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Copy_of_Prevention_of_Heart_Disease_new.pptx
- 1. Prevention of HeartDisease Dr Ashutosh Sahu MD, DM (Cardiology), FESC, FSCAI Sahyadri Hospitals,Nashik
- 2. Coronary Artery Disease ■Major health challenge in India ■ Changes in life style & economic development ■ Decline in the west due to aggressive modification of life style by the entire population ■ In India doubled in the last 20 years
- 3. Indians Run TheHighest Risk For Heart Attacks ! Indians in the age group of 30 - 40 years 10 times > Caucasians
- 4. Burden of CADin India ■An estimated 45 million patients of CAD in India ■By the year 2020 ■Largest CAD burden in the world ■CAD will account for one third of all deaths. ■Sadly, many of Indians will be dying young.
- 5. What do wemean by heart?
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- 7. Blocking of theartery
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- 9. Almost Complete OcclusionWith Calcium Deposition
- 10. Occlusion and Formationof Thrombus
- 11. Why did aheart attack occur? If an artery become blocked , heart tissue will die resulting in heart attack.
- 12. Time Is Myocardium Ongoingmuscle damage
- 13. What Causes heartattack? 9. High Blood pressure (hypertension) Normal BP < 120/80 mm of Hg
- 14. What Causes heartattack? 8. Diabetes Mellitus Normal Blood sugar Levels: Fasting < 100 mg % 2hrs Post Meal < 150 mg %
- 15. What Causes heartattack? 7. High Cholesterol Normal Levels – Total Cholesterol < 150 mg % – TG <150 mg% – LDL < 100 mg % – HDL > 40 Mg%
- 16. What Causes heartattack? 6.Smoking (Tobacco Use) – >1000 harmful chemicals in smoke tar – Increases LDL cholesterol – Increases Triglycerides – Decreases HDL Cholesterol – Increases BP – Increases blood clotting – Resistance to BP medications
- 17. What Causes heartattack? 5. Obesity Ideal Body Weight: (Height in CMs – 100) kGs Abdominal Obesity- waist circumference –Males > 90 cms –Females > 80 cms
- 18. What Causes heartattack? 4. Alcohol- Excess
- 19. What Causes heartattack? 3. Diet - Lack of Fruits & Vegetables
- 20. Which is mostharmful for your heart?
- 22. What Causes heartattack? 2. Lack of exercise
- 23. What Causes heartattack? 1. Stress- Psychosocial problems
- 24. INTERHEART: Impact ofmultiple risk factors on CardioVascular risk Yusuf S et al. Lancet. 2004;364:937-52. Odds ratio for 1st MI (99% CI) 64 512 16 1 2 256 128 32 8 4 Smk (1) DM (2) HTN (3) ApoB- ApoA1 (4) 1+2+3 All 4 All 4 + Obes All 4 + Ps All risk factors 2.9 2.4 1.9 3.3 13.0 42.3 68.5 182.9 333.7 Smk = smoking DM = diabetes HTN = hypertension Obes = obesity Ps = psychosocial factors Note: odds ratio plotted on a doubling scale
- 25. INTERHEART: Association ofrisk factors with acute MI in women and men Yusuf S et al. Lancet. 2004;364:937-52. Adjusted for age, sex, geographic region Note: odds ratio plotted on a doubling scale Risk factor Gende r Current smoking F M Diabetes F M Abdominal obesity F M Psychosocial index F M Hypertension F M 0.25 0.5 1 2 4 8 16 Odds ratio (99% CI) Fruits/Vegetables F M Exercise F M Alcohol F M ApoB-ApoA1 ratio F M
- 26. Stress • Definition: – Stateof tension that arises when you experience demands from your environment or from inside yourself Can be a real OR perceived threat OR
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- 32. Stress and Illness Stress Directbiological effects e.g. physical strain, hormonal changes Maladaptive coping behaviour e.g. smoking, drinking alcohol Emotionally mediated effects on diet and activity level Increased Risk of Disease www.psychlotron.org.uk
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- 35. Stress Happens!! – Childhood –Adolescence – Young adult – Marriage – Parenthood – middle age – aging – Injury – Moving – Death of a loved one – Divorce – Retirement – Pregnancy – Beginning or ending formal schooling • Stress is a normal part of life, especially during changes in life: To test the stress in you life due to life events go to: http://www.stresstoughness.com/lifeevents.htm
- 36. Our Body’s Design •Our bodies are uniquely designed to handle stress. • When presented with a threatening situation it is our most basic survival instinct to either: – Engage in a fight – Or run for our lives • This is what is known as the “fight or flight” response
- 37. During Fight orFlight • Adrenaline is secreted from the kidneys • Cortisol (a hormone) is released providing bursts of energy • The heart suddenly beats faster • Breathe rate and blood pressure increase • Blood sugar is released into the bloodstream • Hearing and sight are enhanced • Digestive system and urine production slow to divert blood to more critical areas, such as the brain and muscles
- 38. It makes usable to fight or run, BUT… • It is rarely necessary AND… • Has some side effects that deteriorate our health – increased blood pressure – Decreased immune function – Several important functions of the body are interrupted
- 39. Over time thiscan result in: • Headaches • Asthma • Hypertension • Ulcers • Low back pain • Heart disease • Stroke • Upper respiratory infections • Difficulty thinking clearly • Depression • Anxiety • Drug abuse • Mental illness • Higher risk for suicide • Addictive disorder
- 41. What can wedo to prevent this? • Fix the fixable • Accept the inevitable • Protect yourself from the physical affects
- 42. STRESS FEELINGS • Worry •Tense • Tired • Frightened • Elated • Depressed • Anxious • Anger
- 43. TYPES OF STRESSORS •External • Internal
- 44. EXTERNAL STRESSORS • PhysicalEnvironment • Social Interaction • Organisational • Major Life Events • Daily Hassles
- 45. INTERNAL STRESSORS • Lifestylechoices • Negative self - talk • Mind traps • Personality traits
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- 51. COSTS OF STRESS •80% of all modern diseases have their origins in stress. • In the UK, 40 million working days per year are lost directly from stress - related illness. • Costs in absenteeism to British industry is estimated at £1.5 billion pounds per year.
- 52. STRESS CONTROL AWARENESS What causesyou stress? How do you react? BALANCE There is a fine line between positive / negative stress How much can you cope with before it becomes negative ? CONTROL What can you do to help yourself combat the negative effects of stress ?
- 54. Principles of StressManagement S – STRENGTH T – TIME MANAGEMENT R – RELATIONSHIPS E – EGO S – SAVINGS S - SPIRITUALITY
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- 56. MENTAL STRENGTH Reading. Observations. Application ofteachings. Ability to live in the present Appreciation. Analysis.
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- 59. Time Management • Makea list What MUST be done What SHOULD be done What would you LIKE to do • Cut out time wasting • Learn to drop unimportant activities • Say no or delegate
- 60. TIME MNAGEMENT • Planyour day • Set achievable goals • Don’t waste time making excuses for not doing something
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- 63. SAVINGS Feel secure aboutmoney. Save. Invest. Feel satisfied.
- 64. SPIRITUALITY Nothing to dowith God / Unknown. Ability to live in present. Meditation Yoga: Physical means. Get the bigger picture.
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- 68. Protect Yourself • Severaltechniques can be used to decrease your bodies response to stress
- 69. Exercise Exercise boosts endorphins whichin turn can –Put us in a better mood –Give us more energy –Reduces anger –Improves mental alertness
- 70. Deep Breathing • Breathin deeply and slowly. • Focus on the air moving in your nose, down your neck into your chest and feel your belly push out. Hold your breath for a few seconds. • Now exhale slowly. First feel your belly contract in towards your spine, then feel the air move through the chest, up the neck, and through your mouth. • Visualize stress leaving your body
- 71. Meditation • Close youreyes and mental follow the air in and out of your body. As you exhale mentally repeat a soothing word like “Peace” Or • Visualize a peaceful scene • Do this for 5 to 30 minutes
- 72. Progressive Muscle Relaxation •While sitting or lying down, tense the muscles of your feet (curling your toes) as hard as you can. • Then relax them. • Do this once or twice for each part of the body • Continue this process for each muscle group all the way up your body until you reach your head. • When finished remain relaxed for a few minutes
- 73. Stretching • Several stretchescan be done at your desk • Tilt head to the left and hold • Tilt head to right and hold • Reach arms over the head and interlace fingers For information of stretches that can be done at your desk or for the head and neck click on the stretching girl
- 74. Get a Massagefrom yourself or from a professional Self-Massage • Sit with your shoulders relaxed • Use your right hand to massage you left shoulder and neck, working your way up to the scalp • Repeat with left hand for right shoulder
- 75. Laugh!! • Find waysto add laughter in your life – Buy tapes of comedians you like and listen to them during your commute or whenever you need a boost. – Read joke books or funny books – Watch your favorite comedy on television – Buy movies that are sure to make you laugh – Don’t take yourself too seriously
Editor's Notes
- #26 Bullet One The key phrase in this definition is “from inside yourself” This leads us to believe that we can control or eliminate stress if we can control the messages that come from inside of us. “A BEAR IS TRYING TO EAT ME!!!” is an environmental source of stress. It is impossible to eliminate all the possible environmental sources of stress in our lives we are bound to go through some stress in our lives. We cannot change that, but we can change the way we perceive those threats.
- #35 Each time you move from one stage in life to another there is likely to be a time of adjustment which typically means more stress. Remember the first day of intermediate school or junior high. While it was exciting and new there was also stress involved. We had to relearn how to function in that new environment.
- #36 “Wonderfully and uniquely made” or “wonderfully evolved” our bodies are able to handle stress in our lives in a way that is designed to protect from harm. Stress is not a new phenomenon. Our ancestors and even animals have this basic response which prepares them to cope with predators. Han Seyle and Walter Cannon coined the term “fight or flight” in the 1930 when they demonstrated what happens in the human body during a stressful situation.
- #37 It is common to hear people who have just been through a trauma say something like, “I wasn’t thinking. I was just running on adrenaline!” Adrenaline is the hormone that prepares the body for an attack. The heart needs to beat faster so blood can get to our muscles. If we are going to run we need more air so we start to breath faster Our blood pressure elevates More blood gets routed to our muscles so they can be used to fight or run Sugar is released into the blood stream so muscles have the energy they need Cortisol is released from the adrenal cortex. Cortisol is also known as the “fight or flight” hormone
- #38 Although there are rare times in our life where we need to run for our lives or fight for our lives, this is rarely the case in our much more civilized lives.
- #39 M.D. Jeremko, “Stress Inoculation Training A Generic Approach for the Prevention of Stress-Related Disorders,” The Personal and Guidance Journal 62 (1984):544-550 found
- #68 We can try to eliminate unnecessary stress, plan for stress or simply be more positive. Our bodies also benefit from stress reduction techniques.
- #73 For an interactive presentation of stretches you can do at your desk, go to http://my.webmd.com/health-e-tools/3836, scroll down and click on “Yoga at your desk” or “Yoga for Neck and Shoulders”