1. Learn and Live: Tips for a Healthy Lifestyle On behalf of the Creighton Cardiac Center and the American Heart Association February 2007

2. Prevalence of cardiovascular diseases in adults age 20 and older by age and sex (NHANES: 1999-2004). Source: NCHS and NHLBI. These data include coronary heart disease, heart failure, stroke and hypertension.

3. Deaths from diseases of the heart (United States: 1900– 2004.) Source: NCHS and NHLBI.

4. Hospital discharges for cardiovascular diseases. (United States: 1970-2004). Note: Hospital discharges include people discharged alive, dead and status unknown. Source: NCHS and NHLBI.

5. Symptoms of a Heart Attack Some heart attacks are sudden and intense, but most heart attacks start slowly, with mild discomfort. Chest discomfort –Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes or that goes away and comes back. –It can feel like uncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body –Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath –May occur with or without chest discomfort.

6. Symptoms of a Heart Attack Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness. As with men, women's most common heart attack symptom is chest pain or discomfort. –But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

7. What do you do??? Don't wait longer than a few minutes (no more than 5) before calling for help. Call 9-1-1... Get to a hospital right away. If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away. If you're the one having symptoms, don't drive yourself unless you have absolutely no other option.

8. Warning Signs of Stroke Sudden numbness or weakness of the face, arm or leg, especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden, severe headache with no known cause

9. Warning Signs of Stroke Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance can be sent for you. Also, check the time so you'll know when the first symptoms appeared.

10. Prevention Pays Off: Know Your Numbers!! Systolic & diastolic blood pressure –Less than 140/90 in everyone –Less than 130/80 for diabetics Whole blood glucose –Less than 126 mg/dl Cholesterol –Total < 200 mg/dl, LDL depends on your risk factors –HDL is “happy” & higher is better Height & weight: BMI < 25

11. Cholesterol It's fairly easy to lower your cholesterol –Eat more foods low in saturated fat & cholesterol –Cut down on high-fat foods, especially those high in saturated fats – Watch your caloric intake

12. Tips for Healthy Living Eat at least 5 servings of fruits & vegetables every day Eat 6 or more servings of cereals, breads, pasta & other whole-grain products Eat fish, poultry (without skin) & leaner cuts of meat instead of fatty ones Eat fat-free or 1% milk dairy products rather than whole-milk dairy products

13. Tips for Healthy Living Enjoy 30–60 minutes of vigorous activities on most (or all) days of the week Maintain a healthy weight

14. Blood Pressure (BP) High BP (HBP) usually has no symptoms The only way to find out if you have HBP is to have your BP checked If your BP is ok, get it checked at least every 2 years If you have prehypertension or if you have a family history of HBP, you're at higher risk Children & adults with smaller or larger than average-sized arms may need special-sized cuffs

15. What's normal blood pressure? BP Category Systolic Diastolic Normal < 120 and < 80 Prehypertension 120-139 or 80-89 High BP Stage 1 140-159 or 90-99 Stage 2 > 160 or > 100

16. 10 Ways to Control Your BP Know your BP. Have it checked regularly. Know what your weight should be. Keep it at or below that level.

17. 10 Ways to Control Your BP Don't use too much salt in cooking or at meals. Avoid salty foods. Eat a diet low in saturated fat according to AHA recommendations. Control alcohol intake. Don't have more than one drink a day if you're a woman or two a day if you're a man.

18. 10 Ways to Control Your BP Take your medicine exactly as prescribed. Don't run out of pills even for a single day. Keep appointments with your doctor. Follow your doctor's advice about physical activity. Make certain your relatives have their BP checked regularly. Live a normal life in every other way.

19. Diabetes (DM): Not so Sweet DM: fasting blood glucose of > 126 mg/dL "Pre-diabetes”: glucose levels are higher than normal but not yet diabetic –Increased risk for developing type 2 DM, heart disease & stroke –One of these conditions: Impaired fasting glucose Impaired glucose tolerance

20. Not so Sweet Type 2 DM is the most common form DM is a major risk factor for stroke & coronary heart disease, including heart attack (MI) Unfortunately, most diabetics are not aware of these risks

21. DM It's critical for diabetics to have regular exams Work closely with your doctor to manage your DM & control any other risk factors –If excess weight is an issue, a doctor may prescribe changes in eating habits, exercise programs and medications to help keep weight in check.

22. DM Diabetics may avoid or delay cardiovascular disease by controlling their blood sugar & other risk factors –Control weight & cholesterol with a low-fat, low- cholesterol diet & regular exercise –It's also important to lower high blood pressure –Do not to smoke –BP should be lower than 130/80 mm Hg

23. Cigarette smoking: Bad News Cigarette smoking: the most important preventable cause of premature death in the United States Smokers have a higher risk of developing a number of chronic disorders –Cardiovascular disease & MIs –Several types of cancer –Chronic obstructive lung disease

24. Bad News Smoking increases the risk of coronary heart disease by itself –when it acts with other factors, it greatly increases risk Smoking increases BP, decreases exercise tolerance & increases the tendency for blood to clot

25. Bad News Smoking also increases the risk of recurrent heart disease after bypass surgery Smoking is the most important risk factor for young men & women –It produces a greater relative risk in persons under age 50 than in those over 50 Women who smoke & use birth control pills greatly increase their risk of MI & stroke –compared with nonsmoking women who use birth control pills

26. Second-hand Smoke The link between second-hand smoke & disease is well known About 37,000 to 40,000 people die from heart & blood vessel disease caused by other people's smoke each year Of these, about 35,000 nonsmokers die from heart disease, which includes MI

27. The Good News About 48 million Americans smoke cigarettes, but most smokers are either actively trying to quit or want to quit Since 1965, more than 40% of all adults who have ever smoked have quit

28. The Good News After 1 year off cigarettes, the excess risk of heart disease caused by smoking is reduced by 50% –After 15 years of abstinence, the risk is similar to that for people who've never smoked In 5 to 15 years, the risk of stroke for ex- smokers returns to the level of those who've never smoked

29. The Good News Male smokers who quit between ages 35 to 39 add an average of 5 years to their lives Female quitters in this age group add 3 years Men & women who quit at ages 65 to 69 increase their life expectancy by 1 year

31. Benefits of Exercise Improves self-image Controls weight Improves cholesterol Prevents/manages BP Prevents bone loss Boosts energy level Helps manage stress & releases tension Improves the ability to sleep well Counters anxiety/depression Increases strength/ability to do other physical activities Provides a way to share an activity with family & friends Establishes good heart-healthy habits in children Helps prevent chronic illnesses associated with age Maintains quality of life & independence longer

32. Painless Ways to Increase Activity Do housework yourself; Garden or mow Go out for a walk before or after meals Walk or bike to the store instead of driving If walking, pick up the pace or choose a hilly route Pedal your stationary bicycle while watching TV Stand up while talking on the telephone Walk the dog Park farther in the lot & walk the extra distance Keep exercise equipment in good working order & use it

33. Painless Ways to Increase Activity Plan outings that include physical activity See the sights in new cities by walking Make a date with a friend to enjoy physical activities Play music while exercising or doing housework Dance with someone or by yourself Join a club that emphasizes physical activity When golfing, walk instead of using a cart Play singles tennis instead of doubles At a picnic, join in on badminton instead of croquet

34. Painless Ways to Increase Activity Walk in the American Heart Association’s Heart Walk

35. Learn More & Live Know your numbers Get active Work with your doctor http://www.americanheart.org

36. The Cardiac Center at 3006 Webster Street

37. Mission Quality patient care through education & research SERVICE, SERVICE, SERVICE We strive to exceed your expectations

38. Division of Cardiology 18 Faculty Cardiologists –11 Non-invasive – 4 Interventional – 3 Electrophysiology 12 Cardiology Fellows 3 NPs/PAs 200+ Staff –Registered Nurses –PharmDs –Exercise Science Specialists –Nutritionists –Tobacco Treatment Specialist –Cardiac Sonographers –Technicians –Clerical Staff –Administrative Professionals

39. Outpatient Sites 3006 Webster (West of CUMC hospital) Lakeside Bergan NW Radial Highway Columbus, NE Onawa, IA 9 Outreach Sites in NE & IA

40. Outpatient Prevention Services Partners in Cardiology –Club Exercise Membership –Individualized Exercise Program Nutrition Education –Private –Group Classes –Cooking Schools Stress Management Tobacco Treatment –Group –Individual

41. Outpatient CV Services Patient Eval & Mgmt EKG Laboratory Studies Chest X-ray Stress Testing Diagnostic Cardiac Cath Cardiovascular Ultrasound Carotid, peripheral, renal, abdominal EECP Cardiac Rehabilitation Arrhythmia Mgmt Services Event Recorders Holter Monitors Heart-Lite Therapeutic Monitoring Anticoagulation medications Arrhythmia medications HIT (Heart Failure Mgmt) Device Mgmt Pacemaker ICD

42. Support Groups The Cardiac Upbeats The Jump Starters Mended Hearts

43. Collaborative Approach With Primary Care Provider Patient Family Among faculty –Built in “second opinion”

44. Call Us With Questions If you or a loved one have questions regarding Heart Health, talk to your primary care physician or contact The Cardiac Center of Creighton University Medical Center at 280-5920 to learn more about the programs available through Creighton's healthcare services.