UNIT TEACHING EVENTS

The Prevention of Heart Disease Asked to fulfill one of the tasks subjects English For Nursing II

Compiled by: Fitria Rachmi Hilma $%r&annah (sna $%rfianti *nnisa Dian Prati+i *ni Rosmardiani R%lly *ndani *-ave Re/a *lfian (22 !! !! (22 !! !! (22 !! !! (22 !! !! ""# "'# ")# ,,#

(22 !! !! ! )# (22 !! !! !.)# (22 !! !! !.0#

PADJADJARAN UNIVERSITY

NURSING FACULTY Jalan Raya Bandung Sumedang km. !" Ja#$nang%&" Sumedang '(!) " Ja*a Ba&a#. T1P(C P*RT(C(P*$T3 D*T2 T(72 P:*C2 3P2*;2R : : Ho+ to Prevent Heart Disease in 2arly 2 s : The 4niversity 3t%dents in the Third 5ear : December 2.6 2 !. : !.8 9!.82 : $%rsin- Fac%lty6 Pad&ad&aran 4niversity Fitria Rachmi Hilma $%r&annah (sna $%rfianti *nnisa Dian Prati+i *ni Rosmardiani R%lly *ndani *-ave Re/a *lfian (22 !! !! (22 !! !! (22 !! !! (22 !! !! ""# "'# ")# ,,#

(22 !! !! ! )# (22 !! !! !.)# (22 !! !! !.0#

GENERAL PURP+SE *fter this meetin-6 participant<s a+areness abo%t heart disease +ill be increased and =no+ ho+ to prevent the ca%ses8 SPECIFIC PURP+SE *fter doin- this activity6 participants +o%ld =no+: a8 The definition of heart
b. The definition and types of heart disease c8 The iss%es of heart disease d. The ris= factors for heart disease e8 The complications of heart disease

,AIN T+PIC Ho+ to ma=e some prevention from heart disease> SUB T+PIC a8 The definition of heart
b. The definition and types of heart disease c8 The iss%e of heart disease d. The ris= factors for heart disease

e8 The complications of heart disease

TEACHING ,ATERIALS *ttached

CHARACTERISTICS +F PARTICIPANTS The 3t%dents in the a-e of late teens and early 2 s Pad&ad&aran 4niversity6 ?est @ava8 In-#&u.#$%nal S#&a#eg$e!8 2Aplain abo%t the materials in either simple or attractive8 28 4se the media6 s%ch as po+er point6 in9foc%s6 and sample video to help participants %nderstandin- the materials easily8 .8 Bive participants an as=in- opport%nity8 "8 7a=e an eval%ation by C%estionin- participants abo%t the materials that have been -iven8 Rund%*n3tep 1penin!.8 9 !.8 ' 3pea=ers !8 Breetin-s8 Participants 7ethod 3peech 7edia Po+er point6 foc%s and mic8 in9 *ns+erin28 2Aplainin- the p%rpose :istenin:isteninof meetin-8 .8 2Aplainin- r%ndo+ns8 7aterials !.8 '9 !.8!' !8 ;no+in- participant<s *ns+erin=no+led-e abo%t heart disease8 28 2Aplainin- abo%t:
a8 The definition of heart b. The definition and types of heart disease c8 The iss%e of heart disease d. The ris= factors for heart disease e8 The complications of

:istenin-

D%estion9 ans+er and speech8

(n9foc%s6 po+er point6 mic6 and a%dio8

:istenin?atchin-

heart disease

f8 The prevention heart disease

of

.8 7a=in- participants feels comfort +ith the activity8 "8 3ho+in- video abo%t vasc%lar disease8 *s=intime !.8!'9 !.8!0 Closinand eval%ation !.8!09 !.82 !8 Bivinan as=in- *s=inopport%nity to the participants8 28 *ns+erin- the C%estions8 :istenin!8 Res%min+hole :isteninmaterials that have been -iven8 28 Closin- the meetin-8 .8 Doin- an eval%ation amon- spea=er after the meetin-8 3peech (n9foc%s6 po+er point6 and mic8 D%estion9 ans+er8 (n9foc%s6 po+er point6 and mic8

EVALUATI+N The eval%ation methods that can be %sed directly to the participants are:
1. ?hat is the definition and types of heart disease> 2. ?hat is the iss%es of heart disease> 3. ?hat is the ris= factors for heart disease> 4. ?hat is the complications of heart disease 5. ?hat is the prevention of heart disease>

)8 Bive some eAample ho+ to prevent vasc%lar diseaseE

TEACHING ,ATERIAL

!. T/e De0$n$#$%n %0 Hea&#

The heart is the or-an that helps s%pply blood and oAy-en to all parts of the body8 (t is divided by a partition or sept%m into t+o halves6 and the halves are in t%rn divided into fo%r chambers8 The heart is sit%ated +ithin the chest cavity and s%rro%nded by a fl%id filled sac called the pericardi%m8 This ama/in- m%scle prod%ces electrical imp%lses that ca%se the heart to contract6 p%mpin- blood thro%-ho%t the body8 The heart and the circ%latory system to-ether form the cardiovasc%lar system8 5o%r heart is the center of yo%r cardiovasc%lar system6 and it is vitally responsible for &%st abo%t everythin- that -ives yo%r body life6 ran-in- from the transportation of oAy-en to the s%ccess of yo%r imm%ne system8 . Hea&# D$-ea-e Cardiovasc%lar disease (also called heart disease# is a class of diseases that involve the heart6 the blood vessels (arteries6 capillaries6 and veins# or both8 Cardiovasc%lar disease refers to any disease that affects the cardiovasc%lar system6 principally cardiac disease6 vasc%lar diseases of the brain and =idney6 and peripheral arterial disease8 The ca%ses of cardiovasc%lar disease are diverse b%t atherosclerosis andFor hypertension are the most common8 *dditionally6 +ith a-in- come a n%mber of physiolo-ical and morpholo-ical chan-es that alter cardiovasc%lar f%nction and lead to s%bseC%ently increased ris= of cardiovasc%lar disease6 even in healthy asymptomatic individ%als8 7any types of heart diseases6 there are: a# *n-ina *n-ina ca%ses pain or ti-htness in the chest area6 creatin- a sort of sC%ee/in- sensation that sometimes resembles indi-estion8 This condition is not a disease in itself8 (tGs most often a symptom of coronary heart disease6 in +hich the arteries s%pplyin- blood to the heart narro+ and stiffen8 *n-ina can also si-nify coronary microvasc%lar disease6 +hich is heart disease affectin- smaller coronary arteries8 There are vario%s types of an-ina6 +hich all si-nal some sort of heart disease and sho%ld be chec=ed o%t by yo%r doctor8 b# Con-enital Heart Disease Con-enital heart disease or heart defects are heart abnormalities present at birth8 They occ%r +hile the fet%s is developin- in the %ter%s and may be ca%sed by viral infections6

medications6 chemicals6 alcohol6 or other %n=no+n ca%ses8 These abnormalities may affect vario%s parts of the heart6 incl%din- the sept%m6 valves6 blood vessels6 aorta6 chambers6 and more8 ?hatever the defect is6 it may disr%pt proper blood flo+6 ca%sin- symptoms li=e:

fati-%e shortness of breath bl%ish s=in rapid heartbeat s+ellin- in the abdomen or aro%nd the eyes

Treatment varies dependin- on the severity of the defect b%t typically involves s%r-ery8 c# Con-estive Heart Fail%re This condition is more common in older people and occ%rs +hen the heart can no lon-er p%mp blood to the rest of the body li=e it sho%ld8 Doctors describe it as losin- p%mpincapacity8 The condition %s%ally res%lts from dama-e ca%sed by a heart attac=6 hi-h blood press%re6 diabetes6 coronary artery disease6 cancer treatments6 or other health iss%es and may res%lt in eAcess fl%id bac=in- %p into the l%n-s and other tiss%es8 Con-estive heart fail%re ran-es from mild to severe6 +ith symptoms s%ch as:

+ei-ht -ain edema (s+ellin-# in the abdomen6 feet6 an=les6 and le-s fati-%e di//iness shortness of breath event%al disability

Treatment involves medications6 and other medical proced%res and s%r-ery for more severe cases8 d# Coronary Heart Disease This type is the most common form of heart disease8 (t occ%rs +hen the arteries that s%pply

blood to the heart become narro+ed and hardened d%e to the b%ild%p of plaC%e6 =no+n as atherosclerosis8 Coronary heart disease is the leadin- ca%se of death in the 4nited 3tates for men and +omen8 Treatment depends on severity and involves =eepin- hi-h blood press%re and hi-h blood cholesterol %nder control6 adoptin- lifestyle chan-es s%ch as re-%lar eAercise6 and in some cases6 s%r-ery options li=e an-ioplasty and bypass s%r-ery8

e# Coronary 7icrovasc%lar Disease *lso called 7HD6 small vessel disease6 or cardiac syndrome I6 this disease affects the heartGs tiny arteries8 (t dama-es the linin- in the artery +alls and ca%ses them to narro+6 increasin- yo%r ris= for heart attac= and heart fail%re8 3ymptoms incl%de chest pain (an-ina#6 shortness of breath6 and fati-%e8 Treatments mostly involve medications8 f# Cyanotic Heart Disease This is a type of con-enital heart defect that res%lts in lo+ blood oAy-en levels thro%-ho%t the body8 (t may be ca%sed by a n%mber of other heart defects li=e valve defects6 hypoplastic left heart syndrome6 Tetralo-y of Fallot6 or by infections or medications %sed d%rinpre-nancy8 3ymptoms may incl%de:

hyperventilation a bl%ish color to the s=in faintinp%ffy eyes or face

Treatments typically involve s%r-ery to repair the defect8

g) Hypertensive Heart Disease

3everal heart problems may occ%r as a res%lt of hi-h blood press%re or hypertension8 These problems are referred to collectively as hypertensive heart disease8 Related problems may incl%de:

coronary artery disease heart fail%re an-ina heart attac= arrhythmias

h# (schemic Heart Disease The +ord ischemic means a red%ced blood s%pply8 (schemic heart disease is any heart disease that res%lts in a red%ced blood s%pply to the heart8 Tho%-h there may be many ca%ses6 most incidences of this disease may be attrib%ted to atherosclerosis6 a narro+in- of the arteries that s%pply the heart +ith blood8 This disease is also referred to as coronary artery disease8 i# (nflammatory Heart Disease This disease involves inflammation of the heart m%scles or the s%rro%ndin- tiss%es6 +hich may be ca%sed by bacterial6 viral6 or f%n-al infections6 or by imm%ne diseases8 3ymptoms %s%ally incl%de:

an-ina shortness of breath s+ellin- in the feet and an=les fati-%e

Those most at ris= incl%de individ%als +ho had a con-enital birth defect or previo%s in&%ry to the heart6 intraveno%s dr%- %sers6 and those +ith an artificial heart valve8 Treatment depends on the eAtent of the dama-e to the heart m%scle and typically involves medications or s%r-ery8 &# 1r-anic Heart Disease This is an overall term that refers to any type of heart disease +here the heart itself is affected6 and doesnGt f%nction as it sho%ld8 This is d%e to a physiolo-ical problem6 s%ch as a deformity or inflammation8

=# P%lmonary Heart Disease *lso called ri-ht9sided heart fail%re6 p%lmonary heart disease occ%rs +hen a disease of the l%n-s affects the heart8 Jlood flo+ to the l%n-s may then slo+ do+n or become bloc=ed6 increasin- blood press%re in the l%n-s8 *s a res%lt6 the ri-ht side of the heart has to +or= harder6 +hich can lead to dama-e to the heart m%scle itself8 Con-estive heart fail%re may res%lt8 P%lmonary heart disease may be ca%sed +hen a p%lmonary artery becomes bloc=ed or by respiratory diseases li=e emphysema8 Treatments may involve medications6 vasodilators6 and oAy-en therapy8 l# 3tr%ct%ral Heart Disease This term describes any condition that affects the str%ct%re of the heart itself8 4s%ally6 it refers to con-enital heart defects6 b%t it can also incl%de abnormalities in the heart valves and vessels that develop later in life d%e to a-in- or disease8 ). T/e I--ue %0 Hea&# D$-ea-e Cardiovasc%lar disease is the leadin- ca%se of deaths +orld+ide6 tho%-h since the !K, s6 cardiovasc%lar mortality rates have declined in many hi-h9income co%ntries8 *t the same time6 cardiovasc%lar deaths and disease have increased at a fast rate in lo+9 and middle9 income co%ntries8 There are the fact abo%t heart disease:
-

The statistics on heart disease in *merica are sta--erin-8 *bo%t )' million people have hi-h blood press%re8 7ore than , million people in the 4838 have had a heart attac=8 *nother !! million have some other type of cardiovasc%lar disease that impacts their heart and circ%latory health8 Heart disease is the leadin- ca%se of death in the 4nited 3tates6 and it is increasin-ly becomin- a serio%s health problem aro%nd the +orld8

Cardiovasc%lar diseases (CHDs# are the n%mber one ca%se of death -lobally: more people die ann%ally from CHDs than from any other ca%se8

*n estimated !,8. million people died from CHDs in 2 disease and )82 million +ere d%e to stro=e8

06 representin- . L of all

-lobal deaths8 1f these deaths6 an estimated ,8. million +ere d%e to coronary heart

:o+9 and middle9income co%ntries are disproportionally affected: over 0 L of CHD deaths ta=e place in lo+9 and middle9income co%ntries and occ%r almost eC%ally in men and +omen8

The n%mber of people +ho die from CHDs6 mainly from heart disease and stro=e6 +ill increase to reach 2.8.8 million by 2 . 8 CHDs are pro&ected to remain the sin-le leadin- ca%se of death8

7ost cardiovasc%lar diseases can be prevented by addressin- ris= factors s%ch as tobacco %se6 %nhealthy diet and obesity6 physical inactivity6 hi-h blood press%re6 diabetes and raised lipids8

K8" million deaths each year6 or !)8'L of all deaths can be attrib%ted to hi-h blood press%re8 This incl%des '!L of deaths d%e to stro=es and "'L of deaths d%e to coronary heart disease8

'. R$-k Fa.#%&The most important behavior ris= factors of heart disease and stro=e are %nhealthy diet6 physical inactivity6 tobacco %se and harmf%l %se of alcohol8 Jehavior ris= factors are responsible for abo%t 0 L of coronary heart disease and cerebrovasc%lar disease (!#8 The effects of %nhealthy diet and physical inactivity may sho+ %p in individ%als as raised blood press%re6 raised blood -l%cose6 raised blood lipids6 and over+ei-ht and obesity8 These intermediate ris=s factors can be meas%red in primary care facilities and indicate an increased ris= of developin- a heart attac=6 stro=e6 heart fail%re and other complications8 Cessation of tobacco %se6 red%ction of salt in the diet6 cons%min- fr%its and ve-etables6 re-%lar physical activity and avoidin- harmf%l %se of alcohol have been sho+n to red%ce the ris= of cardiovasc%lar disease8 The cardiovasc%lar ris= can also be red%ced by preventin- or treatin- hypertension6 diabetes and raised blood lipids8 Policies that create cond%cive environments for ma=in- healthy choices affordable and available are essential for motivatin- people to adopt and s%stain healthy behavior8 There are also a n%mber of %nderlyin- determinants of CHDs6 or Mthe ca%ses of the ca%sesM8 These are a reflection of the ma&or forces drivin- social6 economic and c%lt%ral chan-e N

-lobali/ation6 %rbani/ation6 and pop%lation a-ein-8 1ther determinants of CHDs incl%de poverty6 stress and hereditary factors8 1. C%m2l$.a#$%n-

Heart fail%re8 Heart attac=8 3tro=e8 *ne%rysm8 Peripheral artery disease8 3%dden cardiac arrest8

3. Hea&# D$-ea-e P&e4en#$%n !8 DonOt smo=e or %se tobacco 3mo=in- or %sin- tobacco is one of the most si-nificant ris= factors for developin- heart disease8 Chemicals in tobacco can dama-e yo%r heart and blood vessels6 leadin- to narro+inof the arteries (atherosclerosis#8 *therosclerosis can %ltimately lead to a heart attac=8 ?hen it comes to heart disease prevention6 no amo%nt of smo=in- is safe8 3mo=eless tobacco and lo+9tar and lo+9nicotine ci-arettes also are ris=y6 as is eApos%re to secondhand smo=e8 (n addition6 the nicotine in ci-arette smo=e ma=es yo%r heart +or= harder by narro+in- yo%r blood vessels and increasin- yo%r heart rate and blood press%re8 Carbon monoAide in ci-arette smo=e replaces some of the oAy-en in yo%r blood8 This increases yo%r blood press%re by forcin- yo%r heart to +or= harder to s%pply eno%-h oAy-en8 2ven so9called Msocial smo=in-M P smo=in- only +hile at a bar or resta%rant +ith friends P is dan-ero%s and increases the ris= of heart disease8 ?omen +ho smo=e and ta=e birth control pills are at -reater ris= of havin- a heart attac= or

stro=e than are those +ho donOt do either8 This ris= increases +ith a-e6 especially in +omen older than .'8 The -ood ne+s6 tho%-h6 is that +hen yo% C%it smo=in-6 yo%r ris= of heart disease drops dramatically +ithin &%st one year8 *nd no matter ho+ lon- or ho+ m%ch yo% smo=ed6 yo%Oll start reapin- re+ards as soon as yo% C%it8 28 2Aercise for . min%tes on most days of the +ee= Bettin- some re-%lar6 daily eAercise can red%ce yo%r ris= of fatal heart disease8 *nd +hen yo% combine physical activity +ith other lifestyle meas%res6 s%ch as maintainin- a healthy +ei-ht6 the payoff is even -reater8 Physical activity helps yo% control yo%r +ei-ht and can red%ce yo%r chances of developinother conditions that may p%t a strain on yo%r heart6 s%ch as hi-h blood press%re6 hi-h cholesterol and diabetes8 (t also red%ces stress6 +hich may be a factor in heart disease8 Try -ettin- at least . to ) min%tes of moderately intense physical activity most days of the +ee=8 Ho+ever6 even shorter amo%nts of eAercise offer heart benefits6 so if yo% canOt meet those -%idelines6 donOt -ive %p8 5o% can even brea= %p yo%r +or=o%t time into ! 9min%te sessions8 *nd remember that activities s%ch as -ardenin-6 ho%se=eepin-6 ta=in- the stairs and +al=inthe do- all co%nt to+ard yo%r total8 5o% donOt have to eAercise stren%o%sly to achieve benefits6 b%t yo% can see bi--er benefits by increasin- the intensity6 d%ration and freC%ency of yo%r +or=o%ts8 .8 2at a heart9healthy diet 2atin- a special diet called the Dietary *pproaches to 3top Hypertension (D*3H# eatin- plan can help protect yo%r heart8 Follo+in- the D*3H diet means eatin- foods that are lo+ in fat6 cholesterol and salt8 The diet is rich in fr%its6 ve-etables6 +hole -rains and lo+9fat dairy prod%cts6 +hich can help protect yo%r heart8 Jeans6 other lo+9fat so%rces of protein and certain types of fish also can red%ce yo%r ris= of heart disease8

:imitin- certain fats yo% eat also is important8 1f the types of fat P sat%rated6 poly%nsat%rated6 mono%nsat%rated and trans fat P sat%rated fat and trans fat increase the ris= of coronary artery disease by raisin- blood cholesterol levels8 7a&or so%rces of sat%rated fat incl%de:

Red meat Dairy prod%cts Cocon%t and palm oils 3o%rces of trans fat incl%de:

Deep9fried fast foods Ja=ery prod%cts Pac=a-ed snac= foods 7ar-arines Crac=ers :oo= at the label for the term Mpartially hydro-enatedM to avoid trans fat8 Heart9healthy eatin- isnOt all abo%t c%ttin- bac=6 tho%-h8 7ost people need to add more fr%its and ve-etables to their diet P +ith a -oal of five to ! servin-s a day8 2atin- that many fr%its and ve-etables can not only help prevent heart disease6 b%t also may help prevent cancer8 1me-a9. fatty acids6 a type of poly%nsat%rated fat6 may decrease yo%r ris= of heart attac=6 protect a-ainst irre-%lar heartbeats and lo+er blood press%re8 3ome fish6 s%ch as salmon and mac=erel6 are a -ood nat%ral so%rce of ome-a9.s8 1me-a9.s are present in smaller amo%nts in flaAseed oil6 +aln%t oil6 soybean oil and canola oil6 and they can also be fo%nd in s%pplements8 Follo+in- a heart9healthy diet also means drin=in- alcohol only in moderation P no more than t+o drin=s a day for men6 and one a day for +omen8 *t that moderate level6 alcohol can have a protective effect on yo%r heart8 7ore than that becomes a health ha/ard8

"8 7aintain a healthy +ei-ht *s yo% p%t on +ei-ht in ad%lthood6 yo%r +ei-ht -ain is mostly fat rather than m%scle8 This eAcess +ei-ht can lead to conditions that increase yo%r chances of heart disease P hi-h blood press%re6 hi-h cholesterol and diabetes8 1ne +ay to see if yo%r +ei-ht is healthy is to calc%late yo%r body mass indeA (J7(#6 +hich considers yo%r hei-ht and +ei-ht in determinin- +hether yo% have a healthy or %nhealthy percenta-e of body fat8 J7( n%mbers 2' and hi-her are associated +ith hi-her blood fats6 hi-her blood press%re6 and an increased ris= of heart disease and stro=e8 The J7( is a -ood6 b%t imperfect -%ide8 7%scle +ei-hs more than fat6 for instance6 and +omen and men +ho are very m%sc%lar and physically fit can have hi-h J7(s +itho%t added health ris=s8 Jeca%se of that6 +aist circ%mference also is a %sef%l tool to meas%re ho+ m%ch abdominal fat yo% have:

7en are considered over+ei-ht if their +aist meas%rement is -reater than " inches (! !8) centimeters6 or cm#

?omen are over+ei-ht if their +aist meas%rement is -reater than .' inches (008K cm# 2ven a small +ei-ht loss can be beneficial8 Red%cin- yo%r +ei-ht by &%st ! percent can decrease yo%r blood press%re6 lo+er yo%r blood cholesterol level and red%ce yo%r ris= of diabetes8 '8 Bet re-%lar health screenin-s Hi-h blood press%re and hi-h cholesterol can dama-e yo%r heart and blood vessels8 J%t +itho%t testin- for them6 yo% probably +onOt =no+ +hether yo% have these conditions8 Re-%lar screenin- can tell yo% +hat yo%r n%mbers are and +hether yo% need to ta=e action8

Bl%%d 2&e--u&e. Re-%lar blood press%re screenin-s start in childhood8 *d%lts sho%ld have their blood press%re chec=ed at least every t+o years8 5o% may need more9freC%ent chec=s if yo%r n%mbers arenOt ideal or if yo% have other ris= factors for heart disease8 1ptimal blood press%re is less than !2 F0 millimeters of merc%ry8

C/%le-#e&%l le4el-. *d%lts sho%ld have their cholesterol meas%red at least once every five years startin- at a-e 2 8 5o% may need more freC%ent testin- if yo%r n%mbers arenOt

optimal or if yo% have other ris= factors for heart disease8 3ome children may need their blood cholesterol tested if they have a stron- family history of heart disease8

D$a5e#e- -.&een$ng. 3ince diabetes is a ris= factor for developin- heart disease6 yo% may +ant to consider bein- screened for diabetes8 Tal= to yo%r doctor abo%t +hen yo% sho%ld have a fastin- blood s%-ar test to chec= for diabetes8 Dependin- on yo%r ris= factors6 s%ch as bein- over+ei-ht or a family history of diabetes6 yo%r doctor may recommend first testinyo% for diabetes sometime bet+een a-es . and "'6 and then retestin- every three to five years8

REFERENCES Blobal stat%s report on noncomm%nicable disaeses 2 ! 8 Beneva6 ?orld Health 1r-ani/ation6 2 !!8 Blobal atlas on cardiovasc%lar disease prevention and control8 Beneva6 ?orld Health 1r-ani/ation6 2 !!8 7athers CD6 :oncar D8 Pro&ections of -lobal mortality and b%rden of disease from 2 2 . 8 PLoS Med6 2 )6 .(!!#:e""28 2 to

:im 336 Hos T6 FlaAman *D6 Danaei B6 3hib%ya ;6 *dair9Rohani H et al8 * comparative ris= assessment of b%rden of disease and in&%ry attrib%table to ), ris= factors and ris= factor cl%sters in 2! re-ions6 !KK 92 ! : a systematic analysis for the Blobal J%rden of Disease 3t%dy 2 ! 8 Lancet6 2 !26 .0 (K0'K#:222"N22) 8 The -lobal b%rden of disease: 2 " %pdate8 Beneva6 ?orld Health 1r-ani/ation6 2 08

http:FFbiolo-y8abo%t8comFodFh%mananatomybiolo-yFssFheartQanatomy8htm http:FF+++8health8harvard8ed%Fcate-oryFheart9and9circ%latory9health http:FF+++8mayoclinic8comFhealthFheart9disease9 preventionF?1 "!F$32CT(1$BR14PR2 http:FF+++8+ho8intFmediacentreFfactsheetsFfs.!,FenF