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Cardiovascular Disease A Matter of Heart

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					A MATTER OF HEART:
 Cardiovascular Disease

 Dr. Rita D. Strickland


    NATIONAL BLACK NURSES ASSOCIATION
          NBNA ANNUAL CONFERENCE
          SAN DIEGO, CALIFORNIA
              AUGUST 5, 2010
                                        1
“Create in me a pure
heart, O God, and renew
  a steadfast spirit
     within me.”
                PSALM 51:10




                              2
        2 Major Aspects of the Heart
         Duality of the Heart
   Physiological                   Spiritually
       Most important muscle           Most important organ
       Sustains us by                  Storage unit for the
        pumping blood to                 Holy Spirit
        every cell in our body          Vault for God’s love




                                                                3
THE Physiological HEART
              Approximately the size of
               your fist
              It pumps between 1,500 –
               2,000 gallons of blood every
               day
              It beats 70 times a minute;
               100,000 times a day; 36.5
               million times a year
              It beats about 2.5 billion
               times over a 70-year lifetime


                                           4
             The Spiritual Heart
“He anointed us, set his   “And hope does not
  seal of ownership on       disappoint us,
  us, and put his Spirit     because God has
  in our hearts as a         poured out his love
  deposit, guaranteeing      into our hearts by the
  what is to come.”          Holy Spirit, whom he
2Corinthians 1:21-22         has given us.”
                           Romans 5:5



                                                  5
       The Spiritual Heart

“I will give you a new heart and
  put a new spirit in you; I will
  remove from you your heart of
  stone and give you a heart of
  flesh.” Ezekiel 36:26

                                6
       African Americans and Heart Disease
   African American adults are less likely to be diagnosed with coronary heart
    disease, however they are more likely to die from heart disease.

   Cardiovascular diseases remain the leading cause of disability among
    working adults.

   Stroke alone accounts for the disability of more than a million Americans.

   Although African American adults are 40% more likely to have high blood
    pressure, they are 10% less likely than their non-Hispanic White
    counterparts to have their blood pressure under control.



      Source: http://cdc.gov/nchs/data

                                                                            7
           African Americans and Heart
                     Disease
    Heart disease is the leading cause of death in
     African American women.
    In 2005, African American men were 30% more
     likely to die from heart disease, as compared to
     non-Hispanic white men.
    Cardiovascular disease accounts for nearly 40
     percent of all deaths among African American
     women.

    Source: http://cdc.gov/nchs/data
                                                        8
    Risk Factors For Heart Disease
   Modifiable                            Non-modifiable
       Cigarette smoking                     Age
       Hypertension (High blood              Gender
        pressure)                             Heredity
       High blood cholesterol                Race
       Obesity                               Menopause
       Diabetes
       Inadequate physical activity
       Stress



                                                           9
 “ Risk of heart disease can be
   lowered by as much as 82
percent through simple lifestyle
            changes.”




                                   10
Cardiovascular Health in New York State
   New York State Department of Health




    http://www.nyhealth.gov/nysdoh/heart/dietcd.htm   11
         3 C’s of Heart Disease
   Circulation – narrow or blocked vessels
       Myocardial Infarction (Heart Attack)


   Conduction – electrical dysfunction
       Heart Block (Pacemaker malfunction)


   Contraction – pumping dysfunction
       Heart Failure - Cardiomyopathy

                                               12
    Symptoms of Heart Disease and Stroke

    Heart Disease                       Stroke
   Chest pain that may           Weakness on one side
    radiate to the arm,            of the face or body
    neck or jaw.                  Difficulty in speech
   Nausea                        Sudden severe
   Shortness of breath            headache
   Fatigue                       Difficulty with balance
   Dizziness                     Fainting
   Palpitations
      ***African American women may experience
                                                        13
      symptoms of heart disease differently.
SYMPTOMS OF A HEART ATTACK
   Classic Symptoms                 Symptoms More
     Squeezing chest pain or         Likely in Women
    pressure                           Indigestion or gas-like
      Shortness of breath            pain
      Sweating                         Dizziness, nausea or
      Tightness in chest             vomiting
      Pain spreading to                Unexplained weakness,
    shoulders, neck or arm            fatigue
      Sudden dizziness or              Discomfort/pain
    brief loss of consciousness       between shoulder blades
      Feeling of heartburn or          Recurring chest
    indigestion with or without       discomfort
    nausea and vomiting                 Sense of impending
                                      doom

                                                              14
             Do You Know Your Numbers?
               (American Heart Association Recommendations)

   Total Cholesterol – Less than 200 mg/dL
       LDL – Low Density Lipoprotein (bad) cholesterol -
        Less than 100 mg/dL is best.
       HDL – High Density Lipoprotein (good) cholesterol -
        More than 60 mg/dL is best.
       Triglyceride levels - Less than 150mg/dL is best.
   Blood pressure – Less than 120/80
      JNC VII – Joint National Committee Guidelines
      http://www.nhlbi.nih.gov/guidelines/hypertension/phy
       card.pdf
   Fasting Glucose – Less than 100 mg/dL
   Body Mass Index (BMI) – Less than 25
   Waist circumference – Less than 35” for women and
    40” for men
   Exercise – Minimum of 30 minutes at least 3 days a
    week                                                      15
        Preventing and Managing Heart Disease
   Check family history for high blood
    pressure, stroke, and heart disease
    – Genealogy Health History
       Tell Your Story – Share this
        information with family members
   Early cardiovascular screening
   Regular medical check-up
   Reduce salt and cholesterol intake
   Increase fiber with fresh fruits and
    vegetables
   Stop smoking
   Start an exercise program
   Utilize stress reduction measures
   Modify dietary factors for weigh
    reduction
                                                16
    Living in a Heart Healthy Manner
   Take a daily walk with God.
   Never miss an opportunity to
    laugh.
   Drink plenty of water.
   Learn to love yourself and
    others.
   Tap into the child within your
    spirit.
   Choose to eat foods that are
    nourishing to your body.
   Give honor to God and celebrate
    your life.
                                       17
         Heart Disease and Diet
   There is evidence that plant foods play a role in
    preventing atherosclerotic heart disease.

   The consumption of saturated fat, dietary
    cholesterol, and red meat have all been shown
    to increase the incidence of heart disease.

   Dietary Goal - low in total fat, saturated fat, and
    cholesterol eating habit is essential with a
    moderation of salt intake.

                                                        18
                      Dash Diet
      (Dietary Approach to Stopping Hypertension)

   Type of Food                  Servings (Daily)
   Grains                        6 - 12
    Fruits                       4-6
   Vegetables                    4-6
   Low fat or Non-Fat Dairy      2-4
   Lean meats, fish, poultry     2-3
   Nuts, seeds and legumes       3 – 6/Week
   Fats and sweets               Limited
                                                    19
Uncontrolled hypertension
 and other risk factors can
 increase the possibility of
  heart failure. This can in
turn, lead to the possibility
   of a need for an organ
         transplant.
                                20
     ORGAN TRANSPLANTS

Which organs?
 •   Kidney
 •   Heart
 •   Liver
 •   Lung
 •   Pancreas
 •   Intestine
 •   Cornea
 •   Skin
 •   Bone
 •   Bone Marrow
                         21
 ORGAN TRANSPLANTS

Survival Rates --
98%   kidney
95%   liver
85%   heart
79%   pancreas
70%   small intestine
70%   multi-organ
65%   lungs
65%   heart/lungs


                        22
        ORGAN TRANSPLANTATION
   African Americans have a great need for organ and
    tissue transplantation, yet are often reluctant to
    become donors.
   If more African Americans consented to organ
    donation, more lives would be saved.
   The need for organs for African Americans is so
    great because of the high rate of high blood
    pressure, diabetes, and heart disease -- all of which
    can lead to organ failure.



                                                      23
Waiting List For Transplants As Of
           MAY 7, 2010
                                          Region 9 –
                                                              National
                                          New York


All                                         9,934             116,094
      Kidney                               7,499             90,323
      Pancreas                             177               1,475
      Kidney/Pancreas                      158               2,263
      Liver                                1814              16,682
      Intestine                            9                 247
      Heart                                339               3,168
      Lung                                 37                1,855
      Heart/Lung                           0                 81

  OPTN: Organ Procurement and Transplantation Network – http://www.optn.org
                                                                              24
   Highest Number of Transplants in
       the U.S. – Top 5 States
                        (as of May 7, 2010)

 State                To Date          Year –         Year –
                      1988 - 2010      2009           2010 (Jan-Feb)
 California           58,114           3,058          468

 Pennsylvania         38,399           2,006          306

 Texas                35,193           2,190          379

 New York             30,924           1,940          240

 Florida              27,305           1,803          268

                                                                    25
OPTN: Organ Procurement and Transplantation Network – http://www.optn.org
Transplants in New York State by Recipient
              Age (as of May 7, 2010)
                              To Date        Year –       Year -
                              1988 – 2010    2009         2010
 All Ages                     30,924         1,940        240
 < 1 year – 5 years           843            46           6
 6 – 17 years                 1,396          73           13
 18 – 49 years                14,201         658          97
 50 – 64 years                11,463         843          91
 65 + years                   3,019          322          33
OPTN: Organ Procurement and Transplantation Network – http://www.optn.org
                                                                    26
    Transplants in New York State by
      Recipient Gender (as of May 7, 2010)
                      To Date            Year –           Year -
                      1988 - 2010        2009             2010
 All Genders          30,924             1,940            240


 Male                 18,957     (61%)   1,224    (63%)   153   (64%)



 Female               11,967     (39%)   716   (37%)      87   (36%)



OPTN: Organ Procurement and Transplantation Network – http://www.optn.org
                                                                    27
    Transplants in New York State by Recipient
              Ethnicity (as of May 7, 2010))
                                To Date    Year             Year            Year
                                1988 -2010 2008             2009            2010
All Ethnicities                 30,924          1949        1,940           240
White                           17,890          977         977             110
Black                           6,167           442         425             55
Hispanic                        4,847           366         373             50
Unknown                         3               0           0               0
Asian                           1,553           142         150             21
American Indian/Alaska          123             7           3               2
Native
Pacific Islander                51              2           1               0
Multiracial                     290             13          11              2

OPTN: Organ Procurement and Transplantation Network – http://www.optn.org
                                                                                  28
    ORGAN TRANSPLANTATION
   On an average day, 14 to 16 people will die
    waiting for an organ to become available.
   Kidney failure occurs more frequently
    among members of the African American
    community than in any other race.
   Nearly 70% of the organs transplanted into
    African Americans come from Caucasian
    donors.
   African Americans who receive an organ
    transplant from an African American donor
    have less chance of organ rejection.          29
         Organ Donor Criteria
Age is generally less than 80, but is based
on patient’s current medical history
Dead by Neurologic Criteria
  “Brain   Dead”
Medical    history is examined at the time of
death
Free of HIV
  allserologies (blood) are examined at time of
  death

                                                   30
    How Do You Become A Transplant
               Donor?
   Check the back of your driver’s license
   Communicate with your family your desire to
    have your organs donated in the event of
    your death
   Check with your state regarding organ donor
    procedure
   Register with the Organ Procurement and
    Transplant Network
   Carry your organ donor’s card
    http://www.health.state.ny.us/professionals/patients/donation/organ/
                                                                           31
“The body is a unit, though it is made
  up of many parts; and though all its
  parts are many, they form one body
    – whether Jews or Greeks . . .”
                 1Corinthians 12:12




                                         32
THANK YOU




QUESTIONS?
             33
                  RESOURCES
   http://www.womenheart.org/
   http://www.americanheart.org/
   http://www.nhlbi.nih.gov/educational/hearttruth/
   http://www.womensheart.org/
   http://www.sistertosister.org/
   http://www.health.state.ny.us/professionals/patient
    s/donation/organ/
   http://www.optn.org
   http://www.nhlbi.nih.gov/health/infoctr/index.htm

                                                    34