2. By Atif and Fesser

3. Introduction The world population is 6.2 billion and growing Last year 60 million people died Circulatory diseases such as coronary heart disease and stroke were the biggest killer, killing 17 million people Yet, at any one time the media tends to concentrate upon one or two ‘fashionable illnesses’. The papers fill their pages with the news of the latest ‘epidemic’ and the general public is expected to react as if the great plague of 1665 were just around the corner. In reality bird flu, ebola and CJD (Creutzfeldt-Jakob disease) result in a very small number of deaths each year, yet receive so much media attention. Why don’t we concentrate upon minimizing the risk of suffering from conditions such as heart disease and stroke which affect so many of us each year?

4. What is heart disease? Heart disease is a general term for a wide variety of diseases and conditions that affect the function of the heart. Most of these conditions are caused by atherosclerosis (clogged up arteries) by the build up of atheroma which are fatty deposits that restrict blood flow through an artery as shown here. This can lead to many problems associated With the heart of which some are listed below: Heart attacks Angina pectoris Heart failure Stroke

5. Heart attacks A heart attack is also known as myocardial infarction and is the sudden death of part of the heart muscle due to a blockage of blood flow to a portion of the heart. People suffering a heart attack may experience symptoms such as severe chest pain, sweating, nausea, weakness and shortness of breath. This is because without good blood flow, the heart muscle is starved of oxygen and begins to die. A heart attack most commonly happens when a blood vessel that brings blood to the heart is suddenly blocked by a blood clot. Even though heart attacks usually come on suddenly there are the result of a process called atherosclerosis that took years to develop. A heart attack usually occurs over several hours and fast action in seeking professional help is vital in restoring blood flow to the heart and preventing or reducing the amount of permanent damage done.

6. Stroke A stroke is a ‘brain attack’ that happens when a part of the brain experiences a problem with blood flow. The disruption in blood flow cuts off the supply of oxygen to the cells in that particular part of the brain and therefore these cells begin to die. Damage to the brain can cause loss of speech, vision, or movement in an arm or leg, depending on the part of the brain that is affected. There are two main types of stroke; stroke caused by a blockage in the artery supplying blood to a particular region of the brain (cerebral infarction) or stroke caused by bleeding within the brain (intracerebral hemorrhage). About 85% of all strokes occur because of a lack of blood reaching a particular part of the brain. Blood flow stops when an artery carrying blood to the brain becomes blocked, resulting in a stroke. Clots are more likely to form in arteries that are damaged by atherosclerosis, hence it increases the chance of a stroke. A stroke is very serious as cells in the brain that become damaged cannot be repaired or regenerated. 15% of people that have a stroke die shortly after having it.

7. Signs and symptoms Symptoms are dependant on the cause, severity and type of heart disease. Some signs and symptoms include: Chest pain Cough Cyanosis, or a bluish discolouration of the skin Enlarged veins in the neck Loss of appetite and loss of weight Palpitations or an unusual awareness of the heartbeat Shortness of breath Weakness and fatigue Swelling in the legs and ankles

8. Risk factors & causes Everyone has a certain degree of developing heart disease or stroke, however certain risk factors increase the risk and are shown below: Hypertension (can cause heart enlargement, heart failure etc) Diabetes Smoking Lack of exercise Obesity High cholesterol level Unhealthy diet Excess alcohol consumption A strong family history of atherosclerosis or coronary heart disease Male gender Some of the greater risk factors are discussed on the following slides.

9. Lack of exercise & alcohol On average, the risk of developing heart disease is about a third less in people who exercise compared to those who do not exercise. Having a stroke is also less likely. To gain health benefits and feel better you should do at least 30 minutes of moderate exercise in a day and at least 5 times in a week. Excess consumption of alcohol leads to heart disease and related illnesses. Some scientists believe that 1-2 units per day of alcohol can help protect you from heart disease although this is a matter of controversy.

10. Diet Eating a healthy diet helps to control obesity and lower your cholesterol level, both of which help reduce your health risk. Also there is some evidence that eating oily fish such as sardines and salmon helps to protect against heart disease. It is thought that the ‘omega-3 fatty acids’ in the fish help to reduce the build up of atheroma leading to atherosclerosis. Briefly, a healthy diet means: A minimum of 5 portions of a variety of fruit and vegetables per day. The majority of most meals should be starch-based foods such as cereals, bread and pasta. A minimum of fatty foods such as fatty meats, cheeses, fried food, butter etc. Include 2-3 portions of fish each week, at least one should be oily. If you eat meat, it is better to be lean meat, or poultry such as chicken. If you do fry, choose a vegetable oil such as sunflower or olive oil.

11. Stress Mechanism HPACHANSAM

12. The Stress Factor Stress is a psychological factor causing coronary heart disease (CHD). The release of the hormones adrenaline and noradrenalin cause high blood pressure, leading to atherosclerosis. A study by Friedman and Rosenman found that 70% people with hostile (type A) personalities developed CHD later on in life.

13. Smoking Lifetime smoking roughly doubles your risk of developing heart disease. Your risk of having a stroke and developing other diseases such as lung cancer are also increased. Smoking increases blood pressure and tendency for blood to clot in the arteries. Smoking also decreases HDL (good) cholesterol. As a result it causes atherosclerosis. Smoking is known to have caused damage cerebrovascular system e.g. strokes, especially to those women taking contraceptive pills.