Bad) cholesterol and maintain HDL (good) - cholesterol
Saturated Fats (SAFA) :
Increases the cholesterol levels in the
blood (Total & LDL cholesterol)
Example : Butter, ghee, coconut oil, palm
oil, cheese, yellow portion of egg, meat,
full fat milk & yogurt, pastries
Trans Fat or Hydrogenated Fat (TFA) :
Raise total and LDL (bad) cholesterol
Example :Margarines, cookies, snack foods made with or fried in partially hydrogenated oil.
HeartHealthy
HeartHealthy
Avoid
Avoid
13
• Commercial, Fried, Ready packet
• • Ganthiya, Fafda Fast food
All have high saturated fat and vanaspati So avoid it.
Recommendation - (100 gm/week)
• Oil - take 1 teaspoonful only.
Cereals
• Raw rice and whole grain must be consumed.
• Polished rice, maida, white flour-less nutritious-avoid it.
• Take fruits- ≥ 4-5 cups/day
(1 medium size fruit )
• Take vegetables -
1 cup raw vegetables /day
Half cup cooked vegetables /day
Fruits and Vegetables
Nuts
- like Akhrot, badam etc.
30 gm /week
“Akhrot”- high good cholesterol. Take more.
Dairy products
Recommendation
- 1 cup of milk/day,
- 50gm of cheese/week)
• Avoid Cold Drinks and Sugar Sweetened beverages.
7 Steps for Healthy Heart
1) Have Healthy Food Saturated fat (Fish, Meat, Ghee, Bu�er, Cheese,
Coconut oil, Palm oil, Vanaspa� oil ) leads to stasis of blood cell. 1 unit (1 mmol/litre) reduction in LDL level reduces major heart attack and stroke by 25%. avoid fa�y food. Take more fruits and vegetables.
2) Reduce Weight Obesity leads to high blood pressure, diabetes, high
cholesterol and heart a�ack. It is advisable to reduce weight.
3) Stop Smoking / Tobacco chewing Smoking causes constric�on and spasm of blood
vessels as well as increases cholesterol level. Hence, intake of tobacco or smoking increases the possibility of heart diseases by 20-30 �mes.
4) Exercise Exercise controls the weight gain, diabetes level, high
blood pressure and also makes your heart healthy. Minimum 30 minutes of exercise per day for at least 5 days per week is recommended.
7) Adequate Sleep Sleep for 6 to 8 hours daily. If possible try to rest or nap in
the day�me and avoid sleeping late at night. Sound sleep is essen�al for good health, so sleep before midnight.
5) Reduce stress Stress increases blood pressure and the viscosity of
blood. It also increases cholesterol. So reduc�on in stress is advised and this can be achieved by different methods like yoga, Art of Living, Medita�on etc.
6) Live happily The situa�on of loneliness leads to heart problems.
Social ac�vi�es can reduce the possibility of heart problems.
14
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09
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Civil Hospital (Medicity Campus), Asarwa, Ahmedabad - 380 016Mobile +91 90991 08108 Phone : (079) 22684220, 22684200,Fax : (079) 22682092
U. N. Mehta Institute of Cardiology & Research Centre(Affiliated to B. J. Medical College, Ahmedabad)
For Registration email : [email protected]
“ Redefining... Quality Cardiac Care”
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