4. Coronary Artery Disease (CAD)
• Also known as Ischaemic Heart Disease (IHD)
• It is the narrowing or blockage of the coronary
arteries, usually caused by build-up of
cholesterol & fatty deposits
• It is the most common type of heart disease
5. Burden of Disease
• A global killer
– Globally, CAD is the leading cause of death and is predicted to remain
so for the next 20 years.
– Each year, approximately 3.8 million men and 3.4 million women die
from CAD.2 In 2020, it is estimated that this disease will be
responsible for a total of 11.1 million deaths globally.
– Someone suffers a coronary event every 26 seconds, and someone
dies from one every minute in the USA.
– In Europe, between 1 in 5 and 1 in 7 European women die from CAD,
and the disease accounts for between 16% and 25% of all deaths in
European men.
6. Atherosclerosis
• Atherosclerosis is a disease in which plaque
builds up inside your arteries.
• Plaque is made up of fat, cholesterol, calcium,
and other substances found in the blood. Over
time, plaque hardens and narrows the arteries.
• Atherosclerosis can affect any artery in the body,
including arteries in the heart, brain, arms, legs,
pelvis, and kidneys. As a result, different diseases
may develop based on which arteries are
affected.
10. Risk Factors for CAD
Non-Modifiable
• Male gender
• Advanced age
• Family history of heart disease
• Race
Modifiable
• Cigarette smoking
• High LDL (bad cholesterol)
• High BP >140/90 mmHG
• Uncontrolled diabetes
• Physical inactivity
• Being overweight
• Stress
• Diet high in saturated fat and
cholesterol
• Alcohol intake
12. How is CAD Treated?
• Medicines
– Sometimes lifestyle changes aren’t enough to control your blood
cholesterol levels. For example, you may need statin medications to
control or lower your cholesterol.
– The doctor also may prescribe other medications to:
• Decrease your chance of having a heart attack or dying suddenly
• Lower your blood pressure
• Prevent blood clots, which can lead to heart attack or stroke
• Prevent or delay the need for a stent or surgery
• Reduce heart’s workload and relieve coronary heart disease
symptoms
Take Medications as
Prescribed
13. How is CAD Treated?
• Medical Procedures & Surgery
– Percutaneous Coronary Intervention
Percutaneous coronary intervention, commonly known as
angioplasty, is a nonsurgical procedure that opens blocked or
narrowed coronary arteries. A thin, flexible tube with a balloon or
other device on the end is threaded through a blood vessel to the
narrowed or blocked coronary artery. Once in place, the balloon is
inflated to compress the plaque against the wall of the artery. This
restores blood flow through the artery.
During the procedure, the doctor may put a small mesh tube
called a stent in the artery. The stent helps prevent blockages in
the artery in the months or years after angioplasty.
15. How is CAD Treated?
• Life style changes
– Healthy eating
• When following a heart-healthy diet, you should avoid eating:
A lot of red meat
Palm and coconut oils
Sugary foods and beverages
Foods that are high in salt and sodium
– Maintaining a healthy weight
– Managing stress
– Physical activity
– Smoking cessation
16. Hypertension
was named
'the number one killer'
by
World Health Organization (WHO)
Reference 1 :The World Health Report 2002 http://ish-world.com/public/background-info.htm
17.
18.
19. Blood Pressure
Top number (systolic)
-measures the force of blood on arteries
when the heart beats
120/80
Bottom number (diastolic)
- measures force of blood on arteries
between beats
http://www.nhlbi.nih.gov/files/docs/public/heart/hbp_low.pdf
20. What Is High Blood Pressure?
• Blood pressure that stays elevated
–more than 140/90
http://www.nhlbi.nih.gov/files/docs/public/heart/hbp_low.pdf
21. Reference 7: Reference Card From the Seventh Report of the Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)
22. In 2000, the estimated number of adults living with high blood
pressure globally was 972 million. This is expected to increase to
1.56 billion by 2025
90
Reference 2 : International Society of Hypertensionhttp://ish-world.com/public/background-info.htm
Reference 3 : A global brief on Hypertension World Health Day 2013 World Health Organization
Reference :The World Health Report 2002
http://ish-world.com/public/background-
info.htm
94
2
3
23. In 2008, worldwide, approximately 40% of adults aged 25 and above
had been diagnosed with hypertension ; the number of people with
the condition rose from 600 million in 1980 to1 billion in 2008.
Reference 4 : http://ish-world.com/downloads/pdf/global_brief_hypertension.pdf
4
24. In 2014, more than 1.9 billion adults, 18 years and older, were overweight.
Of these over 600 million were obese.
60
Reference 5 : http://www.who.int/mediacentre/factsheets/fs311/en/
5
28. What does High Blood Pressure do to my
Body?
Hypertension
JNC V. Arch Intern Med 1993;153:154–183
Peripheral
vascular
disease
Kidney Failure
Heart Attack
Heart Failure
Hemorrhage
stroke
CHD = coronary heart disease
CHF = congestive heart failure
LVH = left ventricular hypertrophy
29.
30.
31. Hypertension
• Commandments for Blood
Pressure Control
Eat a low-fat diet
Don’t smoke cigarettes Or use tobacco
products
Take your medicine exactly as prescribed
• Don’t forget to take pills even for a single
day
1
2
3
32. Hypertension
• Commandments for Blood
Pressure Control
Keep your appointments with the doctor
Follow your doctors advice about exercise
Make certain family members have their
blood pressure checked regularly
Live a normal life in every other way!
4
5
6
7
33. How I measure my BP at Home?
• Home Blood Pressure
Monitoring
– Mercury sphygmomanometer
• Standard for BP monitoring
• No calibration
• May be bulky
• Need a second person to use machine
• May be difficult for hearing impaired or
patients with arthritis
34. Hypertension
• Home Blood Pressure
Monitoring
– Aneroid equipment
• Inexpensive, lightweight and portable
• Two person operation/need stethoscope
• Delicate mechanism, easily damaged
• Needs calibration with mercury
sphygmomanometer
35. Hypertension
• Home Blood Pressure
Monitoring
– Automatic equipment
• Contained in one unit
• Portable with easy-to-read digital display
• Expensive, fragile
• Must be calibrated
• Requires careful cuff placement
