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Useful Information


Understanding Risk Factors:

Risk factors are traits and lifestyle habits that increase your risk of disease. The same factors that raise your risk of coronary heart disease will directly or indirectly raise your risk of stroke. The more risk factors you have, the higher your chances of having a heart attack or stroke. Some examples of risk factors are:

  • High Blood Pressure
  • Tobacco Smoke
  • High Blood Cholesterol
  • Physical Inactivity
  • Obesity
  • Diabetes

Some risk factors, however, are out of our control.
These include:

  • Increasing age
  • Sex (gender)
  • Race
  • Family medical history
  • Previous heart attack or stroke.

Other factors that could still affect your heart are an unhealthy response to stress, excessive alcohol, and some illegal drugs.


Atherosclerosis is the process of cholesterol and other substances slowly building up over time in artery walls. The buildup is called plaque. When plaque builds up in an artery to the heart, it reduces the heart muscle’s blood supply. At some point this reduced blood supply can cause chest pain called angina pectoris.

If the plaque ruptures, the artery may become completely closed by a blood clot. When part of the heart doesn’t get the blood supply it needs, that part begins to die. This is a heart attack. A stroke occurs if brain cells don’t get the blood they need and start to die. Many heart attack and stroke risk factors speed up atherosclerosis. This is why it’s so important to work with your doctor to control as many of these factors as you can. By controlling risk you may be able to slow down (or reverse) the buildup of plaque.

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Knowing the signs of a heart attack could be a life saving piece of information. The first thing you should do if you think you are having a heart attack is to call 9-1-1 without hesitation.

The signs of a heart attack are:

  • Uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that lasts more than a few minutes or goes away and comes back.
  • Pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
  • Shortness of breath with or without chest discomfort.
  • Breaking out in a cold sweat, nausea, or lightheadedness.

Be sure to write down the emergency medical services phone
numbers and always keep them by your phone

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Understanding Cholesterol:

Whether you have high cholesterol or not, you need to know what cholesterol is and what you can do to help control it. Keeping cholesterol levels under control is important for everyone: men and women, young, middle-aged and older people; and people with and without heart disease.

Cholesterol is a soft, fat-like substance found in the bloodstream and in all your body’s cells. It’s used to form cell membranes, some hormones, and is needed for other important functions. Your body usually makes about 1,000 milligrams of cholesterol a day, mostly in the liver. Another 100 to 500mg can come directly from foods.

Cholesterol is a part of a healthy body, but too much of it in your blood can be a problem. High blood cholesterol is a risk factor for heart disease and stroke. If you have both high blood cholesterol and heart disease, you have an even greater stroke risk.

The two key components you need to know are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

High cholesterol has no symptoms. It is easy to have high cholesterol and not to know it. That’s why it’s important to have it measured. Knowing your cholesterol can help you take steps to prevent a heart attack or stroke if you’re at high risk.

Everyone age 20 an older should have their cholesterol measured at least once every five years. It’s best to have a blood test called a “lipoprotein profile” to find out your cholesterol numbers. This test is given after a 9 to 12 hour fast. It gives information about the total cholesterol, LDL (bad) cholesterol and HDL (good) cholesterol, as well as triglycerides (blood fats).

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Understanding Hypertension:

Hypertension is the medical term for High Blood Pressure. Blood pressure is a major component for blood to circulate throughout the body. When your heart beats, it pumps blood into your arteries and creates pressure in them. This pressure (blood pressure) causes youm;/r0 blood to flow to all parts of your body. If you’re healthy, your arteries are elastic. They stretch when your heart pumps blood through them. How much they stretch depends on how much force the blood exerts. Under normal conditions, your heart beats about 60 to 80 times per minute. Your blood pressure rises on contraction and falls when the heart relaxes between beats. Your blood pressure can change from minute to minute, with changes in posture, exercise or sleeping.

Two numbers are recorded when measuring your blood pressure. The top (larger) number measures the pressure in your arteries when your heart beats. The bottom or smaller number measures the pressure while your heart rests between beats. Normal pressure is below 120/80mmHg. Blood pressure from 120-139/80-89 is considered “prehypertension.” If you’re an adult and your blood pressure is 140/90mmHg or higher, you have high blood pressure. If you have diabetes or kidney disease, your doctor will want your blood pressure to be lower than 130/80mmHg to not be considered hypertensive.

High Blood pressure doesn’t necessarily have to be related to being tense, compulsive, or nervous. In fact, you can have high blood pressure and not know it. High blood pressure usually has no symptoms, and thus is called the “silent killer”.

About 90-95% of the cases of high blood pressure have no known cause.

Lowering your Blood Pressure:

There are many ways to lower your blood pressure. The chart below outlines a very simple method that anyone can follow.

Lifestyle modifications that will help you reduce
your blood pressure...
Life Style Modification
Effect On Your Blood Pressure
Exercise: 30 to 45 minutes of aerobic exercise should be performed on most days (four to five days) of the week
A single session of exercise at an intensity of 50% to 100% of maximum aerobic power reduces the blood pressure by 18-20mmHg/7-9mmHg. These changes persist up to 12h to 16h following exercise
Weight: An ideal body weight (body mass index of 18.5kg/m² to 24.9kg/m²) should be maintained and weight loss strategies should be implemented.
Blood pressure is reduced by 1.6/1.1mmHg for each 1kg of weight loss.
Alcohol consumption: Should be limited to two drinks or fewer per day, and weekly intake should not exceed 14 standard drinks for men and 9 standard drinks for women.
Limited alcohol consumption can reduce systolic blood pressure by 2mmHg to 4mmHg.
Diet: A reduced fat, low cholesterol diet that emphasizes fruits, vegetables and low fat dairy products should be followed and an adequate intake of potassium, magnesium and calcium should be maintained.
The Dietary Approaches to Stop Hypertension (DASH) diet, reduced blood pressure by 11.4/5.5mmHg.
Salt intake should be restricted to 65 to 100 mmol/day
Dietary sodium restriction may lower blood pressure by 4.2/2.0mmHg to 5.2/3.7mmHg.

For more information on the DASH Diet, you can find it on the Whitby Cardiovascular website, under the Hypertension and Lipid Clinic.

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Heart Failure

Heart failure doesn’t mean that your heart has stopped beating. It means that your heart isn’t pumping as well as it should be and your body is not getting the oxygen-rich blood that it needs.

Heart failure is a condition that occurs when the heart has been damaged and is weak. It can occur and worsen without any symptoms. The most common cause of heart failure is coronary artery disease that results in a heart attack or high blood pressure.

The most common risk factors that lead to heart failure are:

  • Narrowed arteries that supply blood to the heart muscle (known as CAD)
  • High blood pressure
  • Past heart attack (known as a myocardial infarction)
  • Heart valve disease
  • Disease of the heart muscle itself (known as cardiomyopathy)
  • A defect in the heart present at birth (known as congenital heart disease)
  • Infection of the heart valves and heart muscle itself (known as endocarditis or myocarditis)
  • Being overweight
  • Diabetes
  • Certain abnormal heart rhythms
  • Thyroid problems
  • Toxic substances such as alcohol or certain chemotherapy agents.


Angina, or angina pectoris, is a recurring discomfort. It usually lasts just a few minutes. It’s often in the center of the chest, behind the breastbone. People describe it as heaviness, tightness, pain, fullness, uncomfortable pressure or squeezing. Sometimes the pain or discomfort spreads to one or both arms, or the back, neck, jaw or stomach. It may also cause numbness in the shoulders, arms or wrists.

Both angina and a heart attack involve inadequate blood flow to the heart muscle, but there’s a key difference. In angina, the blood flow is reduced, especially when the heart must do more work. This temporarily reduced blood flow leads to chest discomfort. In a heart attack, blood flow to part of the heart muscle is suddenly cut off when a coronary artery is blocked. The resulting chest pain is usually more severe and lasts longer.

Your body has a way to increase the blood flow to the heart muscle when a coronary artery is partly blocked. Other nearby arteries may expand and small branches may open up to carry more blood to the affected area. This is called collateral circulation. If the collateral circulation becomes well developed, anginal symptoms may decrease or even go away. This extra blood flow to the heart muscle can help prevent a heart attack. If a heart attack does occur, the permanent heart damage may be less severe.

Atrial Fibrillation

The heart has electrical impulses that cause it to beat in a regular pattern. Sometimes these impulses lose their regular pattern. One such outcome of this is called Atrial Fibrillation (A.Fib). A.Fib itself isn’t usually life threatening, but it can lead to other problems, such as chronic fatigue, heart failure, and sometimes even a stroke.

Some people who have A.Fib don’t feel a thing. Others notice irregularities immediately. If you have A.Fib, you may have had sensations that include a racing, uncomfortable, irregular heartbeat, and/or a “fluttering” feeling in your chest.

Mitral Valve Prolapse

Your heart is a pump with four chambers. Two are filling chambers (atria) and two are pumping chambers (ventricles). A mitral valve has two flaps or leaflets. They’re shaped sort of like a parachute and are attached to the supporting muscles by strings. These strings help the flaps close evenly. By opening and closing, your mitral valve keeps your blood flowing in just one direction (from the left atrium to the left ventricle).

If you have mitral valve prolapse (MVP), you’re not alone. Studies have shown that MVP occurs in at least 1 to 2 percent of the populations.

The exact cause of mitral valve prolapse is usually unknown. In most cases no other heart disease is present. A few other conditions are occasionally associated with MVP. These include atrial septal defect, coronary artery disease, disease of the heart muscle, and disorders causing inflammation of the heart. Most often if these other diseases are present, they would have been present with or without mitral valve prolapse. In some cases mitral valve prolapse may be inherited.

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Copyright 2005 Whitby Cardiovascular Institute. All rights reserved.