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February is National Heart Month and Dental Month

February 8, 2012

 

“In 2010, an estimated 785,000 Americans had a new coronary attack and about 470,000 had a recurrent attack,” according to the Centers for Disease Control and Prevention. “About every 25 seconds, an American will have a coronary event, and about one every minute will die from one.”

Guidelines for preventing CVD in women

Smoking:  Women should not smoke and should avoid secondhand smoke.

Exercise: Women should have at least 150 minutes/week of moderate exercise or 75 minutes/week of vigorous activity. Additional cardiovascular benefits are provided by increasing moderate-intensity exercise to 300 minutes/week or 150 minutes/week of vigorous activity. Women should perform muscle-strengthening exercises that involve all major muscle groups at least 2 days/week. Women wanting to lose weight should accumulate a minimum of 60−90 minutes of at least moderate-intensity exercise on most or all days.

CVD risk-reduction: Women who recently have suffered acute coronary syndrome or coronary revascularization, new onset or chronic angina, or current/prior symptoms of heart failure who meet certain criteria, a recent cerebrovascular attack, or peripheral vascular disease should enroll in a comprehensive CVD risk-reduction regimen, such as rehabilitation or a community-based exercise program.

Diet: Women should eat plenty of fruits and vegetables, choose whole-grain and high-fiber foods, consume fatty fish at least twice a week, and limit intake of saturated fat, cholesterol, alcohol, sodium, sugar, and trans fatty acids. Specific diet guidelines include:

  • More than 4.5 cups of fruits and vegetables/day
  • 7 ounces (cooked) of fatty fish each week
  • 30 grams/day of fiber
  • Three servings/day of whole grains
  • Less than five servings/week of sugar and fewer than 450 calories/week from sugar-sweetened beverages
  • More than four servings of nuts, legumes, and seeds/week
  • Less than 7% of calories from saturated fat
  • Less than 150 milligrams (mg)/day of cholesterol
  • Less than one serving of alcohol/day
  • Less than 1500 mg of sodium/day
  • No trans fatty acids

Body mass index (BMI): Women should maintain or lose weight to achieve a BMI of less than 25, a waist size below 35″, and other targets.

Eicosapentaenoic acid (EPA): Women who already have hypercholesterolemia or hypertriglyceridemia are advised to take 1800 mg/day of EPA, an omega-3 fatty acid.

Blood pressure: An optimal blood pressure of <120/90 millimeters of mercury (mm Hg) is encouraged. If blood pressure is more than 140/90 mm Hg (or more than 130/80 mm Hg in women with chronic kidney disease and diabetes), most patients are prescribed thiazide diuretics. Beta-blockers and/or ACE inhibitors/angiotensin receptor blockers (ARBs) are the initial treatments for high-risk women with acute coronary syndrome or myocardial infarction (MI), with other medications, such as thiazide diuretics, added as necessary.

Lipids: The lipid goals are low-density lipoprotein (LDL) <100 mg/deciliter (dL), high-density lipoprotein (HDL) >50 mg/dL, triglycerides <150 mg/dL, and non-HDL cholesterol <130 mg/dL.

LDL: Women with coronary heart disease should use drug therapy, as well as lifestyle therapy, to decrease their LDL to <100 mg/dL. Medication also is indicated for women with other atherosclerotic CVD or diabetes or a 10-year absolute risk of >20%. Women who are very high risk should aim for an LDL of 70 mg/dL.

HDL: When HDL levels are low or when non-HDL cholesterol is high, niacin or fibrate therapy may prove useful.

A1c: Women with diabetes should achieve an A1c of <7% (if possible without hypoglycemia).

Antioxidants: Antioxidants such as vitamins E and C taken in supplemental doses are not useful for the prevention of heart disease. Neither are the B vitamins.

Low-dose aspirin: If you are younger than 65, you probably do not need to take low-dose aspirin. In older women, baby aspirin can help to reduce the risk of stroke. Talk to your doctor if you have questions about this.

Hormone therapy and selective estrogen-receptor modulators: Hormone therapy and selective estrogen-receptor modulators are not used for the primary or secondary prevention of cardiovascular disease.

Medications:

−  Warfarin is used for women with chronic or paroxysmal atrial fibrillation.

−  Dapigatran is an alternative to warfarin, used for the prevention of stroke and systemic thromboembolism.

−  Beta blockers are used in all women after MI or acute chest pain with normal ventricular function or with left ventricular failure. 

−  ACE inhibitors are used for women after MI or for those who have heart failure, left ventricular ejection fraction (LVEF) <40%, or diabetes.

−  Aldosterone blockade after MI is indicated in women without hypotension, renal dysfunction, or hyperkalemia if they are already on ACE inhibitors and beta blockers and have an LVEF of <40% and symptomatic heart failure.

Heart Health: What Are You Willing to Do?

I will avoid saturated fats.
Sources of saturated fat include:

  • Fatty meat           
  • Poultry skin
  • Whole milk
  • Lard
  • Coconut oil
  • Palm kernel oil
  • Palm oil
  • Butter
  • Cream
  • Cottonseed oil

I will read ingredient lists to make sure that the foods I choose do not contain partially hydrogenated oils.
These are trans fats.

I will choose healthier sources of fat.
Choose:

  • Olive oil
  • Canola oil
  • Walnut oil
  • Nuts
  • Seeds
  • Avocados

I will eat fatty fish at least two times each week.
The following are fatty fish:

  • Salmon
  • Tuna
  • Mackerel
  • Bluefish
  • Mullet
  • Anchovies
  • Herring
  • Lake trout
  • Sardines

If you do not like fish, take a fish oil supplement that contains eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Alpha-linolenic acid (ALA) is not as good. Your supplement should provide at least 1 gram (g)/day.

I will decrease the amount of sugar that I consume. 

I will eat several sources of soluble fiber each day.
Good sources include:

  • Citrus fruits
  • Apples
  • Pears
  • Prunes
  • Peaches
  • Plums
  • Barley
  • Oats
  • Legumes
  • Broccoli
  • Brussels sprouts
  • Carrots

I will increase my intake of foods that contain calcium and vitamin D.
If you do not think that you can get enough calcium and vitamin D from your diet, take a daily supplement.
Good sources of calcium include:

  • Milk
  • Milk products
  • Fortified orange juice
  • Fortified breads
  • Fortified cereals
  • Beans
  • Dried figs
  • Calcium-fortified tofu
  • Canned salmon with bones
  • Almonds
  • Carnation® Instant Breakfast
  • Ovaltine®
  • Dark-green leafy vegetables
  • Broccoli

I will eat plenty of potassium-rich foods.
These include:

  • Potatoes
  • Sweet potatoes
  • Bananas
  • Oranges
  • Halibut
  • Lima beans
  • Tuna
  • Swiss chard
  • Acorn squash
  • Tomatoes
  • Watermelon
  • Grapes
  • Raisins
  • Pistachios
  • Flounder
  • Parsnips
  • Pinto beans
  • Wheat germ
  • Brussels sprouts
  • Prunes
  • Spinach
  • Salmon
  • Cantaloupe
  • Lentils
  • Milk
  • Milk products

I will commit to consuming more plant stanols/sterols.
I will eat the recommended amount every day.

I will eat more fresh herbs.

I will eat several servings of nuts each week.
The best kinds of nuts are:

  • Walnuts
  • Almonds
  • Brazil nuts
  • Pecans
  • Pistachios

I will use garlic, onions, and leeks often when preparing food.

I will choose cereals that contain more than 5 g of fiber/serving.
Good choices include:

  • Raisin bran
  • Shredded wheat
  • Grape-Nuts
  • Fiber One®
  •  

    What did you commit to?

  1. I will avoid saturated fats.
  2. I will read ingredient lists to make sure that the foods I choose do not contain partially hydrogenated oils.
  3. I will choose healthier sources of fat.
  4. I will eat fatty fish at least two times each week.
  5. I will decrease the amount of sugar that I consume.
  6. I will eat several sources of soluble fiber each day.
  7. I will increase my intake of foods that contain calcium and vitamin D.
  8. I will eat plenty of potassium-rich foods.
  9. I will commit to consuming more plant stanols/sterols.
  10. I will eat more fresh herbs.
  11. I will eat several servings of nuts each week.
  12. I will use garlic, onions, and leeks often when preparing food.
  13. I will choose cereals that contain more than 5 g of fiber/serving.

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Florian Dental
Sami Bilani D.D.S.
2460 Florian Ave,
Hamtramck, MI 48212
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Phone: (313) 875-1700
Email: floriandental@sbcglobal.net

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