Welcome toHealth From Head to Toe:Vascular Risk Reduction

Building Healthy Lifestyles

Objectives ● Promote your knowledge of vascular risk

factors

● Learn chronic disease prevention strategies

● Discuss healthy lifestyle interventions

As I see it, every day you do one of two things: build health or produce disease in yourself.

Adelle Davis (1904-1974)

8 in 10 Canadians have at least one risk factor for vascular disease (i.e. heart disease or stroke)

MANAGEABLE risk factor

Metabolic Syndrome

High Blood Pressure

High Cholesterol

Pre-Diabetes/Diabetes

MODIFIABLE risk factor

Smoking Abdominal Obesity Physical Inactivity Nutrition/High sodium intake Excessive Alcohol Consumption Un-managed Stress Insufficient Sleep

Steps to Reduce Your Risk

Know and control your risk factors!

http://www.phac-aspc.gc.ca/ccdpc-cpcmc/index_e.html#extended

www.heartandstroke.ca

Metabolic Syndrome

Diagnosed if you have 3 or more of the following conditions:

● Blood pressure > 130/85 mmHg● Triglycerides >1.7 mmol/L● HDL (Healthy cholesterol) - Men< 1.0 ;

Women < 1.3 mmol/L● Fasting Blood Glucose >5.6 mmol/L● Abdominal obesity – Waist circumference

> 94 cm in men or > 80 cm in women

Leading Risk Factors for Death in Developed Countries

3

5

4

2

1

High CholesterolHigh Cholesterol

Physical InactivityPhysical Inactivity

Blood PressureBlood Pressure

TobaccoTobacco

OverweightOverweight

Low Fruit & Low Fruit & Vegetable intakeVegetable intake

6

(World Health Organization 2002)

Why Treat Hypertension?

Cholesterol● About 40% of Canadians have high

cholesterol

● Ideal cholesterol levels vary individually based on other risk factors for heart disease or stroke

www.heartandstroke.ca

Lipid Panel

LDL (LOUSY) – promotes the buildupof fatty plaque on the artery walls

HDL (HEALTHY) – helps clear the arteries

Triglycerides – not a type ofcholesterol, but are also a fat found inthe blood

In addition to current Canadian recommendations on management of dyslipidemia, statins are recommended in high-risk hypertensive patients with established atherosclerotic disease or with at least 3 of the following criteria:

• Male• age 55 or older• Smoking• Total-C/HDL-C ratio of 6 mmol/L or higher

• LVH• ECG abnormalities• Microalbuminuria or Proteinuria• Family History of Premature CV disease

Statins

Diabetes

● More than 3 million Canadians have diabetes (90% are Type 2)

● Fasting blood sugar should be tested every 3 years if over age 40 to screen for diabetes

www.diabetes.ca

Courtesy J.P. Després 2006

Mid distance

Last rib margin

Iliac crest

Waist Circumference Measurement

Emberson et al. Eur Heart J. 2004;25:484-491.

10% Reduction

in BP

10% Reductionin Total-C+

45% Reduction

in CVD=

90% of Canadians have other

cardiovascular risk factors!

Lifestyle Modification

Healthy Lifestyles Really

Make a Difference Intervention Amount

Change inSBP/DBP

Reduce daily sodium intake by:

1800 mg -5.1 / -2.7

Weight loss of 4.5kg (<10lb)-7.2/-5.9

Alcohol intake 0-2 drinks per day/day

-3.9 / -2.4

Aerobic exercise

120-150 min/week -4.9 / -3.7

Dietary patterns

DASH dietHypertensiveNormotensive

-11.4 / -5.5-3.6 / -1.8

Reducing Stress -6.1/-4.3

Some Fantastic Effects of Smoking Cessation• Risk of heart attack and stroke drop < 24

hours• Breathing is easier < 3 days• Coughing is improved < 2 weeks• Risk of CAD is reduced by 20 – 50 % < one

year• Risk of stroke normalizes < 5 years• Risk of dying is equal to a non smoker < 15

years.• Smoker Help Line 1-866-332-2322

Physical Activity Physical Activity can:

Decrease risk of heart disease and stroke

Help lower blood pressure Help control blood sugar Help to control weight. Help to reduce stress levels Increase HDL, decreases LDL and

triglycerides.

Physical Activity Recommendations

Frequency: 4 - 7 times per week

Intensity: Moderate

Time: 30-60 minutes

Type: Cardiorespiratory Activity–

- walking, jogging - cycling - non-competitive swimming

Eat a Healthy Diet

Follow Canada’s Food Guide Adequate fruit, vegetables, whole grains, low-fat dairy products. Foods low in saturated and trans fat, sugar & salt,

and high in fiber. Have at least 3 meals a day and an afternoon snack.

Space meals 4-6 hours apart. Eat breakfast each morning. Visit www.healthcanada.gc.ca/foodguide for more

information.

Nutrient Density vs Calorie Density

What About the Food We Eat? The Amount of Fat and Sugar Is What’s Important!

Shake the Salt Habit

1 in 3 Canadians with hypertension could have normal blood pressure if they lowered their sodium intake.

Health Issues Linked to High Sodium Intake

Excretion of calcium in the urine, may lead to osteoporosisStomach cancerWater retentionKidney stonesEnlargement of the heartIncreased severity of asthma symptoms

Osteoporosis is a disease characterized by low bone mass and weakening of bone tissue

Adequate Sodium Intake For Adults

Age Sodium intake per day (mg)

9-50 years 1500

50-70 years 1300

Over 70 years 1200

Sources Of Sodium

Sodium Content of Restaurant Foods

Menu Item Sodium (mg)

Breakfast Egg Sandwich 840

Chicken Caesar Salad 570

12” Pepperoni Pizza 5960

Deluxe Cheeseburger & Medium Fries 1910

Fried Chicken Dinner 2280

Processing Adds Sodium To Food

Food Sodium (mg)

Food Sodium (mg)

Plain pasta 5 Pasta & sauce 800

Cucumber 2 Dill Pickle 385

Fresh salmon 56 Canned salmon 272

Cheddar cheese

176 Processed cheese

407

Coffee – cream & sugar

15 Cappuccino – from mix

250

Salt – o - Meter

http://www.theglobeandmail.com/special-reports/hard-to-shake/

www.sodium101.ca- information on how to reduce dietary

sodium

http://www.sodium101.ca/en/happening/news.html

Potential Benefits of Dietary Sodium Reduction in Canada

Reduction in average dietary sodium from about 3500 mg to 1700 mg

• 1 million fewer hypertensives• 5 million fewer physicians visits a year for

hypertension• Health care savings of $430 to $540 million • Improvement of hypertension treatment & control rate• 13% reduction in CVD• Total health care cost savings of over $1.3

billion/year

Limit Alcohol

• Men: Maximum 14drinks/week

• Women: Maximum 9 drinks/week

• No more than 0-2 drinks per day

Stress

• Increases LDL and decreases HDL

• Raises Blood pressure

• Increases Blood sugars

• Increases Clotting enzymes

What Can You Do?

• Identify what is causing stress

• Establish priorities

• Can you change perspective???If able, modify your situation

• Say “NO” more often??

• Make time for yourself!!

● Adults need 7 – 8 hours of uninterrupted sleep to maintain vascular health.

● Sleep is a process of restoration and regeneration for the body and mind

● Sleep allows the body to heal itself, suppress the appetite hormone, reduce cortisol (stress) which in turn will decrease blood pressure.

Sleep Reduces Vascular Damage

CONCLUSIONUNDERSTAND – vascular protection

KNOW – your stats!

REDUCE – your risk

VISIT - your doctor/health care provider

DEVELOP – your action plan!!!

BHL Hypertension/Stroke Prevention