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Heart Health 101 and ProArginine Plus Janice Heasty RN BSN.

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1 Heart Health 101 and ProArginine Plus Janice Heasty RN BSN

2 Dan Austin RN, High Desert Heart Institute, Nurse Clinical Coordinator and Directory of the CHF (Congestive Heart Failure) Unit When you know what you know, you have the responsibility to pay it forward.

3 Assess Your Risk For a Heart Attack 1. How old are you? A (1 point) B (2 points) C (3 points) D (4 points) E. >66 ( 5points)

4 Assess Your Risk For a Heart Attack 2. Do you have a family history of early coronary artery disease (a mother or sister who was younger than 60 years old or a father or brother younger than 50 years old when he/she had a first heart attack or symptoms of a heart attack? A. No (0 points) B. Yes (2 points)

5 Assess Your Risk For a Heart Attack 3. Do you have high Blood Pressure (BP 140/90)? A. No (0 points) A. No (0 points) B. Yes (1 point) B. Yes (1 point) C. Dont know (1 point) C. Dont know (1 point) 4. Do you have Diabetes or elevated blood sugar? A. No (0 points) A. No (0 points) B. Yes (3 points) B. Yes (3 points)

6 Assess Your Risk For a Heart Attack 5. Are you physically active? A. I accumulate approx. 30 of moderate aerobic activity (walking, going up stairs, vacuuming, dancing, gardening, aerobics, swimming, cycling, spinning, or jogging almost every day. (0 points) A. I accumulate approx. 30 of moderate aerobic activity (walking, going up stairs, vacuuming, dancing, gardening, aerobics, swimming, cycling, spinning, or jogging almost every day. (0 points) B. I exercise only occasionally: I accumulate thirty minutes of aerobic activity one or two days per week. (1 point) B. I exercise only occasionally: I accumulate thirty minutes of aerobic activity one or two days per week. (1 point) C. I rarely engage in regular moderate aerobic physical activity. (2 points) C. I rarely engage in regular moderate aerobic physical activity. (2 points) D. I never engage in moderate physical activity. D. I never engage in moderate physical activity. (3 points) (3 points)

7 Assess Your Risk For a Heart Attack 6. Which of the following best describes your Cholesterol? A. <200mg/dL (0 points) A. <200mg/dL (0 points) B mg/dL (1 point) B mg/dL (1 point) C. >240mg/dL (2 points) C. >240mg/dL (2 points) D. Dont know (2 points) D. Dont know (2 points)

8 Assess Your Risk For a Heart Attack 7. Which of the following best describes your HDL (good) cholesterol? A. <45 mg/dL (2 points) A. <45 mg/dL (2 points) B mg/dL (1 point) B mg/dL (1 point) C mg/dL (0 points) C mg/dL (0 points) D. >60 mg/dL (-1 point) D. >60 mg/dL (-1 point) E. Dont know (1 point) E. Dont know (1 point)

9 Assess Your Risk For a Heart Attack 8. Which of the following best describes you LDL (bad) cholesterol? A. <100 mg/dL (0 point) A. <100 mg/dL (0 point) B. <130 mg/dL (1 point) C. >160 mg/dL (1 point) D. Dont know (1 point) D. Dont know (1 point)

10 Assess Your Risk For a Heart Attack 9. Which of the following best describes your triglyceride level? A mg/dL (0 points) A mg/dL (0 points) B mg/dl (1 point) B mg/dl (1 point) C. >250 mg/dL (2 points) C. >250 mg/dL (2 points) D. Dont know (1 point) D. Dont know (1 point)

11 Assess Your Risk For a Heart Attack 10. Do you smoke? A. Yes (3 points) A. Yes (3 points) B. Smoked previously, stopped within the last year. (2 points) B. Smoked previously, stopped within the last year. (2 points) C. Smoked previously, stopped 5 years ago (1 point) C. Smoked previously, stopped 5 years ago (1 point) D. Smoked previously, stopped 10 years or more ago (0 points) D. Smoked previously, stopped 10 years or more ago (0 points) E. No (0 points) E. No (0 points)

12 Assess Your Risk For a Heart Attack 11. Flossing and Heart Disease: medical research has found a correlation between any level of periodontal disease (including gingivitis) and atherosclerosis, or hardening of the arteries. A. I floss almost every day and see my hygienist at least once/year, if not 2xs/year. (0 points) B. I dont floss, and maybe see my hygienist once/year. (1 point) B. I dont floss, and maybe see my hygienist once/year. (1 point) C. I have no idea what you are talking about (1 point) C. I have no idea what you are talking about (1 point)

13 Assess Your Risk For a Heart Attack 12. Look at a BMI (body mass index) chart. Determine your personal chart. Determine your personal BMI which is considered a better indicator of fatness than weight alone. What is your BMI? BMI which is considered a better indicator of fatness than weight alone. What is your BMI? A (0 points) A (0 points) B (1 point) B (1 point) C (2 points) C (2 points) D (3 points) D (3 points) E. >35 (4 points) E. >35 (4 points)

14 Assess Your Risk For a Heart Attack 13. How would you describe the way you handle anger? A. I avoid getting to the breaking A. I avoid getting to the breaking point. (0 points) point. (0 points) B. I yell or slam doors. (1 point) B. I yell or slam doors. (1 point) C. I always hold my anger in. (2 C. I always hold my anger in. (2 points) points)

15 Assess Your Risk For a Heart Attack 0: Great! You are presently healthy, and following the suggestions of the presentation should make you even healthier. 1-10: Low Risk! It pays to investigate the areas where you amassed points and modify your lifestyle accordingly. You should find this presentation particularly motivating and helpful : Moderate Risk! This presentation will help you understand why its important to begin changing your lifestyle NOW! >20: HIGH RISK FOR HEART DISEASE! Though you may feel well now, get a complete physical ASAP. In the meantime, understand more about your heart and how it works. And youll learn what changes you need to make to begin reducing your risk.

16 Assess Your Risk For a Heart Attack My goal is to help you recognize your personal risk factors for heart disease and motivate you to make the necessary lifestyle changes to keep your heart healthy. YOUR goal is to change the risk factors you can control, so that YOU can greatly reduce the chance of having a heart attack.

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18 What is Cardiovascular Disease? CHD: Coronary Heart Disease CHD: Coronary Heart Disease MI: Myocardial infarction (Heart Attack) MI: Myocardial infarction (Heart Attack) CAD: Coronary Artery Disease CAD: Coronary Artery Disease Atherosclerosis: plaque in the arteries Atherosclerosis: plaque in the arteries HTN: Hypertension (High Blood Pressure) HTN: Hypertension (High Blood Pressure) CHF: Congestive Heart Failure CHF: Congestive Heart Failure CVA: Cerebral Vascular Accident (stroke) CVA: Cerebral Vascular Accident (stroke)

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28 Coronary Heart Disease Disorder of the blood vessels in the heart that can lead to a heart attack. A heart attack happens when an artery becomes blocked, preventing blood flow from getting to the heart muscle. A heart attack happens when an artery becomes blocked, preventing blood flow from getting to the heart muscle.

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33 Coronary Heart Disease (cont.) The arteries become narrowed by fatty deposits which develop into plaque. The blood supply (that is carrying oxygen, sugar and nutrients) cannot get to the heart muscle. The heart muscle cannot keep up with increased demands (exercise, stress, surgery, illness) with these blockages.

34 How Critical is the Problem? C-Shop: Cardiac School age Health Opportunities Program C-Shop: Cardiac School age Health Opportunities Program Western Nebraska: Bridgeport, NE Western Nebraska: Bridgeport, NE 1 out of 3 students tested: Elevated Cholesterol, Triglycerides, or BP 1 out of 3 students tested: Elevated Cholesterol, Triglycerides, or BP Shocking fact: 5 th graders Shocking fact: 5 th graders Education to both students and parents about curbing heart disease through healthy lifestyle choices. Education to both students and parents about curbing heart disease through healthy lifestyle choices. Retest will be when they reach 10 th grade. Retest will be when they reach 10 th grade.

35 How critical is the problem? #1 Killer of both men and women (more than the next 7 causes of death combined including cancer). #1 Killer of both men and women (more than the next 7 causes of death combined including cancer). 50% of all Americans will die of some form of Cardiovascular Disease. 50% of all Americans will die of some form of Cardiovascular Disease. 1 in 3 will die from Coronary Heart Disease. 1 in 3 will die from Coronary Heart Disease.

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37 How Critical is the Problem? (cont.) One woman in America dies from heart disease every minute. (African- American women are 30% more likely to die from CHD). One woman in America dies from heart disease every minute. (African- American women are 30% more likely to die from CHD). If you combine Heart Disease and Stroke, there is one death every 33 seconds. If you combine Heart Disease and Stroke, there is one death every 33 seconds. Heart Disease begins before age 20, many years before anyone has symptoms. Heart Disease begins before age 20, many years before anyone has symptoms.

38 How Critical is the Problem? (cont) 62% of women believe that cancer is a womans greatest threat. 62% of women believe that cancer is a womans greatest threat. Only 13% of American women consider heart disease a health risk themselves. Only 13% of American women consider heart disease a health risk themselves. 9,000 U.S. women younger than 45 years old have had a heart attack each year. 9,000 U.S. women younger than 45 years old have had a heart attack each year. In women younger than 65 years who have a heart attack; their death rate is twice that of men. In women younger than 65 years who have a heart attack; their death rate is twice that of men.

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41 Classic Symptoms of Heart Disease Its the Big One Chest discomfort: pain, pressure, tightness Pain radiating to the left arm or shoulder Cold Sweats Nausea Does everyone experience these symptoms?

42 Vague symptoms of heart attack Unusual or sudden extreme fatigue Shortness of Breath Flu-like symptoms: nausea or vomiting, cold sweats, weakness Feelings of anxiety Something is wrong Pain in one or both arms, shoulders, elbows, neck, jaw, stomach or back.

43 Only 30% of people experience classic signs and symptoms before having a heart attack. Women, diabetics, and older men do not experience the classic symptoms of having a heart attack! Women, diabetics, and older men do not experience the classic symptoms of having a heart attack! 64% of women who died from coronary heart disease had no previous symptoms. 64% of women who died from coronary heart disease had no previous symptoms. Symptoms can often be vague so they are difficult to diagnose. Sometimes, treatment is delayed because their heart attack presents as something else. Symptoms can often be vague so they are difficult to diagnose. Sometimes, treatment is delayed because their heart attack presents as something else.

44 Women Have Poor Outcomes The entire artery is lined with diffuse disease rather than one area. The entire artery is lined with diffuse disease rather than one area. Women start off with smaller vessels, so a small amount of disease is much more significant. Women start off with smaller vessels, so a small amount of disease is much more significant. The collaterals (small connecting blood vessels, natures little bypasses) are gone. The collaterals (small connecting blood vessels, natures little bypasses) are gone. More complications with angioplasty (ballooning the artery open) and stenting. More complications with angioplasty (ballooning the artery open) and stenting. More go for Coronary Artery Bypass Graft surgery (CABG), which is more invasive, carries more risks and has more complications. More go for Coronary Artery Bypass Graft surgery (CABG), which is more invasive, carries more risks and has more complications.

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46 What Can We Do? Education is the Key…. Education is the Key…. Know the facts. Know the facts. Seek the information Seek the information Make the necessary lifestyle changes Make the necessary lifestyle changes TLC (therapeutic lifestyle changes) TLC (therapeutic lifestyle changes) Prevention is the Best Medicine!!!Prevention is the Best Medicine!!! Research shows you can lower your risk for CHD enormously (82%) simply by leading a healthy lifestyle. Research shows you can lower your risk for CHD enormously (82%) simply by leading a healthy lifestyle.

47 Risks Factors That Cannot Be Controlled Gender Gender Increasing Age: t he average age of our population is changing so CHD will remain a MAJOR health issue. Increasing Age: t he average age of our population is changing so CHD will remain a MAJOR health issue. Family History, Genetics Family History, Genetics 1 st degree relatives1 st degree relatives Father, Brother: < 55 years old with CVDFather, Brother: < 55 years old with CVD Mother, Sister: < 65 years old with CVD Race Race

48 With the many risk factors for heart disease, a womans greatest Risk is Ignorance. former 1st lady, Laura Bush With the many risk factors for heart disease, a womans greatest Risk is Ignorance. former 1st lady, Laura Bush

49 Risk Factors That Can Be Controlled Hypertension, High Blood Pressure Hypertension, High Blood Pressure High cholesterol, Elevated Blood Lipids High cholesterol, Elevated Blood Lipids Smoking, Tobacco Use Smoking, Tobacco Use Diabetes Diabetes Obesity, Excessive Body Fat Obesity, Excessive Body Fat Physical Inactivity Physical Inactivity Stress Stress Other: Inflammation: CRP (c-reactive protein) Other: Inflammation: CRP (c-reactive protein) Homocysteine Homocysteine

50 High Blood Pressure The Silent Killer GOOD < 120/80 GOOD < 120/80 BAD BAD Mild HTN 140/80 – 159/91Mild HTN 140/80 – 159/91 Moderate HTN 160/100 – 179/109Moderate HTN 160/100 – 179/109 Severe HTN 180/100 – 209/109Severe HTN 180/100 – 209/109

51 High Blood Pressure Facts Usually doesnt cause symptoms. Usually doesnt cause symptoms. HTNincreases with age and body weight. HTNincreases with age and body weight. Higher in African-Americans, Hispanics, Native Americans, and Hawaiians than Caucasians. Higher in African-Americans, Hispanics, Native Americans, and Hawaiians than Caucasians. ½ of all patients with their first heart attack are hypertensive. ½ of all patients with their first heart attack are hypertensive. HTN doubles the risk for CVD heart failure. HTN doubles the risk for CVD heart failure. Increased risk for End-Organ damage (kidney failure, CVA (stroke), MIheart attack). Increased risk for End-Organ damage (kidney failure, CVA (stroke), MIheart attack).

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53 Pulmonary Hypertension Elevated pressure in the arteries in the lungs. Elevated pressure in the arteries in the lungs. Normal: 25 mmHg pressure at rest Normal: 25 mmHg pressure at rest Right ventricular failure. Right ventricular failure. Must work harder to pump blood through the lungsMust work harder to pump blood through the lungs Heart muscle weakens and/or failsHeart muscle weakens and/or fails

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55 Angelo CiCi Pulmonary artery pressure: 96/ Pulmonary artery pressure: 96/ Severe shortness of breath, on oxygen 24/7 Severe shortness of breath, on oxygen 24/7 Right-sided heart failure: everything backs up: liver congestion Right-sided heart failure: everything backs up: liver congestion On Dec 20, 2008 Angelo had massive heart failure (congestive heart failure, congestive pulmonary failure and pacemaker failure) with simultaneous renal failure. On Dec 20, 2008 Angelo had massive heart failure (congestive heart failure, congestive pulmonary failure and pacemaker failure) with simultaneous renal failure. From this point on he was in and out of the emergency room. "I was so weak I couldn't even open a bottle of water by myself and I had decided I had had enough. I told the nurses I wanted all the IV's removed and I just wanted to go home and die." Angelo CiCi From this point on he was in and out of the emergency room. "I was so weak I couldn't even open a bottle of water by myself and I had decided I had had enough. I told the nurses I wanted all the IV's removed and I just wanted to go home and die." Angelo CiCi

56 Angelo CiCi Pro-Arginine Plus (4 scoops/day) Pro-Arginine Plus (4 scoops/day) I have seen a dramatic, a dramatic reversal in Angelos symptoms Dan Austin RN I have seen a dramatic, a dramatic reversal in Angelos symptoms Dan Austin RN I expected a marginal improvement in the symptoms…what we ended up seeing was remarkable, positive, remodeling of the heart, positive pulmonary artery changes, pulmonary vascular changes… Dr. Siva Arunasalam I expected a marginal improvement in the symptoms…what we ended up seeing was remarkable, positive, remodeling of the heart, positive pulmonary artery changes, pulmonary vascular changes… Dr. Siva Arunasalam The best thing? I can walk through the mall and hold my wifes hand. Angelo CiCi The best thing? I can walk through the mall and hold my wifes hand. Angelo CiCi

57 WHO (World Health Organization) functional classification for Pulmonary Hypertension I- Although you have been diagnosed with pulmonary hypertension, you have no symptoms. II- You dont have symptoms at rest, Ordinary physical activity results in undue fatigue or shortness of breath, chest pain, or heart syncope. III- You are comfortable at rest. Less than ordinary physical activity causes undue fatigue or shortness of breath, chest pain, or heart syncope. IV- You have symptoms even at rest.

58 High Blood PressureInitial Treatment Weight loss Weight loss Decrease in salt intake Decrease in salt intake Stop smoking and avoid 2 nd hand smoke Stop smoking and avoid 2 nd hand smoke Regular exercise decreases BP, stress and weight Regular exercise decreases BP, stress and weight Decrease alcohol consumption Decrease alcohol consumption

59 Pro-Argi-9 Plus L-arginine becomes nitric oxide which relaxes the walls of the artery decreasing blood pressure. L-arginine becomes nitric oxide which relaxes the walls of the artery decreasing blood pressure. Dr. Sivas High Desert Heart Health Study Dr. Sivas High Desert Heart Health Study 13% decrease in systolic BP (decrease the workload of the heart).13% decrease in systolic BP (decrease the workload of the heart). 17% decrease in diastolic BP (decrease end-organ damage).17% decrease in diastolic BP (decrease end-organ damage). CASP (central aortic systolic pressure) measured by B-Pro decreased 6.2%.CASP (central aortic systolic pressure) measured by B-Pro decreased 6.2%.

60 Cholesterol Narrowing of the arteries occurs when extra cholesterol and fat circulates in the blood and builds up in the walls of the arteries that supply blood to the heart, the brain, and other organs. Narrowing of the arteries occurs when extra cholesterol and fat circulates in the blood and builds up in the walls of the arteries that supply blood to the heart, the brain, and other organs. Cholesterol does not dissolve in the blood. The lipo-proteins (HDL, LDL) carry the cholesterol in the bloodstream. Cholesterol does not dissolve in the blood. The lipo-proteins (HDL, LDL) carry the cholesterol in the bloodstream. Blood lipid profilestart at age 20 and retest every 5 years. Blood lipid profilestart at age 20 and retest every 5 years.

61 Total Cholesterol Level Desirable: < 200 mg/dL Desirable: < 200 mg/dL Borderline High: mg/dL Borderline High: mg/dL High: mg/dL High: mg/dL Very High: 290 mg/dL and > Very High: 290 mg/dL and >

62 LDL Low-Density Lipoprotein Bad Cholesterol Major carrier of cholesterol in the blood. Builds up on the arterial walls. Major carrier of cholesterol in the blood. Builds up on the arterial walls. Optimal < 100 mg/dL Optimal < 100 mg/dL Near Optimal mg/dL Near Optimal mg/dL Borderline High mg/dL Borderline High mg/dL High mg/dL High mg/dL Very High 190 mg/dL and > Very High 190 mg/dL and >

63 HDL High-density lipoprotein Good/Healthy cholesterol Carries cholesterol from other parts of the body back to the liver. Carries cholesterol from other parts of the body back to the liver. Good/Protective: 60 mg/dL and > Good/Protective: 60 mg/dL and > Borderline/Desirable: mg/dL Borderline/Desirable: mg/dL Low/Major Risk: < 40 mg/dL Low/Major Risk: < 40 mg/dL

64 Triglyceride Levels A type of fat found in the body (from food and produced in the liver). Unused calories are converted to triglycerides and transported to fat cells to be stored and released via hormone signals to be used as energy. A type of fat found in the body (from food and produced in the liver). Unused calories are converted to triglycerides and transported to fat cells to be stored and released via hormone signals to be used as energy. Good: < 150 mg/dL Good: < 150 mg/dL Borderline High: mg/dL Borderline High: mg/dL High: 200 mg/dL and > High: 200 mg/dL and >

65 Pro-Argi-9 Plus Dr. Sivas study: Remember that these were maximally medically managed patients….. Dr. Sivas study: Remember that these were maximally medically managed patients….. Total Cholesterol: no significant change Total Cholesterol: no significant change LDL: no significant change, though we know ProArgi9+ reduces LDL oxidation. LDL: no significant change, though we know ProArgi9+ reduces LDL oxidation. HDL: Increased 18%. HDL: Increased 18%. Dr. Siva says: This is what REVERSES heart disease We cant say that! Dr. Siva says: This is what REVERSES heart disease We cant say that! This is a difficult marker to increase. This is a difficult marker to increase. Triglycerides: Decreased 45% (released and used for energy? Is this why we feel so energetic on Pro-Argi-9 Plus?) Triglycerides: Decreased 45% (released and used for energy? Is this why we feel so energetic on Pro-Argi-9 Plus?)

66 Smoking Americas Health Crisis Smoking is the leading preventable cause of death in the nation. Smoking is the leading preventable cause of death in the nation. Smoking is the single biggest risk of Cardiovascular Disease. Smoking is the single biggest risk of Cardiovascular Disease. Tobacco Use---Tobacco Abuse--- includes anything with nicotine (chewing tobacco, patches, gum) Tobacco Use---Tobacco Abuse--- includes anything with nicotine (chewing tobacco, patches, gum)

67 Smoking Americas Health Crisis Nicotine Decreases oxygen in the blood Decreases oxygen in the blood Damages the blood vessel which causes plaque to form Damages the blood vessel which causes plaque to form Triggers blood clots to develop Triggers blood clots to develop Reduces HDL (good cholesterol) Reduces HDL (good cholesterol) Causes irregular heart rhythms that could lead to cardiac arrest Causes irregular heart rhythms that could lead to cardiac arrest

68 Smoking Americas Health Crisis Smokers are 2-6 Xs more likely to suffer a heart attack than nonsmokers. Male smokers lose 13.2 years of life expectancy. Male smokers lose 13.2 years of life expectancy. Female smokers lose 14.5 years of life expectancy. Female smokers lose 14.5 years of life expectancy. Second-Hand smoke doubles a non-smoker's risk of heart disease. Second-Hand smoke doubles a non-smoker's risk of heart disease.

69 Smoking Americas Health Crisis The Good News Dont smoke, and if you do, QUIT NOW! QUIT NOW! Quitting begins to decrease cardiovascular risk immediately. Quitting begins to decrease cardiovascular risk immediately. Over time (10 years), the risk of heart disease returns to nearly normal. Over time (10 years), the risk of heart disease returns to nearly normal.

70 Pro-Argi-9 Plus Pro-Argi-9 Plus provides us with the amino acid L-arginine which converts to nitric oxide. On Dr. Sivas list: smoking consumes nitric oxide, the body needs more. Every tissue utilizes Nitric Oxide. * Lowers Blood Pressure * Lowers Blood Pressure * Protects against heart attack and stroke (interferes with unwanted blood clotting) * Protects against heart attack and stroke (interferes with unwanted blood clotting) * Keeps the normal endothelial layer as protective * Keeps the normal endothelial layer as protective * Protects against atherosclerosis * Protects against atherosclerosis Red Wine Extract (Resveratrol): An Antioxidant---acts as a sponge that absorbs free-radicals. Also, keeps the LDL from becoming sticky.

71 Diabetes Now affects 10% of the U.S. population Now affects 10% of the U.S. population Has nearly doubled in the last years Has nearly doubled in the last years About 65% of diabetics die of some type of heart disease at an earlier age than the rest of the population. About 65% of diabetics die of some type of heart disease at an earlier age than the rest of the population. Diabetes increases the risk of Coronary Heart Disease Diabetes increases the risk of Coronary Heart Disease Women: 3-7 Xs Women: 3-7 Xs Men: 2-3 Xs Men: 2-3 Xs

72 Diabetes Good Blood Sugar: < 100 mg/dL Good Blood Sugar: < 100 mg/dL ABCs of Diabetic Control ABCs of Diabetic Control A1c (hemoglobin A1c) a blood test that measures your average blood glucose level over the last 3 months.A1c (hemoglobin A1c) a blood test that measures your average blood glucose level over the last 3 months. BP (blood pressure) the higher your BP, the harder your heart has to work and the more damage inside your arteries.BP (blood pressure) the higher your BP, the harder your heart has to work and the more damage inside your arteries. Cholesterol: LDL (bad) builds up and clogs your arteries.Cholesterol: LDL (bad) builds up and clogs your arteries.

73 Dr. Sivas study with Pro-Argi-9 Plus Glucose:Glucose: D ecreased 8% (Dr. Siva rated this a highly significant finding) D ecreased 8% (Dr. Siva rated this a highly significant finding) Blood Pressure:Blood Pressure: Systolic BP decreased 13% Systolic BP decreased 13% Diastolic BP decreased 17% Diastolic BP decreased 17% Blood Lipids:Blood Lipids: HDL increased 18% HDL increased 18% Triglycerides decreased 45% Triglycerides decreased 45%

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76 Dr. Sivas study with Pro-Argi-9 Plus ABI Ankle-Brachial Index ABI Ankle-Brachial Index The # represents the % of decreased blood flow in the lower extremities.The # represents the % of decreased blood flow in the lower extremities. PAD (peripheral arterial disease) is common in diabetic patients.PAD (peripheral arterial disease) is common in diabetic patients. ABI increased 16%. HUGE!ABI increased 16%. HUGE! When people can walk around with leg pain (claudication is cramping the calvesthe muscles is screaming for oxygen that the clogged arteries cannot deliver). When they can walk without leg pain, their quality of life improves, their ability to exercise improves. When people can walk around with leg pain (claudication is cramping the calvesthe muscles is screaming for oxygen that the clogged arteries cannot deliver). When they can walk without leg pain, their quality of life improves, their ability to exercise improves.

77 Obesity More than 30% of adults are now considered obese. More than 30% of adults are now considered obese. More alarming: at least 15% of children are obese. More alarming: at least 15% of children are obese. People who are 30 pounds or more overweight are more likely to develop heart disease, even if they have no other risk factors. OUCH! People who are 30 pounds or more overweight are more likely to develop heart disease, even if they have no other risk factors. OUCH!

78 Obesity The risk is greater if the weight is around the stomach instead of around the hips (apple vs pear shape). The risk is greater if the weight is around the stomach instead of around the hips (apple vs pear shape). Being overweight increases the chances of developing other major risk factors (high blood pressure, high cholesterol, diabetes). Being overweight increases the chances of developing other major risk factors (high blood pressure, high cholesterol, diabetes).

79 Obesity Waist measurements Waist measurements Men: > 40Men: > 40 Women: > 35Women: > 35 BMI (Body Mass Index) BMI (Body Mass Index) Overweight: > 25 Overweight: > 25 Obese: > 30 Obese: > 30 Morbid Obesity: 100 pounds over your desired weight Morbid Obesity: 100 pounds over your desired weight

80 Pro-Argi-9 Plus Not a weight loss product, but people seem to lose 1 pound/month taking this product. Not a weight loss product, but people seem to lose 1 pound/month taking this product. Dr. Siva spoke about muscle physiology. Dr. Siva spoke about muscle physiology. (Big improvements in 6-minute walk-test) (Big improvements in 6-minute walk-test) Performance enhancement Performance enhancement Increased exercise capacity Increased exercise capacity Delivering more oxygen to the tissue Delivering more oxygen to the tissue More efficient to remove lactic acid More efficient to remove lactic acid

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82 Exercise and Heart Disease 60% of Americans do not get the recommended amount of physical activity. 60% of Americans do not get the recommended amount of physical activity. Research shows that as little as 30 minutes of moderate activity on most, preferable all, days of the week help protect your heart. Research shows that as little as 30 minutes of moderate activity on most, preferable all, days of the week help protect your heart. The BEST heart healthy exercise program includes both aerobic exercise and resistance training. Resistance training helps improve heart health by decreasing BP, changing fat into muscle, increasing your Basal Metabolic Rate. The BEST heart healthy exercise program includes both aerobic exercise and resistance training. Resistance training helps improve heart health by decreasing BP, changing fat into muscle, increasing your Basal Metabolic Rate.

83 Exercise and Heart Disease Aerobic exercise increases HDL. The more the exercising, the higher the HDL. Aerobic exercise increases HDL. The more the exercising, the higher the HDL. Diabetes is better controlled with regular moderate exercise. Diabetes is better controlled with regular moderate exercise.

84 Pro-Argi-9 Plus Performance enhancement Increased exercise capacity Increased exercise capacity Deliver more oxygen to the tissues Deliver more oxygen to the tissues More efficient to remove lactic acid More efficient to remove lactic acid Faster Recovery Faster Recovery Feel Better Move More Move Faster Recover Faster Recover Faster Lose Weight Lose Weight

85 Vitamin D & Heart Disease November 2009 report Intermountain Medical Center in Utah Researchers found that low levels of vitamin D significantly increase the risk for stroke, heart disease, and death. Researchers found that low levels of vitamin D significantly increase the risk for stroke, heart disease, and death.

86 November 2009 report Intermountain Medical Center in Utah The study followed 27, 686 people age 50 and older with no history of CVD. The study followed 27, 686 people age 50 and older with no history of CVD. The participants were divided into 3 groups based on their Vitamin D levels normal, low, or very low. The participants were divided into 3 groups based on their Vitamin D levels normal, low, or very low. After 1 year, the very low levels: After 1 year, the very low levels: 77% more likely to die77% more likely to die 45% more likely to develop CAD45% more likely to develop CAD 78% more likely to have a stroke compared to those with normal Vit. D levels78% more likely to have a stroke compared to those with normal Vit. D levels We concluded that among pts 50 years or >, even a moderate deficiency of Vit. D levels was associated with developing CAD, heart failure, stroke and death, said study co-author Heidi May.

87 Vitamin D & Heart Disease Dr. Tracy Stevens, MD, FAAC, Cardiology, Kansas City, Missouri Get your vitamin D levels checked She thinks that this essential vitamin is seriously underrated. In a recent program involving 600 women, Dr, Stevens and her colleagues found that 97% of the participants were deficient in Vitamin D and low levels of the vitamin have been linked to marked increases in heart disease. When the women took supplements, they reported feeling more energy as their vitamin D levels increased.

88 Pro-Argi-9 Plus D3 (Cholecalciferol) is your best source of vitamin D. D3 (Cholecalciferol) is your best source of vitamin D. Each scoop has 2,500 IU of Vitamin D3 or 625% of your daily values. Each scoop has 2,500 IU of Vitamin D3 or 625% of your daily values.

89 Dr. Sivas Study with Pro-Argi9 Plus Dr. Sivas study found their 33 maximally medically managed patients to be 95% deficient in vitamin D. Dr. Sivas study found their 33 maximally medically managed patients to be 95% deficient in vitamin D. Vitamin D3 increased 183% in their patients. Many measureable data points improved in this study. In addition to improvement of lab values and medical test results, the quality of life (demonstrated by the 6-minute walk test) dramatically improved in these 33 patients. Vitamin D3 increased 183% in their patients. Many measureable data points improved in this study. In addition to improvement of lab values and medical test results, the quality of life (demonstrated by the 6-minute walk test) dramatically improved in these 33 patients.

90 If you dont take care of your body, where will you live?


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