How to Prevent Heart attack ?????

Coronary Artery Disease
In India:
An Emerging Epidemic
http://healthsafetyupdates.blogsp
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Beating Heart
The human heart is really the most amazing organ
in the body.
It beats even before you are born into this world,
continuing to do so until you take your last breath.
For as long as you are alive, your heart is hard at
work.
There is no other muscle in your body that
works in such an astonishing way.
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Facts• 6000 L/day.
• 250-300 grams/fist.
• Beats 100,000 /day. 35 million times / year. 2.5 billion times/ whole
life .
• 5.6 liters of blood . 3 times a minutes through all body.
• In one day, the blood travels a total of 19,000 km.
• The aorta- a garden hose. Capillaries-human hair.
• The heart pumps about 1 million barrels of blood during an average
lifetime--that's enough to fill more than 3 super tankers.
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Growing
but
preventable Epidemic !!
0
2
4
6
8
10
12
14
1960 1962 1968 1990 1994 2001
Heart Disease in Indians
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35
12
20
0
5
10
15
20
25
30
35
40
45
50
India USA China
Comparative CAD deaths in 35-64 age group
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CAD in India - An Emerging Epidemic
• 10% of adult population – 6 crores
• 15-16x105
– die annually because of Cardiovascular disease
• 91 people die/hr in India
• By 2010 – maximum no. of CAD cases in India
Goal of Preventive Cardiology
• Delay Heart Attacks
• Reverse blockage of arteries
• Eradicate premature death & disability by
1. Education – regarding life style changes
2. Early detection – of disease
3. Holistic medical managementhttp://healthsafetyupdates.blogsp
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What is the cause of Increase Heart
Attack in Indians
1. Increase Longevity
2. Better control of Diseases
- Infections (Diarrhea, TB) & Nutritional
3. Increase in Risk Factors & Exposure like HT,DM,lipids
4. Rapid urbanization, industrialization – lead to affluence
& unhealthy life style
- ↑ Smoking, ↑ Alcohol
- Sedentary habits
- Unhealthy food
5. Genetic Predisposition – Metabolic Syndromehttp://healthsafetyupdates.blogsp
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Is CAD different in Indian Population ?
• Younger Age - 10 year earlier
• Angiogram - Triple Vessel, Extensive, Rapid progr.
• Increase Mortality – 2 to 3 times
 About 25% of MI - under the age of 40.
 About 67% of MI - under the age of 55
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THE HEART
HEART
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NORMAL CORONARIESNORMAL CORONARIES
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NORMAL AND DISEASEDNORMAL AND DISEASED
CORONARIESCORONARIES
NORMAL AND DISEASEDNORMAL AND DISEASED
CORONARIES-CORONARIES- Cont.Cont.
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AtherosclerosisNORMAL AND DISEASEDNORMAL AND DISEASED
CORONARIESCORONARIES-Cont.-Cont.
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Atherosclerosis- contd.NORMAL AND DISEASEDNORMAL AND DISEASED
CORONARIES- Cont .CORONARIES- Cont .
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HEART UNDER MULTIPLE
STRESS
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Risk Factors
• Age
• Family History
• Gender
Hypertension x 3Hypertension x 3
Serum cholesterol x 4Serum cholesterol x 4
Obesity x 2.5Obesity x 2.5
Diabetes Mellitus x 3Diabetes Mellitus x 3
Stress x 2.5Stress x 2.5
Cigarette, Smoking x 3Cigarette, Smoking x 3
Physical Inactivity x 2.5Physical Inactivity x 2.5
Lack of intake of fruits &
vegetables
Non Modifiable Modifiable
Risk of HA (Times)
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Adverse effects of Modern Lifestyle
1. DIET – Rich in fats, salt, Low Fiber, Junk & Fast food,
↑ Dairy Consumption(“being vegetarian”)
2. Lack of Exercise
3. Increase Tobacco Consumption
4. Psychosocial Stress
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Risk Factors For Heart Attacks
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Metabolic Syndrome
Genetic
Environment
HT IGT & DM
Clotting
Factors
Dyslipidaemia
(↑ TGY, ↓ HDL, ↑ LDL-s)
↑ Blockage of Arteries (Heart, Limbs & Brain)
Central Obesity
Insulin Resistance
2-3 times chances of CAD & DMhttp://healthsafetyupdates.blogsp
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How to Diagnose Metabolic Syndrome
1. Waist circumference (Central Obesity)
Men >36”, Women >32”(For South Asia)
Plus
2. BP - > 130/85 mmHg
3. F Blood Sugar > 100 mg/dl
4. HDL-Cholesterol < 40 mg – Male
< 50 mg – Female
5. Triglycerides - > 150 mg/dl
Central Obesity + 2 of the 4 factors
40% persons have
MeTS
after 40 yrs of age
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What can we do to prevent it ??
Heart Disease in Indians
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What are life style changes
• Regular exercise
• Healthy Food habits
• Stress management – Yoga & Meditation
• Tobacco Cessation
Simple, Affordable & Effectivehttp://healthsafetyupdates.blogsp
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Physical Activity
• > 30 min mod. int. exc. 5-7 d / week
Isotonic Exc. - Brisk walking, cycling, Tread
mill (Warmup - maint. - cooldown)
• Incorporate physical activity in daily activity
(eg climbing stairs)
• Patient with CVD or > 2 risk factors for CVD
TMT - to establish safety of exc./supervise exer.
• Calculation : walk 5 km / hr – burn 5 cal. / minhttp://healthsafetyupdates.blogsp
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Risk Factors High Moderate Low
HDL-C ++ +
TGY ++ +
GLU-INTOL. + +
HT + +
BODY WT + +
PSYCHOLOGICAL + +
Exercise Intensity for Coronary Risk Factors
Modification
Low 40% of Max THR, Mod 60-75%, High->75% of Max THR (Target Heart Rate)
LDL(Small Dense) → LDL-Largehttp://healthsafetyupdates.blogsp
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A smoker’s risk of heart
attack is more than 2 to three
times that of nonsmokers & is
directly related to No. of
cigarettes
Cigarette smoking is the
biggest risk factor for sudden
cardiac death.
American Heart Association, 1997
Smoking and Heart
Tobacco chewing (Paan Parag)
Bidis, Cigar - equally bad
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“You need to lose twenty cable channels.”
Treatment of Obesity
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Dietary Management
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Problematic Lifestyle Trends: Eating
• Television advertising
of food,more eating out.
• Increased Convenience
food consumption
• Larger portions of food
• Increased Soft drink
and juice consumption
Cocacolanization & Mcdonalization
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Diet & Heart Disease
 Impact of diet on large pop. is substantial, on individual small
 SAT. F.A. – Palmitic, Myristic (Ghee), Lauric, stearicacid (Beef)
– ↓ TC – 10%-15%, LDL-C ↓ 15-20%
– Animal product, Dairy, Coconut, Palm
 MUFA (Omega – 9)
 Olive oil, peanut, Nuts, cereals, animal
 Trans fatty acids - ↑ LDL, ↓ HDL, ↑ Lp(a)
 Part. hydr. veg oils – margarine, fast foods cookies, chips / cakes
 PUFA (omeg 3 & 6) - Sunflower, Soyabean, Safflower, Corn, Walnut
 Soya & phytochemicals – soyprotein / garlic (Tocotrienol)
 Alcohol → 1-2 drink / day, 5 oz wine / 1/2 Beer
 Fishoils - ↓ TGY, Antiplet, ↓ Fibringen (DART)
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Heart and Alcohol
“Whether Wine is Nourishment,
Medicine or Poison,
is a matter of dose”
Paracelcus –German physician
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Trans & Saturated Fat
• Replacing 2% of Trans fat, lowers the Risk of Heart disease by
53%.
• 5% increase in the Saturated Fat will have 17 % increase in
the risk of Heart Disease.
• Avoid over heating & reuse of oil
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A Comparison of Cooking Fats
77%
49%
25%
24%
20%
13%
28%
77%
69%
61%
62%
33%
9% 14%
18%
13%
15%
11%
10%
69%
Olive oil
Peanut oil
Corn oil
(Mustard)
Soyabean oil
Sunflower oil
Saffower oil
(Kardi)
Butter / Ghee
(Coconut / Palm)
Monounsaturated Fatty Acids
(MUFA)
Protects ‘good’ cholesterol (HDL)
and reduces the level of ‘bad’
cholesterol (LDL)
reduces the risk of heart
disease and diabetes
Polyunsaturated Fatty Acids
(PUFA)
Reduces levels of both ‘good’
(HDL) and ‘bad’ (LDL cholesterol
Oxidises readily
Breaks down into potentially toxic
substances during cooking
Saturated Fatty Acids (SFA)
Increases levels of ‘bad’
(LDL) cholesterol
increases the risk of
cardiovascular disease
3%
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Fruits & Vegetables
2-3 servings of fruits & vegetables reduces heart attacks
by 25-30%
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Little Known Quote
"One-quarter of what you eat
keeps you alive. The other three-
quarters keeps your doctor
alive."
(Hieroglyph found in an
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Nuts & Heart Diseases
• Myth – Nuts are bad for heart & they increase cholesterol
• Fact - WRONG : In fact it is a complete & healthy food

Free from cholesterol

Monounsaturated Fats (MuFA), Protein, CHO,
Minerals, Vitamins, Iron, Calcium & Fiber

20-40 gm/day of Nuts reduces cholesterol
• Caution – Contains calories, can ↑ trigycerides,
Avoid in obese patients
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Exercise
For 50 Years old
Intensity of 60% to 80% of max. Heart Rate
Subtract 220 - 50 = 170
170 x 60% = 102
170 x 80% = 136
Target Aerobic Heart Rate is :
102 - 136
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Physical Activity, SAT.FAT (dairy & Meat)
Life Expectancy
Country SAT.FAT(MILK) Activity Life Exp.
Japan
USA/EUR.
INDIA
5-6 lit/yr
200 lit/yr
>300 lit/yr
+++
++
±
85 yr
79-80 yr
64 yr
One should take low fat milk & its preparations – eg. curd or yogurt (small qty.)http://healthsafetyupdates.blogsp
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Dairy Consumption & Heart Diseases
• Myth - Milk is essential & complete food for human beings
• Fact - WRONG. Only low fat milk is allowed

It contains - SAT.FAT & Cholesterol

Animal Protein - Casein - Cause of Allergy,
damages Heart Cell, Pancreas

Lactose Intolerance & Abdominal Disease

Spread of viral & bacterial disease

lack of ess. Amino acids, iron & ↑ Hormones consumption
• No Mammal Drinks others milk except human beings
• Good alternative source of Calcium are green veg.,Soya,Fruits,Nuts etc.
• Soya milk & its products are good substitute
Slogan – “One should drink milk till you drink your mother’s milk, after
that we have no right to drink others milk”http://healthsafetyupdates.blogsp
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Prevent Heart Disease by Life style
changes
Stress Management
Dietary Management
Exercise
Lipid Management
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Stress Management
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He who on this earth can withstand the storms of desire &
anger, he is a yogi, he is a happy man.
Bhagavad-Gita V,vs.23
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Stress & Heart Disease
Through observation, 60% of the
subjects with known Coronary Artery
Disease in Cardiac Rehab had a high
Stress Score, i.e.
Hostility along with Type-A stress & Isolation
(NEO Profile).
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25 year Finland study on stress
• Persistence Stress
• High Work Demands
&
• Job Insecurity
Had same level of
risk of heart attacks
as
people who smoke
and do not exercise
B.M.J. : Oct 19, 2002http://healthsafetyupdates.blogsp
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Psychosocial Risk Factors
• Lack Of Social Support.
• Behavior Type A.
• Job Stress.
• Low Level Of Job Control.
• Hostility, Anger, Rage.
• Depression.
• Coping Styles.
• Lack Of Religious Affiliations.http://healthsafetyupdates.blogsp
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You can manage “Stress”
Exercise Yoga /Meditation Personal Communication Laughter
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Power of Prayers
Claim:
Some scientific studies report
benefits of prayer.
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Prayers / Meditation
Prefrontal Cortex Prefrontal Cortex
Baseline Meditationhttp://healthsafetyupdates.blogsp
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Where Does Yoga Fit In
Healthy Life Style ?
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YOGA
Advantages
• Improves concentration
• Improves work efficiency
• Improves quality of life
• Increases immunity
• Controls stress
• Can prevent several diseases like heart disease, DM,
psychosomatic illness etc.
• Has the potential to reverse heart disease
• Can keep a person really healthy & happyhttp://healthsafetyupdates.blogsp
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Kayotsarga (Shavasana)
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YOGA
Has Potential To Control Several Diseases
• Hypertension
• Coronary heart disease
• Diabetes mellitus
• Bronchial asthma
• Migraine
• Irritable bowel syndrome
• Psychoneurotic diseases (anxiety, depression etc.)
• Cancer ?
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YOGA
Conclusions :
• Yoga is a complete way of life
• Is the best life style ever devised
• Can keep a person physically, mentally an
spiritually healthy
• Is excellent stress management technique
• Can control several diseases
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• Many people are able to manage
coronary artery disease with lifestyle
changes and medications.
• Other people with severe coronary
artery disease may need angioplasty or
surgery.
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Drugs & Prevention of Heart Attacks
• Antipletelets – Aspirin/Clopidogrel to prevent clot
formation
• Statins – to reduce cholesterol & blockage of arteries
• ACEI – to reduce blockage & control BP/Heart Failure
• B-Blocker – prevent recurrent Heart Attack and
controls BP
“Polypill is the Future”
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PTCA -ANGIOPLASTYPTCA -ANGIOPLASTY
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CABG – BY PASS SURGERY
URGERY
• To improve blood flow to the myocardial tissue that are
at risk for ischemia or infarction as a result of the
occluded artery.
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• Get regular medical checkups.
• Control your blood pressure.
• Control your diabetes .
• Check your cholesterol.
• Don’t smoke.
• Exercise regularly.
• Maintain a healthy weight.
• Eat a heart-healthy diet.
• Manage stress.
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Prevention of Heart Attacks
- Role of
Media
• Powerful & positive role
• Can bring societal changes
• Public education for healthy life style
• Health related articles
• Avoid advertisement of cigarettes , alcohol &
Paan Masalas
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Prevention of Heart Attacks- Role of
Government
• Ban smoking - ↑ Taxes/No advertisement
• Prices of vegetables & fruits - reduce
• Increase prices of SAT.FAT & non veg. food & junk
food
• Encourage physical activity at work places
• School education -
Regarding prevention of diseases & healthy life
style & Spend less time in front of TV &
Computers
• Promote NGO’s – For societal changes
“Barrier of health is poverty & illiteracy”
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Take Home Message
• CAD is a disease of choice & you could choose to
prevent it
• Incidence of Metabolic Syndrome is rising
• DM, HT, Lipid disorder & Smoking are the most common
preventable risk factors
• Life style modification is key to success
- exercise (modify servant culture) & healthy food
• Isolation, hostility & Type A stress is the most serious
source of the disease
• We can delay the onset of disease & can have better
quality & quantity of life
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• WISH YOU ALL THE BEST.
• STAY FIT AND HEALTHY AND LET
YOUR HEART BEAT FORVER !!!!!!!
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“Prevention is better than
Cure”
http://healthsafetyupdates.blogspot.in/
Thanks
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How to Prevent Heart attack ?????

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