CORP-98001-AA JUL2012 HEART DISEASE AND YOU Black Americans

CORP-98001-AA JUL2012

HEART DISEASE AND YOUBlack Americans


2

WHAT IS HEART DISEASE?

2


What is Heart Disease?Heart disease is a broad term used to describe a range of diseases that affect your heart

Coronary Artery Disease(heart attack & stroke)

Arrhythmias

Conditions & Infections


Coronary Artery Disease(heart attack & stroke)

Coronary Artery Disease• Your heart is a pump that

circulates blood, oxygen and nutrients throughout your body

• Coronary artery disease isa disease of the heart, andcan lead to:– Chest pain– Shortness of breath– Heart failure– Heart attack– Stroke


Heart Arrhythmias

• Electrical impulses cause your heart to beat

• When your heart beats too fast, too slow or irregularly, you have an arrhythmia

• Most are harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms

Arrhythmias


The Heart of the MatterHeart disease is the leading cause of death for women and men, regardless of race and ethnicity

African American Males 44.8%

African American Females2 47.3%

White Males 37.4%

White Females3 33.8%

Hispanic/Latino Males 30.7%

30.9%Hispanic/Latino Females4

82.6 Million American Adults Have Heart Disease1

1. American Heart Association. Heart Disease and Stroke Statistics-2012 Update2. American Heart Association. African Americans and CVD – 2012 Statistical Fact Sheet3. American Heart Association. Whites and CVD – 2012 Statistical Fact Sheet4. American Heart Association. Hispanics/Latinos and CVD – 2012 Statistical Fact Sheet

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%


The Heart of the Matter: Major Causes of Death

African American men and women are 30% more likely to die from heart disease

than non-Hispanic white males2

1. American Heart Association. African Americans and CVD – 2012 Statistical Fact Sheet2. The Office of Minority Health. Heart Disease and African Americans. Accessed http://minorityhealth.hhs.gov/templates/content.aspx?

lvl=3&lvlID=6&ID=3018

Heart Disease (31.8)

Cancer (22.4)

Accidents (5.7)

Homocide (4.9)

Diabetes (3.7)

Kidney Disease (2.7)

Heart Disease (35.1)

Cancer (21.8)

Accidents (2.8)

Homocide (.8)

Diabetes (4.7)

Kidney Disease (3.3)

Black Men Black Women


The Heart of the Matter • Heart disease, high blood

pressure and diabetes are prevalent among Black Americans

• Some people have simply accepted this is a way of life

• This doesn’t have to be true for you

• Heart disease and most risk factors can be prevented or treated

Take responsibility for your heart’s health


9

WHAT YOU NEED TO KNOW ABOUT HEALTH CARE DISPARITIES


Disparities in Health Care

Women

Ethnic Groups

RacialGroups

Over 65

Non-English

Smedley BD, Stith AY, Nelson AR. Institute of Medicine. Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Policy, Institute of Medicine. Washington, DC: National Academy Press; 2002. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Accessed: http://www.nap.edu/openbook.php?record_id=12875&page=R1

Racial or ethnic differences in the quality of health care that are not due to access-related factors, clinical needs, preferences,

or appropriateness of intervention


11

Reasons Are Complex

Henry J. Kaiser Family Foundation. Why the Difference Power Point Presentation, slide # 26. Unequal Treatment Confronting Racial and Ethnic Disparities in Healthcare: March 2000.

Health System

Geography

Language

Time

Insurance

Provider

Culture

Bias

Uncertainty

Stereotypes

Patient

Refusal

Preference

Behavior

Language


12

WHAT CAN I DO?


Know Your Risk Factors

Take Charge of Your Heart

Health

Talk to Your Doctor


Know Your Risk Factors


Risk Factors Lead to Heart DiseaseRisk Factors You Can NOT Control• Increasing Age• Family History

Risk Factors You CAN Control• Diabetes• High Blood Pressure• High Cholesterol• Physical Inactivity• Overweight/Obesity• Smoking• Stress• Alcohol

National Heart Lung and Blood Institute. “Your Guide to a Healthy Heart.” 2005. NIH Publication No. 06-5269


Age and Family History

Increasing Age• For men, are you over 45?• For women, are you over

55?

Family History• Does anyone in your

immediate family have a history of heart diseaseor diabetes?

National Heart Lung and Blood Institute. “Your Guide to a Healthy Heart.” 2005. NIH Publication No. 06-5269


Diabetes What is it?• A lifelong disease in which there are high

levels of sugar (glucose) in the blood

Why a major risk factor?• Heart disease and stroke account for about

65% of deaths in people with diabetes1

How many Black Americans affected2?• Nearly 15% of men and women have

diagnosed diabetes• Almost 5% of men and women have

undiagnosed diabetes• Nearly 32% of men and 27% of women

have pre-diabetes

Good diabetes management can help

reduce your risk

Many people are not even aware that they

have diabetes

1. American Heart Association. Cardiovascular Disease and Diabetes. Accessed: http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/Cardiovascular-Disease-Diabetes_UCM_313865_Article.jsp

2. American Heart Association. African Americans and CVD – 2012 Statistical Fact Sheet


High Blood Pressure (Hypertension)What is it?• Blood pressure (the force of blood against the

walls of arteries) that stays high and damages the heart over time

Why a major risk factor?• About 69% of people who have a first heart

attack, 77% who have a first stroke, and 74%who have congestive heart failure have highblood pressure, i.e. higher than 140/90 mm Hg.1

How many Black Americans affected?• More women (45.7%) than men (43%) have

the condition1

1. American Heart Association. High Blood Pressure– 2012 Statistical Fact Sheet


High Blood CholesterolWhat is it?• The body needs cholesterol — a waxy, fat-like

substance in your blood — but too much bad (LDL) cholesterol can lead to plaque build up in arteries and veins

• Your LDL cholesterol level is a better gauge of risk than total blood cholesterol 1

Why a major risk factor?• When levels of bad (LDL) cholesterol are 130 mg/dl

or higher there is a higher risk of developing coronary heart disease 1

How many Black Americans affected? 2

• 28% of women have high bad cholesterol • 34% of men have high bad cholesterol

1. American Heart Association. What Your Cholesterol Levels Mean. Accessed: http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean_UCM_305562_Article.jsp

2. American Heart Association. High Blood Cholesterol– 2012 Statistical Fact Sheet


Physical InactivityWhat is it?• Lack of regular moderate physical activity

Why a major risk factor?• Exercise helps to prevent or reduce high

blood pressure, diabetes and being overweight or obese

How many Black Americans affected?• Over 40% of men and women are inactive1

Moderate exercise for 30 minutes/day• Improves physical wellness• Decreases risk of developing heart disease• Boosts mental wellness• Relieves tension, anxiety, depression• Improves mental alertness

Key Guidelines Snapshot3

Adults (aged 18–64)Moderate-intensity aerobic exercise; 2 hours and30 minutes /week; Muscle-strengthening; 2+days per week

Older Adults (aged 65+)Follow adult guidelines(as abilities allow)Inactivity should be avoided

1. American Heart Association. Physical Inactivity– 2012 Statistical Fact Sheet2. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans.

http://www.health.gov/paguidelines/factsheetprof.aspx


Overweight & ObesityWhat is it?• When your weight exceeds what is

generally considered healthy for your height

• A waist measurement greater than 40 inches for men and 35 inches for women

Why a major risk factor?• Leads to many diseases and conditions,

including high blood pressure and Type 2 diabetes which can cause heart disease

How many Black Americans affected 1

• 71% of men are overweight or obese• 78% of women are overweight or obese

1. American Heart Association. Overweight & Obesity– 2012 Statistical Fact Sheet


Cigarette and Tobacco Smoke

What is it?• Inhalation of the smoke of burning tobacco

encased in cigarettes, pipes, and cigars

Why a major risk factor?• Cigarette smoking and secondhand smoke

further raises risk of heart disease when combined with high cholesterol, high blood pressure, and being overweight or obese


• 24% of men smoke• 17% of women smoke

1. American Heart Association. African Americans & CVD– 2012 Statistical Fact Sheet


Stress and Heart DiseaseWhat is it?• Stress affects each of us in different ways — you

may have physical signs, emotional signs or both

Why a major risk factor?• Stress sets off a chain of events

– Stressful situation – Breathing and heart rate speed up; blood pressure rises– Body experiences “fight or flight” response– When it lasts days/weeks = chronic stress– Chronic stress increases heart rate and blood pressure

How many Americans affected?• 22% of Americans reported extreme stress in 2011• Top reasons: money, work, economy, relationships,

family responsibilities

American Psychological Association. Stress in America report. http://www.apa.org/news/press/releases/2012/01/chronic-disease.aspx


Alcohol Beverages and Heart DiseaseWhat is it?1

• The relation between alcohol and heart disease is complex

• Some say no alcohol at all, but

• Moderate-alcohol use has been shown to reduce coronary heart disease

• Excessive or binge drinking can lead to high blood pressure, heart failure and a higher calorie intake


• In 2010, rates of alcohol use among Black persons 12 and older was 43%

• Rates of excessive/binge alcohol use among Black persons was 20%

4 oz.

1. American Heart Association. Alcoholic Beverages and Heart Disease. Accessed http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Alcoholic-Beverages-and-Cardiovascular-Disease_UCM_305864_Article.jsp

2. Substance Abuse and Mental Health Services Administration, Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2011.


The Multiplier EffectRisk Factors Don’t Add Their Potential Danger

Like 1 + 1 = 2 They Multiply It1

= 10 more likely to

develop heart disease

Woman over 55Overweight

+ High Blood Cholesterol

3

1. National Heart Lung and Blood Institute “The Heart Truth” speaker’s guide. 2010. Publication No. 10-520B, p. 172. National Heart, Lung, and Blood Institute (2006), HEART DISEASE RISK FACTOR "MULTIPLIER EFFECT“ IN MIDLIFE

WOMEN infographic


Talk to Your Doctor


Talk to Your Doctor

• Being honest will get you the most realistic assessment– Help your doctor develop a

plan to lower your overall risk

• Visit your doctor regularly and bring 2–3 questions


Talk to Your Doctor• Do I have heart disease? What tests

should I have?

• What do my test results mean?

• Are my blood pressure numbers within a normal range? Cholesterol numbers?

• Can you help me plan a safe weight loss and exercise program?

• What are the possible side effects of the medications I’ve been prescribed?

Your doctor is your partner — working

together you can live a longer, healthier and

happier life


Take Charge of Your Heart

Health


Enjoy Regular Physical ActivityRecommendation• Pick a physical activity that you like

(brisk walking, dancing, swimming)• Make the time!• Do it for 30+ minutes 5X per week

Why?– 70% of Americans do not get the

physical activity they need1

– Daily physical activity will guarantee you a healthier and more satisfying life while lowering your risks for heart disease, stroke and diabetes1

– Studies show that for every hour of walking, life expectancy may increase by 2 hours2

1. American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=8&CultureCode=en-US2. American Heart Association: Get Moving. Where Do I Start

http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/StartWalking/Get-moving-Where-do-I-start_UCM_307978_Article.jsp

http://mylifecheck.heart.org/Multitab.aspx?NavID=8&CultureCode=en-US


Eat a Heart-Healthy DietRecommendation:• Stock up on healthy foods• Eat a lot of vegetables and fruits• Eat unrefined fiber-rich whole-grain foods• Eat fish at least twice a week• Choose skinless lean meats and poultry• Select fat-free, 1% fat, and low-fat

dairy products• Cut back on saturated/trans fats,

cholesterol, salt and added sugars• Remember candy, cakes, cookies, ice

cream, etc. are occasional special treats!

Why? One of your best weapons for fighting heart diseaseOver 90% of us fail to eat a heart-healthy dietPoor eating can lead to heart disease, stroke, diabetes and obesity

American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=10&CultureCode=en-US


Maintain a Healthy Weight

Recommendation• Know your Body Mass Index or

BMI• Understand your caloric needs• Track your calories• Only eat at restaurants/fast food

1-2 times per week

Why?• When you shed extra fat and

unnecessary pounds, you reduce the burden on your heart, lungs, blood vessels and skeleton



Body Mass Index (BMI) Chart

Weight-control Information Network: an information service of the National Institute of Diabetes and Digestive and Kidney Diseases: Web page, “Understanding Adult Obesity.” Accessed http://win.niddk.nih.gov/publications/understanding.htm#bodymass


Stop Smoking (please!)Recommendation• Do whatever it takes to quit! • Talk with your health-care provider

or look for a quit-smoking program

Why?• Cigarette smokers have a higher risk of

developing cardiovascular disease 1

• Smoking is one of our nation’s top causes of early death1

• Smoking will only add to your stress by taking away your good health and shortening your life1

• On average, smokers die 13–14 years earlier than nonsmokers 2

1. American Heart Association. My Life Check. http://mylifecheck.heart.org/Multitab.aspx?NavID=14&CultureCode=en-US 2. Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/.


Reduce Your Blood SugarRecommendation• Reduce consumption of simple

sugars that are found in soda, candy and sugary desserts

• Get regular physical activity! • Take medications or insulin, if

prescribed for you

Why?• High levels of blood sugar can

damage your heart, kidneys, eyes and nerves

• When you reduce excessive sugars you help protect your vital organs



Control Your Cholesterol

Recommendation• Eat healthy foods low in cholesterol,

trans fats and saturated fats and lots of fiber

• Schedule a cholesterol screening• Get active • Maintain a healthy weight• Take your prescribed medication

Why?• When you control your cholesterol, you

are giving your arteries their best chance to remain clear of blockages that can lead to heart disease and stroke



Manage Your Blood PressureRecommendation:• Eat a heart-healthy diet with less sodium• Enjoy regular physical activity• Maintain a healthy weight• Take your prescribed medication• Managing stress• Limit alcohol• Avoid tobacco smoke

Why?• High blood pressure is the single most

significant risk factor for heart disease• Managing it is common sense for

good health



Stress and Heart DiseaseRecommendation for Stress• Exercise• Maintain a positive attitude• Do not smoke or drink too

much coffee• Enjoy a healthy diet • Maintain a healthy weight• Talk to your doctor or other

healthcare professionals

Why?• Managing stress is good for your

overall health• After a heart attack or stroke,

people can feel depressed, anxious or overwhelmed by stress

American Heart Association/American Stroke Association: webpage, “Stress and Heart Health” Accessed http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Stress-and-Heart-Health_UCM_437370_Article.jsp


Alcohol Beverages and Heart DiseaseRecommendation• Talk to your doctor about benefits and

risks based on your own family history and health

• If you drink alcohol, do so in moderation – 1 to 2 drinks per day for men– 1 drink per day for women

Why?• Alcohol use may be harmful for anyone

with:– Personal/family history of alcoholism– Hypertriglyceridemia– Certain blood disorders– Heart failure– Uncontrolled hypertension – Taking certain medications

4% 804 oz.

Standard Drink Equivalents

American Heart Association. Alcohol Beverages and Cardiovascular Disease. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Alcoholic-Beverages-and-Cardiovascular-Disease_UCM_305864_Article.jsp


40

DISCUSSION


How Heart Healthy Are You?Raise your hand if you….

• Have immediate family members who have heart disease/diabetes

• Smoke or live with someone who does

• Have been tested for type 2 diabetes in the last 2 years

• Had your blood pressure checked in the last year

• Know your cholesterol numbers, i.e., total, LDL and HDL

• Exercise for 30 minutes a day at least 4 days a week

• Know how many calories you should eat in a day


Know Your NumbersRisk Factor Goal

Total cholesterol less than 200 mg/dL

LDL “Bad” less than 160 mg/dL; < 130; <100, <70

HDL “Good” women > 50 mg/dL; men > 40 mg/dL

Triglycerides less than 150 mg/dL

Blood Pressure less than 120/80 mmHg

Fasting Glucose less than 100 mg/dL

Body Mass Index (BMI) less than 25

Waist Circumference women < 35 inches; men < 40 inches

Exercise30 minutes ≥ 5 X week of moderate-intensity aerobic AND muscle strengthening ≥ 2 X week

Diet and Nutritionwith your doctor, determine how many calories you need each day and eat healthy, low sodium/sugar and high fiber foods

Tobacco and AlcoholStop smoking and exposure to secondhand smoke; women: one drink or less per day; men: 2 drinks or less per day

American Heart Association; webpage, “Numbers That Count for a Healthy Heart.” Accessed http://www.heart.org/HEARTORG/Conditions/Numbers-That-Count_UCM_305427_Article.jsp


43

QUESTIONS?


Thank You!


Heart Attack Signs in Women• Uncomfortable pressure, squeezing, fullness or pain in center of

chest

• Pain or discomfort in one or both arms, the back, neck, jaw or stomach

• Shortness of breath with or without chest discomfort

• Breaking out in a cold sweat, nausea or lightheadedness

• Most common heart attack symptom is chest pain or discomfort

• Shortness of breath, nausea/vomiting and back or jaw pain are likely

American Heart Association. Heart Attack Symptoms in Women. Accessed http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Heart-Attack-Symptoms-in-Women_UCM_436448_Article.jsp

If you have any of these signs, don’t wait more than five minutes

before calling 9-1-1 and get to a hospital right away


Stroke Warning Signs

• 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

American Stroke Association: home page. Accessed: http://www.strokeassociation.org/STROKEORG/WarningSigns/Warning-Signs_UCM_308528_SubHomePage.jsp

If one or more of these signs is present, don’t delay — call 9-1-1


CVD Risk and Black American Women

• Heart disease is more prevalent among Black women than White women1

• As are some of the risk factors, high blood pressure (46%), obesity (51%), and diagnosed/undiagnosed diabetes (19%) 2

• Women can lower their heart disease risk by as much as 82% just by leading a healthy lifestyle1

• However, in a 2006 study of women3:– Only 57% knew heart disease is leading cause of death

among women– Awareness was lower among Black (31%) and Latina

women (29%) compared with White women (68%)– Majority (≥ 50%) reported confusion related to heart

disease prevention• More outreach and education clearly is warranted

1. National Heart, Lung and Blood Institute’s “The Heart Truth for African American Women: An Action Plan.” NIH Pub. No. 07-50662. American Heart Association. African Americans & CVD– 2012 Statistical Fact Sheet3. Christian, A. et al. Nine-Year Trends and Racial and Ethnic Disparities in Women’s Awareness of Heart Disease and Stroke: An

American Heart Association Study. Journal of Women’s Health. Volume 16, Number 1. 2007. Abstract accessed: http://online.liebertpub.com/doi/abs/10.1089/jwh.2006.M072?journalCode=jwh


Diabetes, Heart Disease and Stroke

High blood glucose levels can lead to increased deposits of fatty materials inside blood vessels, affecting blood flow and increasing the chanceof clogging and hardening of blood vessels

If you have diabetes: • You are 2X more likely to have heart disease or a

stroke than someone who does not• And are a woman, you have an even greater risk of

heart disease• And have already had one heart attack, you run an

even greater risk of having a second one• Your heart attack may be more serious and more

likely to result in death than someone without diabetes

National Diabetes Information Clearinghouse. Diabetes, Heart Disease and Stroke. Accessed: http://diabetes.niddk.nih.gov/dm/pubs/stroke/#connection

Documents

CORP-98001-AA JUL2012 HEART DISEASE AND YOU Black Americans