Healthy Lifestyle:

• No magic bullet
• Not new
• Requires attention
Leonardo
• 1452 – 1519
• Healthy Behaviours not
a new idea
• “Health Rules” written
more than 500 years ago
still valid today
 Cardiovascular
Disease
The leading cause of death
Risk Factors
Factors You Can’t Control

AGE
GENDER
FAMILY HISTORY
PERSONAL HISTORY
 Age
• Blood vessels narrow and become less elastic

• Men 45 - 65 higher risk

• Women over 55 higher risk (post menopausal)

 Gender
• 37% of men die of cardiovascular disease
• 41% of women
• Knowledge gap
• Symptomatology different between genders
• Diagnostic variations
 Family History
• Parents, brothers and sisters are our most
important genetic reference points

• CHD occurring before age 55 (male) or 65

(female) in these individuals may indicate
an elevated genetic risk
Factors You Can Control
SMOKING
HIGH BLOOD PRESSURE
BLOOD LIPIDS
OBESITY
DIABETES
PHYSICAL INACTIVITY
PSYCHOSOCIAL FACTORS
Smoking
 Smoking and
Coronary Artery Disease Risk
Smoking is a major risk factor for:

• CAD development
• 1st heart attack occurrence
• 2nd heart attack occurrence
• Cardiac arrest / sudden death
• Bypass graft blockages
 Effects of Smoking on the
Cardiovascular System
 heart rate
 blood pressure  O2 demand
 oxygen entry into blood stream
 hemoglobin
 oxygen carriage
 blood clotting  O2 supply
 total cholesterol, LDL-C
 HDL-C
 heart arrhythmias
 arterial wall damage
 Blood Pressure
• More prevalent with age
• Over 50% older than 60 have hypertension
• More prevalent in men
• Targets: <140/90 normal
<130/85
diabetic/renal <125/75
proteinuria
Suggestions for Keeping Blood
Pressure Low:
• Achieve and maintain ideal weight
• Restrict salt intake and salty foods
• Limit alcohol intake
• Get regular exercise
• Take BP medicine when prescribed
• Get adequate calcium and potassium
• Avoid excessive stress
 Blood Cholesterol
- Lipid Screening -
• Men > 40, Women > 50
• 2 or more risk factors for CAD
• Clinical evidence of CAD
• PVD or Carotid disease
• Family hx of CAD or dyslipidemia
• Q 5 years for asymptomatic patients
 Sedentary Lifestyle
• Physical inactivity is risk factor
• Associated with other risk factors:
– obesity
– hypertension
– hyperlipidemia
• New research shows exercise frequency
should be increased
• Tremendous benefits for lowering other risk
factors
Evolution of man?
 Benefits of Exercise
• Reduces fatigue and improves endurance
• Increases symptom threshold
• Increases caloric expenditure
• Decreases triglyceride levels
• Increases HDL cholesterol
• Decreases blood sugar
• Decreases blood pressure
• Improves mental outlook and self-esteem
 Obesity
• Strong genetic influences
• Individuals differ in behaviour
• Diets work only short term
• Best approach is to learn to make
healthy choices
BMI =
kg/m 2
 The Nurse’s Health Study
Age-Adjusted Trends in the Prevalence of Smoking,
Overweight (Body-Mass Index ≥ 25), and Postmenopausal-
Hormone Use
60

50 Overweight

40
Prevalence (%)

Postmenopausal
hormones
30

20 Smoking

10

0
1980 1982 1984 1986 1988 1990 1992
Year
Dietary Guidelines to Reduce Risk
• Limit intake of all fats
• Use more mono- and polyunsaturated fats
• Reduce cholesterol-rich foods
• Use low or nonfat dairy products
• Use only lean meats, fish, skinless poultry
• Increase the use of high fibre foods
• Use a variety of fresh fruits and vegetables
• Eat less salt and salty foods
• Pay attention to portion sizes
 Healthy Diet
• NCEP Dietary guidelines
• Total fat <30%
• Saturated fat < 7%
• Cholesterol < 200 mg/day
• Increase fibre >25 - 35 g /day
 Alcohol Consumption
• Moderate consumption
• 2 or fewer standard drinks/day
• Patients with elevated
triglycerides should be advised
to decrease or eliminate
consumption
Stress
 Stress
• Can become a problem if coping ineffective
• Family/Relationships
• Work
• Money
• Type A/Type E Personality
• Social support is key
 Stress Management
Interpretation

Event Reaction
 General Principles:
• Become physically active every day!
• Follow NCEP guidelines
• Limit alcohol, sugar and caffeine
• Achieve and maintain an ideal weight
• Manage your stress