Presentation delivered to nursing students in Gibraltar in 2002, and also used in cardiac rehab sessions. Includes local statistics.

1. Heart Disease
The Silent Killer
(Risk Factors)
by Jason Easter
Health Promotion Officer

2. • Is a muscle
• Pumps blood to the cells
• Removes waste
• Needs nutrient rich oxygenated
blood
Introduction The Heart:

3. Photo of Arteriosclerosis
What is Arteriosclerosis?
• Underlying cause of heart
disease
• Clogging by fatty,
cholesterol deposits
called “plaque”
• Narrows the channels of
the arteries

4. The Coronary arteries are the blood vessels
that supply the heart muscle itself with
oxygen and nutrients. When these get
damaged we refer to this as
Coronary Heart Disease

5. Heart
disease
suffocates
and is a
killer!
What does is look like?

6. Coronary Heart Disease Risk Factors
Heart disease is not only one
of the biggest killers, it also
has a high degree of
morbidity
Morbidity: is the term we use to say
that it can interfere with the way you live
your life in a large way and for a long
time.

7. Local Heart Disease Statistics

8. • 1997 the figure was 29.4%
• 1998 the figure was 30%
• 1999 the figure was 34%
• 2000 the figure was 39%
• 2001 the figure was 35%
• 2002 the figure was 33%
Coronary Heart Disease Risk Factors
Deaths in Gibraltar by CHD

9. Deaths by cause in the UK 2001
120,891
66,726
52,650
33,509
16,15513,011
95,848
75,809
20,120
101,325
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
CHD
otherCVDs
colo-rectal
cancer
other
cancer
Injuries
CHD Stroke
other CVDs Lung cancer
colo-rectal cancer breast cancer
other cancer Respiratory diseases
Injuries All other causes

10. 30
33
39
35
33
13
15
889
25
19
2625
21
12
15
6
11
21
5
3234 43
10
8
6
2
44
11
98
5
8
6
0
5
10
15
20
25
30
35
40
CHD
Stroke
Cancers
Chest
Diseases
Infections
Degenerative
Diseases
Injuries
Allother
causes
1998 1999 2000 2001 2002
Deaths by cause in Gibraltar

11. Major
Risk
Factors
Coronary Heart Disease Risk Factors

12. Family History
You can’t choose your parents!
"Researchers have
discovered that
specific genes,
which are parts of
the DNA chains,
are linked to
various diseases
and conditions..."
Major Risk Factors Family History

13. Major Risk Factors Cholesterol
Cholesterol
• Cholesterol is a type of fat found in
your blood (a lipid)
• When you have high cholesterol, it can
build up in the walls of your arteries so
they become narrowed
• By lowering your cholesterol you not
only decrease the build up of
cholesterol plaques, but also give the
body some breathing space to allow it
to clear them up.

14. Major Risk Factors Cholesterol
Who is at risk?
• Those with a Western Lifestyle
• The typical high-fat low-fiber diet
• Men tend to die 15 years earlier
than women due to their lifestyle
• Is also the highest killer in women
• Overweight and obese individuals -
including children
• Those suffering from:
• Hyperthyroidism
• Diabetes
• Kidney disease

15. Major Risk Factors Smoking
Smoking
• Smoking damages your blood vessels
throughout your body. Of all the medications
and other therapies that are given, none will
do more good than quitting smoking
• Smoking increases your risk of having a heart
attack two or three-fold
• Risks of continuing: If you already have heart
disease you double the risk of having another
attack

16. Major Risk Factors Smoking
Smoking
• If you are under 50 and smoke, you are 5
times more likely to die of coronary heart
disease than a non-smoker
• Nicotine triggers the release of the stress
hormone adrenalin, which raises your heart
rate and blood pressure, increasing your
heart's need for oxygen
• Carbon monoxide, found in tobacco smoke,
displaces oxygen from your bloodstream -
depriving your heart of oxygen.
• Other chemicals in cigarette smoke aids in
the development of atherosclerosis

17. Major Risk Factors Smoking
Smoking
• How stopping will help your heart: the
ability to carry oxygen to the heart
increases giving the heart the vital
oxygen it needs
• Blood pressure lowers!
• The heart can take it easier!

18. Major Risk Factors Blood Pressure
Blood Pressure
• Due to the plaque deposits in your arteries, this causes the blood
vessels to perform under strain
• Over time the force of the blood flowing through the arteries causes
the smooth lining to roughen and the walls to become thicker. This
in turn causes the arteries to narrow and become less elastic. This
will lead to conditions such as Angina and ultimately a heart attack
(myocardial infarction)

19. Major Risk Factors Diabetes
Diabetes
• Two main types which are young onset (type
1 (IDDM) and mature onset (type 2 (NIDDM).
• The best thing that type 1 diabetics can do for
their heart is to keep their diabetes under
good control.
• Type 2 diabetics can help their heart by
maintaining good control over their diabetes.
This involves losing weight if overweight,
exercising regularly & control over blood
sugars.

20. Major Risk Factors Physical Activity
Physical Activity
• In the last two years lack of exercise has been
clearly recognized as a major risk factor for
coronary heart disease.
• Watching too much television
• Taking the car instead of walking
• These all increase your risk of CHD
• Playing too much video games à

21. Reducing weight makes it easier
Other important Risk Factors
Overweight and Obesity
• Even being moderately overweight increases
your risk of.
• diabetes
• raised blood cholesterol levels
• high blood pressure
• Excess weight increases the amount of work
your heart has to do.
• It's also more difficult to be physically active
if you are carrying excess pounds

22. Other important Risk Factors
Know your Bad fats
Lard
Saturated fat
Butter
Saturated fat
Suet (beef)
Saturated fat

23. Other important Risk Factors
Know your Good fats
Shortening
unsaturated fat
Olive
unsaturated fat
Corn
unsaturated fat

24. Just don’t go
overboard!
Justdon’tgo
overboard! Just don’t go
overboard!
Justdon’t
go
overboard!
Other important Risk Factors
Alcohol
• Alcohol is not considered to be a
major risk factor in CHD, though
it is a factor in other diseases.
It’s main relevance is not so
much in the alcohol as all the
effectively dead calories in the
drink make it difficult to lose
weight
• But a glass of wine each day has
been scientifically proved to help
battle against heart disease.

25. However caffeine has been noted to give palpitations to individuals
sensitive to it.
Other minor Risk Factors
Caffeine
• Not considered to be a major factor but again the amount of milk
and sugar that goes into cups of coffee/tea during the day could
make it harder to lose weight

26. Remember changing you lifestyle will do as
much good, if not more to your health than
taking medications or seeking that ‘magic
bullet’.
It is lifestyle change that is needed in order to
reverse the occurrence of heart disease.
It is important for those who have heart
conditions to take their medications, but
lifestyle change will do more than medications.
Summary Lifestyle Change

27. Useful starting points for patients
ü Stop Smoking
ü Find out their cholesterol levels - lower it if it is high
ü Diabetics must monitor their condition vigilantly
ü Important to exercise regularly where possible
ü Weight reduction to where it should be as
recommended by the BMI
ü Keep blood pressure under control.
ü Important to reduce stressful situations

28. Thank you
for your time!