Transcript Cardiovascular Health by Dr Sarma

SWAAGATH NAMASKAAR
Dr.Sarma@works
1
LET US
LEARN TO LIVE
A HEALTHY LIFE
Dr.Sarma@works
2
Dr.Sarma@works
3
Dedicated to HI-TECH Carbon Factory Employees
A Presentation by
Dr. R.V.S.N.SARMA, M.D., M.Sc (Canada)
Dr.Sarma@works
4
PURPOSE OF THIS TALK
•
Create awareness of a healthy heart
•
Impress on seriousness of the problem
•
Provide guidelines for normal values
•
Help identify the various risk factors
•
Inform the warning symptoms
•
Motivate to adopt life style changes
•
Give dietary advice for a healthy heart
•
Certainly, not to frighten the participants
Dr.Sarma@works
5
I.
THE VOLCANO
II.
THE TRIANGLE
III. OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION
VI.
CHOLESTEROL
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
HOW TO PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
6
I.
THE VOLCANO
II.
THE TRIANGLE
III. OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION
VI.
CHOLESTEROL
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
7
Dr.Sarma@works
8
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION
VI.
CHOLESTEROL
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
9
Dr.Sarma@works
10
THE TRIANGLE
HEART
ATTACK
OBESITY
Dr.Sarma@works
11
THE QUADRANGLE
HEART
ATTACK
DIABETES
HIGH BP
SMOKING & ALCOHOL
OBESITY & ↑ CHOLESTEROL
Dr.Sarma@works
12
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION
VI.
CHOLESTEROL
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
13
Dr.Sarma@works
14
ABOUT WEIGHT
NORMAL WEIGHT
Simply Height in cms – 100
For a man 165 cm height = 165 -100 = 65 kg
IDEAL WEIGHT
[ HEIGHT (in meters) x HEIGHT (in meters) ] x 25
[ 1.65 m x 1.65 m ] x 25 = 2.7225 x 25 = 68 kg
EXCESS WEIGHT = [OUR WEIGHT – IDEAL WEIGHT]
75 kg man – 68 kg ideal weight = 7 kg excess
GOAL WEIGHT
Always try to have realistic goals (Ads, Crash diets)
Only 10% of weight reduction in 6 months
For 75 kg man - 10% = 7.5 kg reduction in 6 months
Dr.Sarma@works
15
OVER WEIGHT - OBESITY
EXCESS WEIGHT = [OUR WEIGHT – IDEAL WEIGHT]
75 kg man if 68 kg is ideal weight = 7 kg excess
OVER WEIGHT
If the excess weight is with in 10% of ideal weight
If for a man, the ideal weight is 68 kg (10% = 6.8)
Any weight from 68.1 to 74.8 kg is over weight
OBESITY
If the excess weight is more than 10% of ideal Wt
For him weight more than 74.8 is Obesity
Dr.Sarma@works
16
OBESITY
BODY WEIGHT IS ONE PARAMETER
CENTRAL OBESITY – even if the weight is normal
TUMMY – WAIST CIRCUMFERENCE
Normal for men < 38 inches,
Normal for women < 32 inches
Waist – HIP RATIO
( Waist measurement ÷ Hip measurement ) x 100
Normal for men < 90 %,
Normal for women < 80 %
Dr.Sarma@works
17
Obesity Trends* Among U.S. Adults
BRFSS, 1985
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
18
Obesity Trends* Among U.S. Adults
BRFSS, 1986
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
19
Obesity Trends* Among U.S. Adults
BRFSS, 1987
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
20
Obesity Trends* Among U.S. Adults
BRFSS, 1988
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
21
Obesity Trends* Among U.S. Adults
BRFSS, 1989
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
22
Obesity Trends* Among U.S. Adults
BRFSS, 1990
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
23
Obesity Trends* Among U.S. Adults
BRFSS, 1991
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
24
Obesity Trends* Among U.S. Adults
BRFSS, 1992
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
25
Obesity Trends* Among U.S. Adults
BRFSS, 1993
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
26
Obesity Trends* Among U.S. Adults
BRFSS, 1994
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
27
Obesity Trends* Among U.S. Adults
BRFSS, 1995
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
28
Obesity Trends* Among U.S. Adults
BRFSS, 1996
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
29
Obesity Trends* Among U.S. Adults
BRFSS, 1997
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
30
Obesity Trends* Among U.S. Adults
BRFSS, 1998
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
31
Obesity Trends* Among U.S. Adults
BRFSS, 1999
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
32
Obesity Trends* Among U.S. Adults
BRFSS, 2000
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
Dr.Sarma@works
33
OBESITY in ADULTS of 40+
♥ 35% of Indian men and 50 % women
above 40+ are obese or over weight
♥ This is increasing every year and is
estimated to become 65% in 10 yrs.
♥ This figure is more in urban societies
♥ Women are obese - much early in age
♥ Tummy – Abdominal obesity is higher
♥ ↑↑ risk of Diabetes, ↑ BP, Heart Disease.
Dr.Sarma@works
34
OBESITY in YOUTH
♥ Consumption of sugars, fats, junk food
is associated with obesity in children.
♥ Couch potatoes and mouse potatoes
♥ Studies show more than 80% of obese
adolescents remain as obese adults
♥ 15% of youth are overweight now
♥ This is triple the proportion in 1980
♥
Dr.Sarma@works
↑↑ risk of Diabetes, ↑BP, Heart Disease
35
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES (SUGAR COMPLAINT)
V.
HYPERTENSION
VI.
CHOLESTEROL
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
36
Dr.Sarma@works
37
DIABETES
♥ What is Diabetes ?
A progressive disease in which our body
Does not make enough Insulin and or
We do not respond properly to Insulin - IR
Results in ↑sugar in blood and complications
♥ What is normal blood sugar ?
In fasting state - FBG – Less than 110
After food (2 hrs)- PPBG – Less than 140
♥ Pre DM = FBG >110 or PPBG > 140
♥ Diabetes = FBG > 126 or PPBG of > 200
Dr.Sarma@works
38
MORE ON DIABETES
♥
Genetic factors – Hereditary
♥
Racial factors – Indians are highly prone
♥
Physical inactivity
♥
Bad dietary habits
♥
Over weight and Obesity
1. ↓ pain sensation – painless heart attacks
2.
4 times higher risk for death than normal
3.
3 times higher risk of brain stroke
4. ↓ good cholesterol, ↑bad cholesterol, ↑TG
5. Cause hardening of blood pipes - ↑ BP
Dr.Sarma@works
39
DIABETES TESTING
♥ Can we rely on urine test ? - No
Urine test cannot conclusively decide DM
♥ What blood test is needed
Fasting Blood Sugar – FBG < 110 is N
2 hrs PPBG (after glucose) < 140 is N
♥ Two tests are needed to confirm DM
♥ How often to test ? – If normal - yearly
♥ Does pre Diabetes need treatment – Yes
♥ What are the treatments options ?
Diet, exercise, tablets, Insulin injections
Dr.Sarma@works
40
DIABETES COMPLICATIONS
♥ What is goal blood sugar
FBG < 110, PPBG < 140
Tight control of blood sugar is a must
♥ What if I do not control my Diabetes ?
It leads to variety of complications such as
Heart disease including heart attacks
Kidney disease and failure
Nervous debility in hands and feet
Loss of eye sight, Brain stroke
Frequent infections, TB
Foot ulcers – leading to removal of foot
Dr.Sarma@works
41
DIABETES - ESSENTIALS
♥ Diet restrictions – Keeping sugar normal
♥ Regular physical activity – Keep normal weight
♥ Loose tummy – abdominal fat ↑ diabetes
♥ Medications - if prescribed, not to stop
♥ Tight blood sugar control
♥ Frequent follow up – at least once a month
♥ Home blood glucose monitoring
♥ Keeping BP with in normal range
♥ Periodic eye testing
♥ Extreme care of feet and hands
♥ Prompt treatment of any infections
♥ Stop smoking, alcohol and junk food
Dr.Sarma@works
42
DIABETES - MISCONCEPTIONS
♥ I am young – I will not have Diabetes - No
♥ None in my family has DM – I do not get it - No
♥ My parents are diabetics – I will sure get it - No
♥ I want only tablets, I can not restrict food - No
♥ My legs are painful – I can not exercise – No
♥ I have to stop medicines to test blood sugar - No
♥ I took tablets – now my diabetes is gone - No
♥ Long term use of tablets harms my health – No
♥ Insulin injections are harmful – No
♥ I am diabetic – I can not have good family life - No
♥ Diabetes ‘cures’ in other systems of medicine - ??
Dr.Sarma@works
43
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION (HIGH BP)
VI.
CHOLESTEROL
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
44
Dr.Sarma@works
45
BLOOD PRESSURE
♥ In B.P reading there are two numbers
♥ The TOP number is called Systolic B.P
♥ It measures the pressure in the blood pipes
when heart pumps – It is normally 120 mm
♥ The LOWER number is called the Diastolic B.P
♥ It measures the pressure in the blood pipes
when heart rests – It is normally 80 mm
♥ It is written as 120/80, 134/ 86 like that..
♥ Top number should not exceed 140
♥ Lower number should not exceed 90
Dr.Sarma@works
46
BLOOD PRESSURE TESTING
Dr.Sarma@works
47
HIGH BLOOD PRESSURE
♥ It is called the ‘silent killer’ – No symptoms
♥ 1 out of every 4 adults 40+ suffer from high B.P
♥ In 60+ age group > 90% are having High SBP
♥ Blood pressure changes with emotional or
physical stress – this may be temporary or persistent
♥ If the blood pipes harden due to age, due to
cholesterol deposits, or due to diseases – then
B.P. is persistently elevated beyond 140/90
♥ Diabetes, smoking, certain medications ↑B.P
Dr.Sarma@works
48
BLOOD CIRCULATION
Dr.Sarma@works
49
What If I have High B.P.
♥ Over time High B.P. causes heart to enlarge
♥ Heart’s pumping power becomes less and less
♥ This causes dysfunction and failure of heart pump
♥ Blood vessels harden and get narrowed - leads
to ↓blood flow to organs like heart, kidney ♥ Results in heart attacks and kidney failure
♥ Blood clots and bleeding from brain blood pipes
leads to paralytic stroke etc.,
♥ If eye blood vessels are affected – loss of vision
♥ Diabetes + High B.P = Fire + Wind - ↑damage
Dr.Sarma@works
50
BLOOD PIPES
NORMAL
Dr.Sarma@works
NARROWED
51
BLOOD PIPES
Beating Heart
Dr.Sarma@works
52
ENLARGED HEART
Dr.Sarma@works
53
Normal weight 350 to 450 g
Dr.Sarma@works
54
Grossly enlarged heart
Dr.Sarma@works
55
B.P. CONTROL
Dr.Sarma@works
56
How to control my B.P. ?
♥ High B.P. has no cure – but good control is possible
♥ It means lifelong commitment for life style change
♥ Salt restriction and fat restriction is a must
♥ Regular physical activity lowers B.P.
♥ Diabetes control is must for all High B.P. cases
♥ Keeping healthy body weight reduces B.P.
♥ Keeping cholesterol at normal level lessens damage
♥ Early detection and control helps a long way
♥ Because there are no symptoms – motivation is a must
♥ Stop smoking and alcohol - also contraceptive pills
Dr.Sarma@works
57
Common Misconceptions
♥ High BP is usually symptomatic. - No
♥ I have white coat Hypertension. – Better check again
♥ High Cholesterol means high BP. – Not always
♥ ↑ BP is a fact of life. I don’t need to worry. - No
♥ My BP is cured, so I stopped treatment. - Never
♥ I’m a woman. High BP is a man’s problem. - No
♥ I can take any OTC medicines. - No
♥ No BP check is needed until 50 years. - No
♥ If I take B.P. medicines my potency will be ↓- False
Dr.Sarma@works
58
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION (HIGH BP)
VI.
CHOLESTEROL
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
59
Dr.Sarma@works
60
What Is Cholesterol?
♥ Cholesterol is a fat like substance made
primarily in the liver
♥ The body needs cholesterol to work normally
♥ The body makes all the cholesterol it needs
♥ It is present in excess in saturated fats like
ghee, dalda, palm oil, coconut oil, coconut
kernel, fat rich milk and ice creams, egg yolk
(yellow), meat, chocolates, cashew nuts etc.,
♥ Fruits and vegetables contain none of it
♥ TG is excess sugar converted into fat by body
Dr.Sarma@works
61
Why is Cholesterol important ?
♥ Too much cholesterol in the blood increases
the risk of fatty deposits in blood vessels
♥
Blood clots can form on these deposits and
block the blood flow causing heart attack or
stroke
♥ Thus high blood cholesterol raises our risk
of heart attack and stroke
Dr.Sarma@works
62
“Good” and “Bad” Cholesterol
♥ HDL cholesterol is the “good” kind
♥
High HDL lowers our heart disease & stroke
♥
LDL cholesterol is the “bad” kind
♥ LDL cholesterol is deposited in blood pipes
♥
High LDL raises our heart disease & stroke
♥ Another fat called Triglyceride (TG) is also
“bad” fat – it also ↑Heart disease & Stroke
Dr.Sarma@works
63
Cholesterol Numbers
Normal Values for blood fats (lipids)
1. Total Cholesterol (TC)
200mg/dl
2. Triglycerides (TG)
150 mg/dl
3. Low density cholesterol (LDL)
100 mg/dl
4. High density cholesterol (HDL)
50 mg/dl
5. TC ÷ HDL ratio = 200 ÷ 50 =
4
LIPID PROFILE TEST is to be done after 10 hr fast
Dr.Sarma@works
64
CHOLESTEROL CONTROL
♥ Test your blood cholesterol (s) values
♥
Know your Cholesterol and TG goal
♥ Discuss with your Doc – How to reduce
♥
Enroll in Low Cholesterol program
♥
Eat right to lower cholesterol
♥
Marriages and parties – be careful
♥
Junk food is dangerous
♥
Low fat cooking books
♥
Do not let a slip – If fallen arise
♥ Say ‘Yes for Me’ and reward yourself
Dr.Sarma@works
65
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION (HIGH BP)
VI.
CHOLESTEROL and TRIGLYCERIDE
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
66
Dr.Sarma@works
67
Blood pipes of Heart
Dr.Sarma@works
68
All of us need to be Alert
♥ Heart attack kills 10,000,000 persons a year –
about 10 deaths every minute
♥ Indian population has high rates of high blood
pressure, Diabetes, high cholesterol, high TG
overweight /obesity and sedentary life style
♥ Heart attack is the number one killer for adults
♥ It may strike very silently without any warning
♥ In the past 20 years heart attacks have become
4 times more common – 2 in 4 die, 1 immediately.
♥ Once it strikes the treatment is costly and not
that effective in reducing death rates
♥ Prevention is the best approach
Dr.Sarma@works
69
A Patient of Heart Attack
Dr.Sarma@works
70
Narrowed Heart Blood Pipe
Dr.Sarma@works
71
How the occlusion develops
Dr.Sarma@works
72
How to Detect Heart Attack
ECG GRAPH
If ECG is inconclusive
Dr.Sarma@works
TREAD MILL TEST (TMT)
73
A B C D E of Treatment
♥ A - Aspirin, Anti anginals (Sorbitrate)
♥
B - Blood pressure control
♥ C - Cholesterol control and
Cigarette Smoking Quitting
♥
D - Diabetes control and
Diet modifications – low fat, low salt
♥
E – Exercise and
Education about life style changes
Dr.Sarma@works
74
CONSULTATION
Dr.Sarma@works
75
TREATMENT
CONTROL
EATING RIGHT
Dr.Sarma@works
76
TREATMENT
♥
Medical treatment with tablets, injections
♥
Dissolving the clot – 6 hrs golden period
♥ Cleaning the choked pipes – PTCA
♥
Placing springs to keep pipes open - Stenting
♥
Grafting new pipes in place of chocked pipes
By Pass Graft - CABG
Dr.Sarma@works
77
BY PASS GRAFT
Dr.Sarma@works
78
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION (HIGH BP)
VI.
CHOLESTEROL and TRIGLYCERIDE
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
79
WARNING SIGNS – HEART ATTACK
♥
Most of the time starts slowly, mild pain
♥
Sometimes sudden severe chest pain
♥ Chest discomfort, squeezing, pressure
♥
Discomfort in other areas of upper body
♥
Shortness of breath, cold body parts
♥
Sudden sweating, nausea, dizziness
♥
Do not wait longer than 5 minutes
♥ Do not neglect it as “Gas Trouble”
Dr.Sarma@works
80
WARNING SIGNS – BRAIN STROKE
♥ Sudden numbness or weakness of the face,
arm or leg, specially on one side of the body
♥
Sudden confusion, trouble in speaking,
writing, or understanding or orientation
♥
Sudden trouble seeing with one or both eyes
♥
Sudden trouble walking, dizziness, loss of
balance or coordination or movements
♥ Sudden severe headache with no known
cause with or without continuous vomiting
Dr.Sarma@works
81
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION (HIGH BP)
VI.
CHOLESTEROL and TRIGLYCERIDE
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
WHY NOT WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
82
To Educate Ourselves !
♥ We are worthy of living healthy !
♥ The information is easy to get
♥ Let us “Learn and Live” a healthy way
♥ Remember that these are preventable
Dr.Sarma@works
83
WHAT TO DO TO PREVENT
The first steps in prevention
♥ Know the risk factors
♥ Identify your risk factors
♥ Control your risk factors
Dr.Sarma@works
84
RISK FACTORS
Non Modifiable Risk Factors
♥
Increasing Age
♥ Heredity
♥
Family history of heart attack
♥
Race, Indians are very prone – we get
10-15 years earlier in life than in the west
♥
Previous heart attack or stroke
♥
Gender (male sex)
Dr.Sarma@works
85
RISK FACTORS
Modifiable Risk Factors
♥
Diabetes
♥
High blood pressure
♥
High blood cholesterol
♥
Overweight and obesity
♥ Tobacco smoke
♥
Physical inactivity
♥ Birth control pills
♥
Drinking too much alcohol
♥
Illegal drugs use
Dr.Sarma@works
86
Healthy Life Style Changes
♥ Control high blood pressure
♥
Don’t smoke. If you smoke, quit
♥
Maintain healthy cholesterol levels
♥ Be more physically active
♥
Control or delay the onset of diabetes
♥
Reduce excess wt. or maintain a healthy wt.
♥
Eat a healthful diet
Dr.Sarma@works
87
Healthy Life Style Changes
♥ Drink not alcohol or at least minimize it
♥ Don’t smoke or breathe other’s smoke
♥ Learn to relax and deal with your stress
♥ Get friends and family to join in healthy living
♥ Take action in your community & work place
Dr.Sarma@works
88
RELAX WITH FAMILY
Dr.Sarma@works
89
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION (HIGH BP)
VI.
CHOLESTEROL and TRIGLYCERIDE
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
90
RIGHT FOOD CHOICE
Dr.Sarma@works
91
EATING RIGHT
♥
Healthy food habits reduce risk of heart
attack and stroke by controlling
♥
High blood cholesterol
♥
High blood pressure
♥
Excess body weight
♥
Diabetes
Dr.Sarma@works
92
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION (HIGH BP)
VI.
CHOLESTEROL and TRIGLYCERIDE
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
93
PHYSICAL ACTIVITY
Dr.Sarma@works
94
PHYSICAL ACTIVITY
Dr.Sarma@works
95
PHYSICAL ACTIVITY
Dr.Sarma@works
96
CHOOSE TO MOVE
♥
Exercise regularly – heart needs it more
♥
Eat healthfully for the sake of your heart
♥
Love your heart – no spare part please
♥ Take time for yourself and family
♥ Learn to relax both at work and at home
Dr.Sarma@works
97
Physical Activity Helps
You Help Yourself
♥ About 75% of Indians are not active enough
for good heart health
♥
Physically inactive ones are sure to develop
High BP, Heart disease, Diabetes, Obesity
♥
Regular, moderate-to-vigorous physical
activity improves your heart’s fitness
♥ Helps reduce your risk of heart disease
Dr.Sarma@works
98
Physical Activity Helps
You Help Yourself
♥
Exercise helps you to
- lower blood pressure
- control blood cholesterol levels
- reach and maintain a healthy weight
- manage diabetes
♥
For all people, 45 to 60 minutes of physical
activity on most or all days of the week
Dr.Sarma@works
99
I.
THE VOLCANO
II.
THE TRIANGLE
III.
OBESITY and OVER WEIGHT
IV.
DIABETES
V.
HYPERTENSION (HIGH BP)
VI.
CHOLESTEROL and TRIGLYCERIDE
VII. THE HEART ATTACK (IHD)
VIII. WARNING SIGNS
IX.
CAN WE PREVENT ?
X.
EATING RIGHT
XI.
BE ON THE MOVE
XII. RED ALERT
Dr.Sarma@works
100
THE RED ALERT
Go Red for Heart Health Campaign Goals
♥ To raise awareness in one and all
♥ To prevent heart disease and stroke
♥ To save lives and live long in good health
♥ To reduce economic burden of society
♥ This must be our Nation’s top most priority
Dr.Sarma@works
101
GO RED FOR HEART
♥ Make a date and keep it up
♥ Tone up as you tune in, physical activity
♥
Carry water or your baggage yourself
♥
Keep out of sight, out of mouth
♥
Eat right to lower cholesterol & weight
♥
Shake the salty, sugary, fatty habit
♥
Be a good looser, use stairs
♥ Quit smoking in four vital steps
♥
Do not let a slip – If fallen arise
♥ Say ‘Yes for Me’ and reward yourself
Dr.Sarma@works
102
Calories burnt in Exercise
Activity done for 1 hour
45 kg
70 kg
90 kg
Bicycling, 10 kmph
160
240
312
Jogging, 10 kmph
610
920
1,230
Skipping rope 15 per min
500
750
1,000
Running at 8 kmph
440
660
962
Swimming at 25 mts/min
185
275
358
Tennis singles
265
400
535
Walking, 5 kmph
Walking, 8 kmph
210
295
320
440
416
572
Dr.Sarma@works
103
Which Physical Activity ?
♥ That is not the relevant question
♥ Any physical activity is OK
♥ We must start doing it and persist with it
♥
Its fruits are bound come soon
♥
Believe that we can bring down our weight
♥
Don’t be a target for the crash weight lowering
advertisements. There are no short cuts !
♥ Only way is give less work to the mouth and
stomach and more work for the limbs & body
Dr.Sarma@works
104
What tests we need ?
For all those 35 years and above as base line
♥
Clinical exam by Doctor including B.P.
♥
Risk assessment as per the questionnaire
♥
Height and weight recording – Ideal weight
♥
Fasting and after glucose blood sugar tests
♥
Fasting test for cholesterols and Triglyceride
♥
ECG, if needed Tread Mill Test (TMT)
♥
Urine for protein, Blood creatinine
Further action depending on the results of these
Dr.Sarma@works
105
Dr.Sarma@works
106
Simple Eating Solutions
Simple eating solution can surprise Us to reduce much weight
• Avoid coffee, tea or any sweetened beverages – Leave sugar to choice
• If you can’t avoid limit to once, or take without sugar and cream
• Don’t offer coffee as courtesy to any visitors – give butter milk
• Lime juice sans sugar, tender coconut, butter milk are healthy drinks
• Be a vegetarian as far as possible. Whole wheat flour better
• Egg white is ok. Discard the yellow. NV treat only on special days
• Celebrate festivals, guest hospitality with non sweet, non fried foods
• Crunchy, munchy fat fried food is very tasty – but our heart hates it
Dr.Sarma@works
107
Simple Eating Solutions…
Simple eating solution can surprise Us to reduce much weight
• Boiled, steam cooked, stewed food is very healthy, charred food not.
• Don’t gift sweets or accept sweets – instead give and take fruits
• At parties, don’t be tantalized to sweets or ice creams- eat salads, veg
• Pickles, papads, chips, sea foods, colas, chocolates are junk foods
• Fast foods don’t have fiber. Take foods which require mastication
• Whole fruits are healthy- canned juices or tinned, processed are not.
• Never force food to others nor allow to be forced. Leave it on table.
• Limit the quantity of food – keep some room for tomorrow too !
Dr.Sarma@works
108
Simple Exercise Solutions
Physical Activity in Our Daily Life At Home
• At home it’s convenient, comfortable and safe to work out .
• You, that way, set a good example for children
• Exercise equipment, one-time expense- all can use it.
• It's easy to have short bouts of activity several times a day.
• Do housework yourself instead of hiring someone else for it.
• Do gardening and watering plants manually
• Go for a short walk before breakfast, after dinner or both!
• Start with 5-10 minutes and work up to 30 minutes.
Dr.Sarma@works
109
Simple Exercise Solutions…
Physical Activity in Our Daily Life At Home
• Walk to the corner store, cutting saloon - instead of driving.
• When walking, pick up the pace. Choose a hilly route.
• When watching TV, jog or pedal stationary bicycle for 15 minutes
• Throw away your video / TV remote control. Self iron your dress
• Get up off the couch and get a drink or water for yourself.
• Stand up while talking on the telephone. Walk the dog.
• Park away at the shopping mall and walk the extra distance
• Plan a trip for site seeing at least once a month - walk.
Dr.Sarma@works
110
Simple Exercise Solutions…
At the Office most of us have sedentary jobs. Work takes up a
significant part of the day. What can we do to increase our physical
activity during the work day?
• Discuss ideas with a co-worker while taking a walk.
• Stand while talking on the telephone.
• Walk down the hall to speak with someone than using phone
• Take the stairs instead of the elevator. Don’t look for a chair always
Dr.Sarma@works
111
Simple Exercise Solutions…
How can we increase our physical activity during the work day?
• Walk while waiting for the train at the railway station.
• Participate in or start a recreation league at your company.
• Form a sports team to start table tennis or shuttle play.
• Schedule exercise time on your calendar and treat it as important
• Get off the bus a few blocks early and walk the rest of the way
• Walk around your building for a break during the work day
Dr.Sarma@works
112
Simply Speaking
1. Our habits are too bad – Need drastic change
2. Turn to vegetarian, fiber rich foods, fruits, milk
3. There are three poisons in our homes
• They are S.O.S – Sugar, Oil and Salt –
• the less we consume them the safer is our ♥
4. Drive the devils out – Smoking and Alcohol
5. Determine to move our feet, limbs and bend –
• lest our heart stops moving very soon
6. Only two options – heed to this or else we perish
Dr.Sarma@works
113
A Place Called Love
Grand Parenthood
Dr.Sarma@works
114
The Final Three
Take Home Things
Dr.Sarma@works
115
SAVE THE HEART
Dr.Sarma@works
116
HAVE THE HEART
kim ganga ambudhi binbitae ambara
manou chandaala veedhee payah
TEN RUPEE NOTE TEST
poorae vaa antaramasti kaanchana
Dr.Sarma@works
ghatee mrit kumbhayorva ambarae ?
117
PAVE THE HEART
WITH COMPASSION
Dr.Sarma@works
118
Our Contact Information
Contact for information – free for every one
♥ The Indian Medical Association - Tiruvallur
♥ Call local to 95 4116 – 260 593, 260288
♥ Call on mobile +91 98940 60593, 98941 10450
♥ Visit us at # 3 Jayanagar, Tiruvallur
♥ Call your local Indian Medical Association
♥ Discuss with your company doctor- Dr. Raju
Dr.Sarma@works
119
International Help line
AHA
The American Heart Association:
♥
Call 1-800-AHA-USA1 (1-800-242-8721)
♥
Call 1-888-MY-HEART (1-888-694-3278)
for heart disease information
♥ Visit www.americanheart.org
All these services are free for every one
Dr.Sarma@works
120
THE PLEDGE
I, ___________________ pledge to do at least five of the following actions
to help lower my risk for heart disease and stroke; I have no right to burden
the society with unhealthy heart and to set a bad example for my children.
1. Know what my BP, Sugar, Ideal weight and cholesterol should be
in
order to try and keep them at goal level.
2. Have my BP, Weight, Sugar, cholesterols checked every 2 years.
3. Reduce the purchase of sugar, salt and oil to half of what I buy now
4. Take measures to maintain a healthy ideal weight.
5. Do moderately intense physical activity for at least 45 minutes every day
On days when I don’t have time, I’ll do the activity in 3 segments of 15’
6. Stay tobacco-free; or, if I smoke, to pick a quit date and achieve to quit
7. Limit my alcohol to none or very occasional
8. Take my medication as my doctor prescribed.
9. Encourage others at risk to join this movement
10. Will recruit at least two people to this movement; they are :
Dr.Sarma@works
121
Your Signature
Namskaar
Dr.Sarma@works
Fir Milaengae
122