Kamis, 22 Maret 2012

HEART DISEASE-PREVENTIVE MEASURES


PREVENIVE MEASURES 

Reduce obesity


Stop cigarette smoking


Exercise regularly


Good control of high blood pressure


Good control of diabetes


Cholesterol lowering- how low to go?


Antioxidant therapy-Vitamin E


he Mediterranean Diet


Fish oils is good for you


An aspirin a day keeps heart attacks at bay


Understanding fats

American Heart Association New Advice on Diet to Prevent and treat Hypertension

The KEY to preventing an acute heart attack would be to.. Identify the patient with plaque disease as early as possible so that effective preventive measures can be started to prevent plaque rupture and thrombosis. Studies have demonstrated that it  is possible to achieve plaque stabilization or even regression and consequently reduce the risk of heart attacks and death from fatal MI.

EBC Or Heartscan Is A Non-Invasive tool For the Early Diagnosis Of Heart Disease which has a sensitivity of 95% and a specificity of 99% for presence of coronary atherosclerotic plaque.

The treatment of coronary heart disease for the 21st century will not be treating heart attacks or its complications, but detecting and treating cholesterol plaque disease to prevent its development

Preventive Measure  Reduce Obesity

4% of Malaysians are obese while 16.6% of Malaysians are overweight  (Pre-obese Body Mass Index 25-29.9; Obese Body Mass IndexI 30.0) Obesity increases blood pressure and workload on the heart.  Obesity is related with increase in stroke (11x), Heart attack(15x), diabetes(30x)

5% reduction of body weight will lead to reduction in blood pressure while a10% reduction of body weight further lowers cholesterol

Preventive Measure   Stop cigarette smoking

In general, chronic exposure to nicotine may cause an acceleration of coronary artery disease, peptic ulcer disease, reproductive disturbances, esophageal reflux, hypertension, fetal illnesses and death, and delayed wound healing. tobacco, the vehicle of nicotine delivery, contains tar (numerous chemicals that cause a thick, sticky substance when smoked) and about 2,000 chemicals total. obacco and its various components have been associated with an increased risk for cancer of various body organs.

Effects of Nicotine Nicotine has both stimulant and depressant effects upon the body. Bowel tone and activity increases along with saliva and bronchial secretions. Stimulation of the central nervous system may cause tremors in the inexperienced user, or even convulsions with high doses. Stimulation is followed with a phase that depresses the respiratory muscles. As a euphoric agent, nicotine causes arousal as well as relaxation from stressful situations.

On the average, tobacco use increases the heart rate 10 to 20 beats per minute, and it increases the blood pressure reading by 5 to 10 millimeters of mercury (because it constricts the blood vessels). Nicotine may also increase diaphoresis (sweating), nausea, and diarrhea because of its effects upon the central nervous system. Nicotine's effects upon hormonal activities of the body is also evident. It elevates the blood level of glucose and increases insulin production. Nicotine also tends to enhance platelet aggregation, which may lead to thrombotic (blood clot) events.

The "positive" effects of nicotine upon the body may also be noted. It stimulates memory and alertness, enhancing cognitive skills that require speed, reaction time, vigilance and work performance. As a mood-altering agent, it tends to alleviate boredom and reduce stress and reduces aggressive responses to stressful events. It also tends to be an appetite suppressant, specifically decreasing the appetite for simple carbohydrates (sweets) and inhibiting the efficiency with which food is metabolized. Peoples who use tobacco products frequently depend upon it providing these side effects to help them accomplish certain tasks at specific levels of performance.

The addictive effects of tobacco have been well documented. It is considered mood and behavior altering, psychoactive, and abusable. As a multisystem pharmacological agent that is voluntarily administered, tobacco is believed to have an addictive potential comparable to alcohol, cocaine, and morphine.

For smokers, the specific health risks of tobacco use include:

nicotine addiction, decreased senses of taste and smell


increased fetal death and diseases, if mothers use


lung disease--emphysema, chronic bronchitis, lung cancer


coronary artery disease--angina, heart attacks


atherosclerotic and peripheral vascular disease--aneurysms, hypertension, blood clots, strokes


oral/tooth/gum diseases--including oral cancer

For nonsmokers exposed regularly to second hand smoke, the specific health risks include:

increased risk of lung cancer over those not exposed to smoke

in infants and children, an increased frequency of respiratory infections (such as bronchitis and pneumonia), asthma, and decreases in lung function as the lungs mature

may experience (upon exposure to smoke) acute, sudden, and occasionally severe, reactions including eye, nose, throat, and lower respiratory tract symptoms

For smokeless tobacco users the specific health risks include:

nicotine addiction, decreased senses of taste and smell

increased infant death and diseases, if mothers use oral/tooth/gum diseases--including a 50 times greater risk for oral cancer with long term or regular use

coronary artery disease--angina, heart attacks

atherosclerotic and peripheral vascular disease--aneurysms, hypertension, blood clots, strokes

SOP SMOKING

A wide range of methods exist for quitting smoking. Family members, friends, and work associates may be supportive or encouraging but the desire and commitment to quit must be a personal decision. It may prove helpful to write up a specific list of the reasons why one wants to quit. A 1990 Gallup poll of smokers revealed that two-thirds of smokers state they would like to quit.

Past attempts to quit tobacco use should be viewed as learning experiences, not failures. Information from people who have been able to successfully quit smoking shows that 70% had made 1 to 2 previously unsuccessful attempts; 20% had made 3 to 5 previously unsuccessful attempts; and 9% had made 6 or more previously unsuccessful attempts before actually quitting.

Like other addictive behaviors, tobacco use is difficult to stop and maintain, particularly if acting totally alone. he best success in quitting has been noted with comprehensive programs that may combine various strategies, over time (usually 4 to 8 weeks with 1 or 2 hours of support per week) including education, peer support, behavior recognition, behavior modification methods, recognition of potential relapse situations, and strategies for confronting such situations. Medications that are nicotine substitutes, such as transdermal nicotine or nicotine gum, may be used temporarily in conjunction with such programs. hese medications require a prescription, therefore seek the support and cooperation of the primary care provider for their use.

Comprehensive programs for quitting smoking have a successful rate of about 20 to 40% of participants. In contrast, 2.5% of people who choose to quit smoking spontaneously, without help, achieve success. Once a person has chosen to quit using tobacco products, it may prove beneficial to elicit a broad range of collaborative methods and support persons to enhance optimal success. If success is not reached initially, simply look at what occurred or what didn't work, develop new strategies, and try again. Multiple attempts are frequently necessary to "beat the habit."

Benefit of quitting within 1 hour blood pressure and pulse rate drop to normal body temperature of extremities (hands/feet) increases to normal within 8 hours of quitting carbon monoxide level in blood drops to normal oxygen level in blood increases to normal within 24 hours of quitting risk of sudden heart attack decreases within 48 hours of quitting nerve endings begin to regenerate senses of smell and taste begin to return to normal within 2 weeks to 3 months of quitting circulation improves walking becomes easier lung function increases up to 30% within 1 to 9 months of quitting overall energy typically increases symptoms associated with chronic use decrease (such as coughing, nasal congestion, fatigue and shortness of breath) cilia (fine, hair-like projections lining lower respiratory tract) function begins to return to normal, which increases the body's ability to handle mucus, clean the respiratory tract, and reduce respiratory infections within 1 year of quitting excess risk of coronary heart disease is half that of a tobacco user within 5 years of quitting lung cancer death rate (for average 1 pack/day former smoker) decreases by nearly 50% risk of cancer of the mouth is half that of a tobacco user within 10 years of quitting lung-cancer death rate becomes similar to that of a nontobacco user precancerous cells are replaced with normal cell growth risk of stroke is typically lowered, possibly to that of a nontobacco user risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases within 15 years of quitting risk of coronary heart disease is that of a nonsmoker

Preventive Measure:   Exercise reduces risk in heart patients

An inactive lifestyle is a risk factor for coronary heart disease. It also contributes to other risk factors including obesity, high blood pressure and a low level of HDL ("good") cholesterol

Regular, moderate-to-vigorous exercise is important in preventing heart and blood vessel disease. Even moderate-intensity physical activities are beneficial if done regularly and long term. Even moderate-intensity physical activity such as brisk walking is beneficial when done regularly for a total of 30 minutes or longer on most days. More vigorous activities are associated with more benefits. Exercise can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people.

Why is exercise or physical activity important? Regular aerobic physical activity increases a person's capacity for exercise. It also plays a role in both primary and secondary prevention of cardiovascular disease. Physical inactivity and cardiovascular mortality are linked.

Exercise can help control blood lipid abnormalities, diabetes and obesity. Aerobic exercise also has an independent, modest blood-pressure-lowering effect for certain groups of people with high blood pressure.

The results of pooled studies show that people who modify their behavior after heart attack to include regular exercise have better rates of survival. Healthy people - as well as many patients with cardiovascular disease - can improve their exercise performance with training.

How can physical activity or exercise help condition my body? Some activities improve flexibility, some build muscular strength and some increase endurance. Some forms of continuous activities involve using the large muscles in your arms or legs, called endurance or aerobic exercises. hey benefit the heart because they make it work more efficiently during exercise and at rest. Brisk walking, jumping rope, jogging, bicycling, cross-country skiing and dancing are examples of aerobic exercises that increase endurance. How can I improve my physical fitness? Programs designed to improve physical fitness take into account frequency (how often), intensity (how hard), and time (how long), and provide the best conditioning.

The FI Formula: F = frequency (days per week) I = intensity (how hard, e. g., easy, moderate, vigorous) or percent of heart Dr. J. Michael Gaziano of Brigham and Women's Hospital in Boston, reported 5-year follow-up findings of 5,290 physicians who had had a heart attack. He reported that those who exercised vigorously 2 to 4 times a week or more had a 40% reduction in risk of death overall and a 50% reduction in risk of cardiovascular death, specifically.

Gaziano, who also works at the Veteran's Affairs Medical Center in West Roxbury, Massachusetts, also noted that among the physicians in the study, those who exercised once a week had a risk reduction of 20% to 30% compared with those who exercised less than 3 times a month.

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