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Coronary Artery Disease and Life style practices to prevent coronary artery disease

PREFACE :- The investigator selected the research study as A Descriptive study to assess knowledge regarding lifestyle practices of hypertensive patients to prevent Coronary artery diseases (CAD) in the selected hospitals of Raipur city Chhattisgarh . As one objective of the study , the investigator prepared this booklet. The main reason to prepare this booklet is to increase the knowledge regarding prevention of coronary artery disease by life style practices . AIM :- to impart knowledge and develop awareness regarding life style practices to prevent coronary artery disease.

OBJECTIVES :The learner of this guide will be able to : Know about the coronary artery disease Define coronary artery disease List out the symptoms, risk factor, diagnosis and treatment Understand about the life style practices and risk factor modification of CAD to prevent coronary artery disease like smoking, nutrition, blood cholesterol, blood pressure, physical activity, weight, diabetes, stress, alcohol.

Coronary Artery Disease

INTRODUCTION

Coronary artery disease (CAD; also atherosclerotic heart disease) is the most common type of heart disease and cause of heart attacks.

CAD is the leading cause of death worldwide. While the symptoms and signs of coronary artery disease are noted in the advanced state of disease, most individuals with coronary artery disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a "sudden" heart attack, finally arises. Lifestyle changes have been shown to be effective in reducing coronary disease. With changes in life style we can reduce the risk of coronary artery disease.

What Is Coronary Artery Disease?

An abnormal accumulation of lipid, or fatty substances, and fibrous tissue in the lining of arterial blood vessel walls. These substances block and narrow the coronary vessels in a way that reduces blood flow to the heart A complete obstruction to blood flow in a coronary artery may result in a myocardial infarction or MI. It is commonly known as HEART ATTACK .

What are the symptoms of coronary artery disease?

The most common symptom of coronary artery disease is : Angina or chest pain :- Angina or chest pain can be described as a heaviness, pressure, aching, burning, numbness, fullness, squeezing or painful feeling. It can be mistaken for indigestion or heartburn. Pain in Left shoulder, arms, neck, back, or jaw. Other symptoms that can occur with coronary artery disease include: Shortness of breath

4 Palpitations (irregular heartbeats, skipped beats, or a "flip-flop" feeling in your chest) A faster heartbeat Weakness or dizziness Nausea Sweating

Risk factor of coronary artery disease

Nonmodifiable Risk Factors Family history of CAD (first-degree relative with cardiovascular disease at 55 years of age or younger for men and at 65 years of age or younger for women) Increasing age (more than 45 years for men; more than 55 years for women) Gender (men develop CAD at an earlier age than women) Race (some race have high prevalence of CAD)

Modifiable Risk Factors (which a person can control, by changing a lifestyle or personal habit or by using medication.) Hyperlipidemia (high lipid or cholesterol level in blood) Cigarette smoking, tobacco use Hypertension Diabetes mellitus Obesity Physical inactivity

How Is Coronary Artery Disease Diagnosed?

Your doctor can tell if you have coronary artery disease by:

Talking to you about your symptoms, medical history, and risk factors. Performing a physical exam. Performing diagnostic tests, including an electrocardiogram (ECG or EKG), angiography, exercise stress tests, electron beam (ultrafast) CT scans, cardiac catheterization, and others. These tests help your doctor evaluate the extent of your coronary heart disease, its effect on the function of your heart and the best form of treatment for you.

How Is Coronary Artery Disease Treated?

Treatment for coronary artery disease involves making: Lifestyle changes

Reduce your risk factors. If you smoke, quit. Avoid high-cholesterol foods and adopt a low-fat, low-salt diet. Keep your blood sugar in control if you have diabetes. Exercise more to maintain a healthy weight (but talk to your doctor before you starting an exercise program).this is explained in detail below. Taking medications,

If making lifestyle changes isn't enough to control your heart disease, medications may be needed to help your heart work more efficiently and receive more oxygen-rich blood.

6 Possibly undergoing invasive and/or surgical procedures, and seeing your cardiologist for regular checkups

Surgery and other procedures. Common procedures to treat coronary artery disease include balloon angioplasty (PTCA), stent placement, and coronary artery bypass surgery. All of these procedures increase blood supply to your heart, but they do not cure coronary heart disease. You will still need to decrease your risk factors to prevent future disease.

Life style practices to prevent coronary artery disease

Lifestyle Changes
Cardiovascular disease is the one of the leading cause of death in India and worldwide. Your lifestyle is not only your best defence against heart disease and stroke. By following these simple steps you can reduce all of the modifiable risk factors for heart disease, heart attack and stroke.

Stop Smoking
Smoking: If you smoke, quit. If someone in your household smokes, encourage them to quit. Commit to quit.

Why you should reduce smoking. Smokers have a higher risk of developing many chronic disorders, including atherosclerosis the buildup of fatty substances in the arteries which can lead to coronary heart disease, heart attack

7 (myocardial infarction) and stroke. Controlling or reversing atherosclerosis is an important part of preventing future heart attack. Smoking decreases your tolerance for physical activity and increases the tendency for blood to clot. It decreases HDL (good) cholesterol. Your risks increase greatly if you smoke and have a family history of heart disease. Smoking also creates a higher risk for peripheral artery disease and aortic aneurysm. It increases the risk of recurrent coronary heart disease after bypass surgery.

Choose Good Nutrition

The food you eat (and the amount) can affect other controllable risk factors: cholesterol, blood pressure, diabetes and overweight. Choose nutrient-rich foods which have vitamins, minerals, fiber and other nutrients but are lower in calories over nutrient-poor foods. Take the diet rich in vegetables, fruits, whole-grain and high-fiber foods, fish, lean protein and fatfree or low-fat dairy products . Soluble fibers, which are found in fresh fruit, cereal grains, vegetables, and legumes, enhance the excretion of metabolized cholesterol. Intake of at least 25 g of fiber each day is recommended. Avoid red meat like pork, beef, goat etc and junk food or too much oily food.. And to maintain a healthy weight (body mass index 18.5 to 25), coordinate your diet with your physical activity level so you're using up as many calories as you take in.

5 Goals to Healthy Eating Eating healthy is easier than you might think. Add these simple healthy eating habits to your daily life over the next few weeks and you'll see just how easy it is. By making small changes like these

8 over time, and taking them one at a time, not trying to rush into all of them at once, the changes are more likely to stick. 1. Eat more fruits and vegetables. Aim for 4-5 servings each of fruits and vegetables every day. Vegetable or 100% fruit juice counts toward this goal.

2. Eat more whole-grain foods. Like fruits and vegetables, whole-grain foods are low in saturated fat and cholesterol and rich in fiber. Whole-grain foods include whole-wheat bread, rye bread, brown rice and whole-grain cereal.

3. Use olive, canola, corn or safflower oil as your main kitchen fat. Limit how much fat or oil you use in cooking, and use liquid vegetable oils such as olive, canola, corn and safflower oils in place of solid fats.

4. Eat more chicken, fish and beans than other meats. In general, skinless poultry, fish and vegetable protein (such as beans) are lower in saturated fat and cholesterol than other meats (beef, pork and lamb, goat).

5. Read food labels to help you choose healthy foods. Food labels provide information to help you make better food choices. Learn what information to look for (for example, sodium content) and how to find it quickly and easily.(take low or no cholesterol, saturated fatty acid ,trance fatty acid, sodium and sugar food stuff )

Reduce Blood Cholesterol

Fat lodged in your arteries is a disaster waiting to happen. Sooner or later it could trigger a heart attack or stroke. You've got to reduce your intake of saturated fat, trans fat ( which are available in red meat-pork, goat, beef, animal oil or fat etc). and cholesterol and get moving. If diet and physical activity alone don't get those numbers down, then medication may be the key. There are two types of cholesterol: "good" and "bad." Too much of bad cholesterol or not enough of good cholesterol can put you at risk for coronary heart disease, heart attack or stroke.

HDL is the "good" cholesterol which helps keep the LDL (bad) cholesterol from getting lodged into your artery walls. A healthy level of HDL may also protect against heart attack and stroke, while low levels of HDL (less than 40 mg/dL for men and less than 50 mg/dL for women) have been shown to increase the risk of heart disease.

If you need to increase your HDL to your reach your goals, do regular physical activity, such as at least 150 minutes of moderate-intensity aerobic physical activity (e.g. brisk walking) every week or 75 minutes of vigorous intensity aerobic physical activity (e.g., jogging, running) or a combination of both every week can help your body produce more HDLs. Reducing trans fats and eating a balanced, nutritious diet is another way to increase HDL. If you smoke - stop: cigarette smoking can decrease your HDL.

How to reduce it :
Regular exercise (such as brisk walking) on most days. Physical activity all the house hold work, physical movement. Balance diet and good food habit Regular check up of blood cholesterol and consult doctor Medication to reduce cholesterol consulted by doctor

Lower High Blood Pressure

Lifestyle plays an important role in treating your high blood pressure. If you successfully control your blood pressure with a healthy lifestyle, you may avoid, delay or reduce the need for medication.

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Your goal is less than 120/80 mmHg. If you've been diagnosed with high blood pressure (a systolic pressure the top number of 140 or above or a diastolic pressure the bottom number of 90 or above)

Healthy lifestyle modification :- Advocate weight reduction; reduction of sodium intake; consumption of fruits, vegetables, and low-fat dairy products; moderation of alcohol intake; and physical activity. Keep healthy weight By doing exercise and healthy diet we can keep a healthy weight. Exercise regularly Regular physical activity at least 30 to 60 minutes most days of the week can lower your blood pressure . Eat a healthy diet Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg. Reduce sodium in your diet Even a small reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg. The recommendations for reducing sodium are:

Limit sodium to 2,300 milligrams (mg) a day or less for normal adult.. A lower sodium level 1,500 mg a day or less is appropriate for people 51 years of age or older, and individuals of any age who have high blood pressure, diabetes or chronic kidney disease. Consider boosting potassium. Potassium can lessen the effects of sodium on blood pressure. The best source of potassium is food, such as fruits and vegetables, rather than supplements. Limit the amount of alcohol you drink Alcohol should be in limit or stop. Too much alcohol is not good for health.

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Be Physically Active Every Day

Be physically active every day. At least 30 minutes of physical activity moderate exercise (such as brisk walking , cycling ),on 5 or more days of the week can help lower blood pressure, lower cholesterol and keep your weight at a healthy level., try to do more physical activity in your daily work like using stair case rather than lift,walk as much as possible, do your house hold work regularly. Middle-aged or older and is sedentary, consult physician before initiating vigorous exercise program. Moderate-intensity activities (40 to 60% of maximum capacity) are equivalent to a brisk walk (1520 minutes per mile). Additional benefits are gained from vigorous-intensity activity (>60% of maximum capacity) for 2040 minutes on 35 days per week. If you're doing nothing now, start out slow. Even 10 minutes at a time may offer some health benefits. Studies show that people who have achieved even a moderate level of fitness are much less likely to die early than those with a low fitness level.T

Aim For A Healthy Weight

12 Obesity is also one of the risk factor for coronary artery disease Good nutrition, controlling calorie intake and physical activity are the only way to maintain a healthy weight. Be active and do much as possible physical activity like walking, running , using staircase, cycling, swimming etc. Take diet accordance to your physical work required. Your Body Mass Index that should be in between 18.5 to 25 kg/m2 (BMI) can help tell you if your weight is healthy. Goal: Achieve and maintain desirable weight (body mass index 18.524.9 kg/m2). When body mass index is 25 kg/m2, waist circumference at iliac crest level 40 inches in men, 35 inches in women.

Manage Diabetes

Cardiovascular disease is the leading cause of diabetes-related death. People with diabetes are two to four times more likely to develop cardiovascular disease due to a variety of risk factors, including high blood pressure, high cholesterol, smoking, obesity and lack of physical activity. How to control diabetes

Choose foods that are lower in calories, sugar, saturated fat, trans fat. Eat foods with more fiber, such as whole grain cereals, oats, breads, crackers, or pasta.. Drink water instead of juice and regular soda. Set a goal to be more active most days of the week. Start slow by taking 10 minute walks, 3 times a day.

Twice a week, work to increase your muscle strength. Use stretch bands, do yoga, heavy gardening (digging and planting with tools), or try push-ups.

Stay at a healthy weight by using your meal plan and moving more. Regular check up of sugar level If it does not control take medicine regularly after consulting your doctor.

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Reduce Stress

Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life that may affect the risk factors for heart disease and stroke. We should do to reduce stress yoga, meditation ,spiritual activity, relaxation, avoid workload, gardening, avoiding stress full situation, music, spend time in leisure activity and entertainment .people under stress should avoid starting smoking or smoke more than they otherwise would. Research has even shown that stress reaction in young adults predicts middle-age blood pressure risk.

Limit Alcohol

Drinking too much alcohol can raise blood pressure and lead to heart failure or stroke. It can contribute to high triglycerides, produce irregular heartbeats and affect cancer and other diseases. It contributes to obesity, alcoholism, suicide and accidents. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in non-drinkers. However, it's not recommended that non-drinkers start using alcohol or that drinkers increase the amount they drink.

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Summery :To conclude this, Coronary artery disease is one of the life threatening disease which lead to heart attack. Risk can be reduced by healthy life style practices. healthy life style practices mean good food habit, physical activity, weight management, no smoking and tobacco, controlling BP blood sugar ,cholesterol and limiting alcohol ect.

References : Brunner and Suddarth, Text book of Medical Surgical nursing, 10th edition, Lippincott publication, 2000, page no, 431. 220. B T Bassavanthappa, Text book of Medical Surgical nursing, J P publication, 2003, page no.

Jhon Luckman, Text book of Medical Surgical nursing, 3rd edition, Saunders publication, 1987, page no. 434. Dr. M Swaminathan, Text Book of food and nutrition, volume 2, Bappco publication, 2003, page no. 160. Nair Ravindran Nair, Textbook of Medical and Surgical Nursing, Pg. No. 459-456.

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