Listen to your HeartListen to your Heart

Noel Peterson, MDNoel Peterson, MD

Eastern Cardiology Eastern Cardiology Greenville, NCGreenville, NC

Director of WomenDirector of Women’’s s Cardiovascular Services and Cardiovascular Services and Preventative Cardiology for Preventative Cardiology for East Carolina Heart Institute East Carolina Heart Institute

at VMCat VMC

One in ThreeCardiovascular disease is the leading

cause of death in women.

It causes more deaths than all forms of cancer combined.

One in every three women die of cardiovascular disease.. but you don’t

have to be the one.

Myth #1 Heart disease only happens to

men

Myth #1Wrong. Coronary artery disease is

leading cause of death in women. Women’s symptoms of heart attacks

can be less dramatic but not less deadly. Sneak up on us slowly

Can be subtleOften mistaken for something less serious

SymptomsFlu-like symptomsFatigue (difficult to pick up your laptop)Discomfort in upper back, shoulder, neckSweating – hot flashNausea, dizziness – feel like going to pass outBreathlessness – panting, unable to carry on

conversationSleeplessness – in month before heart attack

nearly ½ of females report trouble sleeping.Anxiety – many females experience a sense of

impending doom.

SymptomsWomen are often slower to seek

medical attentionPaying attention to early warning signs

and insisting on proper medical care can save your life.

Myth #2 Heart disease is just part of getting old

Myth #2Wrong. The plaque narrowing a 50

year old woman’s arteries probably started building up in her 20’s. Many of the conditions that escalate and compound to become heart disease can be prevented by making good lifestyle choices – eating healthy, being physically active on a regular basis, and not smoking.

Myth #3There’s nothing I can do to prevent

heart disease

Myth #3Wrong.

Many of the risk factors that lead to heart disease are lifestyle related. You can make a tremendous difference in your health by making good choices every day. Stay away from cigarettes. Don’t eat the Krispy Kremes. Choose the baked chicken instead of the fried. Take the stairs instead if the elevator.

““Another supper from a sack – Another supper from a sack – a 99 cent heart attacka 99 cent heart attack””

Tim McGraw

An Ounce of Prevention64% of women who die suddenly of

coronary heart disease have no previous symptoms. Many of those women had at least one risk factor that could have been treated.

 Making health changes in your lives

could reduce your risk for heart disease by as much as 80%.

Who’s at RiskRisk Factors for Heart Disease

-Diabetes -Vascular Disease

-Smoking-Hypertension-High Cholesterol-Low HDL-Family History (first degree male relatives <55, 1st degree female relatives <65)

Who’s at RiskRisk Factors for Heart Disease

-Obesity, esp abdominal-Poor Diet (skinny/unhealthy)-Physical Inactivity-Poor exercise capacity on treadmill (<5 mets) and/or abnormal heart rate recovery.-Collagen Vascular Disease (lupus or RA)-History of preeclampsia, pregnancy induced hypertension, gestational diabetes.

Stress and Heart Disease

Stress has a major impact on heart disease.

Lack of sleep, diet, lack of physical activity and stress are all modifiable risk factors that are key to prevention.

Are we there yet?“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause

and prevention of disease.”Thomas Edison, 1903

Knowledge is powerForm an active partnership with your

doctor. Be sure to know your numbers…

What is your blood pressure? What is a healthy blood pressure?

What is your cholesterol, blood sugar? What should they be?

What is your BMI and waist circumference?

Know Your Numbers

BLOOD PRESSURE

Awareness of High Blood Pressure

• Approximately 39 million women age 20 and older have high blood

pressure.

• 30% of people with high blood pressure don’t know they have it.

HypertensionNormal BP Normal BP <120/80 (125/85)<120/80 (125/85)

Pre-hypertension Pre-hypertension Systolic 125-139Systolic 125-139

Diastolic 85-89Diastolic 85-89

High BPHigh BP Systolic >140Systolic >140

Diastolic >90Diastolic >90

**Age >65**Age >65 Goal <140/<90Goal <140/<90

Cholesterol

Total Cholesterol Total Cholesterol LevelsLevels

•< 200 mg/dL< 200 mg/dL DesirableDesirable

•200 – 239 mg/dL 200 – 239 mg/dL Borderline Borderline high high

•> > 240 mg/dL240 mg/dL ElevatedElevated

HDL CholesterolHDL Cholesterol

““Good CholesterolGood Cholesterol””• The higher the betterThe higher the better

• >> 60 mg/dL = Low risk 60 mg/dL = Low risk

• 50-59 mg/dL 50-59 mg/dL

• < 50 = High Risk< 50 = High Risk

LDL CholesterolLDL Cholesterol

““BadBad”” Cholesterol Cholesterol

• The lower the betterThe lower the better

• <70 mg/dL = Goal for CAD, vascular <70 mg/dL = Goal for CAD, vascular disease disease and diabetics and diabetics

• <100 mg/dL = Multiple risk factors <100 mg/dL = Multiple risk factors

TriglyceridesTriglycerides< 150 mg/dL < 150 mg/dL = Normal= Normal

150-199 mg/dL 150-199 mg/dL = Borderline= Borderline

200-499 mg/dL200-499 mg/dL = High= High

>> 500 mg/dL 500 mg/dL = Extremely Elevated= Extremely Elevated

BLOOD SUGAR

DiabetesPre-diabetes FSBS 100-125

HgBA1c 6-6.5

Diabetes FSBS >125HgBA1C >6.5

BODY COMPOSITIO

N

Body Mass IndexNormal Normal <25<25

OverweightOverweight 25-29.925-29.9

ObeseObese 30-34.930-34.9

Morbidly ObeseMorbidly Obese >35>35

55’’44”” 145 lbs BMI is ? 145 lbs BMI is ?

Abdominal Circumference

Measured at level of belly button

Women <35 inches

Men <40 inches

Group of risk factors that occur together and increase your risk for CAD, stroke, and type II diabetes.

Metabolic Syndrome

Metabolic Syndrome3 or more of the following 3 or more of the following characteristics:characteristics:

• Abdominal Obesity

• Impaired fasting blood sugar

• Increased blood pressure

• Increased fasting triglycerides

• Decreased fasting hdl

What can I do to prevent heart disease

Know Your NumbersModify Your Risk FactorsLifestyle Changes

““The only way to keep your health The only way to keep your health is to eat what you donis to eat what you don’’t want, drink t want, drink what you donwhat you don’’t like, and do what t like, and do what youyou’’d rather not.d rather not.””

Mark Twain

Physical ActivityOnly 16% of women meet physical activity goal

Goal: 10,000 steps/dayCardiovascular exercise goal

150 min/week Resistance training

Twice per week

Physical ActivityExercise Capacity

<5 METS (5 times increased risk of death)5-8 METS>8 METS (decreased risk of death)

For each increase of 1 MET there was a 17% decreased risk of death from all causes

Walking briskly 3 mph – 3.3 Mets, Stairs 4.0 Mets, Mowing yard with push mower 6-6.5 Mets.

Lifestyle Golden Rules Adequate sleep 7-8 hours/nightExercise 30 minutes/5 days per week.Drink adequate water 60-80oz/day.Never, ever skip breakfastAvoid processed foods

If it doesn’t have a mama or come from the ground don’t eat it! Shop the perimeter of grocery store.

Nothing artificial is good for you

Golden RulesKnow Your Numbers!

Blood PressureCholesterolBlood Sugar

BMIAbdominal Circuference