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Women of Summa:  It’s Time for a Heart to Heart Vivian von Gruenigen, BSN, MD Chair Obstetrics and Gynecology Women’s Serv...
5 Leading Cause of Death in All Females, All ages <ul><li>Heart Disease 27% </li></ul><ul><li>Cancer 22% </li></ul><ul><li...
Differences in gender <ul><li>Women get heart disease later in life </li></ul><ul><li>Symptoms more subtle </li></ul><ul><...
Differences in Gender <ul><li>The signs and symptoms are more subtle than the obvious crushing chest pain often associated...
What Is Heart Disease? <ul><li>Coronary Heart Disease </li></ul><ul><li>High Blood Pressure </li></ul><ul><li>Heart Failur...
What Have We Learned? <ul><li>Risk Factors </li></ul><ul><ul><li>Factors leading to heart disease can start in young women...
Why Is It Important? <ul><li>Cardiovascular disease kills 1 in 3 women </li></ul><ul><ul><li>Tens of millions </li></ul></...
What is a heart attack? <ul><li>A heart attack occurs when the blood flow to a  part  of the heart muscle is  blocked </li...
What Is A Heart Attack? <ul><li>Warning Signs </li></ul><ul><li>Chest discomfort </li></ul><ul><li>Discomfort in upper bod...
Signs <ul><li>Women may experience fewer typical symptoms than men, most commonly  shortness of breath, weakness, a feelin...
Stroke Warning Signs <ul><li>Sudden  numbness or weakness  of the face, arm or leg, especially on  one side  of the body  ...
Am I at risk? <ul><li>Vascular injury accumulates  from adolescence , making primary prevention efforts necessary from chi...
Am I At Risk? If you have any of these risk factors,  you are at risk for heart disease.
Your Risk:  High Blood Cholesterol <ul><li>Cholesterol is a soft,  fat-like substance  found in the bloodstream and in all...
Your Risk:  High Cholesterol- Lipid Profile <ul><li>Includes: </li></ul><ul><li>Total Cholesterol </li></ul><ul><li>LDL [l...
Your Risk:  High Blood Cholesterol <ul><li>Total Cholesterol Level  </li></ul><ul><li>Desirable = Less than 200 </li></ul>...
Your Risk:  High Blood Cholesterol <ul><li>HDL  – the higher your HDL, the better </li></ul><ul><li>HDL Cholesterol Risk L...
Your Risk: High Blood Pressure <ul><li>High blood pressure = hypertension (HTN) </li></ul><ul><li>Blood pressure, is simpl...
Your Risk: High Blood Pressure <ul><li>Risk Factors </li></ul><ul><li>Genetics </li></ul><ul><ul><li>African Americans </l...
Your Risk: High Blood Pressure <ul><li>Normal Blood Pressure   </li></ul><ul><li>Around  120/80 </li></ul><ul><li>Hyperten...
Classification of Blood Pressure in Adults <ul><li>OPTIMAL: <120 systolic and <80 diastolic </li></ul><ul><li>PREHYPERTENS...
Your Risk: Diabetes <ul><li>Incidence is increasing </li></ul><ul><li>Type I Diabetes – also called juvenile </li></ul><ul...
Your Risk: Diabetes <ul><li>Complications of Diabetes </li></ul><ul><li>Stroke, TIA </li></ul><ul><li>Blindness </li></ul>...
Your Risk: Diabetes <ul><li>Prevention and Control </li></ul><ul><li>Control your weight and cholesterol (low-saturated fa...
Your Risk: Obesity & Overweight <ul><li>The majority of Americans are overweight </li></ul><ul><li>Excess Weight : </li></...
 
Your Risk: Obesity & Overweight <ul><li>Set goals, potential roadblocks </li></ul><ul><li>Lifestyle change, not a diet </l...
Your risk: Physical inactivity <ul><li>Regular, moderate-intensity physical activity can lower your risk of  </li></ul><ul...
Your risk: Physical inactivity <ul><li>Inactive women: </li></ul><ul><li>White females – 38% </li></ul><ul><li>Black femal...
Your risk: physical inactivity <ul><li>Most Americans favor walking as their favorite physical activity </li></ul><ul><li>...
 
Your Risk: Smoking <ul><li>Benefits of Quitting </li></ul><ul><li>Within 1 to 2 years of quitting, the risk of coronary he...
Your risk: Nutrition Quality <ul><li>Be aware of calories </li></ul><ul><li>Low fat </li></ul><ul><li>Lean meats </li></ul...
Decreasing your sodium intake: where is salt found in our diets?
Your risk:  Depression <ul><li>Depression is twice as common in women as in men, and it  increases the risk of heart  dise...
Your risk:  HRT <ul><li>Can estrogen replacement therapy reduce my risk for heart disease? </li></ul><ul><li>No. Estrogen ...
First aid <ul><li>Call for help </li></ul><ul><li>Aspirin  </li></ul><ul><li>Oxygen </li></ul><ul><li>Nitroglycerin </li><...
Women in Recovery and Rehabilitation after a Heart Attack <ul><li>The first year following a heart attack, women tend to <...
What Can I Do To Prevent Heart Disease? <ul><li>Eat a  healthy diet  low in saturated fat, trans fat, cholesterol and sodi...
What Can I Do To Prevent Heart Disease? <ul><li>You are here </li></ul><ul><li>You are an advocate </li></ul><ul><li>You a...
“ Women, whether subtly or vociferously, have always been a tremendous  power  in the destiny of the world.” Eleanor Roose...
Be the kind of woman that when your feet hit the floor each morning the devil says~~ &quot;Oh crap , She's up!“ Email from...
<ul><li>Questions? </li></ul>YOU are beautiful, smart and have the power to make a difference
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It's Time for a Heart to Heart

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It's Time for a Heart to Heart

  1. 1. Women of Summa: It’s Time for a Heart to Heart Vivian von Gruenigen, BSN, MD Chair Obstetrics and Gynecology Women’s Service Line Director Summa Akron City Hospital
  2. 2. 5 Leading Cause of Death in All Females, All ages <ul><li>Heart Disease 27% </li></ul><ul><li>Cancer 22% </li></ul><ul><li>Stroke 8% </li></ul><ul><li>Respiratory Disease 5% </li></ul><ul><li>Alzheimers 4% </li></ul>
  3. 3. Differences in gender <ul><li>Women get heart disease later in life </li></ul><ul><li>Symptoms more subtle </li></ul><ul><li>Women are much more likely to die from their first heart attack than men </li></ul><ul><li>Women hesitate to call 911, and get to the hospital ~60 minutes later than men </li></ul><ul><li>In the past, CV research was done in men </li></ul><ul><li>Women experience a unique increase in lipids after menopause </li></ul>Matthews KA et al. J Am Col Cardio 2009
  4. 4. Differences in Gender <ul><li>The signs and symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks </li></ul><ul><li>This may be because women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease. </li></ul>
  5. 5. What Is Heart Disease? <ul><li>Coronary Heart Disease </li></ul><ul><li>High Blood Pressure </li></ul><ul><li>Heart Failure </li></ul><ul><li>Valve Disease </li></ul><ul><li>Diseases of Pulmonary Circulation </li></ul>
  6. 6. What Have We Learned? <ul><li>Risk Factors </li></ul><ul><ul><li>Factors leading to heart disease can start in young women and develop over time </li></ul></ul><ul><li>The Disease </li></ul><ul><ul><li>Heart disease can strike women at any age </li></ul></ul><ul><li>Prevention and Treatment </li></ul><ul><ul><li>Healthy lifestyle changes can prevent or postpone heart disease </li></ul></ul>
  7. 7. Why Is It Important? <ul><li>Cardiovascular disease kills 1 in 3 women </li></ul><ul><ul><li>Tens of millions </li></ul></ul><ul><li>64% of women who die suddenly from coronary heart disease have no previous symptoms </li></ul><ul><li>80% of cardiovascular disease is preventable </li></ul>
  8. 8. What is a heart attack? <ul><li>A heart attack occurs when the blood flow to a part of the heart muscle is blocked </li></ul><ul><li>Most heart attacks start slowly , with mild pain or discomfort </li></ul><ul><li>Interrupted blood flow to your heart can damage or destroy a part of the heart muscle . </li></ul>
  9. 9. What Is A Heart Attack? <ul><li>Warning Signs </li></ul><ul><li>Chest discomfort </li></ul><ul><li>Discomfort in upper body </li></ul><ul><li>Shortness of breath </li></ul><ul><li>Cold sweat </li></ul><ul><li>Nausea </li></ul><ul><li>Lightheadedness </li></ul>
  10. 10. Signs <ul><li>Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue </li></ul><ul><li>Women also have more symptoms compared to men (2.6 on average vs 1.8 symptoms in men) </li></ul><ul><li>Approximately one quarter of all myocardial infarctions are silent , without chest pain or other symptoms. </li></ul><ul><li>The onset of symptoms in myocardial infarction (MI) is usually gradual , over several minutes, and rarely instantaneous. </li></ul><ul><li>Emergency </li></ul>
  11. 11. Stroke Warning Signs <ul><li>Sudden numbness or weakness of the face, arm or leg, especially on one side of the body    </li></ul><ul><li>Sudden confusion , trouble speaking or understanding    </li></ul><ul><li>Sudden trouble seeing in one or both eyes    </li></ul><ul><li>Sudden trouble walking , dizziness, loss of balance or coordination    </li></ul><ul><li>Sudden, severe headach e with no known cause </li></ul>
  12. 12. Am I at risk? <ul><li>Vascular injury accumulates from adolescence , making primary prevention efforts necessary from childhood. </li></ul><ul><li>Risk factors can be modified, treated or controlled and some can’t </li></ul><ul><li>The more risk factors you have, the greater your chance of developing coronary heart disease </li></ul><ul><li>“ Deadly quartet” of chronic conditions that includes </li></ul><ul><ul><li>Diabetes, </li></ul></ul><ul><ul><li>Obesity, </li></ul></ul><ul><ul><li>Blood pressure </li></ul></ul><ul><ul><li>Cholesterol </li></ul></ul>
  13. 13. Am I At Risk? If you have any of these risk factors, you are at risk for heart disease.
  14. 14. Your Risk: High Blood Cholesterol <ul><li>Cholesterol is a soft, fat-like substance found in the bloodstream and in all your body’s cells </li></ul><ul><li>The saturated fats, trans fats and cholesterol you eat may raise your blood cholesterol </li></ul><ul><li>Cholesterol can build up in the walls of arteries, narrowing the flow </li></ul><ul><li>If a narrowed artery gets blocked by a clot or other particle , the heart or brain loses its blood supply, resulting in a heart attack or stroke </li></ul>www.3dchem.com
  15. 15. Your Risk: High Cholesterol- Lipid Profile <ul><li>Includes: </li></ul><ul><li>Total Cholesterol </li></ul><ul><li>LDL [low-density lipoprotein] (bad) </li></ul><ul><li>HDL Cholesterol (good) </li></ul><ul><li>Triglycerides </li></ul>
  16. 16. Your Risk: High Blood Cholesterol <ul><li>Total Cholesterol Level </li></ul><ul><li>Desirable = Less than 200 </li></ul><ul><li>Borderline high = 200 to 239 </li></ul><ul><li>High = 240 and above </li></ul><ul><li>~ 50% of women have a total cholesterol of 200 mg/dL </li></ul><ul><li>and above, which puts them at risk for heart disease. </li></ul>www.nhlbi.nih.gov
  17. 17. Your Risk: High Blood Cholesterol <ul><li>HDL – the higher your HDL, the better </li></ul><ul><li>HDL Cholesterol Risk Levels </li></ul><ul><li>Less than 50 mg/dL for women </li></ul><ul><li>Therefore, want > 50 </li></ul><ul><li>LDL – is the main carrier of harmful cholesterol </li></ul><ul><li>LDL Cholesterol Risk Levels </li></ul><ul><li>> 130 mg/dL Borderline, >160 high, > 190 very high </li></ul><ul><li>Therefore, want between 100-130 </li></ul>
  18. 18. Your Risk: High Blood Pressure <ul><li>High blood pressure = hypertension (HTN) </li></ul><ul><li>Blood pressure, is simply the pressure of the blood as it circulates </li></ul><ul><li>No one knows exactly what causes most cases of HTN </li></ul><ul><li>HTN is called the “silent killer,” because it increases the risk for </li></ul><ul><ul><li>heart attack, angina, stroke, kidney failure , heart failure and peripheral artery disease (PAD) </li></ul></ul><ul><li>1 in 3 adults has HTN, tens of millions </li></ul>
  19. 19. Your Risk: High Blood Pressure <ul><li>Risk Factors </li></ul><ul><li>Genetics </li></ul><ul><ul><li>African Americans </li></ul></ul><ul><li>Over age 35 </li></ul><ul><li>Overweight </li></ul><ul><li>Physical inactivity </li></ul><ul><li>Nutrition </li></ul><ul><ul><li>Salt, alcohol </li></ul></ul><ul><li>Diabetes, kidney disease </li></ul><ul><li>Pregancy </li></ul>
  20. 20. Your Risk: High Blood Pressure <ul><li>Normal Blood Pressure </li></ul><ul><li>Around 120/80 </li></ul><ul><li>Hypertension </li></ul><ul><li>Above 140/90 </li></ul>
  21. 21. Classification of Blood Pressure in Adults <ul><li>OPTIMAL: <120 systolic and <80 diastolic </li></ul><ul><li>PREHYPERTENSION </li></ul><ul><ul><li>120-139 systolic or 80-89 diastolic </li></ul></ul><ul><li>STAGE 1 HYPERTENSION </li></ul><ul><ul><li>140-159 systolic or 90-99 diastolic </li></ul></ul><ul><li>STAGE 2 HYPERTENSION </li></ul><ul><ul><li>>160 systolic or >100 diastolic </li></ul></ul>
  22. 22. Your Risk: Diabetes <ul><li>Incidence is increasing </li></ul><ul><li>Type I Diabetes – also called juvenile </li></ul><ul><ul><li>The body fails to make insulin </li></ul></ul><ul><li>Type II </li></ul><ul><ul><li>The most common </li></ul></ul><ul><ul><li>95% of Americans Middle-aged. </li></ul></ul><ul><ul><li>Linked with obesity and physical inactivity. </li></ul></ul><ul><ul><li>The body doesn’t make enough. </li></ul></ul>
  23. 23. Your Risk: Diabetes <ul><li>Complications of Diabetes </li></ul><ul><li>Stroke, TIA </li></ul><ul><li>Blindness </li></ul><ul><li>Heart attack, angina </li></ul><ul><li>Kidney disease </li></ul><ul><li>High blood pressure </li></ul><ul><li>Erectile dysfunction </li></ul><ul><li>Loss of legs or feet </li></ul><ul><li>Nerve disease </li></ul>People with diabetes are two to four times more likely to develop cardiovascular disease.
  24. 24. Your Risk: Diabetes <ul><li>Prevention and Control </li></ul><ul><li>Control your weight and cholesterol (low-saturated fat and low-cholesterol diet) </li></ul><ul><li>If you take medicine, take it exactly as directed </li></ul><ul><li>Discuss exercise with your physician </li></ul><ul><li>Nutritionist consult/team </li></ul>
  25. 25. Your Risk: Obesity & Overweight <ul><li>The majority of Americans are overweight </li></ul><ul><li>Excess Weight : </li></ul><ul><li>Strains your heart </li></ul><ul><li>Raises blood pressure and cholesterol </li></ul><ul><li>Can lead to diabetes </li></ul>
  26. 27. Your Risk: Obesity & Overweight <ul><li>Set goals, potential roadblocks </li></ul><ul><li>Lifestyle change, not a diet </li></ul><ul><li>You may need help or support </li></ul><ul><ul><li>Team approach </li></ul></ul><ul><li>Keeping weight off can be as challenging as losing it </li></ul>
  27. 28. Your risk: Physical inactivity <ul><li>Regular, moderate-intensity physical activity can lower your risk of </li></ul><ul><li>Heart disease and heart attack </li></ul><ul><li>HTN </li></ul><ul><li>High cholesterol </li></ul><ul><li>Overweight or obesity </li></ul><ul><li>Diabetes </li></ul><ul><li>Stoke </li></ul><ul><li>Cancer </li></ul>
  28. 29. Your risk: Physical inactivity <ul><li>Inactive women: </li></ul><ul><li>White females – 38% </li></ul><ul><li>Black females – 52% </li></ul><ul><li>Hispanic females – 54% </li></ul><ul><li>All healthy adults ages should be getting at least 30 minutes of moderate intensity activity 5 days a week </li></ul>
  29. 30. Your risk: physical inactivity <ul><li>Most Americans favor walking as their favorite physical activity </li></ul><ul><li>Many places - at home, local parks, YMCAs, travel… </li></ul><ul><li>Many types – swim, resistance, ski, golf… </li></ul><ul><li>Find your sole-mate or mates </li></ul><ul><ul><li>Family, friends, colleagues </li></ul></ul><ul><li>Stay motivated </li></ul>
  30. 32. Your Risk: Smoking <ul><li>Benefits of Quitting </li></ul><ul><li>Within 1 to 2 years of quitting, the risk of coronary heart disease is substantially reduced </li></ul><ul><li>A smoker’s cough will go away </li></ul><ul><li>It is easier to be physically active </li></ul><ul><li>Second hand smoke is real </li></ul>
  31. 33. Your risk: Nutrition Quality <ul><li>Be aware of calories </li></ul><ul><li>Low fat </li></ul><ul><li>Lean meats </li></ul><ul><li>Fiber, whole grains </li></ul><ul><li>Low fat dairy </li></ul><ul><li>Fruits and veggies </li></ul><ul><ul><li>Diversify your colors </li></ul></ul><ul><li>Whole foods versus processed </li></ul><ul><li>White food…sugar </li></ul><ul><li>Limit fast foods </li></ul><ul><ul><li>Super size me </li></ul></ul>
  32. 34. Decreasing your sodium intake: where is salt found in our diets?
  33. 35. Your risk: Depression <ul><li>Depression is twice as common in women as in men, and it increases the risk of heart disease by 2-3 times </li></ul><ul><li>Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment </li></ul><ul><li>Talk to your doctor if you're having symptoms of depression </li></ul>
  34. 36. Your risk: HRT <ul><li>Can estrogen replacement therapy reduce my risk for heart disease? </li></ul><ul><li>No. Estrogen replacement therapy, also called hormone replacement therapy (HRT </li></ul><ul><li>New studies have shown that when it comes to heart health, HRT may do more harm than good. </li></ul><ul><li>If you’re taking HRT to help prevent heart disease, talk to your doctor about whether you should stop. </li></ul>
  35. 37. First aid <ul><li>Call for help </li></ul><ul><li>Aspirin </li></ul><ul><li>Oxygen </li></ul><ul><li>Nitroglycerin </li></ul><ul><li>Automated external defibrillator (AED) </li></ul><ul><li>Opiod painkillers </li></ul><ul><li>Air travel kits </li></ul>
  36. 38. Women in Recovery and Rehabilitation after a Heart Attack <ul><li>The first year following a heart attack, women tend to </li></ul><ul><li>have a higher rate of disability and death , and show </li></ul><ul><li>poorer psychological adaptation than men. </li></ul><ul><li>Social support and mood were the best predictors </li></ul><ul><li>of overall quality of life at one year for women </li></ul><ul><li>Those with more social support tended to have a higher rate of persistency, while a belief in the positive health benefits of exercise increased the amount of exercise undertaken by the participant. </li></ul><ul><ul><ul><ul><ul><li>Moore SM et al J Cardio Rehab 2003 </li></ul></ul></ul></ul></ul>
  37. 39. What Can I Do To Prevent Heart Disease? <ul><li>Eat a healthy diet low in saturated fat, trans fat, cholesterol and sodium. </li></ul><ul><li>Keep your weight under control. </li></ul><ul><li>Be physically active at least 30 minutes on most or all days of the week. </li></ul><ul><li>Control your blood pressure and cholesterol levels. </li></ul><ul><li>Manage your blood sugar if you have diabetes . </li></ul><ul><li>Don’t smoke , and avoid tobacco smoke. </li></ul><ul><li>Taking your medicines as directed by your physician </li></ul>
  38. 40. What Can I Do To Prevent Heart Disease? <ul><li>You are here </li></ul><ul><li>You are an advocate </li></ul><ul><li>You are educated </li></ul><ul><li>Teach those who are not as fortunate </li></ul><ul><li>Lead by example </li></ul><ul><li>Grass roots </li></ul>
  39. 41. “ Women, whether subtly or vociferously, have always been a tremendous power in the destiny of the world.” Eleanor Roosevelt
  40. 42. Be the kind of woman that when your feet hit the floor each morning the devil says~~ &quot;Oh crap , She's up!“ Email from Aunt Jeanette 
  41. 43. <ul><li>Questions? </li></ul>YOU are beautiful, smart and have the power to make a difference

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