This document discusses prevention and control of heart disease. It begins by defining heart disease as a general term covering diseases that affect the heart. Heart disease is the number one killer in the United States and the second leading cause of death in Bangladesh. The document then discusses risk factors for heart disease such as age, family history, smoking, high blood pressure, cholesterol, obesity, and lack of exercise. It provides categories of risk factors and lists symptoms of heart attack and stroke. The document concludes by emphasizing that heart disease is highly preventable through diet, exercise, and reducing risk factors.

1. Prevention & Control of
Heart Disease
The Heart of Health
[Dr] Amzad Ali
Email: ali.amzad@gmail.com
Skype: ali.amzad
Cell: +8801713 004696

2. What is Heart Disease?What is Heart Disease?
Heart Disease- The Silent Killer

3. What is Heart Disease?
 A general term that covers a number of
diseases which affect the heart, including
coronary artery disease, heart-failure and
angina.
 Heart Disease is the number one killer in the
United States and 2nd
in Bangladesh.
 Increasing in Bangladesh among all ages

5. Are You at Risk?
Classic cardiac risk factors:
High blood pressure (even if treated)
High cholesterol
Diabetes
Smoking
Family history of early heart disease
Age > 55 for women, >45 for men but any
age can be affected
Obesity
Lack of exercise and poor exercise tolerance
Chronic kidney disease

7. Category Risk Factors
Predisposing factors Age, sex, family history, genes
Risk-modifying behaviors Smoking, atherogenic diet, alcohol intake,
physical activity
Metabolic risk factors Dyslipidemias, hypertension, obesity,
diabetes, metabolic syndrome
Disease markers Calcium score, catheterization results, stress
test results, left ventricular hypertrophy on
echocardiogram, personal history of vascular
disease, inflammatory state
Four Basic Categories of Risk Factors
Braunwald, 7th
edition page 1058

9. Myocardial Infarction
or
Heart Attack
 Symptoms: uncomfortable pressure, fullness,
squeezing pain, pain spreading to the
shoulders, neck and arms.
 Chest discomfort and light headedness
 Anxiety/nervousness
 Paleness or pallor
 Increased irregular heart rate

10. Cerebrovascular Accident
or
Stroke
 Blood vessel in the brain becomes blocked by
atherosclerosis- the tissue supplied by the
artery dies.
 Embolus – which is a traveling blood clot.

11. Symptoms of Stroke
 Sudden numbness or weakness of the face, arm
or leg, especially on one side of the body.
 Sudden confusion, trouble speaking, or
understanding.
 Sudden trouble seeing in one or both eyes.
 Sudden trouble walking, dizziness, loss of balance
or coordination.
 Sudden severe headache with no known cause.
 If you have any of these symptoms you need
immediate medical attention!

12. Unchangeable Risk Factors
 Age- the older you get, the greater the chance.
 Sex- males have a greater rate even after women
pass menopause.
 Race- minorities have a greater chance.
 Family history- if family members have had CHD,
there is a greater chance.
 Personal Medical History- other diseases such as
Diabetes Mellitus can increase chances.

13. Changeable Risk Factors
 Hypertension
 Serum cholesterol
 Obesity
 Diabetes Mellitus
 Physical Inactivity
 Cigarette Smoking
 Alcohol Intake

14. How can You Stop CVD?
Diet and Nutrition, there are several
guidelines listed by the American Heart
Association:
 Eat a variety of fruits and vegetables every
day. ( 5 servings - they are naturally low in fat
and high in vitamins and minerals)
 Eat a variety of grain products ( 6 a day)

15. Diet and Prevention of CVD
 Choose nonfat or low-fat products.
 Use lean meats- choose chicken, fish, turkey
and lean cuts of beef and pork.
 Switch to fat-free milk- gradually reduce the
fat content of the milk you drink.
 Maintain a level of physical activity that keeps
you fit and matches the # of calories you eat.
 Balance the # of calories you eat with the
number of calories you use each day.

16. Exercise and CVD
 Serves several functions in preventing and
treating those at high risk.
 Reduces incidence of obesity.
 Increases HDL
 Lowers LDL and total cholesterol
 Helps control diabetes and hypertension
 Those at high risk should take part in a
specially supervised program.

17. Cardiovascular Disease
Prevention in Women
 A five-step approach
Assess and stratify women into high risk, at risk,
and optimal risk categories
Lifestyle approaches recommended for all women
Other cardiovascular disease interventions:
treatment of HTN, DM, lipid abnormalities
Highest priority is for interventions in high risk
patients
Avoid initiating therapies that have been shown to
lack benefit, or where risks outweigh benefits

18. Risk Stratification:
 High Risk
Diabetes mellitus
Documented atherosclerotic disease
Established coronary heart disease
Peripheral arterial disease
Cerebrovascular disease
Abdominal aortic aneurysm
Includes many patients with chronic kidney disease,
Obesity
Hypertension
Smoking
Physical inactivity

19. What Should I Eat?

21. Different levels of prevention
Prevention: strategies that prevent
development of diseases or interrupt
progression of disease
 Primary prevention: reduce exposure or
susceptibility – promote good health; sex
education; protection
 Secondary prevention: early detection and
treatment, reduce risk (treat Sti’s)

23. Individual
Behaviour Change
Healthy eating
Healthy activity
Healthy weight
Environmental
Change
Complementary
Approaches to
Prevention

24. Modifiable Risk
General
population
At-risk
individuals
and
groups
CVD
patients
A FRAMEWORK FOR STRATEGIES
Prevent Modifiable
Risk Variables
Prevent
Recurrent
Events
End-
stage
Acute Care
Population-wide
strategies
Treat high risk
not high risk
factor levels
Implement proven
treatments
Address Inequalities

26. Conclusion
 Cardiovascular disease is the number
one killer globally and 2nd
in Bangladesh.
 It is highly preventable and controllable
with diet, exercise and reduction of risk
factors.
 Knowledge, attitude and practices
developed in early age and act NOW
 Good resource:www.americanheart.org

27. References
1. WHO. Tech. Report Series 137. WHO. 1952.
2. WHO.Constitution Of World Health Organization. 1946.
3. WHO. Role of Health sector in Food and Nutrition. Tech.
Report Series 137. Geneva. 1980.
4. IGNOU. Concepts in Nursing. Available online at:
http://www.ignou.ac.in/edusat/BNS/BNS101-Blk2-3-4/Block1en/38-66
5. WHO. Ageing and Health. A health promotion approach for
developing countries. WHO, Regional Office for the Western
Pacific United Nations Avenue.Manila, Philippines;2000.11-15.
6. Ghai OP, Gupta P. Essential Preventive Medicine. Vikas
Publishing House Pvt Ltd. India;1999:23,817-819.
7. Park K. Park’s textbook of preventive and social medicine. 20th
edition, 2013. Banarsidas Bhanot publishers, Jabalpur, India