 Hi, and welcome to Healthy Heart Equals Healthy You. My name is Jill Bates, and I'm eager to share information about how we can make a difference in our health by committing to a heart-healthy life. February is Heart Health Month. It's a perfect time for us to teach our students about healthy living, but also a perfect time for us to think about our own health. You know, heart disease is the leading cause of death for both men and women in the United States. Chances are we all know someone affected by heart disease and stroke because about 2,300 Americans die of cardiovascular disease each day, an average of one death every 38 seconds. The good news? It's also one of the most preventable, making heart healthy choices, knowing our family health history and the risk factors for heart disease, having regular checkups and working with our medical team to manage our health are all integral aspects of saving lives from this often silent killer. So what is heart disease? Well, there are numerous answers to this question. Heart disease is actually a broad term used for a wide variety of diseases of the heart and blood vessels such as coronary artery disease, heart rhythm disorders, and congenital heart defects. There are several risk factors for heart disease. Some we can control and some we can't. We know that men and women are equally at risk for heart disease and heart disease can occur at any age. However, four out of five people who die from coronary heart disease are age 65 or older. Also, the presence of heart disease in a parent or sibling, especially at a young age, increases our risk of developing heart disease. Women tend to get coronary artery disease an average of 10 years later than men. The risk for women increases as they approach menopause and continues to rise as they get older due to low estrogen levels. And of course, people who have had a previous heart attack or stroke are more likely than others to suffer future events. Although we can't control our gender, age, or family history, we can control other risk factors. We can stop smoking, monitor our cholesterol levels and blood pressure, increase our physical activity, watch our diet and weight, monitor diabetes, and manage our stress. Now to clarify, when I used the term heart disease during this webinar, I am primarily referring to coronary artery disease, also called coronary heart disease or cardiovascular disease. Plaque, which is made up of fat, cholesterol, calcium, and other substances in the blood, builds up inside the coronary arteries which supply oxygen-rich blood to the heart muscle. This plaque buildup is called atherosclerosis. A plaque can grow large enough to reduce or completely block blood flow through an artery. More frequently, a plaque may rupture, causing a blood clot to form that either blocks the artery or breaks off and travels somewhere else in the body, causing a blockage as another site, like the carotid arteries in the neck or in the major arteries of the legs, arms, or pelvis. When the blockage takes place in a coronary blood vessel that feeds the heart, the result is a heart attack. In the United States, someone has a heart attack every 34 seconds. Symptoms of a heart attack can vary greatly from person to person. Approximately two out of every three people who have heart attacks experience chest pain, shortness of breath, or fatigue a few days or weeks before the attack. During a heart attack, a person may feel pain in the middle of the chest, which can spread to the back, neck, jaws, or arms. A person having a heart attack may also have gas-like pain or pressure in the stomach area, which is often mistaken for indigestion. Other symptoms include nausea and vomiting, lightheadedness or dizziness, shortness of breath, especially in older people, feelings of rustlessness, sweatiness, anxiety, or a sense of impending doom, bluishness of the lips, hands, or feet, heavy pounding of the heart or abnormal heart rhythms, loss of consciousness, or disorientation resembling a stroke, which often occurs in older people. It is important to know and recognize these warning signs because half of the deaths from heart attack occur in the first three or four hours after the onset of symptoms. Call 911. Don't ignore or attempt to tough out the symptoms of a heart attack. If you're the person having these symptoms, drive yourself only as a last resort and realize that doing so places you and others at risk. Chew and swallow an aspirin, unless you're allergic to aspirin or have been told by your doctor never to take it. Take nitroglycerin if prescribed, but don't take anyone else as nitroglycerin because that could put you in more danger. Sudden cardiac arrest is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs. Sudden cardiac arrest usually causes death if it's not treated within minutes. So call 911 immediately and begin CPR. CPR can double or triple a cardiac arrest victim's chances of survival. Use an AED if one is available. Brain death begins in only four to six minutes after cardiac arrest. The chances of survival for a victim of sudden cardiac death drop by seven to 10 percent with every minute that passes without CPR and defibrillation. And very few attempts at resuscitation succeed after 10 minutes, so the key is to act quickly. I wanted to spend a couple minutes talking about women in heart disease. Heart disease is a number one killer of women and is more deadly than all forms of cancer combined. One in 7.5 female deaths is attributable to coronary heart disease and every minute approximately one woman dies from heart disease yet only 20 percent of American women believe that heart disease is our greatest health threat. 90 percent of women have one or more risk factors for developing heart disease or stroke and since 1984 more women than men have died each year from heart disease. A challenge is that some heart disease symptoms in women may be different from those in men. Heart attack symptoms in women are often unrelated to chest pain and you can see the list here that I've mentioned these before, the neck, jaw, shoulder, upper back or abdominal discomfort, shortness of breath, pain in one or both arms, nausea, vomiting, lightheadedness or unusual fatigue and these symptoms often occur during rest or sleep. Additional risk factors include diabetes, mental stress and depression, smoking, inactivity, menopause, pregnancy, complications and broken heart syndrome which is a condition often brought on by stressful situations that can cause severe but usually temporary heart muscle failure and this is most common in post-menopausal women. Now as mentioned earlier heart disease can affect individuals at any age. Million Hearts, an initiative co-led by the U.S. Department of Health and Human Services, CDC and the Centers for Medicare and Medicaid Services is focusing this year on younger adults and heart disease. Younger adults are at risk. National trends show an increase in younger adults ages 35 to 64 dying of heart disease and they see increasing rates of risk factors in this age group such as physical inactivity, tobacco use and hypertension. So what can we do? Well since heart disease can affect everyone in some way we need to let everybody know they can reduce their risk through lifestyle changes and by managing medical conditions. Oh yes and we need to practice what we preach. So let's take control of our heart health. We need to know our numbers. High blood pressure and high cholesterol are major risk factors for heart disease. Ask your health care team to check your blood pressure and blood cholesterol levels regularly and help you take steps to control your levels. About 75 million adults or 33 percent of us have high blood pressure and only about half of people with high blood pressure have their condition under control. Regular exercise limiting salt reducing stress losing weight and limiting alcohol can lower blood pressure. Your doctor may also prescribe medication and if you look at this slide you can see what the blood pressure numbers mean. The top number is a measurement of the pressure that your heart exerts as it pumps the blood or the bottom number is a measurement of the resting pressure in between beats and what do these numbers mean? Well the normal blood pressure for adults and the latest recommendation by the American Heart Association is anything under 119 over 79. Elevated blood pressure is now 120 over anything under 80 and high blood pressure is now 130 over 80 to 139 over 189 with additional problems with blood pressure even higher than that. Another number that we need to know is our cholesterol. Cholesterol is a waxy substance that is assembled in the liver and released into the bloodstream. It's comprised of two special proteins called high density lipoproteins and low density lipoproteins along with fats called triglycerides. HDL or good cholesterol removes cholesterol from the artery walls and bloodstream. An LDL or bad cholesterol deposits cholesterol on the artery walls and begins the process of atherosclerosis. Now your total cholesterol number is a measurement of HDL plus LDL plus 20 percent of your triglycerides. Now you may be used to hearing about numerical ranges for total cholesterol. For many years they were widely publicized but currently these ranges aren't used. Instead total cholesterol levels are considered in context with other risk factors and treatment is recommended accordingly. The American Heart Association recommends that adults age 20 and older have their cholesterol levels checked every four to six years. Another way we can gain control is to make healthy eating a habit. Small changes in our eating habits can make a big difference. Fruits, vegetables, whole grains and fat-free or low-fat dairy products are healthy choices. We should include protein foods such as poultry, fish, beans, eggs, nuts and lean meats and also choose foods that are low in saturated fats, sodium and added sugars. It goes without saying that we should watch our weight. People who are overweight are more likely to develop heart disease and stroke even if they have none of the other risk factors. Excess weight causes extra strain on the heart, influences blood pressure, cholesterol and triglyceride levels and increases the risk of developing diabetes. Also drinking an average of more than one alcoholic drink a day for women or more than two drinks a day for men also increases the risk of heart disease and stroke. It negatively affects blood pressure, weight and the levels of triglycerides and binge drinking is particularly dangerous. We also need to find time to be active. Now that's probably not a news flash but what you may not realize though is that physical activity is anything that makes you move your body and burn calories. It doesn't need to be a formal exercise workout to count. Physical activity can include just walking more. Walking is enjoyable, free, easy, social and is great exercise. Getting at least 150 minutes of exercise a week can put you at lower risk for heart disease. You can reduce your risk even further with more physical activity. Regular physical activity can also lower your blood pressure and improve your cholesterol levels. Quit tobacco for good. Smoking cigarettes and using other tobacco products affects nearly every organ in your body including your heart. Smokers are twice as likely to suffer heart attacks as non-smokers and they are more likely to die as a result. Smoking is also linked to increased risk of stroke and it goes without saying that passive smoking may also be a danger. If you take medications stick to the script. Taking prescribed medications can be tough especially if you feel fine but sticking with your medication routine is important for managing and controlling conditions that could put your heart at risk. Healthy habits can protect you from the harmful effects of stress. Empower yourself by taking action to control stress levels and set goals that are reasonable to achieve. Enjoy stress busting activities like hobbies, walking in nature, taking a relaxing bath or simply laughing. Also educate your social media followers about their potential risk for heart disease and ways to control it. Try using Facebook, Twitter, Instagram or other social media sites to spread the word. Are you interested in learning more? There are a wealth of resources. Check out reputable websites like the American Heart Association, Center for Disease Control or Million Hearts. So healthy habits equal healthy heart equals healthy you. As a review know your blood pressure and cholesterol numbers. Make healthy eating a habit, find time to be active, quit using tobacco, take your medications as prescribed, manage stress, learn CPR, use social media to spread the word, check out reputable resources and choose your parents wisely. Thanks for joining me today. I wish you all a long, happy and healthy life.