Coronary Heart Disease

PEMBAHASAN ANTARA LAIN :
1. Mechanism of cardiac Function --how heart work.
    -Anatomy, Physiology.
2. Coronary Artery Disease --Epidemiology; Pathogenesis; Management.
3. Tanya Jawab (Q & A).
HEART DEVELOPMENT:
Week 3- There is formation of 2 heart tubes.
Week 4-Heart begins to beat (65x/min).
The size of fetus by the end of 1st month of life 6mm (smaller than a grain of rice) but alreary functioned.
HEART FACTS:  Human heart weighs approximately 300 gms. Normal cardiac out put(at rest)=5.5 litres/min. at a speed of approximately 1-3 km/hour.  It pumps 8000 L  or 2000 gallons a day. So working hard, never rest in our whole life.
*Although having the same size as one's fist the heart has the mighty job to keep the blood flowing through the 56,000-96,000 km of blood vessel in our body.
*The heart is the most energy efficient organ. The energy it creates daily is enough to drive a truck for 32 km.
*It has its own blood and electrical supply.
EPIDEMIOLOGY
*CHD (Coronary Heart Desease) is the leading cause of death in the world (7.3 million/year)
*Australian data:
-Prevalence : 1.4 million
-Mortality: 54/day or 1 every 27 mins.
-Specifically, 1 heart attack/9 mins.
-$ 1.8 billion paid for CV(Cardio Vascular) medicines in 2012 - 2013.(21% of Total benefit).
*Declining mortality in developed nations but reverse trend in emerging nations (China, India, Africa, and Middle East)
   (Source: National Heart Foundation).
 RISK FACTORS
* Non-modifiable...
-Age,Gender,Family History --10%
* Modifiable
-Smoking,Hypertension,Diabetes, Obesity
Hypercholesterolaemia (LDL,HDL) --90 %/
INTERHEART: Impact of multiple risk factors on CV risk.
URUTANNYA sbb: Smoking, Diabetes, Hypertension, Obesity,Psychosocial factors.
MANAGEMENT OF CHD (Cardio Heart Disease)
*Primary Prevention: -Smoking Cessation; Regular monitoring and control of diabetes, BP, and Cholesterol; Diet and Exercise; Stress Management strategy; Avoidance of alcohol and caffeine.
*Secondary Prevention:
-Everything in Primary Prevention; Medication.
DIET AND CHD
*RICH in complex carbohydrate; RICH in fiber; RICH in color; LOW salt; LOW saturated fat; LOW Calories (depends on activity level).
RECOMMENDATION:
FAT : *Good : Mono & Polyunsaturated fat. Example: Avocado,Nuts,Olive Oil. *Bad : Saturated & Trans unsaturated fat. Example: Animal Fat, Dairy Product.
ENERGY/CALORIE: *Depends on activity level. *Snacking <600 kJ.
*Use calorie tracker.
FIBRE : Aim: 25 - 30 gm daily.
CARBOHYDRATE: *45-65% of daily energy intake. *Rice, pasta,bread,cereal,potato, fruits & veg. *Glycaemic index.
SODIUM/SALT: <2300 mg/day or 1 tsp. *Avarage ppl consume 3.4gm/day.
*77 % from snack, restaurant food, processed food.
DIETARY PRACTICAL SUGGESTION
*4-6 serves of wholegrain food....
*5 serves of vegetable and 2 serves of fruit
*Beware of added sugar --Aim for <12 gm or 1 tbsp./day.
*Avocado,Olive oil, nuts are rich in good fat.
-Consume >(-) 4 tbsp. of olive oil/day.
-30gm of nuts(15 g walnut, 7,5g hazelnut,7.5g almond).
*Drink plain water; *Read your food label.
ALCOHOL & HEART --menaikkan:
*Tryglyceride *Calorie intake *Blood Pressure
*Risk of Stroke,Cardiomyopathy, Arrhythmia. *Alcoholism.
EXERCISE & CHD :
*Physical activity helps restoring endothelial function, increasing efficiency of glucose metabolism, and reducing BP (in the long run).
*Recommendation:
-Aerobic exercise for a min of 30 mins/day for 5 days/week aiming for 60-75% target heart rate.
CATATAN TAMBAHAN :
*75 % terjadinya penyakit jantung adalah karena Life Style.
*Usahakan minimum 2x dalam setahun untuk check/periksa : Cholesterol, Gula, dan Tekanan Darah.
*Yang mengonsumsi 4 tbsp. of olive oil/daily --20% reduce.
*Hati-hati dengan garam. Kalau sudah ada TDT cukup 1/2 sd.teh/hari.
*Ada pepatah: Tak kenal maka tak sayang. Kita perlu mengenal akan jantung kita, dengan demikian kita akan menyayanginya. Sayangilah jantung Anda!.
Psalm 139:14 (NIV) Our body/organ/being, is wonderful designed by our Creator.
Terimakasih sudah membaca !
Sumber: Coronary Heart Disease Seminar, oleh Dr. Samuel Sidharta, Sp.Jantung di gedung UTS Sydney, hari Minggu, 28 Juni 2015. Diselenggarakan oleh: BISA (Bina Indonesia Sehal Alami).