Coronary Risk FactorsCoronary Risk Factors

IntroductionIntroduction• Coronary Heart Disease (CHD) can Coronary Heart Disease (CHD) can

affect anyone at anytime.affect anyone at anytime.• However, there are circumstances However, there are circumstances

called RISK FACTORS that make it more called RISK FACTORS that make it more likely for you to have a heart problemlikely for you to have a heart problem

• -Risk factors you can change-Risk factors you can change• -Risk factors you cant change-Risk factors you cant change

• You cannot change – age, sex and family You cannot change – age, sex and family history.history.

• Age-we are all getting older!Age-we are all getting older!• Sex-being a man predisposes you to heart Sex-being a man predisposes you to heart

disease before the age of 65yrs.Women disease before the age of 65yrs.Women are protected because of hormones, are protected because of hormones, oestrogen until the menopause.oestrogen until the menopause.

• Family history- Close relative under 50 Family history- Close relative under 50 with heart disease will increase your risk. with heart disease will increase your risk.

Risk Factors We Can Risk Factors We Can ChangeChange• SMOKINGSMOKING• Bad DIETBad DIET• HYPERTENSIONHYPERTENSION• STRESSSTRESS• Lack of EXERCISELack of EXERCISE• ALCOHOLALCOHOL• OVERWEIGHTOVERWEIGHT• High CHOLESTEROLHigh CHOLESTEROL

• Evidence shows that more than half Evidence shows that more than half the fall in CHD deaths in the last 20 the fall in CHD deaths in the last 20 years are down to reductions in the years are down to reductions in the major risk factors- smoking, diet, major risk factors- smoking, diet, obesity and lack of exercise (DoH, obesity and lack of exercise (DoH, 2007)2007)

SMOKINGSMOKING• Smoking is a very powerful Smoking is a very powerful

addiction, both physical addiction, both physical and psychologicaland psychological

• It affects every cell in the It affects every cell in the bodybody

• Every time you puff, up to Every time you puff, up to 4000 chemicals are inhaled 4000 chemicals are inhaled into your lungs. 43 of which into your lungs. 43 of which cause cancer.cause cancer.

• Smokers have more heart Smokers have more heart disease, artery damage, disease, artery damage, strokes, cancer, bronchitis, strokes, cancer, bronchitis, emphysema, osteoporosis, emphysema, osteoporosis, and wrinkles.and wrinkles.

NicotineNicotine• Nicotine is a poison that contracts blood Nicotine is a poison that contracts blood

vessels, including the coronary arteries vessels, including the coronary arteries that supply the heart. This makes them that supply the heart. This makes them stiff and therefore less flexible.stiff and therefore less flexible.

• It will stimulate your brain to produce It will stimulate your brain to produce more adrenaline causing your heart to more adrenaline causing your heart to beat faster and raise your blood beat faster and raise your blood pressure.pressure.

Carbon MonoxideCarbon Monoxide• Replaces the oxygen carried by red Replaces the oxygen carried by red

blood cells, leaving organs including blood cells, leaving organs including the heart short of oxygen.the heart short of oxygen.

• Organs do not work well with Organs do not work well with decreased oxygen.decreased oxygen.

Benefits of Giving UpBenefits of Giving Up..After 2-12 weeksAfter 2-12 weeks: circulation improves and : circulation improves and

exercise becomes easier.exercise becomes easier.After 3-9 monthsAfter 3-9 months: lung efficiency improves : lung efficiency improves

by 5-10%.by 5-10%.After 5 yearsAfter 5 years: risk of heart attack drops to : risk of heart attack drops to

half that of a smoker.half that of a smoker.After 10 yearsAfter 10 years: heart attack risk falls to the : heart attack risk falls to the

same as someone who has never smoked. same as someone who has never smoked.

DIETDIET• Healthy eating is Healthy eating is

important as it has important as it has many benefits such many benefits such as keeping your as keeping your weight and weight and cholesterol downcholesterol down

• MODERATIONMODERATION is the is the key word – a little of key word – a little of what you fancy does what you fancy does you no harmyou no harm

The key to healthy eating The key to healthy eating is; ‘A Balanced is; ‘A Balanced

Diet’Diet’

OVERWEIGHTOVERWEIGHT• Why do we put weight on? Why do we put weight on?

It’s simple!It’s simple!• If we eat more calories than If we eat more calories than

we burn up, the spare we burn up, the spare calories will be stored as fatcalories will be stored as fat

• If you are overweight the If you are overweight the heart has to work harder to heart has to work harder to pump around a ‘bigger pump around a ‘bigger body’body’

• You will feel less likely to You will feel less likely to take regular exercisetake regular exercise

• Your blood pressure may be Your blood pressure may be higher and your cholesterol higher and your cholesterol is more likely to be raised. is more likely to be raised. Also you may have a risk of Also you may have a risk of getting diabetes.getting diabetes.

What can we do?What can we do?

• Aim to eat 3 regular meals. Don’t Aim to eat 3 regular meals. Don’t skip breakfast.skip breakfast.

• ½ fill your plate with veg or salad ½ fill your plate with veg or salad and divide the other half between and divide the other half between the meat, fish, or other protein the meat, fish, or other protein and the potatoes pasta or rice.and the potatoes pasta or rice.

• Limit salt and salty foodsLimit salt and salty foods• Cut back on saturated fat – grill, Cut back on saturated fat – grill,

bake or steambake or steam• Exercise for 30 mins at least 5 Exercise for 30 mins at least 5

times a week.times a week.

CHOLESTEROL (LIPIDS)CHOLESTEROL (LIPIDS)• LDL – the higher the LDL LDL – the higher the LDL

level the more likely level the more likely your arteries are to have your arteries are to have fatty deposits, this can fatty deposits, this can lead to narrowing of the lead to narrowing of the arteries.arteries.

• The main aim of a low The main aim of a low fat diet is to reduce your fat diet is to reduce your LDL levelLDL level

• Regular exercise will Regular exercise will help decrease LDLhelp decrease LDL

CHOLESTEROL (LIPIDS)CHOLESTEROL (LIPIDS)• HDL – this carries HDL – this carries

cholesterol back to the cholesterol back to the liver to be broken down liver to be broken down and eliminatedand eliminated

• The higher the level The higher the level the lower your risk of the lower your risk of developing Coronary developing Coronary Heart DiseaseHeart Disease

TriglyceridesTriglycerides• These are another form These are another form

of cholesterol of cholesterol • High levels of High levels of

triglycerides in the triglycerides in the bloodstream can bloodstream can contribute to the risk of contribute to the risk of heart disease.heart disease.

• Exercise and a lower Exercise and a lower carbohydrate diet can carbohydrate diet can reduce your trig..reduce your trig..

• Omega-3 fatty acids and Omega-3 fatty acids and statins help reduce your statins help reduce your cholesterol and trig..cholesterol and trig..

ALCOHOLALCOHOL

• Most of us enjoy a drink, Most of us enjoy a drink, howeverhowever regular regular heavy drinking is a major health hazard heavy drinking is a major health hazard and it’s on the increaseand it’s on the increase

• 1-2 units per day is said to be beneficial, 1-2 units per day is said to be beneficial, not more than 14 units a week for a not more than 14 units a week for a woman and 21 for a manwoman and 21 for a man

• Small amounts help Small amounts help prevent heart disease prevent heart disease and stroke by and stroke by increasing the good increasing the good cholesterolcholesterol

• Makes the blood less Makes the blood less stickysticky

• Its important not to Its important not to save all your units for save all your units for the weekend, avoid the weekend, avoid binge drinkingbinge drinking

BLOOD PRESSUREBLOOD PRESSURE• It’s essential for our blood to It’s essential for our blood to

travel around the body. It travel around the body. It won’t get anywhere without won’t get anywhere without pressurepressure

• Normal range varies – 100-Normal range varies – 100-150/70-90150/70-90

• Systolic = is the top readingSystolic = is the top reading• Diastolic = the bottom Diastolic = the bottom

readingreading• These figures tell us what the These figures tell us what the

pressure in the heart is pressure in the heart is before the heart pumps before the heart pumps blood and just after it has blood and just after it has pumped the blood around pumped the blood around the bodythe body

• Most cases of increased Most cases of increased BP have no causeBP have no cause

• It may run in familiesIt may run in families• Eating too much salt, Eating too much salt,

being overweight, being overweight, drinking too much alcohol drinking too much alcohol and not exercising enough and not exercising enough can raise itcan raise it

• Stress can also have a Stress can also have a bearing on B.Pbearing on B.P

• Increased B.P occurs as Increased B.P occurs as we get older, but not we get older, but not usually in people with low usually in people with low salt intakessalt intakes

What does it do to you?What does it do to you? walls of the arteries walls of the arteries

can become can become damaged by wear damaged by wear and tear of the blood and tear of the blood flow under pressureflow under pressure

• Arteries affected in Arteries affected in particular are, the particular are, the coronary arteries coronary arteries and the arteries in and the arteries in the brain.the brain.

TREATMENTTREATMENT• Mild increase in B.P can Mild increase in B.P can

be controlled by be controlled by lifestyle changes e.g; lifestyle changes e.g; decreased salt intake, decreased salt intake, losing weight, taking losing weight, taking exercise, reducing exercise, reducing stressstress

• Very high BP should be Very high BP should be controlled with controlled with medication and usually medication and usually for life. The dose can for life. The dose can sometimes be lowered if sometimes be lowered if you make certain you make certain changes to your lifestylechanges to your lifestyle

And finally…..And finally…..• There is only one There is only one

person who can person who can change your change your lifestyle…..YOU!lifestyle…..YOU!

• Take care of your Take care of your heart and it will heart and it will take care of you.take care of you.