Heart Disease Prevention
Smoking.pdf
The Danger of Smoking and Smoking Cessation:
Overview:Smoking harms nearly every organ of the body. Smoking causes many diseases and reduces the health of smokers in general. Smoking causes death.• The adverse health effects from cigarette smoking account for one of every five deaths, each year in the United States.• More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined.• Smoking causes an estimated 90% of all lung cancer deaths in men and 80% of all lung cancer deaths in women.• Smoking causes an estimated 90% of all deaths from chronic obstructive lung disease.Smoking and Increased Health Riskssmoking is estimated to increase the risk of:• coronary heart disease by 2 to 4 times.• stroke by 2 to 4 times.• men developing lung cancer by 23 times.• women developing lung cancer by 13 times.• Dying from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times.Smoking and Cardiovascular Disease:• Smoking causes coronary heart disease, the leading cause of death in the USA• Cigarette smoking causes reduced circulation by narrowing the blood vessels (arteries) and puts smokers at risk of developing peripheral vascular • Smoking causes abdominal aortic aneurysm (i.e., a swelling or weakening of the main artery of the body—the aorta—where it runs through the abdomen).Smoking and Respiratory Disease:• Smoking causes lung cancer.• Smoking causes lung diseases (e.g., emphysema, bronchitis, chronic airway obstruction) by damaging the airways and alveoli (i.e., small air sacs) of the lungs.Smoking and Cancer:Smoking causes the following cancers:• Acute myeloid leukemia• Bladder cancer• Cancer of the cervix• Cancer of the esophagus• Kidney cancer• Cancer of the larynx (voice box)• Lung cancer• Cancer of the oral cavity (mouth)• Cancer of the pharynx (throat)• Stomach cancer• Cancer of the uterusSmoking and Other Health Effects:Smoking has many adverse reproductive and early childhood effects, including increased risk for:• infertility,• preterm delivery,• stillbirth,• low birth weight, and• sudden infant death syndrome (SIDS).Smoking is associated with the following adverse health effects:• Postmenopausal women who smoke have lower bone density than women who never smoked.• Women who smoke have an increased risk for hip fracture than women who never smoked.Smoking Cessation:Nicotine Dependence:• Nicotine is the psychoactive drug in tobacco products that produces dependence. Most smokers are dependent on nicotine. Nicotine dependence is the most common form of chemical dependence in the United States. Research suggests that nicotine is as addictive as heroin, cocaine, or alcohol.• Quitting smoking is difficult and may require multiple attempts. Users often relapse because of stress, weight gain, and withdrawal symptoms.• Examples of nicotine withdrawal symptoms include irritability, anxiety, difficulty concentrating, and increased appetite.Health Benefits of Cessation:• Smoking cessation lowers the risk for lung and other types of cancer.• Smoking cessation reduces the risk for coronary heart disease, stroke, and peripheral vascular disease. Coronary heart disease risk is reduced within 1 to 2 years of cessation.• Smoking cessation reduces respiratory symptoms, such as coughing, wheezing, and shortness of breath. The rate of decline in lung function is slower among persons who quit smoking.• Smoking cessation reduces the risk of developing chronic obstructive pulmonary disease (COPD), one of the leading causes of death in the United States.• Smoking cessation by women during their reproductive years reduces the risk for infertility. Women who stop smoking during pregnancy also reduce their risk of having a low birth weight baby.Percentage of current smokers who tried to stop smoking during the previous 12 months:• 51% of high school smokers during 200913 • 45% of adult smokers during 2008 (nearly 21 million people)12 Methods to Quit Smoking• Brief clinical interventions (i.e., when a doctor takes 10 minutes or less to deliver advice and assistance about quitting)• Counseling (e.g., individual, group, or telephone counseling)• Behavioral cessation therapies (e.g., training in problem solving)• Treatments with more person-to-person contact and intensity (e.g., more time with counselors)• Over-the-counter and prescription nicotine replacement products (e.g., nicotine gum, inhaler, nasal spray, lozenge, or patch)1• Prescription nonnicotine medications, such as bupropion SR (Zyban®) and varenicline tartrate (Chantix®).The combination of medication and counseling is more effective for smoking cessation than either medication or counseling alone.
Exercise.pdf
The Benefit of Exercise:
Exercise for a Healthy HeartA sedentary (inactive) lifestyle is one of the top risk factors for heart disease. It's a risk factor that you can do something about. Regular exercise, especially aerobic exercise, has many benefits like:• Strengthen your heart and cardiovascular system.• Improve your circulation and help your body use oxygen better.• Improve your symptoms of congestive heart failure.• Increase energy levels so you can do more activities without becoming tired or short of breath.• Increase endurance.• Lower blood pressure.• Improve muscle tone and strength.• Improve balance and joint flexibility.• Strengthen bones.• Help reduce body fat and help you reach a healthy weight.• Help reduce stress, tension, anxiety, and depression.• Boost self-image and self-esteem.• Improve sleep.• Make you feel more relaxed and rested.• Make you look fit and feel healthy. How Do I Get Started?Always check with your doctor first before starting an exercise program. Your doctor can help you find a program that matches your level of fitness and physical condition. Here are some questions to ask:• How much exercise can I do each day?• How often can I exercise each week?• What type of exercise should I do?• What type of activities should I avoid?• Should I take my medication(s) at a certain time around my exercise schedule?• Do I have to take my pulse while exercising?What Type of Exercise Is Best?Exercise can be divided into two basic types:• Cardiovascular or aerobic is steady physical activity using large muscle groups. This type of exercise strengthens the heart and lungs and improves the body's ability to use oxygen. Aerobic exercise has the most benefits for your heart. Over time, aerobic exercise can help decrease your heart rate and blood pressure and improve your breathing (since your heart won't have to work as hard during exercise). Aerobic exercises include: walking, jogging, jumping rope, bicycling, skiing, skating, rowing, and aerobics.• Strengthening exercises are repeated muscle contractions (tightening).How Often Should I Exercise?In general, to achieve maximum benefits, you should gradually work up to an aerobic session of at least 20 to 30 minutes, at least three to four times a week. Exercising every other day will help you start a regular aerobic exercise schedule. The American Heart Association recommends working up to exercising on most days of the week. While the more exercise you can do the better, any amount of exercise is beneficial to your health.What Should I Include in My Program?Every exercise session should include a warm-up, conditioning phase and a cool-down.• Warm-up. This helps your body adjust slowly from rest to exercise. A warm-up reduces the stress on your heart and muscles, slowly increases your breathing, circulation (heart rate) and body temperature. It also helps improve flexibility and reduce muscle soreness. The best warm-up includes dynamic stretching (as compared to the “touch your toes†stretches you did in high school) and the beginning of the activity at a low intensity level.• Conditioning. This follows the warm-up. During the conditioning phase, the benefits of exercise are gained and calories are burned. If you experience chest pain, significant breathlessness, or dizziness, you should stop exercising and let your doctor know about your symptoms.• Cool-down. This is the last phase of your exercise session. It allows your body to gradually recover from the conditioning phase. Your heart rate and blood pressure will return to near resting values. Cool-down does not mean sit down! In fact, do not sit, stand still or lie down right after exercise. This may cause you to feel dizzy or lightheaded or have heart palpitations (fluttering in your chest). The best cool-down is to slowly decrease the intensity of your activity. Exercise Scale: The Rated Perceived Exertion (RPE) scale is used to measure the intensity of your exercise. The RPE scale runs from 0-10. The numbers below relate to phrases used to rate how easy or difficult you find an activity. For example, 0 (nothing at all) would be how you feel when sitting in a chair; 10 (very, very heavy) would be how you feel at the end of an exercise stress test or after a very difficult activity.Rated Perceived Exertion (RPE) scale 0 / Nothing at all 0.5 / Just noticeable 1 / Very light 2 / Light 3 / Moderate 4 / Somewhat heavy 5-6 / Heavy 7-9 / Very heavy 10 / Very, very heavyWhat Should I do if I Can’t Do Aerobic Exercise?Some studies suggest that walking is a good exercise for patient who can’t do aggressive exercise; even the data suggest doing 150 minutes of walking could be a good exercise level for those patients. It does not matter in how many cessions a week or how long each cession.This information suggest how important not to accept a sedentary life and not to use any physical limitation as an excuse, because activities even limited will improve health and reduce the chance of having heart disease. Some other forms of exercise for patient with disabilities are:Exercise while sittingWhile performing these exercises, maintain good posture. Keep your back straight; do not curve or slump your back. Make sure your movements are controlled and slow. Avoid quick, jerking movements. Do not bounce. Do not hold your breath during these exercises.• Ankle pumping. Sit on the floor with your feet straight out in front of you. Keeping your heels on the floor, lift your toes up as far as you can. Hold for a count of five.• Knee straightening. Raise your foot to fully straighten your knee out in front of you. Hold for a count of five. Lower your foot to the floor. Repeat on other side.• Hip bending. Lift one knee up toward the ceiling. As you lower this knee, raise your other knee. Alternate each leg as if you were marching in place (while sitting.)• Overhead reaching. Raise one arm straight over your head, with your palm facing away from you. Keep your elbow straight. Slowly lower your arm to your side. Repeat with other arm.• Shoulder touching. Sit with your arms at your sides and your palms facing up. Bend your elbows until your hands are touching your shoulders. Lower your hands to your sides.• Single arm lifts. Sit with your arms at your sides, fingers pointing toward the floor. Raise one arm out to your side, keeping your elbow straight and your palm facing down. Slowly lower your arm to your side. Repeat with your other arm.• Shoulder shrugs. Keeping your back straight, lift your shoulders up and forward toward your ears. Release your shoulders down and back in a smooth circular motion.• Arm circles. Sit with your arms at your sides, fingers pointing toward the floor. Raise both arms out from your sides (about 1 or 2 feet from your body). Keeping your elbows straight and your palms facing toward you, rotate your arms in small circles.• Single shoulder circles. Bending one elbow, put your fingertips on your shoulder. Rotate your shoulder and elbow clockwise, then counter clockwise. Repeat with each arm.How Can I Stick With It?• Have fun! Choose an activity that you enjoy. You'll be more likely to stick with an exercise program if you enjoy the activity. Add variety. Develop a group of several different activities to do on alternate days that you can enjoy. Use music to keep you entertained. Here are some questions you can think about before choosing a routine: What physical activities do I enjoy? Do I prefer group or individual activities? What programs best fit my schedule? Do I have physical conditions that limit my choice of exercise? What goals do I have in mind? (For example, losing weight, strengthening muscles or improving flexibility.)• Schedule exercise into your daily routine. Plan to exercise at the same time every day (such as in the mornings when you have more energy). Add a variety of exercises so that you do not get bored. If you exercise regularly, it will soon become part of your lifestyle.• Find an exercise "buddy." This will help you stay motivated.General Workout Tips for People With Heart Failure• Be sure any exercise is paced and balanced with rest.• Avoid isometric exercises such as push-ups and sit-ups. Isometric exercises involve straining muscles against other muscles or an immovable object.• Don't exercise outdoors when it is too cold, hot, or humid. High humidity may cause you to tire more quickly; extreme temperatures can interfere with circulation, make breathing difficult, and cause chest pain. Better choices are indoor activities such as mall walking.• Make sure you stay hydrated. It is important to drink water even before you feel thirsty, especially on hot days. But, be careful not to drink too much water. Follow your doctor's guidelines about how much fluid you can have in a day.• Extremely hot and cold showers or sauna baths should be avoided after exercise. These extreme temperatures increase the workload on the heart.• Steer clear of exercise in hilly areas unless you have discussed it with your doctor. If you must walk in steep areas, make sure you slow down when going uphill to avoid working too hard.If your exercise program has been interrupted for more than a few days (for example, due to illness, vacation, or bad weather), make sure you ease back into the routine. Start with a reduced level of activity, and gradually increase it until you are back where you started.WarningStop exercising and call your doctor if you have any of the following symptoms: Chest pain Weakness Dizziness or lightheadedness Unexplained weight gain or swelling Pressure or pain in your chest, neck, arm, jaw, or shoulder or any other symptoms that cause concern
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