Sesión Científica mes de Mayo 2011 Asociación Guatemalteca de Cardiología

1. 10 Tips para tu Salud Cardiovascular Dr. David Rodríguez García Miembro de la Asociación Guatemalteca de Cardiologia Guatemala, 17 de Mayo 2011

2. Tip No. 1 !Muevete¡

3. 3 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Muévete¡ De acuerdo a lasguías de laAmerican Heart Association/American College of Sports Medicinesobre la actividadfísica, todaslas personas sanasadultas de entre los 18-65 añosdeben detenercuandomenos 30 minutos de actividad de intensidadmoderada, 5 vecesxsemana. En el día a día: No uses elevador, !sube y baja las gradas¡ Parqueáte lejos de la entrada de tu trabajo.

4. Tip No. 2 !Aliméntate Bien¡

5. 5 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Alméntate Bien¡ Componentesprincipales de la dietaMediterráneaincluyen: Comer cantidadesgenerosas de frutasyvegetales. Consumirgrasassaludablescomoaceite de olivaoaceite de canola. Comer porcionespequeñas de nueces. Bebervinorojo, con moderación, paraalgunos Consumirpeuqñascantidades de carnesrojas. Comer pescado de manera regular. http://www.mayoclinic.com/health/mediterranean-diet/CL00011

6. Tip No. 3 !Prevención¡

7. 7 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Prevención¡ La prevenciónprimariainicia con educaciónyconocimiento. La enfermedad cardiovascular es un riesgoparatodos; pero con el conocimientoapropiado, puedessalvarunavida, incluyendo la propia. Busca información en los sitios apropiados: http://www.americanheart.org/presenter.jhtml?identifier=1200009 http://cvrisk.mvm.ed.ac.uk/calculator/calc.asp http://www.umm.edu/features/tips_prev.htm Chequea tu perfil metabólico y tu PA ocasionalmente http://www.mayoclinic.com/health/mediterranean-diet/CL00011

8. Tip No. 4 !No Fumes¡

9. 9 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡No Fumes¡

10. 7 tips para dejar de fumar – sin importar cuantas veces lo hayas intentado antes 10 | Presentation Title | Presenter Name | Date | Subject | Business Use Only Proponga una fecha específica para dejar de fumar Espere sentirse miserable Quitar los “disparadores” del fumar Intente los “reemplazos” de nicotina Considerar la utilización de medicamentos aprobados para dejar de fumar Conozca por qué anhela los cigarrillos Busque ayuda o asesoría http://www.webmd.com/lung/copd/living-with-copd-10/quit-smoking

11. 11 | Presentation Title | Presenter Name | Date | Subject | Business Use Only !Hoy es un buen día para intentarlo!

12. Tip No. 5 !Ojo con algunos medicamentos¡

13. 13 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Ojo con algunos medicamentos¡ Descongestivos nasales en tabletas o en gotas Algunos medicamentos para migraña (contienen ergotamina) Medicamentos para bajar de peso Algunos medicamentos naturales

14. Tip de Salud Cardiovascular No. 6 ¡Controla la Ira!

15. 15 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Controla la Ira!

16. Efectos CV de la ira 16 | Presentation Title | Presenter Name | Date | Subject | Business Use Only “12,986 middle-agedAfrican-American andwhitemenandwomen, thosewhoratedhigh in traitssuch as anger -- buthad normal bloodpressure -- were more pronetocoronaryarterydisease (CAD) orheartattack. In fact, theangriestpeoplefacedroughlytwicetheriskof CAD andalmostthree times theriskofheartattackcomparedtosubjectswiththelowestlevelsofanger.”

17. Algunas sugerencias de los terapeutas conductuales para contrarestar la ira ”No puedo obtener algo culpando a otras personas, aún si ellas osn responsables del problema. Intentare otro ángulo”. ”¿Importará esto dentro de 5 años? (¿5 horas?¿5 minutos?)" ”Si estaré aún enojado por esto mañana, lo enfrentaré mañana. Por el momento, lo dejaré enfriar”. ”Actuar enojado no es lo mismo que mostar que me importa”." ”Déjame preguntar, en lugar de decir." “Escucharé en lugar de hablar." "Thefastestwayisnotnecessarilythe best wayexcept in a life-or-deathsituation, andthisisnotoneofthem." 17 | Presentation Title | Presenter Name | Date | Subject | Business Use Only

18. Tip de Salud Cardiovascular No. 7 ¡Perdona!

19. 19 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Perdona! The current study investigated the relationship between trait forgiveness and cardiovascular reactivity (CVR) and recovery in 99 normotensive participants (mean age = 33.8). Cardiovascular parameters were obtained at 2-minute intervals during a 10-minute baseline period and a 20-minute recovery period, and at 1-minute intervals during a 4-minute anger recall task and a 4-minute serial subtraction task without harassment. Participants filled out a self-report measure of forgiveness prior to the laboratory procedure. Although forgiveness was not related to CVR, higher levels of trait forgiveness were predictive of lower diastolic blood pressure (DBP) at baseline (p < .02) and faster DBP recovery (p < .003). Findings suggest that forgiveness may be related to overall reductions in blood pressure levels and may aid in cardiovascular recovery from stress. The results also provide preliminary evidence that forgiveness may impact cardiovascular health not through a myocardial or vascular pathway, but through another mechanism. International Journal of Psychophysiology. Volume 65, Issue 2, Pages 87-176 (August 2007)

20. 20 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Perdona! Lawler Kathleen A et al. A change of heart: cardiovascular correlates of forgiveness in response to interpersonal conflict. Journal of behavioral medicine 2003;26(5):373-93. This study sought to examine the psychophysiological correlates of forgiveness in response to interpersonal conflict. One hundred eight college students (44 males and 64 females) participated in two interviews about times of interpersonal betrayal, one about a parent and one about a friend/partner. Measures of forgiving personality and state forgiveness were collected, as well as stress, hostility, empathy, and self-reported illness symptoms. During baseline, interviews and recovery periods, repeated measures were taken of blood pressure, heart rate, frontalis EMG, and skin conductance. Trait forgiveness was associated with lower levels of blood pressure. State forgiveness was associated with lower blood pressure levels, heart rate, and rate pressure product. Acute, stress-induced reactivity was also linked to forgiveness: state forgiveness was associated with diastolic and mean arterial pressure and rate pressure product reactivity during the parent interview. Increased blood pressure recovery after stress was also linked to trait forgiveness. Forgiveness may produce beneficial effects directly by reducing allostatic loadassociated with betrayal and conflict, and indirectly through reductions in perceived stress.

21. 21 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Perdona! Daniel, Mark (2006) Associations among Education, Cortisol Rhythm, and BMI in Blue-collar Women*. Obesity 14(2) ORATHINKAL, JOSE (2008) Forgiveness: A perception and motivation study among married adults. Scandinavian Journal of Psychology 49(2) Bruhn, John G. (1995) Beyond discipline: Creating a culture for interdisciplinary research. Integrative Physiological and Behavioral Science 30(4) Bertolotti, Giorgio (1995) Psychophysiological reactivity, depression, neuroticism and type a behaviour: An interactive effect?. Stress Medicine 11(1) Worthington, Everett L. (2007) Forgiveness, Health, and Well-Being: A Review of Evidence for Emotional Versus Decisional Forgiveness, Dispositional Forgivingness, and Reduced Unforgiveness. Journal of Behavioral Medicine Berry, Jack W. (2001) Forgivingness, relationship quality, stress while imagining relationship events, and physical and mental health.. Journal of Counseling Psychology 48(4) Cioni, Patrick F. (2006) Forgiveness, Cognitive Restructuring and Object Transformation. Journal of Religion and Health Maltby, John (2005) Forgiveness and happiness. the differing contexts of forgiveness using the distinction between hedonic and eudaimonic happiness. Journal of Happiness Studies 6(1) Jamal, Muhammad (2005) Personal and organizational outcomes related to job stress and Type-A behavior: a study of Canadian and Chinese employees. Stress and Health 21(2) Zechmeister, Jeanne S. (2004) Don't Apologize Unless You Mean It: A Laboratory Investigation of Forgiveness and Retaliation. Journal of Social and Clinical Psychology 23(4)

22. 22 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Perdona! http://www.spiritualityhealth.com/newsh/items/selftest/item_232.html

23. Tip de Salud Cardiovascular No. 8 !Combatamos la Tristeza!

24. 24 | Presentation Title | Presenter Name | Date | Subject | Business Use Only !Combatamos la Tristeza! Depresión y mortalidad por cardiopatía isquémica: evidencias del EPIC-Norfolk United Kingdom Prospective Cohort Study. (Depression and Ischemic Heart Disease Mortality: Evidence From the EPIC-Norfolk United Kingdom Prospective Cohort Study.) FUENTE: AMERICAN JOURNAL OF PSYCHIATRY. 2008 ABR;165(4):515-523. Paul G. Surtees; Nicholas W.J. Wainwright; Robert N. Luben...(et.al) Objetivo: Los autores investigaron la asociación entre el trastorno depresivo mayor, incluido su curso clínico, y la mortalidad asociada a cardiopatía isquémica. Método: El presente fue un estudio prospectivo de cohortes con 8.261 varones y 11.388 mujeres con edades comprendidas entre los 41 y los 80 años, sin manifestaciones clínicas de cardiopatía y participantes de la cohorte de Norfolk, RU, del estudio European Prospective Investigation into Cancer (EPIC). Los autores realizaron una evaluación transversal del trastorno depresivo mayor durante el período 1996-2000 e identificaron todas las muertes posteriores debidas a cardiopatía isquémica a través del enlace con información procedente del Office for National Statistics del RU. Resultados: Desde el 31 de julio de 2006 se registraron 274 muertes debidas a cardiopatía isquémica sobre un denominador compuesto por 162.974 personas-año (el período mediano de seguimiento fue de 8,5 años). Los participantes que tuvieron depresión mayor en la evaluación inicial del año precedente tuvieron una probabilidad 2,7 veces mayor de morir durante el período de seguimiento debido a cardiopatía isquémica que los que no la tuvieron, con independencia de la edad, el sexo, el hábito tabáquico, la presión arterial sistólica, el colesterol, la actividad física, el índice de masa corporal, la diabetes, la clase social, el consumo intenso de alcohol y el empleo de fármacos antidepresivos. Esta asociación persistió tras excluir la información de los primeros 6 años del seguimiento. Al tener en cuenta las medidas de los antecedentes de depresión mayor (que incluyeron lo reciente del inicio, la recurrencia, la cronicidad y la edad al inicio) se constató que lo reciente del inicio era el factor que se asociaba más estrechamente con la mortalidad debida a cardiopatía isquémica. Conclusiones: La depresión mayor se asoció con un aumento del riesgo de mortalidad por cardiopatía isquémica. La asociación fue independiente de los factores de riesgo establecidos de cardiopatía isquémica y no se redujo a lo largo de varios años a partir de la evaluación original. Para acceder al texto completo consulte las características de suscripción de la fuente original: ajp.psychiatryonline.org/index.dtl

25. Tip de Salud Cardiovascular No. 9 ¡Abraza!

27. Heart rate increased 10 beats a minute for those without contact compared with five beats a minute for huggers. This is the latest of many studies suggesting humans are "hard-wired" to thrive as social animals, says Tiffany Field of the Touch Research Institute at the University of Miami Medical School. Field's research shows touch lowers output of cortisol, a stress hormone. When cortisol dips, there's a surge of two "feel good" brain chemicals, serotonin and dopamine. U.S. couples aren't very "touchy-feely" in public, Field says. Her studies in U.S. and Parisian cafes show that French couples spend about three times as much time touching as Americans. Comforting physical contact is out of favor among friends and co-workers because of the legal climate, she says. "If you happen to touch someone at the fax machine, you run the risk of being sued." Some studies have indicated that touch among friends might be helpful but doesn't produce nearly as much physical stress relief as contact with a partner, says psychologist Kathleen Light, co-author of the UNC study. The findings suggest one reason that isolated, lonely people tend to have poorer health, says Ohio State University psychologist Janice Kiecolt-Glaser. Although ours is a youth-oriented culture, older adults may benefit most from touch, she says. "The older you are, the more fragile you are physically, so contact becomes increasingly important for good health."

28. Tip de Salud Cardiovascular No. 10 ¡Ríete!

29. 28 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Ríete! The University of Maryland Medical Center has been at the forefront of laughter research. Their first significant findings were presented in 2000 to the American Heart Association’s 73rd Scientific Sessions. The study surveyed a group of 300, half of whom had suffered a heart attack or had undergone coronary artery bypass surgery and the other half who were of the same age but did not have heart disease. The two questionnaires featured either multiple choice or true/false questions to determine the participants’ likeliness to laugh in situations and their levels of anger and hostility. You can take a sample survey here. Their findings revealed that those with a history of heart disease were 40% less likely to laugh than those without the disease. The second major study by the University of Maryland presented in 2005 focused on monitoring changes in the blood vessels, specifically the endothelium (inner lining), as participants experienced different emotions. When the volunteers were shown intense and stressful clips of movies their blood vessels reduced blood flow (called vasoconstriction) by an average of 35%. However, when participants viewed clips of a funny film, their endothelium dilated and expanded to increase blood flow an average of 22%. Further research in 2008 found that during laughing the participants’ mean flow-mediated dilation was 19%. It is believed that an unhealthy endothelium is the first step in developing hardened arteries (atherosclerosis). The study showed that laughing may help keep the endothelium healthy which should theoretically improve one’s defense against heart disease and high blood pressure. “The magnitude of change we saw in the endothelium is similar to the benefit we might see with aerobic activity, but without the aches, pains and muscle tension associated with exercise,” said Dr. Miller, who led the research and is director of preventive cardiology at the University of Maryland Medical Center, “We don’t recommend that you laugh and not exercise, but we do recommend that you try to laugh on a regular basis. Thirty minutes of exercise three times a week, and 15 minutes of laughter on a daily basis is probably good for the vascular system.” More information on the study in 2000 can be found here, the 2005 study and Miller quote here and the 2008 study here http://www.zona.com/blog/index.php/a-laugh-a-day-to-keep-the-doctor-away/

30. 29 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Ríete! Health news - Is laughter the best medicine? 16 March 2005 - written by Bupa's Health information team Laughter really may be the best medicine, according to research presented to the American College of Cardiology. Laughing appears to boost your blood flow and researchers say it may reduce your risk of developing heart disease.1 But the benefits of laughing don't stop with your heart: laughing has previously been found to help fight infections, relieve hay fever, ease pain and help control diabetes. What did this study find? The researchers found that laughing increased blood flow by more than 20 percent - a similar effect to that of aerobic activity.1 The positive effect of laughing lasted for 30-45 minutes. In contrast, stress decreased the flow by about 35 percent.1 Almost everyone seems to benefit from having a good laugh:1 95 percent of the volunteers in the study (19 out of 20) had better blood flow after watching a comedy movie clip 70 percent (14 out of 20) had a worse blood flow after watching a stressful film sequence What do these findings mean for me? According to the researchers, regular laughter in your life could help to reduce your risk of developing heart disease. They recommend 15 minutes of laughter a day as well as regular exercise to reduce your risk of cardiovascular disease. http://www.bupa.co.uk/health_information/html/health_news/160305laugh.html

31. 30 | Presentation Title | Presenter Name | Date | Subject | Business Use Only !Ríete¡ CORPORATE LAUGHTER Stress is the #1 reason for missed work in the corporate world. Laughter has been successfully used in companies to reduce people's stress, raise people’s spirits and to create team building. A session of laughter creates enthusiasm, motivation and a sense of wellbeing. Each Corporate Laughter session is 30 minutes and takes place in your own office. Corporate Laughter sessions are now being scheduled. http://www.ilaugh.us/Corporate.html

32. 31 | Presentation Title | Presenter Name | Date | Subject | Business Use Only ¡Ríete! Estaban operando a un paciente de transplante de los riñones, cuando el doctor grita: - ¡Detengan todo! ¡Detengan todo que ha habido un rechazo! ¿Un rechazo? ¿El riñón transplantado? Peor aún, ¡el cheque! ¡El cheque no tiene fondos! -------------------------------------------------------------------------------------------------------------------------------------- El médico al paciente: - Lo siento, pero tendra usted que dejar el alcohol, el tabaco y el sexo, porque le queda poco tiempo de vida. - ¿Y así viviré más, doctor? - No, pero los días se le harán larguísimos. -------------------------------------------------------------------------------------------------------------------------------------- El medico le dice a su paciente en tono muy enérgico: En los proximos meses nada de fumar, nada de beber, nada de salir con mujeres ni ir a comer a esos restaurantes caros, y nada de viajes ni vacaciones.... ¿Hasta que me recupere doctor? ¡No! ¡Hasta que me pague todo lo que me debe! http://www.bepop.com.ar/humor/Medicos.html

33. 32 | Presentation Title | Presenter Name | Date | Subject | Business Use Only Gracias