2.  “The collective term for various forms of diseases of the heart and blood vessels.”  Examples?  Heart attack, coronary artery disease (CAD), hypertension, stroke, peripheral vascular disease, congestive heart failure, angina

3.  Atrial fibrillation  Irregular atrial rhythm  Usually treated with medications  Arrhythmia  Irregular heartbeat  Usually treated with medications  Valve problems:  Stenosis  Incomplete closure  Prolapse  Heart failure  Myocardial infarction

4.  About 2,200 Americans die every day from CVD.  Remains the #1 killer although death rates have declined 30% since 1998.  CVD discriminates  Men more likely to have CVD; women more likely to die  Lower incomes, lower educational levels and specific ethnicities are more likely to develop CVD.

5. Oregon.gov, 2010

6.  Chest discomfort  Discomfort in arms, neck, jaw, stomach  Short of breath  Cold sweat  Nausea, vomiting  Lightheadedness, dizziness  Differences between men and women?

7.  Modifiable  What is the #1 modifiable risk factor?  #2?  Non-modifiable  Age  Gender  Heredity  Where do income level and education fit in??

8.  Cigarettes, cigars, chew  Nicotine is main, active ingredient  Thought to be the most physically addictive drug.  Amount of nicotine in products has increased 10% between 1998 & 2004.

9.  Acts as a stimulant  Increases heart rate, blood pressure, alertness, concentration, memory.  May act as mild sedative Decreases anxiety, irritability, mild depression  3 out of 4 smokers want to quit  75% will quit but start again within one year

10.  “If excessive smoking actually plays a role in the production of lung cancer, it seems to be a minor one.”  The National Cancer Institute, 1954  “Tobacco use imposes enormous public health and financial costs on this nation – costs that are completely avoidable.” Kathleen Sebelius, Secretary of Health & Human Services, 2010

11. Source: www.medicineworld.org

12.  Leading preventable cause of death in U.S.  Causes more deaths every year than HIV, illegal drug use, alcohol use, motor vehicle accidents, suicides and murders combined!  Smokers die an average of 14 years earlier than non- smokers.

13. Source: www.cancercontrol.cancer.gov

15. Source: news.bbc.co.uk

16.  Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and Adolescents  Restricts sale, distribution, and promotion of tobacco products to make them less accessible to youth.  Law went into effect June 22, 2010  (FDA, 2010)  http://www.fda.gov/TobaccoProducts/Labeling/Cigar etteProductWarningLabels/ucm2024177.htm http://www.fda.gov/TobaccoProducts/Labeling/Cigar etteProductWarningLabels/ucm2024177.htm

17. (Fda.gov, 2011)

18. (FDA.gov, 2011)

19.  Thoughts?  Warnings were to appear Sept. 2012 but…. (FDA.gov, 2011)

21. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% CDC, 2011

22. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% CDC, 2011

23. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% CDC, 2011

24. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% CDC, 2011

25. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% CDC, 2011

26. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% CDC, 2011

27. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% CDC,2011

28. *Prevalence reflects BRFSS methodological changes in 2011, and these estimates should not be compared to previous years. 15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35%

29. NationMaster.com, 2012

31.  Portion Sizes  Physical Inactivity  Genetics  Media  Technology

32.  Energy Imbalance  Is it enough to say “eat less, exercise more”?  Humans are programmed to eat and store excess.  Portion Sizes  School Lunches  Government subsidies

33. (Brownell, 2006)

34.  What is the recommended amount of daily activity?  Schools and PE  Sedentary Workplaces  Communities  “We have engineered activity out of our lives” (TWON, 2012)

35.  “Toxic advertising”  Health claims on food  TV time has increased

36. (Center for Media Literacy, 2011; Heidi Cody, 2000)

37.  Hyperlipidemia  Elevated lipids in the blood  Hypercholesterolemia  High cholesterol (LDLs usually)  Not always due to dietary intake

38. http://www.mayoclinic.com/images/image_popup/ww5r236.jpg

39.  Blood supply is somehow cut off to the brain causing brain cells to die.  “Approx. 2 million brain cells die per minute during a stroke aging the brain about 3.5 years each hour.” (Insel & Roth, 2009)  Important to receive prompt treatment upon onset of symptoms.

40. Source: http://www.strokesurvivors.ca/new/images/stroke_diagram.gif

41.  ~700,000 Americans suffer a stroke every year. 1/3 will die.  Strokes may cause permanent damage  Paralysis, speech impairment, memory loss, behavior changes.

42. Oregon,gov, 2010

43.  Sudden numbness/weakness of face, arm, leg – especially on one side.  Sudden confusion, trouble speaking or understanding.  Sudden trouble seeing in one or both eyes.  Sudden trouble walking, dizziness, loss of balance/coordination  Sudden severe headache with no known cause.  3 statement test  “Give me a smile”, “Hold out your arms”, “Say this for me”

44.  TIA – “ministroke”  Temporary stroke like symptoms  Brief, usually only last a few minutes  No permanent damage occurs  Can be a precursor to a stroke.

45.  Hypertension: arteries are narrowed, causes heart to pump harder which creates more force against the artery walls.  “Silent” disease  May cause damage to every organ  Damage is irreversible

46.  Primary (essential):  90% of all cases  Cause is unknown – probably genetics and environment.  Secondary  10% of cases  Cause is due to medications or other diseases.  Approx. 1/3 of Americans have hypertension.  Risk increases with age.

47.  If left untreated, carries high mortality risk.  Risk factors:  Family history, race, stress, obesity, tobacco use, aging, high sodium intake  Complications:  Stroke, heart attack, heart failure, hypertensive retinopathy, renal failure