Associate Director of Clinical Trials Division of Cardiovascular Medicine University of Florida 1
1. Cancer 2. Housework 3. Heart Disease 4. Children who don t leave home 5. 2, 3, 4 10/25/2016 12:36 PM More Women Die of Heart Disease Than Breast Cancer At All Ages AGE (years) Mortality rates/ 100,000 women in the USA 0 1.25 2.5 3.75 5 15-24 25-44 0 5 10 15 0 40 80 120 HEART DISEASE BREAST CANCER 45-64 65 and over 0 600 1200 1800 Murphy SL. Death: final data for 1998. Nat l Vital Stat Rep 2000;48:1-105 10/25/2016 12:36 PM 2
No Heart, No TaTa s 10/25/2016 12:36 PM Heart disease is the leading cause of death of American women. responsible for 1 in 3 female deaths in the U.S. 43.8 million women are currently living with some form of Heart Disease 50,742 women die each year from heart attacks How to motivate ourselves to adopt changes in behavior that promote better health and well being Today- Specifically Putting ourselves first! to be mindful of our mental and physical needs CONSISTENTLY 3
No, dear nothing is wrong. I had a lovely day at work today!! Increase our physical activity Eliminate our social isolation Reduce excess weight Stop smoking Aggressively manage other medical conditions Diabetes High blood pressure High cholesterol 4
Be Kind to yourself! Take a deep breath and Box Breath!!! Each morning before you start the car, before you leave the car at your destination--- take a deep breath and Box Breath!!!!!!!!!!!!!!!!!!!!! Repeat this at least 3 times during the day 5
Weight Blood Pressure Cholesterol Blood Sugar Nearly 2 out of 3 women over the age of 20 are obese A BMI between 18.5 and 24.9 is considered healthy for women over age 20 To calculate your exact BMI value: multiply your weight in pounds by 703, then divide by your height in inches, finally divide again by your height in inches. 6
What s your numbers? Normal Blood Pressure is <120/<80 Pre Hypertension 120-139/80-89 Stage I Hypertension 140-159/90-99 Stage II Hypertension > 160/ > 100 Get it checked!!!! Get it treated!!!! Weight Reduction DASH Diet Reduce Sodium Physical Activity 5-20 mmhg/22 lb loss 8-14 mm Hg 2-8 mm Hg 4-9 mm Hg Have it checked!! Treatment has been demonstrated to reduce risk for heart attack, stroke and death Medications for treatment are generally well tolerated, but lab work is required 7
Total Cholesterol Level Category Less than 200 mg/dl Desirable lower risk 200 239 mg/dl Borderline high higher risk 240 mg/dl and above High blood cholesterol = greater than twice the risk LDL Cholesterol Level Category Less than 100 mg/dl Optimal with heart disease 100 129 mg/dl Near or above optimal 130 159 mg/dl Borderline high 160 189 mg/dl High 190 mg/dl and above Very high HDL Cholesterol Level Category 60 mg/dl and above High HDL cholesterol = lower risk 40 59 mg/dl Higher HDL level, the better Less than 40 mg/dl Low HDL higher risk 8
What is your number? Have it checked!!! Insulin resistance and metabolic syndrome precede diabetes Abdominal obesity >35 inches in women Triglycerides > 150 mg/dl HDL < 50mg/dL Blood Pressure > 130/> 85 mm Hg Fasting glucose > 110 mg/dl Diabetes-Fasting Blood sugar greater than 126 Get Active Control Cholesterol Eat Better Manage Blood Pressure Lose Weight Reduce Blood Sugar Stop Smoking www.americanheart.org Smoking increases the risk of heart disease and stroke by 2 to 4 times Women who smoke have a 25 percent higher risk of developing heart disease as compared to men who smoke 9
Nicotine dangerously increases: heart rate and blood pressure Carbon monoxide and tobacco robs your heart, brain and arteries of oxygen Damages your blood vessels causes sticky blood causing risk of blood clots Lowers your tolerance for physical activity and decreases HDL (good) cholesterol. Increased activity/exercise is a wonder medication that that has little actual cost 10
Exercise Results in Reductions in: All-cause mortality Coronary heart disease High blood pressure Stroke Type II diabetes Metabolic syndrome Colon and breast cancer Insulin sensitivity Depression Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory committee Report, 2008. Washington DC: U.S. Dept. HHS, 2008 Yet: Exercise is the hardest pill to swallow 11
We walked everywhere We did chores cleaning the floor meant using a broom, washing the dishes meant washing the dishes we worked on the farm We used to get up to change the channelalthough with only 3 stations, there wasn t much to change to!! We took the stairs- there were no elevators or escalators 12
We circle the parking lot looking for the closest space We interact with our friends on line We sit on the sofa to play games We use automatic everything. We are in the midst of an epidemic of obesity and diabetes..and Our children and grandchildren are at risk When was the last time you took a walk in your neighborhood? When was the last time you did a physical activity with your grandchildren? When was the last time you played a sport rather than watch it on T.V.? Even walking the dog.. 13
80 Yr Old 54 Yr Old 71 Yr Old 14
Our social network is incredibly important Associated with improved outcomes, reduced cognitive decline Maintenance of better physical performance within a high-functioning cohort is influenced by prior exercise behavior and social network emotional support. We are becoming more isolated and alone Can you name all of your neighbors? Take on a Medical Mission Talk the Talk Walk the Walk Commitment Cards Sign up 10 walking friends Walking is safe-no contraindications. Keep it simple. More steps each day. Find a buddy Do it as a family Do it as a neighborhood 15
Make conscious decisions to: Park in the back of the lot Take the stairs instead of the elevator/escalator Walk the golf course Participate in a sport rather than just observe 16