February American Heart Month

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1 February American Heart Month A note from the author Hello friends! I hope everyone is starting their new year off right keeping those new year s resolutions in mind and enjoying this not so typical winter weather. This February, I wanted to take a trip back to the basics and feature an article that is familiar to many, American Heart Month. As most of you know, every year, we celebrate the American Heart Association s Awareness Month in order to help increase knowledge and up-to-date medical information regarding heart disease. Also, as many of you know, heart disease is the #1 killer in the United States. Whether you, or someone you know, suffers from heart disease in some way, shape, or form, celebrate with us this month by reading the article below and sharing the information you learned with your loved ones. What is American Heart Month? Heart disease kills an estimated 630,000 Americans each year. It's the leading cause of death for both men and women. In the United States, the most common type of heart disease is coronary artery disease (CAD), which can lead to a heart attack. You can greatly reduce your risk for CAD through lifestyle changes and, in some cases, medication. Since 1963, February has been celebrated as American Heart Month to urge Americans to join the battle against heart disease. Since 2004, February also has been the signature month for the American Heart Association's Go Red For Women campaign and the message that heart disease is not only a man's problem. The Prevalence of Heart Disease Heart disease is the leading cause of death for American women and men, accounting for 1 in 4 deaths in the United States, equal to 2,200 deaths per day. Nearly half of

2 Americans have at least one risk factor for heart disease, such as high blood pressure, obesity, physical inactivity, or an unhealthy diet. Risk also increases with age. The good news is that individuals of all ages can reduce their risk for heart disease by making lifestyle changes and managing medical conditions through appropriate treatment plans. With a record number of young adults living at home or in close contact with older relatives, they have a golden opportunity to encourage parents and other family members to make heart-healthy changes and offer support along the way. But. What IS Heart Disease? The term "heart disease" refers to several types of heart conditions. The most common type of heart disease in the United States is coronary artery disease, which affects the blood flow to the heart. Decreased blood flow can cause a heart attack. Look below to learn more. Coronary Artery Disease Coronary artery disease (CAD) is the most common type of heart disease in the United States. For some people, the first sign of CAD is a heart attack. You and your health care team may be able to help you reduce your risk for CAD.

3 Causes of CAD CAD is caused by plaque buildup in the walls of the arteries that supply blood to the heart (called coronary arteries) and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over time, which could partially or totally block the blood flow. This process is called atherosclerosis. Too much plaque buildup and narrowed artery walls can make it harder for blood to flow through your body. When your heart muscle doesn t get enough blood, you may have chest pain or discomfort, called angina. Angina is the most common symptom of CAD. Over time, CAD can weaken the heart muscle. This may lead to heart failure, a serious condition where the heart can t pump blood the way that it should. An irregular heartbeat, or arrhythmia, also can develop. Diagnosing CAD To find out your risk for CAD, your health care team may measure your blood pressure, cholesterol, and sugar levels. Being overweight, physical inactivity, unhealthy eating, and smoking tobacco are risk factors for CAD. A family history of heart disease also

4 increases your risk for CAD. If you re at high risk for heart disease or already have symptoms, your doctor can use several tests to diagnose CAD. Test What it Does ECD or EKG (electrocardiogram) Echocardiogram Measures the electrical activity, rate, and regularity of your heartbeat. Uses ultrasound (special sound wave) to create a picture of the heart. Exercise stress test Measures your heart rate while you walk on a treadmill. This helps to determine how well your heart is working when it has to pump more blood. Chest X-ray Cardiac catheterization Uses x-rays to create a picture of the heart, lungs, and other organs in the chest. Checks the inside of your arteries for blockage by inserting a thin, flexible tube through an artery in the groin, arm, or neck to reach the heart. Health care professionals can measure blood pressure within the heart and the strength of blood flow through the heart s chambers as well as collect blood samples from the heart or inject dye into the arteries of the heart (coronary arteries). Coronary angiogram Monitors blockage and flow of blood through the coronary arteries. Uses X-rays to detect dye injected via cardiac catheterization.

5 Reducing Your Risk for CAD If you have CAD, your health care team may suggest the following steps to help lower your risk for heart attack or worsening heart disease: Lifestyle changes, such as eating a healthier (lower sodium, lower fat) diet, increasing physical activity, and quitting smoking. Medications to treat the risk factors for CAD, such as high cholesterol, high blood pressure, an irregular heartbeat, and low blood flow. Surgical procedures to help restore blood flow to the heart.

6 Heart Attacks Every 43 seconds, someone in the United States has a heart attack. A heart attack, also called a myocardial infarction, occurs when a part of the heart muscle doesn t receive enough blood flow. The more time that passes without treatment to restore blood flow, the greater the damage to the heart muscle. Every year, about 735,000 Americans have a heart attack. Of these cases: 525,000 are a first heart attack. 210,000 happen to people who have already had a first heart attack. One in 5 heart attacks is silent the damage is done, but the person is not aware of it.coronary artery disease (CAD) is the main cause of heart attack. A less common cause is a severe spasm, or sudden contraction, of a coronary artery that can stop blood flow to the heart muscle. If you know the signs and symptoms of a heart attack and recognize that you or someone near you is having a heart attack, seek immediate treatment by calling The longer you wait, the more damage to the heart muscle can occur.

7 Signs and Symptoms of a Heart Attack The five major symptoms of a heart attack are Pain or discomfort in the jaw, neck, or back. Feeling weak, light-headed, or faint. Chest pain or discomfort. Pain or discomfort in arms or shoulder. Shortness of breath. Other symptoms of a heart attack could include unusual or unexplained tiredness and nausea or vomiting. Women are more likely to have these other symptoms. Call If you notice the symptoms of a heart attack in yourself or someone else, call immediately. The sooner you get to an emergency room, the sooner you can receive treatment to prevent total blockage and heart muscle damage or reduce the amount of damage. At the hospital, health care professionals can run tests to determine whether a heart attack is occurring and decide the best treatment.

8 In some cases, a heart attack requires cardiopulmonary resuscitation (CPR) or electrical shock (defibrillation). Bystanders trained to use CPR or a defibrillator may be able to help until emergency medical personnel arrive. Remember, the chances of surviving a heart attack are greater the sooner emergency treatment begins. Life After a Heart Attack If you ve had a heart attack, your heart may be damaged. This could affect your heart s rhythm, pumping action, and blood circulation. You also may be at risk for another heart attack or conditions such as stroke, kidney disorders, and peripheral arterial disease (PAD). You can lower your chances of having future health problems following a heart attack with these steps: Physical Activity Talk to your health care team about the things you do each day in your life and work. Your doctor may want you to limit work, travel, or sexual activity for some time after a heart attack. Lifestyle Changes Eating a healthier diet, increasing physical activity, quitting smoking, and managing stress in addition to taking prescribed medications can help improve your heart health and quality of life. Ask your health care team about attending a program called cardiac rehabilitation to help you make these lifestyle changes.

9 Other Conditions Related to Heart Disease Coronary artery disease is the most common type of heart disease, but there are many other conditions that affect the heart. Acute coronary syndrome is a term that includes heart attack and unstable angina. Angina, a symptom of coronary artery disease, is chest pain or discomfort that occurs when the heart muscle is not getting enough blood. Angina may feel like pressure or a squeezing pain in the chest. The pain also may occur in the shoulders, arms, neck, jaw, or back. It may feel like indigestion.

10 There are two forms of angina stable or unstable: Stable angina happens during physical activity or under mental or emotional stress. Unstable angina is chest pain that occurs even while at rest, without apparent reason. This type of angina is a medical emergency. Aortic aneurysm and dissection are conditions that can affect the aorta, the major artery that carries blood from the heart to the body. An aneurysm is an enlargement in the aorta that can rupture or burst. A dissection is a tear in the aorta. Both of these conditions are medical emergencies. Arrhythmias are irregular or unusually fast or slow heartbeats. Arrhythmias can be serious. One example is called ventricular fibrillation. This type of arrhythmia causes an abnormal heart rhythm that leads to death unless treated right away with an electrical shock to the heart (called defibrillation). Other arrhythmias are less severe but can develop into more serious conditions, such as atrial fibrillation, which can cause a stroke. Atherosclerosis occurs when plaque builds up in the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of cholesterol deposits. Plaque buildup causes arteries to narrow over time.

11 Atrial fibrillation is a type of arrhythmia that can cause rapid, irregular beating of the heart's upper chambers. Blood may pool and clot inside the heart, increasing the risk for heart attack and stroke. Cardiomyopathy occurs when the heart muscle becomes enlarged or stiff. This can lead to inadequate heart pumping (or weak heart pump) or other problems. Cardiomyopathy has many causes, including family history of the disease, prior heart attacks, uncontrolled high blood pressure, and viral or bacterial infections. Congenital heart defects are problems with the heart that are present at birth. They are the most common type of major birth defect. Examples include abnormal heart valves or holes in the heart's walls that divide the heart's chambers. Congenital heart defects range from minor to severe. Heart failure is often called congestive heart failure because of fluid buildup in the lungs, liver, gastrointestinal tract, and the arms and legs. Heart failure is a serious condition that occurs when the heart can't pump enough blood to meet the body's needs. It does not mean that the heart has stopped but that muscle is too weak to pump enough blood. The majority of heart failure cases are chronic, or long-term heart failures. The only cure for heart failure is a heart transplant. However, heart failure can be managed with medications or medical procedures. Peripheral arterial disease (PAD) occurs when the arteries that supply blood to the arms and legs (the periphery) become narrow or stiff. PAD usually results from atherosclerosis, the buildup of plaque and narrowing of the arteries. With this condition, blood flow and oxygen to the arm and leg muscles are low or even fully blocked. Signs and symptoms include leg pain, numbness, and swelling in the ankles and feet. Rheumatic heart disease is damage to the heart valves caused by a bacterial (streptococcal) infection called rheumatic fever.

12 Am I At Risk for Heart Disease? Several health conditions, your lifestyle, and your age and family history can increase your risk for heart disease. These are called risk factors. About half of all Americans (47%) have at least one of the three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking. Some of the risk factors for heart disease cannot be controlled, such as your age or family history. But you can take steps to lower your risk by changing the factors you can control. Risk factors for heart disease include: Medical Conditions Several medical conditions can increase your risk for heart disease. If you have one of these conditions, you can take steps to control it and lower your risk. o High Blood Pressure High blood pressure is a major risk factor for heart disease. It is a medical condition that occurs when the pressure of the blood in your arteries and other blood vessels is too high. The high pressure, if not controlled, can affect your heart and other major organs of your body, including your kidneys and brain. High blood pressure is often called a silent killer because many people do not notice symptoms to signal high blood pressure. Lowering blood pressure by changes in lifestyle or by medication can reduce your risk for heart disease and heart attack. o High Cholesterol Cholesterol is a waxy, fat-like substance made by the liver or found in certain foods. Your liver makes enough for your body s needs, but we often get more cholesterol from the foods we eat. If we take in more cholesterol than the body can use, the extra cholesterol can build up in the walls of the arteries, including those of the heart. This leads to narrowing of the arteries and can decrease the blood flow to the heart, brain, kidneys, and other parts of the body. Some cholesterol is good, and some is bad. High cholesterol is the term used for high levels of low-density lipoprotein, or LDL, which are considered bad because they can lead to heart disease. A higher level of high-density lipoprotein cholesterol, or HDL, is considered good because it provides some protection against heart disease. A blood test can detect the amount of cholesterol and triglycerides (a related kind of fat) in your blood. o Diabetes

13 Diabetes mellitus also increases the risk for heart disease. Your body needs glucose (sugar) for energy. Insulin is a hormone made in the pancreas that helps move glucose from the food you eat to your body s cells. If you have diabetes, your body doesn t make enough insulin, can t use its own insulin as well as it should, or both. Diabetes causes sugars to build up in the blood. The risk of death from heart disease for adults with diabetes is two to four times higher than adults who do not have diabetes.talk to your doctor about ways to manage diabetes and control other risk factors. Behavior Your lifestyle choices can increase your risk for heart disease and heart attack. To reduce your risk, your doctor may recommend changes to your lifestyle. The good news is that healthy behaviors can lower your risk for heart disease. o Unhealthy Diet Diets high in saturated fats, trans fat, and cholesterol have been linked to heart disease and related conditions, such as atherosclerosis. Also, too much salt (sodium) in the diet can raise blood pressure levels. o Physical Inactivity Not getting enough physical activity can lead to heart disease. It also can increase the chances of having other medical conditions that are risk factors, including obesity, high blood pressure, high cholesterol, and diabetes. Regular physical activity can lower your risk for heart disease. o Obesity Obesity is excess body fat. Obesity is linked to higher bad cholesterol and triglyceride levels and to lower good cholesterol levels. In addition to heart disease, obesity can also lead to high blood pressure and diabetes.

14 Talk to your health care team about a plan to reduce your weight to a healthy level. o Too Much Alcohol Drinking too much alcohol can raise blood pressure levels and the risk for heart disease. It also increases levels of triglycerides, a form of cholesterol, which can harden your arteries. Women should have no more than 1 drink a day. Men should have no more than 2 drinks a day. o Tobacco Use Tobacco use increases the risk for heart disease and heart attack. Cigarette smoking can damage the heart and blood vessels, which increases your risk for heart conditions such as atherosclerosis and heart attack. Also, nicotine raises blood pressure, and carbon monoxide reduces the amount of oxygen that your blood can carry. Exposure to other people s secondhand smoke can increase the risk for heart disease even for nonsmokers.

15 Family History and Other Characteristics Family members share genes, behaviors, lifestyles, and environments that can influence their health and their risk for disease. Heart disease can run in a family, and your risk for heart disease can increase based on your age, and your race, or ethnicity. o Genetics and Family History When members of a family pass traits from one generation to another through genes, that process is called heredity. Genetic factors likely play some role in high blood pressure, heart disease, and other related conditions. However, it is also likely that people with a family history of heart disease share common environments and other potential factors that increase their risk. The risk for heart disease can increase even more when heredity combines with unhealthy lifestyle choices, such as smoking cigarettes and eating an unhealthy diet. Family health history is a record of the diseases and health conditions present in your family. Family health history is a useful tool for understanding health risks and preventing disease. To help people collect and organize their family history information, CDC s Office of Public Health Genomics collaborated with the US Surgeon General and other federal agencies to develop a Web-based tool called My Family Health Portrait.

16 o Other Characteristics Both men and women can have heart disease. Some other characteristics that you cannot control, like your age, sex, and race or ethnicity, can affect your risk for heart disease. Age. Your risk for heart disease increases as you get older. Sex. Heart disease was the number one killer of both men and women in Race or ethnicity. In 2013 heart disease was the leading cause of death in the United States for non-hispanic whites, non-hispanic blacks, and American Indians. For Hispanics, and Asian Americans and Pacific Islanders, heart disease is second only to cancer as a cause of death. Know your Statistics- Don t Be a Statistic Heart disease and stroke are the first and fourth leading causes of death in the United States. Heart disease is responsible for 1 of every 4 deaths in the country. For some groups, such as African Americans, the burden is even greater. As a nation, we can and must change these numbers. The good news is that heart disease and stroke can be prevented, and February American Heart Month is a great time to refresh your memory on the small but important actions you can take. The national Million Hearts initiative is working to prevent 1 million heart attacks and strokes by How can you reduce your risk? One way is to know your ABCS: Ask your health care provider about taking Aspirin. Make control your goal: if you have high Blood Pressure, work with your health care provider to get it under control. Find out how to best manage high Cholesterol. Stop Smoking or don t start.

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18 The ABCS of Heart Health As mentioned above, the Million Hearts initiative is a national initiative with an ambitious goal to prevent 1 million heart attacks and strokes by The Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services co-lead the initiative on behalf of the U.S. Department of Health and Human Services. Below are the ABCS of Heart Health, as advertised by Million Hearts to help increase awareness of heart disease this month. A: Aspirin Talk to your health care provider and team to see if taking an aspirin each day is right for you. B: Blood Pressure Control High blood pressure is one of the leading causes of heart disease and stroke. One in three American adults has high blood pressure that s about 70 million people. Unfortunately, less than half of people with high blood pressure have their condition under control. Work with your health care team to find out if you have high blood pressure. If you do, take steps to reduce it: Get active by exercising for at least 30 minutes most days of the week. Eat a heart-healthy diet that is high in fresh fruits and vegetables and low in sodium, saturated and trans fats, and cholesterol.

19 Follow your health care provider's instructions when it comes to taking medicines or measuring your blood pressure at home. C: Cholesterol High cholesterol affects 1 in 3 American adults. Getting a simple blood test is the only way you can know if have high cholesterol. Your doctor can suggest steps you can take to prevent high cholesterol or to reduce your levels if they are high. S: Smoking Cigarette smoking greatly increases your risk for heart disease. If you're a smoker, quit as soon as possible, and if you don't smoke, don't start. Get help from QUIT-NOW or Smokefree.gov. Learn more about Million Hearts and ways to protect your heart during February and throughout the year at millionhearts.hhs.gov. Preventing Heart Disease with Healthy Living Habits By living a healthy lifestyle, you can help keep your blood pressure, cholesterol, and sugar normal and lower your risk for heart disease and heart attack. A healthy lifestyle includes the following: Eating a healthy diet. Maintaining a healthy weight. Getting enough physical activity. Not smoking or using other forms of tobacco.

20 Limiting alcohol use. Healthy Diet Choosing healthful meal and snack options can help you avoid heart disease and its complications. Be sure to eat plenty of fresh fruits and vegetables and fewer processed foods. Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt (sodium) in your diet also can lower your blood pressure. Limiting sugar in your diet can lower you blood sugar level to prevent or help control diabetes. Healthy Weight Being overweight or obese increases your risk for heart disease. To determine if your weight is in a healthy range, doctors often calculate your body mass index (BMI). If you know your weight and height, you can calculate your BMI at CDC s Assessing Your Weight website. Doctors sometimes also use waist and hip measurements to calculate excess body fat. They may use special equipment to calculate excess body fat and hydration status.

21 Physical Activity Physical activity can help you maintain a healthy weight and lower your blood pressure, cholesterol, and sugar levels. For adults, the Surgeon General recommends 2 hours and 30 minutes of moderate-intensity exercise, like brisk walking or bicycling, every week. Children and adolescents should get 1 hour of physical activity every day. No Smoking Cigarette smoking greatly increases your risk for heart disease. If you don t smoke, don t start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit. Limited Alcohol Avoid drinking too much alcohol, which can raise your blood pressure. Men should have no more than 2 drinks per day, and women only 1.

22 Preventing Heart Disease by Controlling Other Medical ConditIons If you have high cholesterol, high blood pressure, or diabetes, you can take steps to lower your risk for heart disease. Check Cholesterol Your health care provider should test your blood levels of cholesterol at least once every 5 years. If you have already been diagnosed with high cholesterol or have a family history of the condition, you may have your cholesterol checked more frequently. Talk with your health care team about this simple blood test. If you have high cholesterol, medications and lifestyle changes can help reduce your risk for heart disease. Control Blood Pressure High blood pressure usually has no symptoms, so be sure to have it checked on a regular basis. Your health care team should measure your blood pressure at least once every 2 years if you have never had high blood pressure or other risk factors for heart disease. If you have been diagnosed with high blood pressure, also called hypertension, your health care team will measure your blood pressure more frequently to ensure you have the condition under control. Talk to your health care team about how often you should check your blood pressure. You can check it at a doctor s office, at a pharmacy, or at home. If you have high blood pressure, your health care team might recommend some changes in your lifestyle or advise you to lower the sodium in your diet; your doctor may also prescribe medication when necessary to help lower your blood pressure. There are many strategies to help monitor and improve blood pressure control and medication adherence to improve health outcomes for patients with hypertension.

23 Manage Diabetes If your health care provider thinks you have symptoms of diabetes, he or she may recommend that you get tested. If you have diabetes, monitor your blood sugar levels carefully. Talk with your health care team about treatment options. Your doctor may recommend certain lifestyle changes to help keep your blood sugar under good control those actions will help reduce your risk for heart disease. Take Your Medicine If you take medication to treat high cholesterol, high blood pressure, or diabetes, follow your doctor s instructions carefully. Always ask questions if you don t understand something. Never stop taking your medication without talking to your doctor, nurse, or pharmacist. Talk with Your Health Care Team You and your health care team can work together to prevent or treat the medical conditions that lead to heart disease. Discuss your treatment plan regularly, and bring a list of questions to your appointments. If you ve already had a heart attack, your health care team will work with you to prevent another heart attack. Your treatment plan may include medications or surgery and lifestyle changes to reduce your risk. Be sure to take your medications as directed and follow your doctor s instructions. Living with Heart Disease Like anyone who has suffered a heart attack, it s natural to feel like no one understands what you re going through. But there s no reason to feel like you re fighting this battle alone. There are many resources available to help you cope and educate yourself about getting on track to a heart-healthy life. The American Heart Association has a wonderful website where survivors have shared their stories, like this one:

24 For some, like Lidia Morales, being open with other women about her struggles has helped her become more accepting of her diagnosis and more optimistic about her future. I show people my surgery scar and tell them it s my beauty mark because this experience has taught me so many things about my life, explains Lidia. When you re living with heart disease, the most important thing to realize is that the future does not have to look grim. Visit the American Heart Association s website ( ) to find out how listening to the advice of your doctor, making positive lifestyle changes, and knowing where to look for the support you need, can help you maintain a full and productive lifestyle. Other great topics you can find on the website listed above include: Tips for taking heart medication AHA-Accredited Hospital Near You Combating Depression After Stroke Staying Social after Heart Disease Establishing trust with your Cardiologist How to Stay Positive About Your Heart Disease Treatment Living with Heart Disease, You Are Not Alone Caring for Someone with Heart Disease Understanding your Heart Diagnosis Eat Well to Stay Healthy Depression and Heart Disease Visit the AHA website today to find more resources for you and your family:

25 How can American Heart Month make a difference? We can use this month to raise awareness about heart disease and how people can prevent it both at home and in the community. Here are just a few ideas: Encourage families to make small changes, like using spices to season their food instead of salt. Motivate teachers and administrators to make physical activity a part of the school. This can help students start good habits early. Ask doctors and nurses to be leaders in their communities by speaking out about ways to prevent heart disease. How can I help spread the word? In this information age, it is much easier today, than ever before, for you to make a difference. This toolkit is full of ideas to help you take action today. For example:

26 Add information about living a heart healthy lifestyle to your newsletter. Tweet about American Heart Month. Host a community event where families can be active while learning about local health resources. Take action: Be the cure! Join the American Heart Association s national movement in support of healthier communities and healthier lives. Get Involved-Take action to promote heart health. Here s some ideas: o Celebrate National Wear Red Day to raise awareness about women and heart disease. Encourage everyone in your community to wear red on February 3, Visit for more information. o Host an American Heart Month event at local schools, health centers, and libraries. Work with local recreation and fitness centers to spread the word about the importance of physical activity to prevent heart disease. o Contact your local Red Cross to host a CPR (cardiopulmonary resuscitation) training event in your community. Urge local community members to learn CPR and AED (automated external defibrillator). These skills can help save the life of someone who has sudden cardiac arrest. o Host a 20-minute group walk around your office at lunchtime. o Conduct a cooking demonstration using a heart-healthy recipe. o Follow CDC s Million Hearts on Facebook ( and Twitter ( to learn more about heart disease and stroke prevention. Resources:

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