Kimberly A. Rogers, BSN, RNAugust 2013 HEART DISEASE Risk Factors & Prevention Heart Disease Risk...

Kimberly A. Rogers, BSN, RN August 2013

HEART DISEASERisk Factors & Prevention

Heart DiseaseRisk Factors & Prevention

Section I: U.S. Disease Statistics

U.S. Disease Statistics

• 25% of all deaths in the U.S. for all ethnic groups are caused by heart disease

• 600,000 people in the U.S. die each year of heart disease

• Over ½ of all heart disease deaths in the U.S. annually (385,000) are caused by coronary heart disease

• There are 935,000 heart attacks each year in the U.S. (Hillsborough County Population is 1.2 million)

• Coronary heart disease costs the U.S. economy $1.89 billion each year

(Centers for Disease Control, 2013)

1. Epidemiological &Statistical Data

2. Health Status

Section II: Hillsborough County Statistics

Epidemiological & Statistical Data: Hillsborough County vs. State of Florida Coronary Disease Death Rates

(Florida Charts.com, 2013)

1990 1995 2000 2005 2010 20150

Hillsborough Males Hillsborough FemalesFlorda Males Florida Females

Epidemiological & Statistical Data Summary• Hospitalizations and deaths from Coronary Heart Disease

have dropped in Hillsborough County and statewide since the early 1990’s

• The rate of deaths from Coronary Heart Disease is still higher in Hillsborough County than the state for males

• The rate of deaths from Coronary Heart Disease is higher for men than women, in Hillsborough County and statewide

Health Status: Percentage of People with Cardiovascular Disease

(Florida Department of Health, 2013)

Florida Hillsborough5.0%6.0%7.0%8.0%9.0%

10.0%11.0%12.0%13.0%14.0%15.0%

10.2% 10.5%

Health Status: Percentage of Adults Who Smoke, Hillsborough County vs. Florida Statewide

(Floridacharts.com, 2013)

2002 201010.0%12.0%14.0%16.0%18.0%20.0%22.0%24.0% 22.8%

Hillsborough County Florida

Health Status: Percentage of Adults Who Are Overweight or Obese in Hillsborough County vs. Florida Statewide

2007 201040.0%

64.2% 64.6%62.1%65.0%

Health Status: Percentage of Adults with High Cholesterol in Hillsborough County vs. Florida Statewide

2007 201030.0%

35.8%38.9%

37.1%38.6%

Health Status: Percentage of Adults with Hypertension in Hillsborough County vs. Florida Statewide

2007 201020.0%

28.3%30.6%

Health Status Summary• The health status data discussed in these

slides all represent known risk factors for coronary artery disease (American Heart Association, 2013)

Section III: Heart Disease Risk Factors

Non-Modifiable Heart Disease Risk Factors

• Age (Increased Risk Above 65 Years of Age)• Gender (Increased Risk for Males)• Heredity (Increased Risk for African Americans, Mexican

Americans, Native Americans, Native Hawaiians, and Some Asian Americans)

(American Heart Association, 2013)

Modifiable Heart Disease Risk Factors

• Tobacco Smoke (Increases 2X – 4X above non-smokers)• Second-hand Smoke Also Increases Risk• High Blood Cholesterol

• Total Cholesterol Should be <200 mg/dL• LDL Should be 100 mg/dL – 160 mg/dL depending on other

risk factors

• High Blood Pressure

Modifiable Heart Disease Risk Factors (cont’)

• Physical Inactivity• Overweight & Obesity• Diabetes• Stress• Alcohol Consumption• Diet/Nutrition

Section IV: Heart Disease Characteristics & Symptoms

Coronary Artery Disease & Anatomy

(Drchandler.com, 2005)

Coronary Artery Disease Progression

(Bean et al, 2006)

Signs & Symptoms of Coronary Heart Disease• Chest Pain (squeezing, pressure, or heaviness)

• Pain in Shoulders, Arms, Neck, Jaw, or Back

• Persistent Indigestion or Nausea

• Fatigue and Weakness

• Shortness of Breath

• Sweating

• Lightheadedness

Signs & Symptoms of CoronaryHeart Disease in Diabetics

• Diabetic Nerve Damage Can Interfere with Pain Signals in the Body

• Diabetics Can Have Some or All of the Typical Symptoms

• Some Diabetics May Have a Heart Attack without Symptoms

• When in Doubt, Always Call 9-1-1

(National Institutes of Health, 2011)

Differences in Signs & Symptoms of CoronaryHeart Disease in Women

• Women May Not Have Typical Symptoms

• Signs Can Be Subtle

• May Perceive as Flu-like Symptoms

• May Have Shortness of Breath without Chest Pain

• May Have Back Pain or Pressure

• May Have Dizziness, Light-headedness, or Fainting

Section V: Heart Disease Prevention

Prevention: Controlling Modifiable Risk Factors• Hypertension

• Comply with medications

• Reduce salt intake

• Maintain a healthy weight

• Limit alcohol

• Manage stress

Prevention: Controlling Modifiable Risk Factors• Elevated Cholesterol & Triglycerides

• Adopt a heart healthy diet

• Increase physical activity

• Take any cholesterol medications as directed by your doctor

• Obesity & Sedentary Lifestyle• Exercise at least 30 minutes a day – can be broken into three

10-minute sessions

• Adopt a heart healthy diet (American Heart & Dash Diet)

Prevention: Controlling Modifiable Risk Factors• Poorly Controlled Blood Sugar

• Perform blood sugar checks as recommended by doctor

• A1C Checks

• Medications: insulin or oral medications taken as directed

• Diet & Exercise

• Smoking• There are many options & resources available for smoking

cessation

Section VI: Heart Disease Diagnosis & Treatment

Diagnosis of Coronary Artery Disease• History & Physical Exam

• Lab Work

• EKG

• Stress Test

• Echocardiogram

• Cardiac Cath

Treatment of Coronary Artery Disease• Medication

• Risk Factor Modification

• Cardiac Stent

• Coronary Artery Bypass Graft Surgery (CABG)

Heart Attack• Persistent Symptoms = Acute Event

• This is a Cardiac Emergency• Early Activation of EMS is Important

• Call 9-1-1

• Rapid Intervention is Associated with Better Outcomes (Less than 120 Minutes from Onset of Symptoms)

• Treatment• Cardiac Stent

• Coronary Artery Bypass Graft Surgery

Section VII: Florida Hospital Zephyrhills Heart Institute

Florida Hospital Zephyrhills Heart Institute• Established in 2006

• Award-winning Program

• Accredited Chest Pain Center

• Offers Comprehensive Cardiac Care

• Has Performed Thousands of Procedures

• Highly Skilled Staff – Board Certified Cardiologists, Cardiac Surgeons, and Specialized Cardiac Care Nurses & Technical Support Staff

Florida Hospital Zephyrhills Heart InstituteServices Offered

• Open-heart Surgery• Coronary Bypass Grafting

• Cardiac Valve Repair/Replacement

• Minimally Invasive Valve Surgery

• Thoracic Aneurysm Repair

• Cardiac Catheterization• Diagnostic Heart Caths

• Coronary Angioplasty & Stenting

• Radial Catheterization

Florida Hospital Zephyrhills Heart InstituteServices Offered (Cont’)

• Other Catheterization Procedures• Valvuloplasty

• Renal Artery Stenting

• Peripheral Artery Stenting

• Electrophysiology Procedures• Electrophysiology Studies

• 3D Mapping

• Cardiac Ablations, Including Atrial Fibrillation

• Pacemakers/Defibrillators

• Other Cardiac Testing Procedures & Services• Stress Tests

• Echocardiograms

• Tilt Table Tests

• Cardiac Rehabilitation Program

• Congestive Heart Failure Support Group

• Device Support Group

• Other Services• State of the Art Cardiovascular Operating Room (CVOR)

• Cardiac Intensive Care Unit (CVICU)

• Cardiac Step-down Unit (CSDU)

• Cardiac Procedure Recovery Unit (CRU)

ReferencesThe American Heart Association (2013). Retrieved from www.heart.org .

Bean, C.A., et al (2006). Image. ACC Atlas of Pathophysiology, 2nd Edition.

Philadelphia: Lippincott & Wilkins.

Centers for Disease Control and Prevention (2013). Heart Disease Facts. Retrieved

from http://www.cdc.gov/heartdisease/facts.htm.

Florida Department of Health. (2013) Retrieved from www.Floridacharts.com.

ReferencesDrchandler.com (2005). Image. Retrieved from http://

drchander.com/diagnoseCAD.html.

National Institutes of Health (2011). What Are the Signs and Symptoms of Diabetic

Heart Disease? Retrieved from http://

www.nhlbi.nih.gov/health/health-topics/topics/dhd/signs.html.

U.S. Census Bureau (2010). American Fact Finder. Retrieved from

http://factfinder2.census.gov/faces/nav/jsf/pages/searchresults.xhtml

Kimberly A. Rogers, BSN, RNAugust 2013 HEART DISEASE Risk Factors & Prevention Heart Disease Risk...

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