 Hello, my name is Jennifer Dankers and I'm a member of the Heart and Vascular Team at MidMichigan Health. As a certified nurse practitioner, I'm the coordinator of MidMichigan's Heart Failure Clinic. Today, I'm here to talk to you about heart disease and stroke prevention. More life, more health, more knowledge about prevention of heart attack and stroke. Heart disease is an umbrella term that includes many different forms. The most common is coronary artery disease. This is when cholesterol plaque builds up in the arteries that supply blood to the heart. It can cause chest pain or discomfort called angina because the heart muscle does not get enough blood. A heart attack occurs when the plaque totally blocks an artery carrying blood to the heart. Over time, coronary artery disease can weaken the heart muscle, lead to heart failure, or the inability to pump blood to the body effectively. It can also cause an irregular heartbeat or arrhythmia. Heart disease is the number one cause of death in the United States, leading to one in three deaths each year. The financial burden is large as well, causing about $108 billion each year on the disease. To understand stroke, it helps to understand something about the brain. The brain controls our movements, stores our memories, and is the source of our thoughts, emotions, and language. The brain also controls many functions of the body, like breathing and digestion. To work properly, your brain needs oxygen. When someone has a stroke, brain cell death occurs due to a blood clot in an artery cutting off oxygen to the brain, or because of sudden bleeding in the brain that damages brain cells. A stroke can cause lasting brain damage, long term disability, and even death. Stroke is the fourth leading cause of death in the United States, causing one out of every 19 deaths each year. It is the leading cause of serious long term disability. In the United States, someone has a stroke every 40 seconds, and someone dies from stroke every four minutes. Stroke also has a heavy financial burden, costing the United States $36 billion each year. Cardiovascular disease, heart disease, and stroke have five major risk factors. Family genetics, high blood pressure, diabetes, high cholesterol, and smoking. While we're not able to change our genes, the other four risk factors can be modified to significantly reduce the risk of heart disease and stroke. And you can see that a significant percentage of people in the United States have several risk factors for heart disease and stroke. Risk factors provide an area for prevention of these cardiovascular diseases. Treating high blood pressure, diabetes, high cholesterol, quitting smoking, being more active, and maintaining a healthy weight are all ways to prevent heart disease and stroke. We'll talk about each of these individually. High blood pressure is a major risk factor for cardiovascular disease, heart attack, and stroke. The force of blood against your artery walls is defined as blood pressure. When the pressures are high throughout the day, this is called high blood pressure or hypertension. Genetics impact blood pressure, increasing age as well as race, other medical conditions, and family history, combined with other factors to elevate blood pressure. In addition, lifestyle impacts blood pressure. A diet high in sodium and not enough potassium, as well as being overweight, physically inactive, using heavy amounts of alcohol or smoking, also increase blood pressure. There are several benefits to lower blood pressure, including decreased risk of heart disease and stroke. In fact, lowering your blood pressure 12 to 13 points for four years can reduce your heart disease risk by 21%. Reduce your stroke risk by 37%. And overall, reduce your total cardiovascular death by 25%. Most people have a blood pressure goal of less than 120 over 80. Knowing your numbers and screening for high blood pressure can help prevent cardiovascular disease, such as heart disease and stroke. To reduce blood pressure, eat a diet that is low in sodium, maintain a healthy weight, be physically active, limit your alcohol use, know where you stand and get treatment if you have hypertension. The next risk factor we'll talk about is diabetes. The food we eat during the day is turned into glucose or sugar for our bodies to use as energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. Diabetes occurs when the blood sugar levels or glucose levels are above normal. This can happen as the body is either not able to make enough insulin or is unable to use its own insulin as well as it should, or a combination of both. This causes sugars to build up in the blood. 75% of people with diabetes die of some form of heart disease or blood vessel disease. Lifestyle impacts diabetes risk. Eating a diet that's high in calories, high in fat, and high in sugar can lead to diabetes, as well as being overweight and physically inactive. There's also a genetic component to diabetes as well. To prevent and control diabetes, it is important to eat small portions which are lower in fat and sugar. Be active 30 minutes on five or more days of the week, as well as maintain a healthy weight. If you do have diabetes, take charge of your diabetes, meaning you should know your blood sugar levels and goals. Take your diabetic medications and follow up with your provider on a very routine basis. High cholesterol is a major risk factor for cardiovascular disease and stroke. Cholesterol is a waxy, fat-like substance found in the body. Extra cholesterol can build up in your arteries and form plaques. The plaque can build up in narrow arteries causing less oxygen and blood to be available to the tissues. The different forms of cholesterol made up in the body include LDL, or the bad cholesterol, HDL, the good cholesterol, and triglycerides. Genetics impact cholesterol. Cholesterol can increase with age as well as other medical conditions and family history. To maintain a normal cholesterol level, it is important that you eat a healthy diet, avoiding saturated and trans fats, increase your fiber intake, and maintain a healthy weight. Exercising regularly and not smoking and avoiding secondhand smoke is also important as this causes injury to blood vessels, making it easier for cholesterol to build up. The next major risk factor for heart disease and stroke is smoking. Smoking can cause reduced circulation by narrowing the arteries. It can cause abdominal aortic aneurysm or swelling or weakness in the main artery of the body, the aorta, which can lead to rupture. Quitting smoking now can greatly reduce your risk of heart disease and stroke into the future. There are many ways to quit. Nicotine patch, gum, lozenge, inhalers, nasal sprays, and behavior change counseling sessions are available. Please keep in mind to change your lifestyle and behavior can take time. Time and repetition is needed for permanent change to replace the unhealthy behaviors with new healthy ones. It's important to mentally practice the good behavior through visualization and try a high-tech solution such as an app to track your progress. Overall, the prevention of heart disease and stroke is in your hands. Maintaining a healthy weight, eating a diet low in salt, low in fat, low in sugar, and being active for 30 minutes each day can greatly reduce your risk. Preventing and treating high blood pressure as well as high cholesterol levels is important, as well as limiting alcohol use and not smoking. I hope you found the information on heart disease and stroke prevention helpful. At MidMichigan Health, we celebrate the power of health throughout life with you.