 Healthy Steps for a Healthy Heart
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Heart Disease and Stroke: The Nation’s Leading Killers
Heart disease and stroke-the principal components of cardiovascular disease-are
the first and third leading causes of death in the United States, accounting
for more than 40% of all deaths. About 950,000 Americans die of cardiovascular
disease each year, which amounts to one death every 33 seconds. Although cardiovascular
disease is often thought to primarily affect men and older people, it is a major
killer of women and people in the prime of life. More than half of all cardiovascular
disease deaths each year occur among women. Arkansans have one of the highest
death rates from heart disease in the US.
Deaths Only Part of the Picture
A consideration of deaths alone understates the burden of cardiovascular disease.
About 61 million Americans (almost one-fourth of the population) live with this
disease. Heart disease is a leading cause of disability among working adults.
Stroke alone accounts for disability among more than 1 million Americans. Almost
6 million hospitalizations each year are due to cardiovascular disease.
The economic impact of cardiovascular disease on the U.S. health care system
continues to grow as the population ages. The estimated cost of cardiovascular
disease in the United States in 2001 is $298 billion, including health care
expenditures and lost productivity.
Risk Behaviors Are Largely Responsible
Three health-related behaviors contribute markedly to cardiovascular disease:
Tobacco use. Smokers have twice the risk for heart attack of nonsmokers. Nearly
one-fifth of all deaths from cardiovascular disease, or about 190,000 deaths
a year, are smoking-related. Every day, more than 3,000 young people become
daily smokers.
Lack of physical activity. People who are not physically active have twice
the risk for heart disease of those who are active. More than half of U.S. adults
do not achieve recommended levels of physical activity.
If you're inactive, doing anything is better than nothing! Studies show that
people who have a low fitness level are much more likely to die early than people
who have achieved even a moderate level of fitness. If you want to exceed a
moderate level of fitness, you need to exercise three or four times a week for
30 to 60 minutes at 50-80 percent of your maximum capacity. Some of the benefits
of exercise are:
- Reduces the risk of heart disease by improving blood circulation throughout
the body
- Keeps weight under control
- Improves blood cholesterol levels
- Prevents and manages high blood pressure
- Prevents bone loss
- Boosts energy level
- Helps manage stress
- Releases tension
- Improves the ability to fall asleep quickly and sleep well
- Improves self-image
- Counters anxiety and depression and increases enthusiasm and optimism
- Increases muscle strength, increasing the ability to do other physical activities
- Provides a way to share an activity with family and friends
- Establishes good heart-healthy habits in children and counters the conditions
(obesity, high blood pressure, poor cholesterol levels, poor lifestyle habits,
etc.)
that lead to heart attack and stroke later in life
- In older people, helps delay or prevent chronic illnesses and diseases
associated with aging and maintains quality of life and independence longer
Poor nutrition. People who are overweight have a higher risk for cardiovascular
disease. Almost 60% of U.S. adults are overweight or obese. Only 18% of women
and 20% of men report eating five servings of fruits and vegetables each day.
Healthy food habits can help you reduce three of the major risk factors for
heart attack -- high blood cholesterol, high blood pressure and excess body
weight. They'll also help reduce your risk of stroke, because heart disease
and high blood pressure are major risk factors for stroke. The American Heart
Association Eating Plan for Healthy Americans is based on these new dietary
guidelines, released in October 2000:
- Eat a variety of fruits and vegetables. Choose 5 or more servings per day.
- Eat a variety of grain products, including whole grains. Choose 6 or more servings
per day.
- Include fat-free and low-fat milk products, fish, legumes (beans), skinless
poultry and lean meats.
- Choose fats and oils with 2 grams or less saturated fat per tablespoon, such
as liquid and tub margarines, canola oil and olive oil.
- Balance the number of calories you eat with the number you use each day. (To
find that number, multiply the number of pounds you weigh now by 15 calories.
This represents the average number of calories used in one day if you're moderately
active. If you get very little exercise, multiply your weight by 13 instead
of 15. Less-active people burn fewer calories.)
- Maintain a level of physical activity that keeps you fit and matches the number
of calories you eat. Walk or do other activities for at least 30 minutes on
most days. To lose weight, do enough activity to use up more calories than you
eat every day.
- Limit your intake of foods high in calories or low in nutrition, including foods
like soft drinks and candy that have a lot of sugars.
- Limit foods high in saturated fat, trans fat and/or cholesterol, such as full-fat
milk products, fatty meats, tropical oils, partially hydrogenated vegetable
oils and egg yolks. Instead choose foods low in saturated fat, trans fat and
cholesterol from the first four points above.
- Eat less than 6 grams of salt (sodium chloride) per day (2,400 milligrams of
sodium).
- Have no more than one alcoholic drink per day if you're a woman and no more
than two if you're a man. "One drink" means it has no more than 1/2
ounce of pure alcohol. Examples of one drink are 12 oz. of beer, 4 oz. of wine,
1-1/2 oz. of 80-proof spirits or 1 oz. of 100-proof spirits.
Following this eating plan will help you achieve and maintain a healthy eating
pattern. The benefits of that include a healthy body weight, a desirable blood
cholesterol level and a normal blood pressure. Every meal doesn't have to meet
all the guidelines. It's important to apply the guidelines to your overall eating
pattern over at least several days. These guidelines may do more than improve
your heart health. They may reduce your risk for other chronic health problems,
including type 2 diabetes, osteoporosis (bone loss) and some forms of cancer.
What is a heart attack?
The heart works 24 hours a day, pumping oxygen- and nutrient-rich blood to
the body. Blood is supplied to the heart through its coronary arteries. In coronary
heart disease (CHD), plaques or fatty substances build up inside the walls of
the arteries. The plaques also attract blood components, which stick to the
artery wall lining. Called atherosclerosis, the process develops gradually,
over many years. It often begins early in life, even in childhood. The fatty
buildup or plaque can break open and lead to the formation of a blood clot that
seals the break. The clot reduces blood flow. The cycle of fatty buildup, plaque
rupture, and blood clot formation causes the coronary arteries to narrow, reducing
blood flow.
When too little blood reaches the heart, the condition is called ischemia.
Chest pain, or angina, may occur. The pain can vary in occurrence and be mild
and intermittent, or more pronounced and steady. It can be severe enough to
make normal everyday activities difficult. The same inadequate blood supply
also may cause no symptoms, a condition called silent ischemia.
If a blood clot suddenly cuts off most or all blood supply to the heart, a
heart attack results. Cells in the heart muscle that do not receive enough oxygen-carrying
blood begin to die. The more time that passes without treatment to restore blood
flow, the greater the damage to the heart.
Heart Attack Warning Signs
Some heart attacks are sudden and intense -- the "movie heart attack,"
where no one doubts what's happening. But most heart attacks start slowly, with
mild pain or discomfort. Often people affected aren't sure what's wrong and
wait too long before getting help. Here are signs that can mean a heart attack
is happening:
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. This feeling often comes along with chest discomfort.
But it can occur before the chest discomfort.
Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness
If you or someone you're with has chest discomfort, especially with one or
more of the other signs, 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.
Calling 9-1-1 is almost always the fastest way to get lifesaving treatment.
Emergency medical services staff can begin treatment when they arrive -- up
to an hour sooner than if someone gets to the hospital by car. The staff are
also trained to revive someone whose heart has stopped. You'll get treated faster
in the hospital if you come by ambulance, too.
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.
What is Stroke?
A stroke occurs when the blood supply to the part of the brain is suddenly
interrupted (ischemic) or when a blood vessel in the brain bursts, spilling
blood into the spaces surrounding the brain cells (hemorrhagic). The symptoms
of stroke are easy to spot: sudden numbness or weakness, especially on one side
of the body; sudden confusion or trouble speaking or understanding speech; sudden
trouble seeing in one or both eyes; sudden trouble walking; dizziness; or loss
of balance or coordination. Brain cells die when they no longer receive oxygen
and nutrients from the blood or when they are damaged by sudden bleeding into
or around the brain. These damaged cells can linger in a compromised state for
several hours. With timely treatment, these cells can be saved. Stroke is diagnosed
through several techniques: a short neurological examination, blood tests, CT
scans, MRI scans, Doppler ultrasound, and arteriography. Stroke seems to run
in some families. Family members may have a genetic tendency for stroke or share
a lifestyle that contributes to stroke. The most important risk factors for
stroke are hypertension, heart disease, diabetes, and cigarette smoking. Other
risks include heavy alcohol consumption, high blood cholesterol levels, illicit
drug use, and genetic or congenital conditions. Some risk factors for stroke
apply only to women. Primary among these are pregnancy, childbirth, and menopause.
Stroke prevention is still the best medicine. The most important treatable
conditions linked to stroke are:
High blood pressure. Treat it. Eat a balanced diet, maintain a healthy weight,
and exercise to reduce blood pressure. Drugs are also available.
Cigarette smoking. Quit. Medical help is available to help quit.
Heart disease. Manage it. Your doctor can treat your heart disease and may
prescribe medication to help prevent the formation of clots. If you are over
50, scientists believe you and your doctor should make a decision about aspirin
therapy.
Diabetes. Control it. Treatment can delay complications that increase the risk
of stroke.
Transient ischemic attacks (TIAs). Seek help. TIAs are small strokes that last
only for a few minutes or hours. They should never be ignored and can be treated
with drugs or surgery.
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