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What Women Need to Know About Heart Disease


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Do you know your risk for cardiac disease? Take a closer look at guidelines, tools, and techniques that can assess your own risk and learn the latest on preventing cardiovascular disease. This community lecture at Summit Medical Group offers information regarding cardiac screenings such as cholesterol testing, calcium scoring, stress testing and echocardiograms .

Susan L. Simandl, MD, FACC
Suzanne Shugg, BSN, MSN, RN, ACNP, DNP

Published in: Health & Medicine
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What Women Need to Know About Heart Disease

  1. 1. Women’s Cardiac Health and Wellness Center at the Summit Medical Group Susan L. Simandl, MD, FACC Suzanne Shugg, DNP, CLS
  2. 2. Overview <ul><li>Why do women need to know about heart disease? </li></ul><ul><li>What is heart disease? </li></ul><ul><li>What are some symptoms of heart disease? </li></ul><ul><li>What are the risk factors for heart disease? </li></ul><ul><li>Why are heart disease risk factors so important? </li></ul>
  3. 3. When you hear “heart attack” what do you think of?
  4. 4. “ Just a Little Heart Attack”
  5. 5. Are you surprised? <ul><li>Only 53% of women said they would call 9-1-1 if experiencing the symptoms of a heart attack </li></ul><ul><li>However, 79% said they would call 9-1-1 if someone else was having a heart attack </li></ul><ul><li>For themselves, 46% of women would do something other than call 9-1-1—such as take an aspirin, go to the hospital, or call the doctor </li></ul>
  6. 6. Why should women care about heart disease? <ul><li>Cardiovascular disease (CVD) kills over 460,000 women per year – about one woman per minute </li></ul><ul><li>CVD kills more women than the next 5 causes of death combined </li></ul><ul><li>One woman in three has some form of CVD </li></ul><ul><li>Heart disease can be prevented </li></ul>
  7. 7. What is Cardiovascular Disease? Cardiovascular disease (or CVD) includes heart and blood vessel diseases — diseases that affect the circulatory system.        
  8. 8. Examples of cardiovascular diseas e <ul><li>Coronary heart disease (heart attack) </li></ul><ul><li>Cerebrovascular disease (stroke and TIA) </li></ul><ul><li>High blood pressure </li></ul><ul><li>Congestive heart failure </li></ul><ul><li>Congenital cardiovascular defects </li></ul><ul><li>Peripheral vascular disease (aneurysms) </li></ul>
  9. 9. Coronary artery disease: The most common form of heart disease in the US
  10. 10. Coronary angiogram with atherosclerosis Severe narrowing of an artery
  11. 11. Coronary CT Angiogram <ul><li>Coronary calcium scans can show calcium deposits in the arteries of the heart </li></ul><ul><li>Calcium deposits increase your risk of heart attack </li></ul>
  12. 12. What are the symptoms of a heart attack? <ul><li>Symptoms of heart attack may be different in women then men </li></ul><ul><li>Women may have chest discomfort, but less often than men </li></ul><ul><li>Women are significantly more likely than men to have </li></ul><ul><ul><li>Fatigue </li></ul></ul><ul><ul><li>Neck pain, jaw pain, upper back pain, arm pain or stomach pain or discomfort </li></ul></ul><ul><ul><li>Shortness of breath </li></ul></ul><ul><ul><li>Dizziness or Fainting </li></ul></ul><ul><ul><li>Nausea or vomiting </li></ul></ul>
  13. 13. Risk factors for cardiovascular disease <ul><li>Modifiable </li></ul><ul><li>High blood pressure </li></ul><ul><li>High cholesterol </li></ul><ul><li>Smoking </li></ul><ul><li>Obesity </li></ul><ul><li>Most forms of diabetes </li></ul><ul><li>Physical Inactivity </li></ul><ul><li>Diet high in saturated fats </li></ul><ul><li>Not Modifiable </li></ul><ul><li>Family history of “premature” coronary artery disease or stroke </li></ul><ul><li>Age </li></ul>
  15. 15. What should my blood pressure be?
  16. 16. Why is treating high blood pressure so important?
  17. 17. How do I lower my blood pressure? <ul><li>Obtain a healthy weight </li></ul><ul><li>Consume less salt </li></ul><ul><li>Regular exercise </li></ul><ul><li>Limit alcohol </li></ul><ul><li>Avoid pain relievers like advil, naprosyn </li></ul>
  18. 18. Relative Risk of Coronary Events for Smokers Compared to Non-Smokers Quitting can be tough, but there is help!
  19. 19. Risk Reduction for CHD Associated with Exercise in Women Physical activity can reduce your risk of heart disease. Check with your doctor prior to starting an exercise program.
  20. 20. What is body mass index or BMI? An estimate of body fat based on height and weight
  21. 21. Body Weight and CHD Mortality Among Women l Normal
  22. 22. What Do I need to know about Cholesterol?
  23. 23. Where Does Cholesterol Come From? <ul><li>The liver produces 75% of the cholesterol </li></ul><ul><li>The other 25% comes from food. </li></ul><ul><li>Cholesterol in our diet comes from animal products . </li></ul>
  24. 24. Optimal Cholesterol Levels: <ul><li>Total Cholesterol </li></ul><ul><ul><li>less than 200 </li></ul></ul><ul><li>LDL or Bad Cholesterol </li></ul><ul><ul><li>less than 100 </li></ul></ul><ul><li>HDL or Good Cholesterol </li></ul><ul><ul><li>For men above 40 </li></ul></ul><ul><ul><li>For women above 50 </li></ul></ul><ul><li>Triglycerides below 150 </li></ul>
  25. 25. Cholesterol: More than Meets the EYE <ul><li>Over 50% of patients with normal cholesterol levels still have Heart Attacks . </li></ul><ul><li>Sometimes Advanced cholesterol testing should be preformed. </li></ul>
  26. 26. Cholesterol <ul><li>Traditional cholesterol testing </li></ul><ul><li>Advanced cholesterol Testing </li></ul>
  27. 27. When Should Advanced Lipid Testing Be Used? <ul><li>A family history of premature coronary heart disease </li></ul><ul><li>Diabetics </li></ul><ul><li>Intermediate Risk Patients </li></ul>
  28. 28. Nutritional Supplements Summary <ul><li>FIBER: soluble fiber to reduce bad (LDL) cholesterol. </li></ul><ul><li>Plant Sterols: to reduce (LDL) Bad Cholesterol. </li></ul><ul><li>Omega 3 Fish Oil: Reduce triglycerides and modestly increase HDL (good) cholesterol. </li></ul>
  29. 29. Overview of Nutritional Supplements Fiber Reduce LDL cholesterol by 10-18% Omega 3 Reduce Triglycerides by 50% Plant Sterols/Stanols Reduce LDL cholesterol by 10%
  30. 30. Fiber <ul><li>Fiber is found in: </li></ul><ul><ul><li>Oatmeal & Oat bran </li></ul></ul><ul><ul><li>Kidney beans </li></ul></ul><ul><ul><li>Apples & pears </li></ul></ul><ul><ul><li>Barley </li></ul></ul><ul><ul><li>Prunes </li></ul></ul><ul><ul><li>Psyllium containing products such as Metamucil . </li></ul></ul><ul><li>The recommended amount of Soluble Fiber is 10-25 grams daily </li></ul><ul><li>This can lower LDL cholesterol about 18% </li></ul>
  31. 31. Omega 3 Fish Oil <ul><li>Omega 3 Fats are found in: </li></ul><ul><ul><li>Salmon, Mackerel </li></ul></ul><ul><ul><li>Shellfish </li></ul></ul><ul><ul><li>Nut and plant oils </li></ul></ul><ul><ul><li>Prescription Medication; Lovaza </li></ul></ul><ul><ul><li>Over the counter Supplements: Carlsons </li></ul></ul><ul><ul><li>Fish Oil lowers triglycerides and will modestly increase HDL </li></ul></ul><ul><ul><li>Minimize stomach upset by refrigerating Carlsons fish oil </li></ul></ul>
  32. 32. Plant Sterols/Stanols <ul><li>Food and drinks enriched with plant sterols/stanols </li></ul><ul><ul><li>Margarines </li></ul></ul><ul><ul><li>Orange juice </li></ul></ul><ul><ul><li>Yogurt drinks </li></ul></ul><ul><li>Reduce LDL Cholesterol </li></ul><ul><li>Recommend dose 2 Grams a day, in divided doses </li></ul><ul><li>Examples Cardio Chews, Nature Made Cholestoff </li></ul>
  33. 33. Life Style Changes <ul><li>Weight Loss : </li></ul><ul><ul><li>Every 6 lbs weight loss will increase HDL. </li></ul></ul><ul><ul><li>Avoid trans fats in baked products & fried foods and eat mostly unsaturated fats. </li></ul></ul><ul><li>Exercise: </li></ul><ul><ul><li>Most days of the week by swimming, walking, or biking </li></ul></ul><ul><ul><li>Raises your HDL and helps maintain weight loss. </li></ul></ul><ul><ul><ul><li>150 min/week for weight maintenance </li></ul></ul></ul><ul><ul><ul><li>300 min/week for weight loss </li></ul></ul></ul>
  34. 34. Life Style Changes Continued: <ul><li>Quit Smoking: </li></ul><ul><ul><li>Quitting can improve your HDL. </li></ul></ul><ul><ul><li>20 minutes after quitting, your blood pressure decreases. </li></ul></ul><ul><ul><li>Within 24 hours, your risk of a heart attack decreases. </li></ul></ul><ul><ul><li>Within one year, your risk of heart disease is half that of a smoker. </li></ul></ul>
  35. 35. Customized Prevention: <ul><li>Review your history, physical examination and test results to determine the best treatment plan for your risk profile </li></ul>
  36. 36. Summit Medical Group Cardiology <ul><li>General Cardiology </li></ul><ul><li>Electrophysiology </li></ul><ul><li>Interventional Cardiology </li></ul><ul><li>Pacemaker Clinic </li></ul><ul><li>Coumadin Clinic </li></ul><ul><li>Heart Failure Clinic </li></ul><ul><li>Women’s Cardiovascular Health </li></ul><ul><li>Preventive Cardiology/Lipid Management </li></ul>
  37. 37. Meet The Cardiac Team <ul><li>Fred Aueron MD Andrew Beamer MD Robert Charney MD Kenneth Gantz MD Avinash Kothavale MD </li></ul><ul><li>Sunil Mirchandani MD </li></ul><ul><li>Kimberly Prado DNP Gregory Sachs MD </li></ul><ul><li>Beth Langlois NP </li></ul><ul><li>Andrea Sarok PA </li></ul><ul><li>Roy Sauberman MD/EP </li></ul><ul><li>Daniel Schwartz MD Marina Shaferman PA Suzanne Shugg DNP Susan Simandl MD Robert Slama MD William Tansey MD Whitney Gaydos PA </li></ul>
  38. 38. Additional Support <ul><li>Nutritionist: </li></ul><ul><li>Susan Canonico </li></ul><ul><li>908-508-8909 </li></ul><ul><li>Smoking Cessation/Behavioral Health: </li></ul><ul><li>Katherine DiDonato PhD </li></ul><ul><li>908-508-8903 </li></ul><ul><li>Preventive Health/Lipid Clinic: </li></ul><ul><li>Suzanne Shugg DNP/CLS </li></ul><ul><li>908-277-8700 then press 1 </li></ul><ul><li>Women’s Cardiovascular Health </li></ul><ul><li>Susan Simandl, MD </li></ul><ul><li>973-467-4220 </li></ul>
  39. 39. Cardiovascular Testing at the Summit Medical Group <ul><li>Calcium Scoring </li></ul><ul><li>CT Angiogram </li></ul><ul><li>Echocardiogram </li></ul><ul><li>Vascular Testing </li></ul><ul><li>Advanced Lipid Testing </li></ul><ul><li>Exercise & Nuclear Stress Testing </li></ul><ul><li>Holter Monitoring </li></ul><ul><li>Cardiac MRI </li></ul>
  40. 41. Resources <ul><li>American Heart Association </li></ul><ul><li>Go Red for Women </li></ul><ul><li>National Heart Lung and Blood Institute </li></ul><ul><li>The Heart Truth </li></ul><ul><li>Choose my plate .Gov </li></ul><ul><li>Womens Heart Foundation </li></ul><ul><li>National Women’s Health Information Center </li></ul><ul><li>National Coalition for Women </li></ul><ul><li>National Lipid Association </li></ul><ul><li>Mayo Clinic </li></ul>