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Cholesterol_ blood pressure_ and heart disease

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					Cholesterol, blood pressure,
and heart disease
   By Melissa Bess
   Nutrition and Health Education
   Specialist
   University of Missouri Extension
   FNEP STAFF TRAINING ONLY, DO NOT
   USE WITH FNEP PARTICIPANTS




                              06/2007
Introduction
        •   About cholesterol
        •   LDL vs. HDL
        •   Triglycerides
        •   Healthy levels
        •   Common misconceptions
        •   What affects cholesterol?
        •   Why does it matter?
        •   Prevention of high cholesterol
Introduction (continued)
        •   About blood pressure
        •   Common misconceptions
        •   Controlling high blood pressure
        •   Heart disease risk factors
About cholesterol
        • Soft, fat-like, waxy substance
        • Bloodstream and cells
        • Needed for cell membranes and
          hormones and to make vitamin D
        • Comes from 2 sources
          – Body produces it (mostly genetic) in liver
            (1000 mg day)
          – Food sources (animal products – meats,
            poultry, fish, eggs, butter, whole milk, and
            cheese, not from plant sources) (100 – 500
            mg day)
          – Foods with trans fats or saturated fats may
            cause the body to produce more
            cholesterol
About cholesterol
        • Must be transported through
          blood
        • Carriers are called lipoproteins
          – Low-density lipoprotein (LDL)
          – High-density lipoprotein (HDL)
        • Lipoprotein = protein + fat
          – LDL, more fat, less protein
          – HDL, more protein, less fat
LDL vs. HDL
       • LDL = “bad”
       • Too much can clog arteries by
         forming plaque
       • Atherosclerosis can cause heart
         attack or stroke
LDL vs. HDL
       • HDL = “good”
       • Tends to carry cholesterol away
         from arteries and back to liver
       • May also remove excess
         cholesterol from plaque in
         arteries, slows buildup
Triglycerides
        • Form of fat
        • Also made in body (body fat
          stored as triglyceride) and from
          food
        • Help transport dietary fat,
          metabolism
        • Trigger liver to make more
          cholesterol, rising LDL and total
          cholesterol
Healthy Levels
           • Total cholesterol
                – Optimal – under 200 mg/dL
                – Borderline high risk – 200-239 mg/dL
                – High risk – 240 mg/dL and up
           • LDL
                – Optimal – less than 100 mg/dL
                – Near/Above optimal – 100-129 mg/dL
                – Borderline high – 130- 159 mg/dL
                – High – 160 – 189 mg/dL
                – Very high – 190 mg/dL
   Source: National Cholesterol Education Program, National Heart,
   Lung, and Blood Institute
Healthy Levels
               • HDL
                   – Low - less than 40 mg/dL
                   – High – above 60 mg/dL (may lower
                     risk for heart disease)
                   – Women tend to have higher HDL due
                     to estrogen (needs to be over 50
                     mg/dL)
               • Triglycerides
                   – Normal – less than 150 mg/dL
                   – Borderline high – 150 – 199 mg/dL
                   – High – above 200 mg/dL
 Source: National Cholesterol Education Program, National Heart, Lung, and Blood
 Institute
Common misconceptions
       • Using margarine instead of butter
         will help lower my cholesterol
       • Thin people don’t have to worry
         about high cholesterol
       • If a label lists no cholesterol, it’s a
         “heart-healthy” choice
       • Eggs – good or bad?
       • Women don’t need to worry about
         cholesterol
       • Only middle-aged people should
         have their cholesterol checked
What affects cholesterol?
        • Diet
            – Poly and monounsaturated fats may help
              lower cholesterol when used in place of
              saturated fats, but still limit
            – High carbs, excessive alcohol may
              increase triglycerides
            – Soluble fiber may lower LDL, not HDL
        •   Weight
        •   Physical activity
        •   Age
        •   Gender
        •   Heredity
Why does it matter?
        • Coronary heart disease is caused
          by atherosclerosis
        • Single leading cause of death
        • The higher LDL you have plus risk
          factors increases risk for heart
          attack
          – Smoking
          – High Blood pressure
          – Low HDL
          – Family history of early heart disease
          – Age
Prevention of high cholesterol
        • Get it checked
        • Watch fats, eat healthy
        • Consume less than 300 mg of
          cholesterol a day
        • Be active
        • Quit smoking
        • Some may need medication
           – Lipitor, Crestor, Zocor
           – Vytorin
           – Zetia
Blood pressure
       • 1 in 3 adults has hypertension
       • No symptoms, nearly 1/3 of those
         people don’t know they have it
       • No known cause
       • 2 forces
          – Blood pumps to arteries and through
            circulatory system
          – Arteries resist blood flow
       • Arteries elastic, stretchy
       • Heart beats 60-80 times a minute
Blood pressure
       •   Systolic (top) – heart is beating
       •   Diastolic (bottom) – heart resting
       •   Normal – 120/80 mm Hg
       •   Pre-hypertensive – 120-139/80-89 mm
           Hg
       •   Hypertensive – 140/90 mm Hg
       •   May take several readings
       •   “White coat hypertension”
       •   Hypertension increases risk for heart
           disease and stroke
       •   Number 1 controllable risk factor for
           stroke
Blood pressure
       • Sodium/salt
          – Holds excess fluid in body, heart has
            to work harder
       • Potassium
          – Blunts effects of salt on blood
            pressure
Common misconceptions
       • Symptoms of high blood pressure
         include nervousness, sweating,
         and difficulty sleeping
       • High cholesterol = high blood
         pressure
       • Everyone has high blood
         pressure, I don’t need to worry
       • Women don’t need to worry about
         high blood pressure
Controlling hypertension
        • Reduce fat (particularly saturated
          fat)
        • Stop smoking
        • Cut back on alcohol
        • Be active
        • May need medication
        • Stress management
Heart disease risk factors
        • Uncontrollable
           – Age
           – Male gender
           – Heredity (including race) – African
             Americans = higher blood pressure.
             Also higher among other races
        • Controllable
           – Smoking (2-4x higher than non-
             smokers)
           – High cholesterol (high HDL can be
             positive risk factor)
           – High blood pressure
Heart disease risk factors
        • Controllable
           – Physical inactivity
           – Obesity/overweight (especially in
             abdominal area)
           – Diabetes
        • Other factors
           – Stress
           – Too much alcohol
             • Moderate drinkers = less risk than non-
               drinkers (may increase HDL cholesterol)
Phytonutrients
        • Soy protein may reduce risk of heart
          disease
          – Especially when replacing foods high in
            saturated fat
        • Plant sterols/stanols
          – Found naturally in fruits/veggies, plant oils
            may lower LDL
        • Omega-3 fatty acids
          – Two weekly servings of fish may be heart
            healthy
        • Folic Acid
          – May lower homocysteine levels
        • Antioxidants
• Questions??
• Activity time!