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
"Cardiovascular Disease A Matter of Heart"