1. Cardiovascular Disease: Knowing the Risk Factors, Symptoms, and Prevention
Arvi Grover M.D.
Director of Cardiovascular Research,
Director of Heart Health Program,
KMH Cardiology

2. What are heart disease and stroke? What are the warning signs?
Today’s presentation
The Heart Truth……………..
What are heart disease and stroke?
What are the warning signs?
What are the risk factors?
How can you reduce your risks?
How to talk to your doctor?
Today’s presentation is made possible by The Heart Truth campaign, created by the Heart and Stroke Foundation to raise awareness among Canadian women that heart disease and stroke is one of their biggest health risks, killing seven times more women than breast cancer. During the next hour, we will cover a range of topics on heart disease and stroke and how they affect women.

3. Simple Stats
9 out of 10 Canadians over the age of 20 have at least one of the following risk factors:
smoking,
physical inactivity during leisure time,
less than recommended daily consumption of vegetables and fruit,
stress,
overweight or obesity,
high blood pressure,
or diabetes.
2 in 5 have three or more of these risk factors
Addressing these risk factors will reduce the risk not only of CVD, but also of many other chronic diseases that share the same risk factors. ,
AHA Heart Disease and Stroke Statistics 2010 Update. Circulation 2010;121:e41-e215.

4. Most common type is coronary artery disease
What is heart disease?
Damage to the heart
Most common type is coronary artery disease
angina caused by reduced blood supply and oxygen to the heart
heart attack caused by reduction or stoppage of blood supply/oxygen
What is heart disease? The term heart disease describes a number of conditions that can affect and damage the structure and function of the heart. While there are many kinds of heart disease, most heart disease is a result of a blockage to the arteries that serve the heart. These arteries provide oxygen-rich blood to the heart, so when they’re blocked, the heart muscle becomes starved of oxygen, causing angina or a heart attack. Stroke is very similar - most strokes are a result of a blockage in the blood vessels that serve the brain.

5. Do you know the warning signs of a heart attack?

6. Heart Attack Symptoms - MEN
Chest pain
Discomfort in other areas of the upper body
One or both arms
Back, neck or jaw
Stomach
Shortness of breath
Other signs
Cold sweat
Nausea
Lightheadedness
Fatigue

7. Heart Attack Symptoms - WOMEN
As with men, chest pain or discomfort
More likely- other symptoms:
Shortness of breath
Nausea/vomiting
Back or jaw pain
Not feeling right
Fatigue
Palpitations
Musculoskeletal complaints
Hot flashes

8. Cardiovascular Disease Risk Factors
History of CAD/PAD
Male Sex
History of TIA/CVA
Smoking
Hypertension(high blood pressure)
Diabetes Mellitus
Dyslipidemia (high cholesterol)
Low HDL < 1.0
Elevated LDL / TG
Family History - event in first degree relative > 55 male, > 65 female
Chronic Kidney Disease
Obesity
Lack of regular physical activity
Diet poor in fruits, vegetables, and fiber
Age > 45 male, > 55 female

9. Risk Factors that Can’t Be Changed
Age
Gender: Male
Heredity – Family History
Race
Previous CAD, PVD or CVA

10. Exercise is a Medicine Physicians should prescribe it, Patients should take it!
Instead of an allergy, exercise may be the long sought vaccine to prevent chronic disease and extend life
As the evidence has continued to mount about the health detriments of being physically inactive, it has become clear that exercise is a “medicine” – a vaccine that can prevent multiple chronic and mental diseases, as well as improve and extend our quality of life.
Therefore, we have come to the point where we are now asking ourselves - ….
Are we reaching a point where NOT prescribing physical activity should be consider patient neglect?

11. Do You Really Think We have a Chance Without Exercise?
Obesity
Coronary artery disease
Diabetes
Hypertension
Cancer
Depression and anxiety
Arthritis
Osteoporosis
Etc, etc, etc…
Patients
Physicians
NO!
EIM takes the position that to make exercise a “pill” that every patient takes, physicians and their healthcare teams must play a major role in helping encourage and support their patients in becoming more physically active!

12. Physical Activity and Reduced Mortality (Lancet, Vol 378, Issue 9798, Pages 1244-1253, October 2011)
Those who exercised for at least 90 min / week or 15 min/day had a 14% reduction in mortality
Further extra 15 min/day reduced mortality even more by 4% and reduced cancer risk by another 1%
Inactive individuals had a 14% increased mortality risk

13. Cardiovascular Diet

14. Cardiovascular Care Smoking cessation Physical activity Diet
Cessation-class, medications, counseling
Physical activity
Goal minutes daily
Risk assessment prior to initiation
Diet
DASH diet, Mediterranean diet, fiber, omega-3 fatty acids
<7% total calories from saturated fats

15. Cardiac Screening – Heart Health Program
Know your personal and family history
Appropriate screening for your level of risk
Program consists of aprox. 6 visits over 1 year
Testing to determine current status
Multi-disciplinary approach to increase your education on proper lifestyle, including diet and exercise
Take charge of your health

16. Prevention Begins with You
Take one step at a time
Replace unhealthy habits with healthier ones
Eat for a healthy heart
Start walking—try 10 minutes and add time gradually to reach 2 hours and 30 minutes each week

17. How to Keep Going View changes as a new lifestyle, not quick fixes
Set realistic goals
Buddy up
Don’t worry about slipping up—get back on track
Reward your successes
Be your own advocate—ask questions and seek information

18. The Heart Truth®
It’s up to you to protect your heart health—start today!

19. Heart Health Program
Speak to your doctor to see if you could benefit from enrollment
No cost to patients
Services include regular Cardiology/Dietician assessment
6 visits over 14 months
Multiple locations across GTA and Southeastern Ontario