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
Some risk factors, however, are out of our control.
- Sex (gender)
- Family medical history
- Previous heart attack
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
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.
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
numbers and always keep them by your phone
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
stroke. If you have both high blood cholesterol
and heart disease, you have an even greater stroke
The two key components you need to know are low-density
lipoprotein (LDL) and high-density lipoprotein
High cholesterol has no symptoms. It is easy
to have high cholesterol and not to know it.
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
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).
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.
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
ideal body weight (body mass index of 18.5kg/m² to 24.9kg/m²)
should be maintained and weight loss strategies
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
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
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.
UNDERSTANDING CARDIAC CONDITIONS
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
- 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
- Infection of the heart valves
and heart muscle itself (known as endocarditis
- Being overweight
- 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
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
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,
heart damage may be less severe.
The heart has electrical impulses that cause it
to beat in a regular pattern. Sometimes these
impulses lose their regular pattern. One such
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,
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
These strings help the flaps close evenly. By
opening and closing, your mitral valve keeps
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 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.