The document discusses statistics on heart disease in the United States, risk factors for heart attacks such as obesity and lack of exercise, tools for assessing heart health like cholesterol tests and calcium scoring, lifestyle changes to reduce risk including a heart-healthy diet, exercise, weight control, and stress management, and supplements and medications that may help such as omega-3s, fiber, and blood pressure medications. The goal is to motivate readers to make lifestyle changes through diet, exercise, stress relief and medical treatment to lower their risk of heart disease and heart attacks.

1. Un break my heart?
DrRic Saguil

3. I feel fine?
AHA says at 40, 1 in 5 in a lifetime will not be fine.

4. stats AHA
• 750,000 people had a heart attack -2013
• 116,000 people with MI died -2013
• 1 in 3 report no physical activity outside work -2014
• proportion on ideal diet from 0.7 -1.5 -2004 to 2012
• 13 mill adults obese (17%) -2009 to 2012
• 80 mill adults HBP (33%) -2009 to 2012
• 43% adults total cholesterol >200 -2009 to 2012

6. • Family history
• Sedentary / Sitting
• Smoking
• Diabetes
• High cholesterol
• High blood pressure
• Waist line

7. Eat healthy?
Exercise?
Mind your weight?

8. “…when I have a
heart attack, don’t
revive me, I’m ready
to meet the Lord”

10. Tools
• Cholesterol level (+ the fancy one)
• C reactive protein
• Coronary calcium
• Ankle brachial index
• Intimal thickness

11. Calcium Score
• when in doubt (unsure
about risk)
• to reclassify risk
• avoid adverse outcomes
• establish subclinical
disease

12. Questionnaires
•Framingham
•Heart of 29
• RealAge
http://cvdrisk.nhlbi.nih.gov/calculator.asp
https://www.heart.org/HEARTORG/Conditions/My-Life-Check-Heart-of-29
https://www.sharecare.com/static/realage-sharecare

13. carotid intimal
medial thickness

15. BMI
http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.html

16. Standard of Care
• Control Total Chol LDL
• Control Glucose
• Control Blood Pressure
• Control Weight+/- Gastric
Bypass
• Control Sleep (CPAP)
• Control Mood
(DON’T FEEL BAD / FEEL INSPIRED)

18. Diet
• limit saturated and
trans fats
• eat food containing
omega 3 fatty acids
• reduce salt
http://www.eatright.org/resource/food/planning-and-prep/cooking-tips-and-trends/heart-healthy-cooking-

19. eatright.org
Limit Saturated and Trans Fat
Select lean cuts of beef and pork, especially cuts with "loin" or "round" in their name.
Cut back on processed meats high in saturated fat, such as hot dogs, salami and bacon.
Bake, broil, roast, stew or stir-fry lean meats, fish or poultry.
Drain the fat off of cooked, ground meat.
When you make a stew or soup, refrigerate leftovers and skim off the fat with a spoon before reheating and serving.
Eat fish regularly. Try different ways of cooking such as baking, broiling, grilling and poaching to add variety.
Include plant foods as sources of protein, including soybeans, pinto beans, lentils and nuts.
Replace higher-fat cheeses with lower-fat options such as reduced-fat feta and part-skim mozzarella.
Thicken sauces with evaporated fat-free milk instead of whole milk.
Move toward using lower-fat milk and yogurt. Start with 2-percent products, then move to 1-percent and finally to fat-free to adjust to the new taste.
Use liquid vegetable oils and soft margarine instead of stick margarine or shortening.
Limit trans fats often found in foods such as cakes, cookies, crackers, pastries, pies, muffins, doughnuts and French fries. Many food manufacturers
Use a small amount of oils such as canola, olive and soybean in recipes and for sautéing.
Make salad dressings with olive, walnut or pecan oil.
Eat Foods Containing Omega-3 Fatty Acids
Select oils that provide omega-3 fatty acids, such as canola, flaxseed or soybean oil.
Add walnuts to cereal, salads or muffins. Try walnut oil in salad dressings, too.
Eat two 4-ounce portions of fatty fish each week, such as salmon, lake trout, albacore tuna (in water, if canned), mackerel and sardines.
Some chickens are given feed that is high in omega-3s so their eggs will contain more as well. When buying eggs, check the package label.
Reduce Salt (Sodium)
Prepare foods at home so you can control the amount of salt in your meals.
Use as little salt in cooking as possible. You can cut at least half the salt from most recipes.
Add no additional salt to food at the table.
Select reduced-sodium or no-salt-added canned soups and vegetables.
Check the Nutrition Facts panel for sodium and choose products with lower sodium content.
Season foods with herbs, spices, garlic, onions, peppers and lemon or lime juice to add flavor.

21. Supplements
• omega 3 oils
• red yeast rice (RYR)
• plant sterol
• fiber

22. RYR
• Thorne Research Choleast
• Natures Plus Herbal Active RYR
• Whole Foods RYR
• Now Foods RYR
inhibit HMGCoA reductase (inhibit cholesterol production)

23. Plant Sterols
• Andrew Lessman ProCaps
Laboratories CholestaCare
• Enzymatic Therapy Cholesterol
Shield
• Nature Made CholestOff Plus
• Pure Encapsulations CholestePure
• Shaklee Cholesterol Reduction
Complex
• Source Naturals Cholesterol Rescue
decrease absorption of dietary cholesterol in the gut/resoprtion

24. Fiber
• 25-35grams daily

25. …the others
• niacin
• asa 81mg
• plants in a bottle

27. Activity
• 30min 5days a week
moderate
• 30 min 3 days a week
intense

29. Relaxation Practice
non RX decrease in:
-anxiousness
-insomnia
-carb hunting
-blood pressure
• 10-20minutes RPM
• 10-20minutes night

30. Standard of Care
• Control Total Chol LDL
• Control Glucose
• Control Blood Pressure
• Control Weight+/- Gastric
Bypass
• Control Sleep (CPAP)
• Control Mood
(DON’T FEEL BAD / FEEL INSPIRED)

31. Lifestyle changes are more
impacting than any RX alone!!!
• Lyon Diet Heart Study =
70% reduction in heart
• Dart Study = 29%
decrease in repeat MI
• Scandinavian Simivstatin
Survival Study 37%
reduction in repeat
procedure
<fat/>fish/>fiber
mediterranean type diet
no info on survival change

32. Till next February
• Monthly goals
• Seasonal rewards (pampering the new you)
• RX Holidays?
• Quarterly MD visits
• Team reassessment
new clothes
new equipment
massage/trainer hire
enrollment fee
coaches eyes

34. Invite to monthly yoga meditation class
www.herbal411.com
Local Appearances
May = Fibromyalgia Summit