Ischemic heart disease is the most common type of cardiovascular disease and affects men and women both equally. While factors such as age and/or heredity to contribute to the likelihood of cardiovascular disease, the majority of cases found in Canadians were related to risk factors that are modifiable. The major risk factors for cardiovascular disease are:

•    Smoking: Smoking greatly increases the risk of the development of blocked arteries, blood clots, reduction of oxygen in the blood as well as increased blood pressure. Smoking, either first and/or second hand are harmful to human health in general, and specifically is high-risk for developing ischemic heart disease and stroke. Non-smokers can die just as prematurely from second-hand smoke; smoking nearly doubles the risk of stroke as well. Quitting smoking not only provides immediate but also long lasting health benefits; within hours of smoking cessation the risk of heart attack already begins to decrease.
•    Lack of Exercise: People who are physically inactive have twice the risk of having heart disease as well as a stroke. More than half of the Canadian population reports to being inactive; for those who have already experienced a heart attack, it is vital to have and maintain a healthy level of exercise in order to increase chances of survival.
•    Unhealthy Eating: 56% of Canadians report eating less than 5 servings of fresh fruit and vegetables per day, with the minority only reporting that they eat fresh fruit and vegetables in the amounts recommended in Canada's Food Guide. Not only do fresh fruits and vegetables protect the heart and blood vessels, but they provide fiber and contain anti-oxidants (substances which work against the development of blockage in the arteries).
•    High Cholesterol: Cholesterol is one of the fats in the blood that contributes to the growth of all cells in the body. Too much cholesterol ca lead to blockage of the arteries. There are 2 main types of cholesterol:
1.    Low-density lipoprotein (LDL) cholesterol is most often referred to as "bad cholesterol" because it's high levels contribute to artery blockage.
2.    High-density lipoprotein (HDL) cholesterol is most often referred to as "good cholesterol" because it helps to carry LDL-cholesterol away from the artery walls.
Triglycerides are not a type of cholesterol but they are, however, a type of fat thatis found in the blood and are linked with excess weight, excessive alcohol consumption and/or diabetes.
•    High Blood Pressure (Hypertension): This is the measure of the force (pressure) of blood against the walls of the blood vessels (arteries). The top number of a blood pressure reading represents the pressure when the heart contracts and pushes blood out (systolic) and the bottom number is the lowest pressure when the heart relaxes between beats (diastolic). Blood pressure that is consistently more than 140/90 mmHg is considered high, although for those people who have diabetes, 130/80 mmHg is considered high. High blood pressure can, over an extended period of time, cause scarring that promotes the build-up of fatty plaque which is a substance that can narrow and eventually block the arteries. Fatty plaque also causes strain to the heart, initially causing a thickening of the heart muscle and eventually causing the heart to weaken. Very high blood pressure can cause blood vessels in the brain to burst, resulting in a stroke. While high blood pressure is one of the most important risk factors for cardiovascular diseases, it is also the number one modifiable risk factors for strokes. More than 2.6 million Canadians have been diagnosed with hypertension; there is a possibility that just as many people are living with hypertension and are simply not aware of it. It is expected that more than 90% of people 55-65 with normal blood pressure are expected to develop high blood pressure over their lifetime. In 2007 21 million Canadians visited community physicians due to high blood pressure; blood pressure medication that is prescribed by a physician has also risen. Approximately 2.3 billion dollars a year are spent on direct costs of high blood pressure.
•    Sodium: While the human body does require some sodium in order to function in a healthy manner, too much sodium can lead to high blood pressure, which in turn is a major risk for strokes, heart disease, and/or kidney disease.
•    Obesity/Overweight: Being significantly overweight and/or obese increases the risk of developing a wide range of serious health issues, including heart disease, Type 2 diabetes as well as high blood pressure.
•    Stress: High levels of stress and/or prolonged stress may manifest itself in a physical sense, causing high cholesterol, increased blood pressure, and/or disturbances in heart rhythm. These conditions can all increase the risk of developing heart disease. As well, for some people, living with high levels of stress may cause them to not get enough rest, a proper diet, regular physical exercise etc. which in turn are all factors that can elevate the risks of heart disease.
•    Diabetes: Diabetes occurs when insulin does not control the level of sugar in the body, either because not enough insulin is produced or because the body does not react properly to the insulin that is produced. Insulin is then required to break down sugar in the body. Diabetes increases the risk of high blood pressure, coronary artery disease and strokes, particularly for those whose sugar levels are poorly controlled. Diabetes can result in poor circulation caused by damage to the blood vessels.

The third and final blog in this series will provide information on how to lower the risks of cardiovascular disease as well as the current treatment methods; this blog will be available within the next 10-14 days.

Canadians all across the country spent the weekend celebrating Valentine's Day on Saturday. And while the majority of men and women enjoyed affairs of the heart this weekend not enough are taking care of their heart. In fact, Health Canada states that although mortality rates have been reduced in the past forty years, heart disease is still one of the leading causes of death in Canadians. 1.6 millions Canadians are estimated to be living with either heart disease or those who are living with the effects of a stroke.

Anyone who gets a diagnosis for heart/cardiovascular disease should know that this disease is preventable and manageable, especially when it comes to making changes for a healthier lifestyle. There are 6 different types of cardiovascular disease (cardiovascular disease refers to more than one disease of the circulatory system, including the heart and blood vessels, whether the blood vessels are affecting the lungs, brain, kidneys, etc. These 6 are the leading cause of death in Canadians:

•    Ischemic Heart Disease: This is the most common type of cardiovascular disease in Canadians and other industrialized countries; this refers to problems with the circulation of blood to the heart muscle. A partial blockage of one or more of the coronary arteries can result in a lack of enough oxygenated blood (ischemia) which then causes symptoms such as angina (chest pain) and dyspnea (shortness of breath).An artery's complete blockage causes necrosis (damage to the tissues) and/or a myocardial infarction (heart attack).
•    Cerebrovascular (Stroke): This refers to a problem with the circulation of blood in the blood vessels of the brain. A blockage with effects lasting less than 24 hours is known as a transient ischemic attack. Complete blockage with long-term effects is known as a cerebrovascular thrombosis (clot). It is also common for a blood vessel in the brain bursting which results in long term effects on health.
•    Peripheral Vascular Disease: This disease affects the circulation found primarily in the legs; patients with this disease typically complain of pain in their calves, especially when walking.
•    Heart Failure: This occurs when the pumping action of the heart cannot provide enough blood to the rest of the body as it is needed, resulting in damage to the heart muscle (i.e. from a heart attack) or from excessive, chronic abuse of alcohol, or because of a heart muscle known as cardiomyopathy. People with heart failure usually complain of shortness of breath as well as leg swelling.
•    Rheumatic Heart Disease: This was once more common among Canadians, but now is more prevalent in many poor countries. This disease begins in childhood with a bacterial infection which affects joints and heart valves; the heart problems appear many years later, in which often the heart valves require to be replaced via surgery. Other infections can also occur attacking the inner tissues of the heart including valves (endocarditic) and the outer tissues overlying the heart (pericarditis).
•    Congenital Heart Disease: This begins because of a problem with the structure of the heart due to a birth defect. These anatomical defects can be as minor as a small hole in one of the inside walls of the heart or they can be as major and complex which can affect the way blood flows through the heart and lungs. Some congenital heart problems can be fatal unless immediately corrected by surgery, others cause disability in varying degrees and can be treated by surgery later in life with either one or more surgeries.

This blog dealt with identifying the major types of cardiac disease; the next blog will address treatment and identification issues surrounding cardiac disease.

Many Canadians experience what is known as 'the winter blues'. Shorter daylight hours, combined with the anticlimactic feeling once the holiday season is over, can make people feel somewhat dejected. While feeling blue is a normal human reaction to life, some people experience clinical depression throughout the winter months. This is known as Seasonal Affective Disorder (SAD) and can be quite problematic. While it is normal and healthy for all people to experience some forms of feeling mildly depressed during the winter months, SAD is a form of clinical depression that is triggered by the winter season.

People who are suffering from SAD experience such symptoms as:

•    Feeling down constantly;
•    Low energy;
•    Sleep difficulties (either not being able to sleep or oversleeping);
•    Appetite difficulties, including sudden cravings for foods that are high in carbohydrates;
•    Lack of interest in what is happening in life and activities that were normally enjoyed;
•    Concentration difficulties and difficulties in processing information;
•    Feelings of depression, hopelessness, and/or anxiety;
•    Social withdrawal;
•    Weight gain.

Researchers believe that SAD is the result of the days becoming shorter in the winter months. Studies have suggested that SAD is more prevalent in northern countries; this is a result of winter days being shorter in the more northern countries. It is estimated that two to three percent of the population of Ontario suffers from Seasonal Affective Disorder every year. As well, studies have shown that up to 100,000 people who reside in British Columbia experience SAD every year. A much larger percentage of the Canadian population suffers from the 'winter blahs' with symptoms very similar to SAD, but not to the extent of fitting the criteria for clinical depression.

The current typical treatment for SAD is light therapy, also known as phototherapy. This requires the person experiencing the symptoms of SAD to be exposed to bright artificial light. This treatment mimics the person being exposed to the level of sunlight normally experienced during the summer months. These light boxes can be purchased and used in the person's home; the majority of people have a significant positive result from as little as 30 minutes a day of being exposed to a special fluorescent light box. The most common ‘dose’ of light is 10,000 lux. Lux is a measure of light intensity. Typically, indoor light is under 400 lux; a cloudy day is typically 3,000 lux; a sunny bright day is typically more than 50,000.

Portable light boxes are safe and are now commercially available for those who experience the symptoms of SAD and typically cost between $200 and $400. The side effects of using a light box are usually quite mild; some people may experience nausea, headaches, eye strain, and/or feeling 'edgy' when they first start to use light therapy. These negative feelings usually do not last long and will go away as the therapy progresses. Anti-depressant medications may also be effective for those who are experiencing severe reactions to the lack of sunlight.

If you are experiencing these symptoms during the winter months, consult with your health care professional about whether or not light therapy may be beneficial for you. Also check your individual and/or group health plan to see if the cost of a fluorescent light box is covered through your health insurance.

Travelers in Canada and the United States are experiencing delays in North American airports due to the recent incident aboard a Northwest Airlines flight. The flight had originated from Amsterdam and was scheduled to land in Detroit. A Nigerian man attempted to ignite an incendiary device on the flight Christmas Day, but succeeded only in starting a small fire. An Al Queda group in Yemen is claiming responsibility for the failed attack.

The Canadian government has announced that it has ordered 44 full-body scanners. Passengers departing from major Canadian airports and flying to the United States will then have a choice of either being scanned or submitting to a physical ‘pat down’ by an airport guard. The first dozen of the full-body scanners are due to be delivered by the end of next week and be operational by March. Airports in Toronto, Ottawa, Vancouver, Edmonton, Regina, Winnipeg, Montreal, Halifax and possibly Gander are the first Canadian cities to receive the scanners. Other unspecified locations will receive scanners in the later months of 2010. Until the scanners are operational the Minister of State for Transport is recommending that all passengers traveling to the United States through Canada be automatically subjected to the secondary screening program. This would entail passengers being asked to submit to a physical pat-down or a full-body scan in addition to the already existing security measures.

The Canadian Air Transport Security Authority has indicated that it will follow the recommendations of the federal privacy commissioner:

• That the body scanners will be used only when a passenger fails a metal detector and then refuses a physical pat-down;
• That the screening officers must be in a different room than the passenger and must not wear/have any identifying information.
  

The scan requires the passenger to pass through a stand-up probe that looks similar to a phone booth and takes approximately one minute. It works by projecting low level millimeter wave radio frequency energy over and around the passenger’s body. It is capable of peering beneath clothing to project a graphic three dimensional image of the person onto a computer screen in a remote room. There the security officer can detect weapons or explosive devices hidden beneath the clothing. The scan has already been approved for use in the United Kingdom as well as the Netherlands. In Canada the scan will not be used on anyone under the age of 18, due to the fears that the resulting images could possibly amount to child pornography.

For Canadians traveling to the United States, be advised that the new security measures will make wait times longer; allow for plenty of time to pass through Customs as well as the security checks. It is also advisable to call ahead and ask what exactly will the rules are regarding carry-on luggage and other items, i.e. laptop computers, cell phones.

With the Christmas season upon Canadians, alcohol can factor into many of the seasonal parties and functions. However, for women who are pregnant alcohol consumption can cause serious defects in the unborn child. It is estimated that nine babies for every 1,000 that are born in Canada have Fetal Alcohol Spectrum Disorder which can cause birth defects and/or developmental disabilities.

Fetal Alcohol Spectrum Disorder is an umbrella term that describes the range of disabilities and/or diagnoses that are a result of alcohol consumption during pregnancy; impact of FASD varies from child to child. The degree of disability and birth defects usually depends on the amount of alcohol that was consumed, how often it was consumed and at what stage of the pregnancy it was consumed, as well as the health status of the pregnant mother. It should be noted that no amount of alcohol is considered safe for pregnant women .

It is estimated that more than 3,000 babies in Canada are born each year with FASD, and approximately 300,000 Canadians are currently living with some form of FASD. Research suggests that the cases of FASD are higher in aboriginal communities as well as rural, remote Northern communities. However, FASD has been found in all communities in Canada regardless of location as well as financial status.

FASD causes mild to severe health problems for those who suffer from it. It can impact delays in development, cause intellectual problems and well as problems learning how to socialize with others. Some common examples of FASD are:

• Learning disabilities (particularly in mathematical concepts);
• Difficulty in understanding that actions have consequences;
• Depression;
• Obsessive-compulsive disorder;
• Physical disabilities such as kidney problems and internal organ problems;
• Skeletal abnormalities, i.e. facial deformities.

FASD can also cause behavioral problems such as:

• Difficulties in handling money and/or telling time;
• Difficulties in reasoning and being able to competently think problems through;
• Difficulties in learning from past experiences and not repeating the same mistakes over and over;
• Difficulties in scheduling, i.e. remembering appointments;
• Difficulty in maintaining socially appropriate behaviors;
• Difficulties in everyday tasks, i.e. paying rent, grocery shopping, job performance.

People with FASD can also develop secondary disabilities; early diagnosis is essential for being able to access professional help and on-going supports. These secondary disabilities can include such issues as:

• Mental health issues;
• Poor performance in school or completion of education;
• Problems with the law;
• Chronic unemployment;
• Drug and/or alcohol abuse;
• Homelessness.

If FASD is suspected, it is vital that a doctor trained in this issue do a medical diagnosis in order to rule out other medical conditions that are usually treatable. A medical diagnosis of FASD involves a team of doctors who are trained to assess psychological, speech as well as everyday functioning of the person. While there is no cure for FASD, proper medical intervention can help to provide those with FASD to lead more productive and satisfying lives.

In order to prevent FASD it is recommended that all women follow these steps:

• As 50% of pregnancies are unplanned, most women do not realize they are pregnant in the early stages. Therefore, if a woman even suspects she may be pregnant, or is planning to become pregnant, cease all alcohol consumption immediately.
• For women who are not using birth control but are having sex, avoid consuming alcohol as there is no way of knowing when you may become pregnant.
• For women who are concerned about their consumption of alcohol, seek the help and advice of your healthcare professional.

It is essential that pregnancy and alcohol consumption are not mixed, since there is no safe amount of consumption during any stage of pregnancy.