1. CARDIOVASCULAR DISEASE The Nature of CVD Extent and Trend of CVD Risk factors Social determinants High Risk Groups

2. The Nature of CVD CVD includes al the disease of the heart and blood vessels. Major diseases include heart disease, stroke and peripheral vascular disease. Atherosclerosis is the build up of fatty tissues on the inner walls of arteries. It interferes with blood supply to the body.

3. Coronary Heart Disease Most common type of CVD = 20% of all deaths. Blood supply to the heart is decreased by narrowing arteries. Angina = blockage decreases blood flow to the heart and causes pain as a result of cramping of the heart muscle. Blockage = heart attack.

4. Cerebrovascular Disease Disease of the arteries of the brain. Stroke = an interruption of blood supply to the brain. Caused by atherosclerosis. Stroke = blood vessel may also burst.

5. Peripheral Vascular Disease Affects the blood vessels in the limbs. Arteriosclerosis = hardening of the arteries that interferes with blood supply to the muscles and skin. Close links with smoking and diabetes. Can result in gangrene and limb amputation.

6. Extent and Trend of CVD 35% of all deaths in Australia. Death rate increases with age and causes the greatest amount of death in older people. There has been a downward trend since the 1970s. This is most significant in males aged over 45 years. Males more likely to experience coronary heart disease than females. Decline in CVD - improved medical care eg. Drugs to manage blood pressure. - reduction of risk behaviour that contributes to CVD.

7. AIHW, Australia’s Health 2008 http://www.aihw.gov.au/publications/aus/ah 08/ah08.pdf http://www.aihw.gov.au/publications/aus/ah 08/ah08.pdf Pg:200

8. Risk Factors Majority of risk factors are associated to LIFESTYLE. The potential for people to alter their lifestyle varies according to the environmental factors eg: socioeconomic status.

9. Risk Factors Non-modifiable risk factors include: - Age. Risk increases with age usually with a slow progression of atherosclerosis. - Heredity. Family history - Gender. Males are at a higher risk.

10. Risk Factors Modifiable risk factors - Smoking. 5 times more likely to develop CVD. Due to increase heart rate, constriction of blood vessels and reduction in oxygen carrying capacity of the blood. - High Blood Pressure. Linked with high salt intake and overweight. - High Blood Fats = Atherosclerosis

11. Risk Factors - Overweight & Obesity. Increased risk due to extra burden on heart and lungs. Obesity linked with HBP and blood fats. - Lack of Physical Activity. Less efficient heart, higher levels of blood fats and easily gain weight. - Others include poor nutrition, alcohol, contraceptive pill and diabetes.

12. Risk Factors Other risks include alcohol, contraceptive pill (esp. with smoking) and diabetes. Males are more likely to engage in risk behaviours for CVD.

13. PROTECTIVE FACTORS Opposite of risk factors that lower chances of developing heart disease. MAINTAIN HEALTHY LEVELS OF BLOOD PRESSURE AND CHOLESTEROL: Regular BP and Ch checks for early identification and management. QUIT SMOKING:

14. PROTECTIVE FACTORS ENJOY HEALTHY EATING: From the 5 food groups mainly fruit/veg, moderatly: meats poultry, fish and dairy as well as oils and fats. VISIT DOCTOR REGUARLY: Detection of early signs and give advice on lowering the risk of CVD.

15. PROTECTIVE FACTORS BE PHYSICALLY ACTIVE: 30 min moderate intensity PA on most days will lower BP, Ch and maintain weight. ACHIEVE AND MAINTAIN A HEALTHY WEIGHT: Being overweight and carrying weight around the waist increase the risk of CVD and diabetes. Others include: controlling diabetes, managing stress, limiting saturated fats and sugars.

16. Social Determinants Socio-economic Status - More likely to demonstrate risk behaviours eg. Smoking, obesity & physical inactivity. Metro to Remote/Rural locations - Variation most notable in coronary heart disease. - linked to higher levels of smoking, obesity, lack of access to appropriate medical services and prevention support. - higher ATSI population also contributes. More likely to ask elders for assistance than Western medicine.

17. Social Determinants Gender - Males more likely to ignore early warning signs & less likely to access medical services (masculinity). Mass Media & Education - Contributed to the decline. - Greater awareness from health promotion campaigns conducted by gov. and non gov. agencies (National Heart Foundation). - Increased access to health products = better nutrition, better exercise amenities in public parks. - Some groups are still disadvantaged = low socio-economic.

18. LOCATION (rural compared to metropolitan area) - People in rural and remote areas: higher coronary heart disease due to higher levels of smoking, obesity, lack of access to health services, lack of prevention support. - Higher ATSI population live in this area and often consult an elder rather than health care.

19. High Risk Groups Males ATSI Socio-economically disadvantaged People born in Australia Specific groups – family history of heart disease, smokers, people with high blood pressure, overweight people, ‘blue collar’ workers, people over 65.