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Cardiovascular health Will examine what we know re CV health and Coronary heart disease (CHD) American and Canadian info & resources, mostly allopathic,

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Presentation on theme: "Cardiovascular health Will examine what we know re CV health and Coronary heart disease (CHD) American and Canadian info & resources, mostly allopathic,"— Presentation transcript:

1 Cardiovascular health Will examine what we know re CV health and Coronary heart disease (CHD) American and Canadian info & resources, mostly allopathic, some web-based Then look at integrative approaches relying on text chapter 18 as framework

2 Cardiovascular health CV disease is now “the major cause of death and disability and of rising health care costs in Canada” In groups of 5, record what you know about CV disease / health and what you know re treatment / prevention – allopathic & less conventional or “alternative”

3 CHD ~ what is it ? Narrowing of coronary arteries Atherosclerosis vs arteriosclerosis Angina (lack of oxygen induced) to full blown heart attack Cholesterol, vital to hormone & vitamin D production, bile to digest fat etc present everywhere Excess cholesterol is issue re athero etc


5 CV Disease Deaths by sex, Stats Can, 1994

6 Risk Factors in General smoking high blood pressure high cholesterol physical inactivity obesity diabetes

7 Risk Factors and CHD The risk factors that you cannot control include: Age (45 years or older for men; 55 years or older for women) Family history of early heart disease (father or brother affected before age 55; mother or sister affected before age 65)

8 Risk Factors and CHD The risk factors that you can control include: High blood cholesterol (high total cholesterol and high LDL ("bad") cholesterol)high total cholesterolhigh LDL ("bad") cholesterol) Low HDL ("good") cholesterol Smoking High blood pressure Diabetes -- if you have diabetes, your risk for developing heart disease is high, as high as a heart disease patient's risk for having a heart attack; need to lower cholesterol under medical supervision, in much the same way as a heart disease patient, in order to reduce high risk of getting heart disease.Diabetesheart disease Obesity/overweight Physical inactivity


10 What makes cholesterol hi or low ? Your blood cholesterol level is affected not only by what you eat but also by how quickly your body makes LDL ("bad") cholesterol and disposes of it In fact, your body makes all the cholesterol it needs, and it is not necessary to take in any additional cholesterol from the foods you eat

11 Benefits of cholesterol - lowering Huge risk reducer (lots of evidence) both for people with high cholesterol & those with avg levels Studies use ‘statins’ (discussed in your text) as cholesterol lowering drugs – longitudinal studies in Scotland etc showed dramatic reductions in incidences of CHD, 20-37% reductions *** See notes re studies in ‘Handout’ format below this slide***

12 What makes cholesterol hi or low ? – Factors re LDL levels: Heredity What you eat Weight Physical activity/exercise Age and sex Alcohol Stress *** see definitions in Handout format below this slide ***

13 Framingham Heart Study huge study, “best” one re mass of data on cholesterol reductions 0n web site; *** see material below this slide re Framingham


15 Types of Blood Pressure Medications Diuretics Beta-blockers ACE inhibitors Angiotensin antagonists Calcium channel blockers (CCBs) Alpha-blockers Alpha-beta-blockers Nervous system inhibitors Vasodilators *** see definitions of each below this slide ***





20 Integrative medicine re CHD “when applied to CV disease, preventative medicine in Western society is a concept most people accept, few people practice, and almost no one pays for” [ text 409 ] Most of the $200 billion annual US price tag is spent on the treatment of symptomatic disease & end- organ failure

21 Integrative medicine re CHD Reliance on therapeutic vs preventative strategies fosters a “magic bullet” mentality in N America No single strategy, medication, or intervention program guarantees avoidance of ‘negative cardiac events’

22 Integrative medicine re CHD Huge sums of $$$ to conquer a largely behavioural disease thru pharmacology, surgery, catheterization-based interventions & genetic engineering So, what are the integrative suggestions from your text and elsewhere ???

23 Integrative CV Health CHD as a complex of genetic, environmental, cultural, and behavioural factors Text notes that “genetic markers,” that is, risk factors we can’t control, are important (lipid metabolism, diabetes, hypertension), CV health / prevention of CHD is remarkably variable Non-allopathy here is predominantly diet and lifestyle interventions - * consider these as primary or at least adjunctive treatments for CHD and CV health

24 Text & CV Health Diet – goes thru studies re epidemiological links, avocados, Mediterranean-style diets (mono- unsat fats), and serial monitoring of types of fat intake & body weight/BMI Exercise – evidence also strong here Alcohol – red wine vs beer vs hard liquor – what does evidence say ?

25 Text & CV Health Dietary Supplements & Herbs ~ digoxin (also called digitalis, both derived from plant foxglove) vs angiotensin inhibitors ~ plant-based diets re antioxidants and antiinflammatories [ purslane ] ~ garlic and teas, hawthorn berries rich in flavinoids (anti-inflam), folic acid, Vitamin E-rich foods

26 Text & CV Health Note the crystal clear summary pp 410-411 esp tables 18-1, 18-2, and 18-3 * what makes this “alternative” is the element of informed, evidence-based choice * Also, difference betw choices in acute coronary syndromes vs chronic stable CHD vs at-risk Emphasis is on delay and avoid

27 Last 3 classes: Tuesday: chronic fatigue & GI system Thursday: oncology * start wrap-up Tuesday 11 th, last class, synthesis & yes, chapters 31 & 33 are required re this unit

28 Evidence ~ MC Exams Multiple multiples NOT when they’re logic, don’t test knowledge So, no more than 8 on exam, and only if content, not logic-based # of alternatives evidence – 4 good ones better than 5 th bad one so I’m going to do that too

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