This document discusses perceptions and realities about women and heart disease. It notes that heart disease is the number one killer of women, yet they are less likely to be correctly diagnosed due to perceptions that heart disease primarily affects men and that women experience different symptoms than men. The document summarizes several risk factors for heart disease in women such as high cholesterol, smoking, high blood pressure, diabetes, obesity, lack of exercise, and family history. It provides statistics on the prevalence of these conditions in women and how they can be managed through lifestyle changes and medical treatment to reduce heart disease risk.
Women and Heart Disease: New Concepts in Prevention and ManagementSummit Health
Coronary heart disease is the leading cause of
death for all women. Significant disparities
exist in the prevention, diagnosis, recognition,
management, and clinical outcomes of
cardiovascular disease in women.
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMPraveen Nagula
DIABETES IS ONE OF THE MOST COMMON NONCOMMUNICABLE DISEASES WORLD WIDE.
EVERY 6 SECONDS ONE PERSON IS AFFECTED BY DIABETES..
THEME FOR 2014-2016
LETS UNITE FOR DIABETES
Women and Heart Disease: New Concepts in Prevention and ManagementSummit Health
Coronary heart disease is the leading cause of
death for all women. Significant disparities
exist in the prevention, diagnosis, recognition,
management, and clinical outcomes of
cardiovascular disease in women.
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMPraveen Nagula
DIABETES IS ONE OF THE MOST COMMON NONCOMMUNICABLE DISEASES WORLD WIDE.
EVERY 6 SECONDS ONE PERSON IS AFFECTED BY DIABETES..
THEME FOR 2014-2016
LETS UNITE FOR DIABETES
SGLT2 inhibitors in Heart failure: A prized addition to HF treatment optionsahvc0858
Early Diabetes and Dyslipidaemia Treatment Optimisation.
Presentation by Dr Chan Wan Xian
Cardiologist, Echocardiologist
Heart Failure Intensivist
Asian Heart & Vascular Centre
www.ahvc.com.sg
Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia.
Several distinct types of DM are caused by a complex interaction of genetics and environmental factors.
Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production.
The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system.
Learn why heart disease is a major issue and what you can do to prevent and reverse the number one killer of American's today. Review extensive science and studies demonstrating the effect of nutrient dense foods, exercise and mental health on heart health. Establish your own personal heart health program today.
We have made great strides in the treatment of cancer. More individuals are surviving a cancer diagnosis, but cancer treatments can have a detrimental impact on cardiovascular health.
Dr. Susan Dent, a medical oncologist who co-founded the first multidisciplinary cardio-oncology clinic in Canada, discussed the importance of optimizing cardiovascular health for patients during and following completion of their cancer treatment.
Prevalence of obesity.Body composition & body shape (body fat distribution ) and CVD risk .Mechanisms linking obesity with cardiovascular disease.Fat-but-Fit Paradigm and CVD,The Relationship of Metabolic Risk Factors and Cardiorespiratory Fitness. Metabolically Healthy but Obese ( MHO ) Phenotype and CVD.Obesity Paradox in Patients With CVD
Chronic coronary syndrome (CCS) is a term that defines coronary artery disease as a chronic progressive course. It has been introduced to replace the previous term ‘stable coronary artery disease’.
Cardiovascular safety of anti-diabetic drugs.Cardiovascular Outcome Trials ...magdy elmasry
Cardiologists and diabetes.Target organs and action mechanism of antidiabetic drugs.Cardiovascular Outcome Trials
( CVOTs ) in Diabetes.Completed and ongoing CVOTs in type 2 diabetes.Diabetes Medications
and
Cardiovascular Impact.Recommendations for management of diabetes
Cardiovascular safety of anti-diabetic drugs.
SGLT2 inhibitors in Heart failure: A prized addition to HF treatment optionsahvc0858
Early Diabetes and Dyslipidaemia Treatment Optimisation.
Presentation by Dr Chan Wan Xian
Cardiologist, Echocardiologist
Heart Failure Intensivist
Asian Heart & Vascular Centre
www.ahvc.com.sg
Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia.
Several distinct types of DM are caused by a complex interaction of genetics and environmental factors.
Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production.
The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system.
Learn why heart disease is a major issue and what you can do to prevent and reverse the number one killer of American's today. Review extensive science and studies demonstrating the effect of nutrient dense foods, exercise and mental health on heart health. Establish your own personal heart health program today.
We have made great strides in the treatment of cancer. More individuals are surviving a cancer diagnosis, but cancer treatments can have a detrimental impact on cardiovascular health.
Dr. Susan Dent, a medical oncologist who co-founded the first multidisciplinary cardio-oncology clinic in Canada, discussed the importance of optimizing cardiovascular health for patients during and following completion of their cancer treatment.
Prevalence of obesity.Body composition & body shape (body fat distribution ) and CVD risk .Mechanisms linking obesity with cardiovascular disease.Fat-but-Fit Paradigm and CVD,The Relationship of Metabolic Risk Factors and Cardiorespiratory Fitness. Metabolically Healthy but Obese ( MHO ) Phenotype and CVD.Obesity Paradox in Patients With CVD
Chronic coronary syndrome (CCS) is a term that defines coronary artery disease as a chronic progressive course. It has been introduced to replace the previous term ‘stable coronary artery disease’.
Cardiovascular safety of anti-diabetic drugs.Cardiovascular Outcome Trials ...magdy elmasry
Cardiologists and diabetes.Target organs and action mechanism of antidiabetic drugs.Cardiovascular Outcome Trials
( CVOTs ) in Diabetes.Completed and ongoing CVOTs in type 2 diabetes.Diabetes Medications
and
Cardiovascular Impact.Recommendations for management of diabetes
Cardiovascular safety of anti-diabetic drugs.
A simplified view of Victor Dzau´s cardiovascular continuumMy Healthy Waist
By Luis Miguel Ruilope, MD, Professor, Internal Medicine, Complutense University, Head of the Hypertension Unit, 12 de Octubre Hospital, Madrid, Spain.
Heart attacks don’t happen just to men. Some 435,000 women have heart attacks each year, and about 267,000 of them die—six times as many as die from breast cancer. If you’re a woman, recognizing these seven common signs of a heart attack could save your life:
Women's Heart Health
You want to live to 100 but you are worried about your heart health.
You do not want to rely on drugs as your only option for keeping your heart healthy.
Then this FREE webinar is for you! Join me and discover the 5 secrets to heart health!
Learn natural and safe methods of lowering cholesterol, reducing inflammation and protecting your heart.
Heart of the Matter - Ali Ahmad, MD, FACC - Livingston Library - 1.6.2020Summit Health
Heart disease is the leading killer of adults nationwide and it carries a significant morbidity for the population at risk. Learn about traditional and non-traditional risk factors associated with coronary artery disease, and how to modify your risk and prevent heart disease. Also, learn about how heart disease affects different ethnic backgrounds, particularly the high-risk groups, such as South Asians.
Living a Heart Healthy Life - Liliana Cohen - West Orange Public Library - 2....Summit Health
Learn how to make healthy choices that impact heart health, the typical mistakes to avoid, and how to recognize the signs and symptoms of a heart attack.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
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Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
1. PERCEPTIONS Vs REALITY:
WOMEN AND HEART DISEASE
Dr.Jayasree.H.Nambiar
DCH,DNB(Paed),DNB(Cardio),FIC(AIMS),FICC.
Consultant Interventional Cardiologist
BMH, Calicut.
2. What is Heart Disease?
• Heart : The most hard-working muscle of our body –
pumps 4-5 liters of blood every minute during rest
• Supplies nutrients and oxygen rich blood to all body
parts, including itself.
• Coronary arteries
surrounding the heart keep it
nourished with blood
3. What is Atherosclerosis?
What is Coronary Artery disease?
• Over time, fatty deposits called plaque build up within
the artery walls. The artery becomes narrow. This is
atherosclerosis
• When this occurs in the coronary arteries, heart does not
get sufficient blood, the condition is called coronary
artery disease, or coronary heart disease
4. What are the symptoms of Coronary
artery disease?
• No symptoms for long period
• Chest pain for short period on exertion
also known as Angina or minor heart
attack
• Myocardial Infarction or major heart
attack-Severe chest pain, death of heart
muscle, heart failure, irregular heart beats
• Sudden Death
5.
6. How Big is the Problem ?
No. 1 killer disease worldwide
12 Million deaths annually.
During last 30 years large declines in
developed countries -rising health
awareness and government
programmes
Alarming increase in developing
countries especially India
7. Why Should I (Indian)
be Worried ?
• Indians More susceptible than any other
ethnic group
– 3.4 times more than Americans
– 6 times more than Chinese
– 20 times more than Japanese
– Occurs even at lower cholesterol levels
• Get the disease at much younger age
- 5-10 years earlier than other communities
• Disease follows more severe and malignant course
– 3 times higher rate of second heart attack and two times
higher mortality than whites
8. Kerala - Statistics
• 110 People die of heart disease daily.
• 38,000 people die of heart attack
every year(ICMR, WHO)
• 50% of total death due to
Cardiovascular disease
• (28% in India)
• ↑se to 2/3 by 2020
10. What do we need to
Know?
WOMEN AND HEART
DISEASE
11.
12.
13.
14. Gender Bias in the Treatment of Women
―… The community has
viewed women‘s health almost
with a ‗bikini’ approach,
looking essentially at the
breast and reproductive
system, and almost ignoring
the rest of the woman as part
of women‘s health ….‖
15. Heart Disease is the #1 Killer of
Women
• Coronary heart disease is the
single leading cause of death and
a significant cause of morbidity
among women.
• In 1997 CHD claimed the lives
of 502,938 women (men had less
deaths)
• Since 1984, CVD has killed
more women than men each
year.
16. Death From Breast Cancer or
Heart Disease in Women in the US
US Vital Statistics, 1990
18. In Perspective:
• 1 in ―2‖ women will die
of heart disease.
• 1 in ―25‖ women will die
of breast cancer.
19. Coronary Heart Disease in Women
• Presentation and differences from men
• 2/3 of women who die suddenly have no
previously recognized symptoms.
• Women are more prone to non-cardiac
chest pain…..
• In fact they may experience little or no
squeezing chest pain in the center of the
chest, lightheadedness, fainting, or
shortness of breath with an MI (as seen
on ―ER‖).
20. Not So Straight Forward
• Because of these atypical symptoms, women
seek medical care later than men and are
more likely to be misdiagnosed.
• Women presenting with MI and CAD are
more likely to be older, have a history of DM,
HTN, Hyperlipids, CHF, and unstable angina
than male counterparts.
• Because of these comorbid conditions, there
tends to be diagnostic confusion.
21. Misperceptions and Missed Opportunities
Leading to Access Inequity
• Women were less likely to have an
EKG or be admitted to the telemetry
floors.
• Women are under-diagnosed and
can therefore get a false sense of
security.
• Less aspirin, beta-blockers, statins,
anti arrhythmic treatment, cardiac
cath, PTCA, CABG
• Women were less likely to enroll in
cardiac rehabilitation after an MI or
bypass surgery.
22. CHD Mortality in Younger Women
2.9
4.1
5.7
8.2
10.7
14.4
18.4
21.8
25.3
6.1
7.4
9.5
11.1
13.4
16.6
19.1
21.5
24.2
0
5
10
15
20
25
30
< 50 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89
DeathduringHospitalization(%)
Men
Women
Figure 1. Rates of death during hospitalization for Myocardial Infarction among w omen and men, according to age. The interaction betw een sex
and age w as significant (P<0.001).
Women under 65 suffer the highest relative sex-specific CHD mortality
23. Women vs Men
• Mortality from CABG-
particularly among younger
women-is double that among
men.
• More women than men die 1
year after an MI.
• CHD is Largely Preventable
• We need to address risk factors
earlier and more aggressively,
thereby reducing women‘s
cardiovascular risk.
25. What Increases Risk?
• High Cholesterol
• Smoking
• High Blood Pressure
• Diabetes
• Obesity
• Alcohol
• Physical Inactivity
26. • Family history of cardiovascular disease.
• If your parents have cardiovascular disease
(especially if they were diagnosed before age
50), you have an increased risk of developing it.
27. Emerging Risk Factors
• Lipoprotein (a)
• Homocysteine
• Prothrombotic factors
• Proinflammatory factors
• Impaired fasting glucose
• Subclinical atherosclerosis
– Other clinical forms of atherosclerotic disease
(peripheral arterial disease, abdominal aortic
aneurysm, and symptomatic carotid artery disease)
– Abnormal internal or common carotid CIT, ankle-
arm index <0.9, coronary Ca2+
28. Gender Differences in CAD Risk
Factors
• Increasing recognition that atherosclerosis is
an inflammatory process
• Ridker PM, et al: A prospective case-
controlled study among 28,263
postmenopausal women
– Among 12 markers of inflammation, C
reactive protein was the strongest
univariate predictor of the risk of CV
events
Ridker PM, et al. N Engl J Med. 2000
30. CHOLESTEROL ( A TYPE OF FAT)
• Everybody needs cholesterol, it serves a vital
function in the body.
• It circulates in the blood.
• Too much cholesterol can
deposit in the arteries in the
form of plaque and block
them
• No symptoms till heart attack
31. WHERE DOES IT COME FROM ?
• Two sources of
cholesterol: Food
& made in your
body
• Food sources: All
foods containing
animal fat and
meat products
65%
35%
32. GOOD VS. BAD CHOLESTEROL
• LDL cholesterol
– known as bad cholesterol. It has
a tendency to increase risk of
heart disease
– major component of the plaque
that clogs arteries
• HDL cholesterol
– known as the good cholesterol.
Increases with exercise
– helps carry some of the bad
cholesterol out of arteries.
33. Know your Number!
Desirable numbers
• Total Cholesterol < 200;
• LDL < 100
• HDL > 40
• Triglycerides < 200
• Get the levels tested routinely and keep them
under control
• The only thing worse than finding out that you
have one of these conditions is…….NOT finding
out that you have it!!
And that’s not your Mobile Number!
34. Look before your eat
• Eat a variety of fruits and vegetables every
day. (5 servings - they are naturally low in
fat and high in vitamins and minerals and
anti oxidants). Eat colored vegetables and
fruits
• Eat a variety of grain products
• Choose nonfat or low-fat products.
• Use less fat meats- chicken, fish and lean
cuts
Switch to fat-free milk—toned/skimmed
milk
36. Cigarette Smoking
• Increases blood pressure
• Decreases HDL
• Damages arteries and blood
cells
• Increases heart attacks
• Cigarette smoke contains
more than 4,000 chemicals,
and 200 of these chemicals
are poisonous
37. Preventable Risk- Smoking
• A. 50% of heart attacks among
women are due to smoking. Smokers
tend to have their first heart attack 10
years earlier than nonsmokers.
• B. If you smoke, you are 4-6x‘s more
likely to suffer a heart attack and
increase your risk of a stroke.
• C. Women who smoke and take
OCP‘s increase their risk of heart
disease 30x‘s.
38. Cigarette Smoking
If you think YOU are smoking the cigarette, you are mistaken…
“It’s the other way round”!
39. SMOKING:
• Stop!!!!!(avg. attempt = 8 times)
• Women who have other smokers
in their household have a 2.5 X's
greater likelihood of relapse.
Circulation 2002:106
• Smoking cessation was
associated with a 36% reduction
in mortality among patients with
CHD.
JAMA 2003:290
40. Quit Smoking
In just 20 mins after quitting , blood pressure
decreases
After 24 hrs the chance of heart attack decreases
Within 1 year of quitting, CHD risk decreases,
within 2 years it reaches the level of a non
smoker.
42. HYPERTENSION
• 65% of all hypertension remains
either undetected or inadequately
treated.
• People who are nor motensive at
55 have a 90% lifetime risk of
developing HTN.
• Prevalence increases with age
and women live longer-
hypertension is more common in
females.
• HTN is more common with OCP
and obesity.
43. CONTROLLING BLOOD PRESSURE
• Adults should have their blood pressure
checked at least once every two years, as
there are no symptoms to tell if you have
high blood pressure
• Optimal levels : 120 /80 mm Hg
• If high
– Modify your lifestyle – Diet, Weight, Exercise,
Salt restriction
– Adhere to the prescribed medication without fail,
to decrease chances of getting heart disease – Do
not stop your medicines without consulting your
doctor, even if the blood pressure becomes
normal
44. Weight Management
On average, ~ 1/2 to 1mm
decrease in blood pressure for
each pound weight loss in
obese hypertensives (up to
~20# loss)
Weight reduction can raise
HDL-cholesterol
Obesity is the major risk for
CHD
45. Exercise
• 30-45 mins of walking
5x‘s/week reduces risk of MI
in females 50%.
• Helps control BP, increases
HDL, decreases body fat, DM
risk, possibly prostate, breast
and uterine cancers.
47. Diabetes
• At any given cholesterol level,
diabetic persons have a 2 or 3 x
higher risk of heart attack or stroke
• A diabetic is more likely to die of a
heart attack than a non-diabetic
• ~80% Diabetics die from heart
disease
• Risk of sudden death from a heart
attack for a diabetic is the same as
that of someone who has already had
a heart attack.
48. Diabetes Creates Higher Risks for Women
With CAD
• 65% of diabetics die from heart disease or
stroke
• 4.2 million American women have diabetes
– Diabetes increases CAD risk 3-fold to 7-
fold in women vs 2-fold to 3-fold in men
– Diabetes doubles the risk of second heart
attack in women but not in men
• Every year, heart disease kills 50,000 more
American women than men
• Statistics are particularly high among African
American women American Heart Association
Centers for Disease Control and Prevention
Manson JE, et al. Prevention of Myocardial Infarction. 1996
50. Controlling Blood Sugar
• Normal blood sugar:
• Fasting < 100; Post meals <140
• Keep HBA1C < 6.5%
• If high
– Modify your lifestyle – Diet, Weight,
Exercise
– Adhere to the prescribed medication
without fail, to decrease chances of
getting heart disease – Do not stop your
medicines without consulting your
doctor, even if the blood sugar becomes
normal
52. Obesity
• People who are overweight (10-30 % more than their
normal body weight)
• Obese have 2 to 6 times the risk of developing heart
disease
• Normal Waist Circumference
<88cm in females
< 92cm in males
• Pears or apples?
53. Obesity
A. 1/3 of adult women are obese and its
increasing
B. Active women have a 50% risk
reduction in developing heart disease.
54. Obesity and Coronary Heart Disease Mortality
0
1
2
3
4
5
6
<19 19.0-
21.9
22.0-
24.9
25.0-
26.9
27.0-
28.9
29.0-
31.9
>32.0
Nurses‘ Health Study: Women who never smoked
Relative Risk of Coronary Heart Disease mortality
Body Mass Index (kg/m2)
55.
56. Metabolic Syndrome
Risk Factor Defining Level
Abdominal Obesity Waist Circumference
Men >40 inches
Women >35 inches
TG‘s >150
HDL
Men <40
Women <50
BP >130/85
Fasting Glucose >100 mg/dl
59. Alcohol Consumption
In small amounts it acts as a vasodilator-Good!
1-2 drinks
In large amounts it acts as a vasoconstrictor-BAD!
3-4 drinks
This is a very fine line!
61. 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.
62. Exercise, Exercise, Exercise
•Mortality is halved in retired men who
walk more than two miles every day
•Regular exercise can halve the risk of
heart disease, particularly in men who
walk briskly
•Someone who is inactive has as great a
risk of having heart disease as someone
who smokes, has high blood pressure or
has high cholesterol
•Exercise significantly reduces the
chances of diabetes and stroke
•With regular exercise, blood pressure in
those with hypertension is reduced by as
much as 20mms Hg
63. How is cardiovascular disease
associated with menopause?
• After menopause, a woman‘s risk of
cardiovascular disease increases.
• In women who have undergone early
menopause (before age 50) or surgical
menopause, the risk of cardiovascular
disease is also higher, especially when
combined with other risk factors.
• Estrogen helps a woman‘s body protect her
against cardiovascular disease.
• After menopause, cardiovascular disease
becomes more of a risk for women because
of the reduced level of estrogen.
64. Postmenopausal Hormone
Therapy and Cardio protection
• First randomized trial
• HERS trial (Heart and
Estrogen/Progestin
Replacement Study)
– Secondary CAD
prevention trial
– Randomized trial of
placebo vs estrogen
and
medroxyprogesterone
– Follow-up = 4 years
– N = 2,763 women
with an intact uterus
HERS trial. JAMA. 1998.
65. Heart Disease
• There is a continuum of CVD risk, it is not a
―have or have-not‖ condition.
• CHD is less in women who control their risk
factors. JAMA Oct. 6, 2004
• The average age of our population is
increasing and so CHD will remain a major
public health issue.
66. Other Heart Diseases In Women
• RHD & Aortorto arteritis more common in
women
• Congenital heart diseases like ASD more in
women.
• Can cause morbidity & maternal/neonatal
mortality during pregnancy and delivery.
• Needs screening of pregnant women with
Echo/Foetal Echo.
67. “GO RED” Conclusions
Heart disease is a number one killer.
Majority of the causes for heart diseases are
known and can be modified.
Adoption of guidelines for prevention of
cardiovascular diseases can help people to
have a lifelong low level of heart diseases
and stroke.
68. Contd……..
Chances of Heart disease in women are high
& that is on the increase.
Most of the risk factors have a higher impact
in women than men.
Since younger women have a higher mortality
than men(<40yrs) grave implications in
family & society.
All females should be made aware of this
through educative programmes starting at
school & College levels.
69. Contd…
Preventive measures save economy & health.
Girl students be screened for RHD &
Congenital Heart diseases through school
health programmes.
Separate ‗Women & Child care‘ wings for
Cardiology departments.
Concessional rate Cardiac check ups for
women.
Realizing this ‗Cardiac Explosions‘ in women
Govt. schemes on a ‗Go Red‘ Basis!!!.