TYPES OF CVD

I guess everyone knows what is CVD a.k.a. Cardiovascular Disease a.k.a Heart Attack. But actually, there are MANY types of CVD ranging from the brain vessels to the deep veins of the leg.

They are: 

• Stroke
• Coronary heart disease
• Rheumatic heart disease
• Congenital heart disease
• Aortic aneurysm and dissection
• Peripheral arterial disease
• Deep venous thrombosis (DVT)
• Pulmonary embolism

Reference: WHO

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THE BENEFITS OF FRUITS ON THE HEART

Consuming enough fruits is a very important component of our diet. 

Fruits are rich in vitamins and minerals which is able to be a cure for many diseases. 

Did you know ... the risk of heart attack can be reduced by eating fruit. 

The fruit is red or pink contains

antioxidant known as lycopene.

What is lycopene???

Lycopene is a carotenoid pigment that we can find in tomatoes, watermelon, papaya, pink guava and so on.




What is interesting here, a scientific study has shown that intake of lycopene is able to protect ourselves from a heart attack.

Oxidative LDL carries cholesterol which is the cause of atherosclerosis leading to heart attack and stroke. 

Lycopenene antioxidant acts as a barrier Oxidative processes.

 When the process of Oxidative prevented then, the development of atherosclerosis is reduced.

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Alkohol dan Penyakit Kardiovaskular

Pengambilan alkohol yang “sederhana” dapat menlindungi kita daripada penyakit jantung. Maksud “sederhana” ialah satu hingga dua unit sehari bagi lelaki, dan hanya satu unit untuk wanita. Satu unit adalah 12oz bir, 4oz wain, 1.5oz 80-proof spirits, atau 1oz 100-proof spirits. Pengambilan alkohol yang sederhana dapat membawa kebaikan seperti berikut:

1. meningkatkan tahap HDL (kolesterol baik) dan mengurangkan tahap LDL (kolesterol jahat)
2. merendahkan tekanan darah
3. 

   menghalang pembekuan darah dengan mengganggu fungsi platelet (sel darah yang membekukan darah)

Kita tidak harus mengambil alkohol lebih daripada yang sepatutnya kerana alkohol meningkatkan tahap trigliserida darah. Selain itu, ia juga akan menyebabkan tekanan darah tinggi, kegagalan jantung, obesiti dan kencing manis. Pengambilan alkohol yang berlebihan akan menyebabkan strok dan penyakit-penyakit yang serius seperti sindrom janin alkohol, cardiomyopathy, jantung aritmia dan lain-lain.

Tetapi, bukan semua orang boleh minum arak. Individu-individu yang mempunyai keadaan seperti berikut harus menjauhkan diri daripada alkohol:

1. kegagalan jantung
2. cardiomyopathy
3. tekanan darah tinggi
4. kencing manis
5. aritmia
6. strok

Kita seharusnya tidak mengambil alkohol; kita harus menjaga jantung kita dengan mempraktikkan gaya hidup yang sihat, sperti pengambilan makanan yang berkhasiat dan senaman.

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Blood Pressure

Many people these days suffer from high blood pressure (hypertension) and is often called the 'silent killer'.

'Silent Killer' facts:

• 1 in 5 adults have high blood pressure, yet most don't know it!
• No warning signs or symptoms to alert you that your blood pressure is too high.
• High blood pressure leads to heart disease and stroke.

What is blood pressure (BP)?

Blood pressure is the measure of how much work your heart need to do to pump blood around the body. Normally blood pressure reading give 2 numbers, for example 120/80. The top number (120) is the systolic pressure, the peak pressure when the heat beats. The bottom number (80) is the diastolic pressure, the pressure when the heart rests. BOTH NUMBERS ARE IMPORTANT.

Ideal blood pressure for most people is less than 120/80.

Many things affect your blood pressure, physical activities normally increase BP as well as mood changes such as excitement, anger or fear. However, these changes is temporary. Long period of high blood pressure at rest are the main worry.

What causes high blood pressure?

• Hereditary
• Kidney disease
• Overweight
• Excessive alcohol intake
• High salt intake
• Lack of physical activity

Why is it important to control high blood pressure?

Normal blood pressure delivers blood to all parts of the body without damaging sensitive organs. High blood pressure means your heart has to pump HARDER to deliver the same amount of blood around the body. This can cause permanent damage to delicate organs, such as eyes, kidneys and brain. High BP also increase  your risk of developing heart disease!

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Chinese Celebrities with CVD!

Chen Hung Lieh 陈鸿烈

During 24^th November 2009, he was fainted due to angina pectoris. He was sent to Tseung Kwan O Hospital, but unfortunately he died at 11pm on the same day. He was died when he was 66 years old.

Ricky Hui 许冠英

There were rumors that he required pacemaker for him to breathe just before he died; unfortunately, the device unable to save him from the killing disease.  He was died because of myocardial infarction in his house, 8^th November 2011.

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Western Celebrities with Cardiovascular Disease

CVDs do affect everyone, even some of the famous celebrities. Therefore, we must aware of these killing diseases.

Elizabeth Taylor

She was diagnosed with congestive heart failure in 2004. She died of the condition, which limits the heart’s ability to pump around the body, in 2011. While five million Americans are living this disease, about 20% die within a year of diagnosis and 50% die within 5 years, according to TIME’s Healthland.

Robin Williams

He was forced to postpone his stand-up tour after experiencing shortness of breath. Physicians found that he needed an aortic valve replacement, a procedure that was performed successfully at the Cleveland Clinic in Ohio in March 2009.

Miley Cyrus

In her 2009 autobiography “Miles To Go”, she disclosed that she has tachycardia, a heart condition that causes her heart to beat faster than normal.

“The type of tachycardia I have isn’t dangerous. It won’t hurt, but it does bother me. There is never a time onstage when I’m not thinking about my heart,” she wrote.

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Drugs that treat CVD!

There are 5 main groups of drugs used in treating hyperlipidemia and cardiovascular disease; which are HMG CoA reductase inhibitors or statins, niacin, fibrates, bile acid sequestrants and cholesterol absorption inhibitors.

1. HMG CoA reductase inhibitors (statins)
   They inhibit the first enzymatic step of cholesterol synthesis and act as the first line and more effective treatment for patient with elevated LDL cholesterol level. The therapeutic benefits of the statins are they can promote plaque stabilization, improvement of coronary endothelial function, inhibition of platelet thrombus formation, anti-inflammatory activity. The examples of statins are lovastatin, simvastatin, pravastatin, atorvastatin, fluvastatin, rosuvastatin.
2. Niacin
   It can help to reduce LDL cholesterol level and it is the most effective agent to increase HDL cholesterol levels. It is usually used in combination with statins. Niacin decrease LDL cholesterol by strongly inhibits lipolysis in the adipose tissue. However, the adverse effect of niacin is that it will cause an intense cutaneous flush and pruritus. Besides, it may also lead to hyperuricemia and gout.
3. Fibrates
   Fenofibrate and gemfibrozil are derivatives of fibric acid that help to lower serum triglyceride and increase HDL levels. However, fenofibrate is more effective is lowering LDL cholesterol and triglyceride level as compared to gemfibrozil. The adverse effects of fibrates are formation of gallstones, inflammation of muscle, and gastrointestinal distress.
4. Bile Acid Sequestrants (Resins)
   Cholestyramine, cloestipol and colesevelam are examples of resin that prevent bile acids from returning to the liver by enterohepatic circulation. The lowering of the bile acid concentration causes hepatocytes to increase conversion of cholesterol to bile acids, which decrease the level of cholesterol in the blood.
5. Cholesterol Absorption Inhibitors
   Ezetimibe inhibits intestinal absorption of cholesterol in the small intestine, causes a decrease in the delivery of intestinal cholesterol to the liver.

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Eat less salt!

In our previous post, CVD - A Killer, we disclosed that Cardiovascular disease is the leading cause of death in Malaysia and also worldwide, and HIGH BLOOD PRESSURE is a major risk factor. Are you at risk?

In Malaysia, there are 5.8 MILLION of people who is having high blood pressure, a high-sodium diet may be to blame. In certain people, sodium or salt increases the blood pressure as it holds excess fluid in the body, increasing the burden on the heart. Too much salt in the diet also increases risk for stroke, heart failure, osterporosis, stomach cancer and kidney disease.

Reduce Salt in Your Diet

Basically, the more you eat food with little or no salt the better it is. According to the American Heart Association, we should AIM TO EAT LESS THAN 1500 mg of sodium per day which is around 6 grams of salt - > one teaspoon

Tips for Reducing Sodium in the Diet

• Read the Nutrition Facts Label to compare and find foods lower in sodium.

• Choose fresh fruits and vegetables
• Limit the amount of processed foods.
• Avoid FAST FOOD.
• Avoid adding salt when cooking and/or eating.
• Try use spice and herbs to replace salt in cooking.

How much Sodium is in Salt?

Salty Six - Common Foods Loaded with Excess Sodium

AHA also listed out the 6 popular foods that contains high amount of salt.

Reducing your salt intake definitely give benefits to your heart and hopefully with a few points given from here. You are able to make the SMART choice and further reduce your risk to cardiovascular heart disease.

Source:

1. American Heart Association
2. National Heart Association of Malaysia
3. British Heart Foundation

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I Like to Move It Move it!

Physical inactivity is one of the factors that lead to CVD that we can change. Changing is always difficult for those who always try to find excuse, being lazy and do not love their health. Are you in these categories? I really hope that you are not.

Having CVD is not an excuse to be physically inactive. There are physical activities that are recommended for those with CVD.  The important things you need to know is the intensity, duration and the dose of your activities.

"What BENEFITS will I get from being active?"

There is a lot! Nah, I give you some of the benefits;

• Reduce blood pressure
• Increase HDL, Lower TG.
• Reduce insulin resistance
• Manage unhealthy body weight
• Enhance psychosocial status/ mental well-being

"How long did I need to have the physical activity or exercise?"

Try to achieve at least 30 minutes per day of moderate-intensity exercise. You don't need to force yourself to exercise straight for 30 minutes without stop. You may do it in 10 minutes for 1 session and try to do 3 sessions so that the aim to exercise in 30 minutes will be accomplished. 

"What is the examples of moderate-intensity physical activity?"

It's simple! Most of the housework is consider as moderate-intensity P.A. Other examples:

• Gardening
• Cycling
• Brist walking
• Climbing stairs
• Basketballs (Shooting baskets)
• Washing cars
• Swimming

"Every patient of CVD are safe to do those activities?"

Recommended for patient with stable Coronary heart disease, while those with Advanced Coronary Heart Disease should have low intensity PA, short duration and less frequent. It is better to have your consultations more with your fitness consultant.

WARNING!

Always carry your nitrate medication when you engage in physical activity.

If you develop angina, chest pains or discomfort while doing physical activity, you should:

      1. Stop and rest immediately

      2. If rest does not bring rapid relief of the chest pain/discomfort, take your nitrate medication 

          (e.g. ‘Anginine’ or ‘Isordil’ sub-lingual tablets placed under your tongue or ‘Nitrolingual’ spray) and 

          if the pain/discomfort goes away with rest and 1 tablet or spray, then

      3. Inform your doctor as soon as possible about this episode of chest pain/discomfort.

If the pain/discomfort does not go away with rest and 1 tablet or spray, then: 

      4. The dose of nitrate medication may be repeated 5 minutes after the initial dose

      5. If symptoms are not relieved completely within 10–15 minutes by medication and rest, call for 

          an ambulance immediately, and rest quietly while waiting for transport or assistance – regard this 

          pain/discomfort as a heart attack

      

Note: in particular circumstances where an ambulance is not readily available, such as in a rural 

environment:

      • Quickly notify the nearest hospital, health clinic or doctor for advice, and

      • It may be appropriate to arrange for someone to drive you to the hospital.

What are you waiting for?. Improve your health and get to move now! Enjoy your leisure time with physical activity and exercise with your loves ones. It should be great to be healthy together! 

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Sample Menu for CVD Patient

This the example of menu that an individual with cardiovascular disease can follow. The caloric content of this 1 day menu is 1800kcal.

Capati with Yellow Dhal

 Breakfast

1 piece of Capati weighed 64g
¼ cup of Yellow Dhal Curry weighed 36g

1 whole Orange weighed 155g

1 glass of Plain Water

Nasi Ayam Masak Merah

Lunch

Half serving White Rice weighed 204g

Ayam Masak Merah (chicken breast) weighed 160g

1 cup Stir-fried Mustard Greens weighed 48g

1 glass of Apple Juice

Apple Juices

Stir-fried Mustard Greens

Afternoon Tea

3 pieces of Cream Cackers (6.5X6.5X0.5cm) weighed 21g

1 glass of Plain Water

Dinner

Half serving of White Rice weighed 204g

1 small piece of Fried Indian Mackerel weighed 33g

1 cup of Stir-fried Water Convulvolus weighed 35g

1 medium slice of Honey Dew weighed 175g

Low Fat Milk

1 glass of Plain Water

Supper

1 glass of Low Fat Milk

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Survive HEART ATTACK...When You Are Alone

MOST people are ALONE when they suffer a heart attack, without help, the person whose heart is beating improperly and who begins to feel faint, has only about 10 SECONDS left before losing consciousness.

There are ways to SURVIVE this deadly incident. The main way is to cough!. Yes. Coughing repeatedly and very vigorously can help prolonging the time before the victim faints.

1. Deep breath should be taken before each cough
2. Cough must be deep and prolonged as though your are coughing out sputum from deep inside the chest.
3. A breath and a cough is repeated about every 2 second WITHOUT STOPPING until help arrives or heart feel to be beating normal again.

These 3 steps are very important as deep breaths get oxygen into the lungs and coughing movement squeeze the heart and keep the blood circulating.

The squeezing pressure on the heart helps it to regain normal rhythm.

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Lipid Profile

Age, hereditary factors, weight, smoking, blood pressure, physical activities are important in determining cardiac risk. However, the most important indicator for cardiac risk is the lipid profile.

Do you know what the lipid profile is??

The lipid profile measures cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C or known as ‘good cholesterol’), and low density lipoprotein cholesterol (LDL-C or known as ‘bad cholesterol’)

Table of Lipid Profile Values

	mg/dL	mmol/L
Total Cholesterol
Desirable	< 200	< 5.1
Borderline High	200 - 239	5.1 - 6.1
High	> 239	> 6.1
LDL Cholesterol - The "Bad" Cholesterol
Optimal	< 100	< 2.6
Near/Above Optimum	100 - 129	2.6 - 3.3
Borderline High	130 - 159	3.3 - 4.1
High	160 - 189	4.1 - 4.8
Very High	> 189	4.8
HDL Cholesterol - The "Good" Cholesterol
Low (Undesirable!)*	< 40	< 1.0
High (Desirable!)	> 60	> 1.5
Serum Triglycerides
Normal	< 150	1.7
Borderline High	150 - 199	1.7 - 2.2
High	200 - 499	2-2 - 5.6
Very High	> 499	> 5.6

*The American Heart Association sets different thresholds for HDL cholesterol in men (< 40 mg/dL = low) and women (< 50mg/dL = low), a discrimination that the National Cholesterol Education Program no longer makes.

The values in the above table are indicated in milligrams per deciliter blood (mg/dL) and millimol/liter (mmol/L). The unit mg/dL is common in the US, whereas mmol/L is generally used in the rest of the world.

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Nutrition Prescription For CVD

Medical Nutrition Therapy goals for cardiovascular disease...

1. To provide low fat diet
2. To provide low cholesterol diet
3. to provide low sodium restricted diet if necessary

The table below showed the National Cholesterol Education Panel (NCEP) recommendation steps in fat controlled diet...

	Recommended Intake
	Step1	Step 2
Total fat	Less than 30%
Saturated fat (SFA)	Less than 10% of total calories	Less than 7% of total calories
Monounsaturated fat (MUFA)	10-15% of the total calories
Polyunsaturated fat (PUFA)	Up to 10% of the total calories
Carbohydrate	50-60% of the total calories
Protein	10-20% of the total calories
Cholesterol	< 300mg/day	<200 mg/day
Total calories	To achieve and maintain desirable weight

LDL cholesterol is a main carrier of cholesterol in the blood while HDL cholesterol carries cholesterol from the arteries to the liver.So, its means increasing level of LDL cholesterol is bad for us.There is some nutritional factors that affect LDL cholesterol.

Increase LDL-C

• Saturated and trans fatty acid -coconut milk, animal fat,margerine, shortening
• dietary cholesterol
• Excess body weight

Decrease LDL-C

• Polyunsaturated fatty acid- omega-3, omega-6, plant source,corn oil
• Viscous fiber- oats, barley, beans         
• plant stanols
• Weight loss
• isoflavone

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