How To Prevent   Heart Disease & Stroke Richard Saint Cyr, MD DABFP
What Is #1 Cause Of Death in China? <ul><li>Injuries & Poisonings </li></ul><ul><li>Strokes </li></ul><ul><li>Heart Attack...
What Is #1 Cause Of Death in China? <ul><li>Cancer </li></ul><ul><li>Strokes </li></ul><ul><li>Heart Attacks </li></ul><ul...
Deaths in China Since 1982 A: Urban B: Rural
Heart Disease <ul><li>High Blood Pressure  高血压   [gāoxuèyā] </li></ul><ul><li>Heart Attacks  心脏病发作  </li></ul><ul><li>Stro...
Cholesterol Plaque =  Heart Attack & Stroke
You Can Control Your Risk! <ul><li>Lifestyle factors are a factor in 90% of the risk for a first heart attack </li></ul>
How Can You Prevent It? <ul><li>Control high blood pressure </li></ul><ul><li>Stop smoking </li></ul><ul><li>Control chole...
How Good Is Prevention? <ul><li>You can reduce your chances by 55-84% by following those 8 prevention steps </li></ul><ul>...
Lifestyle Factors & Survival Data from Paffenberger, RS Jr, Hyde, RT, Wing, AL, et al, N Engl J Med 1993; 328:538
Our Patient: John Doe
Joe’s Stats <ul><li>Age: 45 </li></ul><ul><li>Weight: 100kg </li></ul><ul><li>Height: 175cm </li></ul><ul><li>Waist size: ...
First, Let’s Assess Joe’s Cardiovascular Risk <ul><li>www.myhealthcheckup.com </li></ul><ul><li>You input cholesterol, blo...
Sample Report
Closer Look: Graph
Closer Look: The Report
Joe’s Report <ul><li>His risk of heart attack & stroke over the next 10 years:  27% </li></ul><ul><li>Average risk: 3% </l...
Joe’s Heart Is Too Old <ul><li>His cardiovascular age is 55.8 years </li></ul><ul><li>He has the heart of a man 11 years o...
Yikes!  怎么办? <ul><li>Three Major Things To Do: </li></ul><ul><li>Lower his blood pressure to 140mmHg </li></ul><ul><li>Imp...
Prevention Tip #1:  Control High Blood Pressure <ul><li>AKA “hypertension” </li></ul><ul><li>“ The silent killer” – no sym...
What Is Blood Pressure?   © 1996 Wellsource, Inc.
High Blood Pressure Can…
How Effective Is Control of Blood Pressure? <ul><li>Every drop of 5 mmHg: </li></ul><ul><ul><li>Stroke <42% </li></ul></ul...
Get Checked! <ul><li>Every Two Years If Healthy: </li></ul><ul><ul><li>Systolic <120mmHg </li></ul></ul><ul><ul><li>Diasto...
How To Prevent Hypertension <ul><li>Keep weight down (BMI <25) </li></ul><ul><ul><li><5-20 mmHg for each 10-kg weight loss...
Joe Needs To Lose Weight <ul><li>Lowering weight is the most effective way to prevent & treat high blood pressure </li></u...
Weight Gain = Disease… PS. “Cholelithiasis” = gallstones Source: uptodate.com 
Weight Loss =  Lower Blood Pressure Source: uptodate.com 
Do You Know Your BMI? <ul><li>BMI = “Body Mass Index” </li></ul><ul><ul><li>weight (kg) / height (meters) squared </li></u...
Are You an Apple or Pear? “ Apples” are at higher risk for heart attack, stroke, diabetes, high blood pressure
“ Apple” Fat Is Worst Risk <ul><li>Abdominal circumference is best when: </li></ul><ul><ul><li>Men 102 cm (40 in) or less ...
Risk Factor Chart *      Disease risk for type 2 diabetes, hypertension, and CVD. +     Increased waist circumference can ...
Joe’s BMI Category? <ul><li>BMI = 32.7 (100kg / 1.75m2) </li></ul><ul><ul><li>=  OBESE </li></ul></ul><ul><li>Waist circum...
Joe Needs To Lose 23kg <ul><li>At 77kg, that would bring his BMI to 25 (now just “overweight” and not “obese” </li></ul><u...
How To Prevent Hypertension: Step 2 <ul><li>Keep weight down (BMI <25) </li></ul><ul><ul><li><5-20 mmHg for each 10-kg wei...
Exercise: How Much Is Enough? <ul><li>A brisk walk 20 minutes a day is great </li></ul><ul><ul><li>Out of breath </li></ul...
How Does It Help Your Heart? <ul><li>Lowers blood pressure </li></ul><ul><li>Raises your “good” cholesterol, HDL </li></ul...
Any Exercise Helps Your Heart Coronary events are less frequent among those who exercise. In a study of 5159 men, aged 40 ...
How To Prevent Hypertension: Step 3 <ul><li>Keep weight down (BMI <25) </li></ul><ul><ul><li><5-20 mmHg for each 10-kg wei...
Low Salt = Low Blood Pressure <ul><li>Goal is under 2.4 grams of sodium each day </li></ul><ul><ul><li>=1 teaspoon </li></...
Read The Labels! <ul><li>High Salt Foods: </li></ul><ul><ul><li>Soy sauce </li></ul></ul><ul><ul><ul><li>1 tablespoon (15m...
Change Diet = Avoid Pills Data from Stamler, R, Stamler, J, Grimm, R, et al, JAMA 1987; 257:1484.   Intervention: weight l...
The Ideal Diet: Each Day… <ul><li>Four-five servings of fruit </li></ul><ul><li>Four-five servings of vegetables </li></ul...
One Serving = Source: http://www.wellcome.com.hk/en/kids_corner.html
Fruits & Vegetables <ul><li>Five servings a day lowers risk of heart attack & stroke by 25% </li></ul><ul><ul><li>Three se...
Fiber is Important <ul><li>High fiber lowers risk  of heart attack & stroke by 40-50% </li></ul><ul><li>Where to get fiber...
Fats: Bad vs Good <ul><li>Type of fat is more important than amount </li></ul><ul><li>Trans-fatty acids 反试脂肪 :  bad </li><...
Fish is Good! <ul><li>The more, the better: </li></ul><ul><ul><li>>4 a week: 38% decrease </li></ul></ul><ul><ul><li>2-4 p...
How To Prevent Hypertension: Step 4 <ul><li>Keep weight down (BMI <25) </li></ul><ul><ul><li><5-20 mmHg for each 10-kg wei...
How much is “moderate?” <ul><li>Women: one drink a day </li></ul><ul><li>Men: two drinks a day </li></ul><ul><li>Moderate ...
How Much Is “One Drink”? <ul><li>Standard drink = 0.5oz (12g) alcohol </li></ul><ul><ul><li>12 oz (360ml) of beer </li></u...
“ Moderate” Is Important! <ul><li>Moderate drinking: low risk for alcohol problems </li></ul><ul><ul><li>Women: <2 drinks ...
Asses Your Risks vs. Benefits <ul><li>Too much alcohol causes early death: </li></ul><ul><ul><li>Strokes </li></ul></ul><u...
Joe’s Other Lifestyle Choices: <ul><li>Three Major Things To Do: </li></ul><ul><ul><li>Lower his blood pressure to 140mmHg...
Cholesterol = Atherosclerosis
Prevention Tip:  Lower cholesterol <ul><li>Each 30% decrease in cholesterol lowers risk by 30% </li></ul><ul><li>Who Shoul...
How To Lower Your Cholesterol <ul><li>Exercise </li></ul><ul><ul><li>At least 150 minutes a week </li></ul></ul><ul><li>Di...
Joe’s #3 Prevention Step:  Stop Smoking <ul><li>In China: 57% men smoke; 5% women </li></ul><ul><li>Increases your risk: <...
How To Stop Smoking <ul><li>Never start! </li></ul><ul><li>Taper off and stop </li></ul><ul><li>Use nicotine patches or gu...
It’s Never Too Late To Quit <ul><li>One Year After Stopping: </li></ul><ul><ul><li>Risk of heart attacks & strokes <50% </...
Joe’s Action Plan <ul><li>Exercise </li></ul><ul><ul><li>Fast walk, 30 minutes, after dinner </li></ul></ul><ul><li>Lose 1...
Back To Joe, 6 Months Later <ul><li>Weight: from 100 to 88kg </li></ul><ul><li>Smoking: “a couple a day” </li></ul><ul><li...
His New Profile: Much Better <ul><li>10 Year Risk: now 15.7% (from 27%) </li></ul><ul><ul><li>58% improvement </li></ul></...
Still A Bit To Go…
His Next 6 Month Plan? <ul><li>Continue diet and exercise! </li></ul><ul><li>Lose 10kg </li></ul><ul><li>Stop smoking </li...
Summary <ul><li>Assess your risk! </li></ul><ul><ul><li>Know your BMI & waist circumference </li></ul></ul><ul><ul><li>Kno...
Always Remember… <ul><li>You have control of 90% of your risk factors for heart attack and stroke! </li></ul>
Thank You! More Information at MyHealth Beijing .com
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How To Prevent Heart Disease & Stroke

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Practical information from a family doctor on what you can do -- without medicines -- to prevent the most common killers in the world, heart attacks and strokes.

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How To Prevent Heart Disease & Stroke

  1. 1. How To Prevent Heart Disease & Stroke Richard Saint Cyr, MD DABFP
  2. 2. What Is #1 Cause Of Death in China? <ul><li>Injuries & Poisonings </li></ul><ul><li>Strokes </li></ul><ul><li>Heart Attacks </li></ul><ul><li>Cancer </li></ul><ul><li>Lung Diseases </li></ul>
  3. 3. What Is #1 Cause Of Death in China? <ul><li>Cancer </li></ul><ul><li>Strokes </li></ul><ul><li>Heart Attacks </li></ul><ul><li>Lung Diseases </li></ul><ul><li>Injuries & Poisonings </li></ul>
  4. 4. Deaths in China Since 1982 A: Urban B: Rural
  5. 5. Heart Disease <ul><li>High Blood Pressure 高血压 [gāoxuèyā] </li></ul><ul><li>Heart Attacks 心脏病发作 </li></ul><ul><li>Strokes 中风 </li></ul><ul><li>Chest pains –“Angina” 心绞痛 [xīnjiǎotòng] </li></ul><ul><li>Poor Circulation 静脉性跛行 </li></ul>
  6. 6. Cholesterol Plaque = Heart Attack & Stroke
  7. 7. You Can Control Your Risk! <ul><li>Lifestyle factors are a factor in 90% of the risk for a first heart attack </li></ul>
  8. 8. How Can You Prevent It? <ul><li>Control high blood pressure </li></ul><ul><li>Stop smoking </li></ul><ul><li>Control cholesterol </li></ul><ul><li>Prevent diabetes </li></ul><ul><li>Decrease your obesity </li></ul><ul><li>Daily fruits & vegetables </li></ul><ul><li>Physical activity </li></ul><ul><li>Moderate alcohol </li></ul>
  9. 9. How Good Is Prevention? <ul><li>You can reduce your chances by 55-84% by following those 8 prevention steps </li></ul><ul><ul><li>Nurses Health Study: 55% reduction </li></ul></ul><ul><ul><ul><li>Weight, diet, exercise, not smoking </li></ul></ul></ul><ul><ul><li>Womens Health Study: 84% reduction </li></ul></ul><ul><ul><ul><li>Same profile </li></ul></ul></ul>
  10. 10. Lifestyle Factors & Survival Data from Paffenberger, RS Jr, Hyde, RT, Wing, AL, et al, N Engl J Med 1993; 328:538
  11. 11. Our Patient: John Doe
  12. 12. Joe’s Stats <ul><li>Age: 45 </li></ul><ul><li>Weight: 100kg </li></ul><ul><li>Height: 175cm </li></ul><ul><li>Waist size: 48 inches (122 cm) </li></ul><ul><li>Smoker: ½ pack a day </li></ul><ul><li>Alcohol: 2-3 beers a day </li></ul><ul><li>Blood Pressure: 152/92 </li></ul><ul><li>Cholesterol: 250; LDL 189; HDL 30 </li></ul>
  13. 13. First, Let’s Assess Joe’s Cardiovascular Risk <ul><li>www.myhealthcheckup.com </li></ul><ul><li>You input cholesterol, blood pressure, age, etc </li></ul><ul><li>It reports: </li></ul><ul><ul><li>10 year risk of heart attack & stroke </li></ul></ul><ul><ul><ul><li>>10% risk is high risk </li></ul></ul></ul><ul><ul><li>Cardiovascular age (is your heart young or old?) </li></ul></ul>
  14. 14. Sample Report
  15. 15. Closer Look: Graph
  16. 16. Closer Look: The Report
  17. 17. Joe’s Report <ul><li>His risk of heart attack & stroke over the next 10 years: 27% </li></ul><ul><li>Average risk: 3% </li></ul><ul><li>Anything over 10% = high risk </li></ul>
  18. 18. Joe’s Heart Is Too Old <ul><li>His cardiovascular age is 55.8 years </li></ul><ul><li>He has the heart of a man 11 years older! </li></ul>
  19. 19. Yikes! 怎么办? <ul><li>Three Major Things To Do: </li></ul><ul><li>Lower his blood pressure to 140mmHg </li></ul><ul><li>Improve his cholesterol numbers 25% </li></ul><ul><li>Stop smoking </li></ul><ul><li>Doing all this can bring his risk down 80% to normal! </li></ul>
  20. 20. Prevention Tip #1: Control High Blood Pressure <ul><li>AKA “hypertension” </li></ul><ul><li>“ The silent killer” – no symptoms for years </li></ul><ul><li>You have high blood pressure when: </li></ul><ul><ul><li>Systolic (the 1 st number) >140 </li></ul></ul><ul><ul><li>Diastolic (2 nd number) >90 </li></ul></ul><ul><li>This is the #1 cause of heart attack & stroke </li></ul>
  21. 21. What Is Blood Pressure?   © 1996 Wellsource, Inc.
  22. 22. High Blood Pressure Can…
  23. 23. How Effective Is Control of Blood Pressure? <ul><li>Every drop of 5 mmHg: </li></ul><ul><ul><li>Stroke <42% </li></ul></ul><ul><ul><li>Heart Attack <21% </li></ul></ul>
  24. 24. Get Checked! <ul><li>Every Two Years If Healthy: </li></ul><ul><ul><li>Systolic <120mmHg </li></ul></ul><ul><ul><li>Diastolic <80 mmHg </li></ul></ul><ul><ul><ul><li>(Healthy!) </li></ul></ul></ul><ul><li>Every Year If Borderline: </li></ul><ul><ul><li>Systolic between 120-139 mmHg </li></ul></ul><ul><ul><li>Diastolic between 80-89 mmHg </li></ul></ul>
  25. 25. How To Prevent Hypertension <ul><li>Keep weight down (BMI <25) </li></ul><ul><ul><li><5-20 mmHg for each 10-kg weight loss </li></ul></ul><ul><li>Exercise at least 150 minutes a week </li></ul><ul><ul><li><4 to 9 mmHg </li></ul></ul><ul><li>Lower your salt intake </li></ul><ul><ul><li><2 to 8 mmHg </li></ul></ul><ul><li>Healthy diet </li></ul><ul><ul><li><8 to 14 mmHg </li></ul></ul><ul><li>Moderate your alcohol use </li></ul><ul><ul><li><2 to 4 mmHg </li></ul></ul>
  26. 26. Joe Needs To Lose Weight <ul><li>Lowering weight is the most effective way to prevent & treat high blood pressure </li></ul><ul><li>Your blood pressure drops 5-20 mmHg for each 10-kg weight loss </li></ul>
  27. 27. Weight Gain = Disease… PS. “Cholelithiasis” = gallstones Source: uptodate.com 
  28. 28. Weight Loss = Lower Blood Pressure Source: uptodate.com 
  29. 29. Do You Know Your BMI? <ul><li>BMI = “Body Mass Index” </li></ul><ul><ul><li>weight (kg) / height (meters) squared </li></ul></ul><ul><li>Assesses your obesity risk </li></ul><ul><ul><li>Normal : 18.5 – 24.9 </li></ul></ul><ul><ul><li>Overweight: 25.0 – 29.9 </li></ul></ul><ul><ul><li>Obesity: 30.0 and Above </li></ul></ul><ul><li>Many websites do this: just Google “BMI calculator” </li></ul>
  30. 30. Are You an Apple or Pear? “ Apples” are at higher risk for heart attack, stroke, diabetes, high blood pressure
  31. 31. “ Apple” Fat Is Worst Risk <ul><li>Abdominal circumference is best when: </li></ul><ul><ul><li>Men 102 cm (40 in) or less </li></ul></ul><ul><ul><li>Women 88 cm (35 in) or less </li></ul></ul><ul><li>Measure yourself above hip bone </li></ul>
  32. 32. Risk Factor Chart *     Disease risk for type 2 diabetes, hypertension, and CVD. +     Increased waist circumference can also be a marker for increased risk even in persons of normal weight. Extremely High Extremely High III 40.0 + Extreme Obesity Very High Very High II 35.0 – 39.9 Very High High I 30.0 – 34.9 Obesity High Increased 25.0 – 29.9 Overweight - - 18.5 – 24.9 Normal - - < 18.5 Underweight Men > 102 cm (40 in) Women > 88 cm (35 in) Men 102 cm (40 in) or less Women 88 cm (35 in) or less Obesity Class BMI (kg/m 2 ) Disease Risk* Relative to Normal Weight and Waist Circumference
  33. 33. Joe’s BMI Category? <ul><li>BMI = 32.7 (100kg / 1.75m2) </li></ul><ul><ul><li>= OBESE </li></ul></ul><ul><li>Waist circumference: 122cm </li></ul><ul><li>Risk Category: Very High </li></ul><ul><ul><li>Increased heart attacks, stroke, diabetes </li></ul></ul>
  34. 34. Joe Needs To Lose 23kg <ul><li>At 77kg, that would bring his BMI to 25 (now just “overweight” and not “obese” </li></ul><ul><ul><li>This could lower his blood pressure 10-40 mmHg without medicines </li></ul></ul><ul><li>A more reasonable first goal is to lose 10% weight (10kg) </li></ul>
  35. 35. How To Prevent Hypertension: Step 2 <ul><li>Keep weight down (BMI <25) </li></ul><ul><ul><li><5-20 mmHg for each 10-kg weight loss </li></ul></ul><ul><li>Exercise at least 150 minutes a week </li></ul><ul><ul><li><4 to 9 mmHg </li></ul></ul><ul><li>Lower your salt intake </li></ul><ul><ul><li><2 to 8 mmHg </li></ul></ul><ul><li>Healthy diet </li></ul><ul><ul><li><8 to 14 mmHg </li></ul></ul><ul><li>Moderate your alcohol use </li></ul><ul><ul><li><2 to 4 mmHg </li></ul></ul>
  36. 36. Exercise: How Much Is Enough? <ul><li>A brisk walk 20 minutes a day is great </li></ul><ul><ul><li>Out of breath </li></ul></ul><ul><ul><li>Tired </li></ul></ul><ul><ul><li>Sweating </li></ul></ul><ul><li>Fast heart rate is not so important </li></ul><ul><ul><li>Moderate rate helps the heart </li></ul></ul><ul><ul><li>Fast rate loses weight </li></ul></ul>
  37. 37. How Does It Help Your Heart? <ul><li>Lowers blood pressure </li></ul><ul><li>Raises your “good” cholesterol, HDL </li></ul><ul><li>Lowers risk for heart attacks and angina </li></ul><ul><li>Many non-cardiac benefits, of course… </li></ul>
  38. 38. Any Exercise Helps Your Heart Coronary events are less frequent among those who exercise. In a study of 5159 men, aged 40 to 49 years, followed for an average of almost 19 years, the age-adjusted coronary heart disease event rate per 1000 person-years is lower in those who perform any physical activity compared to inactive subjects.  Data from Wannamethee, SG, Shaper, AG, Alberti, KG, Arch Intern Med 2000; 160:2108.
  39. 39. How To Prevent Hypertension: Step 3 <ul><li>Keep weight down (BMI <25) </li></ul><ul><ul><li><5-20 mmHg for each 10-kg weight loss </li></ul></ul><ul><li>Exercise at least 150 minutes a week </li></ul><ul><ul><li><4 to 9 mmHg </li></ul></ul><ul><li>Lower your salt intake </li></ul><ul><ul><li><2 to 8 mmHg </li></ul></ul><ul><li>Healthy diet </li></ul><ul><ul><li><8 to 14 mmHg </li></ul></ul><ul><li>Moderate your alcohol use </li></ul><ul><ul><li><2 to 4 mmHg </li></ul></ul>
  40. 40. Low Salt = Low Blood Pressure <ul><li>Goal is under 2.4 grams of sodium each day </li></ul><ul><ul><li>=1 teaspoon </li></ul></ul><ul><ul><li>Average in US: 4-5 grams a day </li></ul></ul><ul><li>80% salt intake is from processed foods </li></ul><ul><li>Low salt also protects your kidneys… </li></ul>Image: mayoclinic.com
  41. 41. Read The Labels! <ul><li>High Salt Foods: </li></ul><ul><ul><li>Soy sauce </li></ul></ul><ul><ul><ul><li>1 tablespoon (15ml) = 1,000mg salt </li></ul></ul></ul><ul><ul><li>Instant noodles & soups </li></ul></ul><ul><ul><ul><li>Ramen – 1,800mg salt </li></ul></ul></ul><ul><ul><li>Canned anything </li></ul></ul><ul><ul><li>MSG (monosodium glutamate) </li></ul></ul>
  42. 42. Change Diet = Avoid Pills Data from Stamler, R, Stamler, J, Grimm, R, et al, JAMA 1987; 257:1484. Intervention: weight loss, salt restriction, and avoidance of excess alcohol (squares)
  43. 43. The Ideal Diet: Each Day… <ul><li>Four-five servings of fruit </li></ul><ul><li>Four-five servings of vegetables </li></ul><ul><li>Two-three servings of low-fat dairy </li></ul><ul><li><25 percent fat </li></ul><ul><li>Low salt = under 2.4 grams </li></ul><ul><li>= “DASH Diet” (“Dietary Approaches to Stop Hypertension”) lowers blood pressure >11 mmHg </li></ul>
  44. 44. One Serving = Source: http://www.wellcome.com.hk/en/kids_corner.html
  45. 45. Fruits & Vegetables <ul><li>Five servings a day lowers risk of heart attack & stroke by 25% </li></ul><ul><ul><li>Three servings: 11% </li></ul></ul><ul><li>Cruciferous vegetables </li></ul><ul><ul><li>Broccoli, cabbage, cauliflower, brussels sprouts </li></ul></ul><ul><li>Green leafy vegetables </li></ul><ul><li>Citrus fruits </li></ul><ul><li>Vitamin C </li></ul>
  46. 46. Fiber is Important <ul><li>High fiber lowers risk of heart attack & stroke by 40-50% </li></ul><ul><li>Where to get fiber: </li></ul><ul><ul><li>Cereals #1 </li></ul></ul><ul><ul><ul><li>10grams per day of cereals lowers risk 29% </li></ul></ul></ul><ul><ul><li>Vegetables </li></ul></ul><ul><ul><li>Fruit </li></ul></ul>
  47. 47. Fats: Bad vs Good <ul><li>Type of fat is more important than amount </li></ul><ul><li>Trans-fatty acids 反试脂肪 : bad </li></ul><ul><ul><li>Margarine, most fast foods, pre-packaged snack foods </li></ul></ul><ul><li>Polyunsaturated & monounsaturated fats: good </li></ul><ul><ul><li>Butter, olive oil, natural foods </li></ul></ul>
  48. 48. Fish is Good! <ul><li>The more, the better: </li></ul><ul><ul><li>>4 a week: 38% decrease </li></ul></ul><ul><ul><li>2-4 per week: 23% decrease </li></ul></ul><ul><ul><li>Once a week: 15% decrease </li></ul></ul><ul><ul><li>1-3 times a month: 11% decrease </li></ul></ul><ul><li>Benefit is from the omega-3 fatty acid </li></ul><ul><ul><li>Best fish: salmon, mackerel, sardines </li></ul></ul>
  49. 49. How To Prevent Hypertension: Step 4 <ul><li>Keep weight down (BMI <25) </li></ul><ul><ul><li><5-20 mmHg for each 10-kg weight loss </li></ul></ul><ul><li>Exercise at least 150 minutes a week </li></ul><ul><ul><li><4 to 9 mmHg </li></ul></ul><ul><li>Lower your salt intake </li></ul><ul><ul><li><2 to 8 mmHg </li></ul></ul><ul><li>Healthy diet </li></ul><ul><ul><li><8 to 14 mmHg </li></ul></ul><ul><li>Moderate your alcohol use </li></ul><ul><ul><li><2 to 4 mmHg </li></ul></ul>
  50. 50. How much is “moderate?” <ul><li>Women: one drink a day </li></ul><ul><li>Men: two drinks a day </li></ul><ul><li>Moderate drinking can decrease risk of heart disease and stroke by ~30% </li></ul>
  51. 51. How Much Is “One Drink”? <ul><li>Standard drink = 0.5oz (12g) alcohol </li></ul><ul><ul><li>12 oz (360ml) of beer </li></ul></ul><ul><ul><li>5 oz (150ml) wine </li></ul></ul><ul><ul><li>1.5 oz (45ml) of 80 proof spirits </li></ul></ul>
  52. 52. “ Moderate” Is Important! <ul><li>Moderate drinking: low risk for alcohol problems </li></ul><ul><ul><li>Women: <2 drinks per day </li></ul></ul><ul><ul><li>Men: <3 drinks per day  </li></ul></ul><ul><li>Heavy drinking: at risk for alcohol problems </li></ul><ul><ul><li>Women: >7 drinks per week or 3 drinks per occasion </li></ul></ul><ul><ul><li>Men: >14 drinks per week or 4 drinks per occasion  </li></ul></ul><ul><li>Binge drinking: high risk </li></ul><ul><ul><li>Women: 4 or more drinks in a row  </li></ul></ul><ul><ul><li>Men: 5 or more drinks in a row </li></ul></ul>
  53. 53. Asses Your Risks vs. Benefits <ul><li>Too much alcohol causes early death: </li></ul><ul><ul><li>Strokes </li></ul></ul><ul><ul><li>Liver disease </li></ul></ul><ul><ul><li>Cancers </li></ul></ul><ul><ul><li>Accidents </li></ul></ul><ul><ul><li>Sudden death </li></ul></ul>
  54. 54. Joe’s Other Lifestyle Choices: <ul><li>Three Major Things To Do: </li></ul><ul><ul><li>Lower his blood pressure to 140mmHg </li></ul></ul><ul><ul><li>Improve his cholesterol numbers 25% </li></ul></ul><ul><ul><li>Stop smoking </li></ul></ul><ul><li>Doing all this can bring his risk down 80% to normal! </li></ul>
  55. 55. Cholesterol = Atherosclerosis
  56. 56. Prevention Tip: Lower cholesterol <ul><li>Each 30% decrease in cholesterol lowers risk by 30% </li></ul><ul><li>Who Should Be Screened? </li></ul><ul><ul><li>Men at 35 </li></ul></ul><ul><ul><li>Women at 45 </li></ul></ul><ul><ul><li>Younger if risk factors </li></ul></ul>
  57. 57. How To Lower Your Cholesterol <ul><li>Exercise </li></ul><ul><ul><li>At least 150 minutes a week </li></ul></ul><ul><li>Diet </li></ul><ul><ul><li>Same diet as we discussed </li></ul></ul><ul><li>Medicines </li></ul><ul><ul><li>Natural: omega-3; niacin </li></ul></ul><ul><ul><li>Prescription </li></ul></ul>
  58. 58. Joe’s #3 Prevention Step: Stop Smoking <ul><li>In China: 57% men smoke; 5% women </li></ul><ul><li>Increases your risk: </li></ul><ul><ul><li>Heart attack >70% </li></ul></ul><ul><ul><li>Stroke >50% </li></ul></ul><ul><li>Lung Cancer </li></ul>
  59. 59. How To Stop Smoking <ul><li>Never start! </li></ul><ul><li>Taper off and stop </li></ul><ul><li>Use nicotine patches or gum </li></ul><ul><li>Some prescription medicines can help </li></ul><ul><li>TCM & Acupuncture may help </li></ul><ul><li>Keep trying! </li></ul><ul><ul><li>It usually takes 7 tries before someone stops </li></ul></ul>
  60. 60. It’s Never Too Late To Quit <ul><li>One Year After Stopping: </li></ul><ul><ul><li>Risk of heart attacks & strokes <50% </li></ul></ul><ul><li>After 5-10 years: </li></ul><ul><ul><li>Risk almost similar to nonsmokers </li></ul></ul>
  61. 61. Joe’s Action Plan <ul><li>Exercise </li></ul><ul><ul><li>Fast walk, 30 minutes, after dinner </li></ul></ul><ul><li>Lose 10kg in 6 months </li></ul><ul><li>Diet change </li></ul><ul><ul><li>Less KFC; more salads; smaller portions </li></ul></ul><ul><li>Cut back on smoking </li></ul><ul><li>Fish oil supplement (1 gram a day) </li></ul><ul><li>Cut back alcohol to 1 or 2 a day </li></ul>
  62. 62. Back To Joe, 6 Months Later <ul><li>Weight: from 100 to 88kg </li></ul><ul><li>Smoking: “a couple a day” </li></ul><ul><li>Blood pressure: 138/88 </li></ul><ul><li>Cholesterol: Total 213 (from 250), HDL 38 (from 30), LDL 140 (from 189) </li></ul><ul><li>Glucose: 102 (from 120) </li></ul>
  63. 63. His New Profile: Much Better <ul><li>10 Year Risk: now 15.7% (from 27%) </li></ul><ul><ul><li>58% improvement </li></ul></ul><ul><li>Heart Age: now 51.6 (from 55.8) </li></ul><ul><ul><li>He just gained back 3 years of his life </li></ul></ul>
  64. 64. Still A Bit To Go…
  65. 65. His Next 6 Month Plan? <ul><li>Continue diet and exercise! </li></ul><ul><li>Lose 10kg </li></ul><ul><li>Stop smoking </li></ul><ul><li>Probably start Rx for cholesterol </li></ul><ul><li>Start aspirin daily (81mg) </li></ul>
  66. 66. Summary <ul><li>Assess your risk! </li></ul><ul><ul><li>Know your BMI & waist circumference </li></ul></ul><ul><ul><li>Know your blood pressure & cholesterol </li></ul></ul><ul><ul><li>Know your 10-year cardiovascular risk </li></ul></ul><ul><li>If your risk is high: </li></ul><ul><ul><li>think about lifestyle changes </li></ul></ul><ul><ul><li>see your doctor </li></ul></ul>
  67. 67. Always Remember… <ul><li>You have control of 90% of your risk factors for heart attack and stroke! </li></ul>
  68. 68. Thank You! More Information at MyHealth Beijing .com

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