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