Anemia. What are the symptoms? No energy Tired Leg cramps Problems sleeping Pale skin Dizzy Difficulty breathing Trouble concentrating

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What is anemia? Anemia develops when your blood does not have enough healthy red blood cells (RBC). Hemoglobin is an iron rich protein in the RBC that carries oxygen throughout your body. When you have anemia your body organs do not get enough oxygen. This could mean a problem with your hemoglobin or RBC. Anemia What causes anemia? There are many types of anemia. Most are caused by one of the following: Blood loss Decreased or defective RBC Destruction of RBC Some specific examples: Poor diet Ongoing bleeding problems Heart, liver, lung and kidney diseases Hereditary diseases like sickle cell Cancer and/or cancer treatment How do you know if you have anemia? Your doctor can run a blood test called a complete blood count (CBC) which will tell if your hemoglobin is low. Your doctor may do other tests to find the cause, such as a bone marrow test. What are the symptoms? No energy Tired Leg cramps Problems sleeping Pale skin Dizzy Difficulty breathing Trouble concentrating What are the treatments? Always ask your doctor for the best way to treat your anemia. Your doctor must know the cause before treating your anemia. Your doctor may order iron supplements or vitamins. You may need blood transfusions. Medication injections (Erythropoietin/ Epogen) to increase your body s production of RBC. Eat a healthy diet with foods high in iron and vitamin C such as: Organ meats like liver and kidney Fish, oysters, clams, eggs, cheese, milk Fresh fruit, leafy green vegetables, whole grains and broccoli FS 65.3 Data Classification: Public Domain VAM.CT.Anemia(10/12)

Know your CAD Alphabet! Coronary arteries supply your heart with blood and oxygen. Decreased blood flow through these arteries is called Coronary Artery Disease (CAD). CAD is the LEADING cause of death in both women and men in America! Take this to your next doctor s appointment. A Aspirin. Aspirin (or other anti-platelet medication) can reduce the chance of a blood clot blocking the coronary arteries and causing a heart attack. Recommendation: daily 81mg 325mg other: B Blood Pressure. Elevated blood pressure can make the heart work harder. Your blood pressure today: Target blood pressure: less than 140/90 less than 130/80 (Risk Factors) Recommendations: Add beta blocker (if post-mi or other indication) Adjust or add medication D.A.S.H. Diet & other lifestyle changes C Cholesterol. High LDL ( bad ) cholesterol levels increase your chances of having narrowing of the arteries and heart disease. Your last LDL level: Target LDL level: less than 100 less than 70 (Risk Factors) Recommendations: Adjust or add medication Low saturated fat, low cholesterol diet, no trans fats D Do not Smoke! Smoking makes the heart work harder and increases the risk of a heart attack. Recommendations: Quit Date E Exercise. Exercise helps you achieve and maintain a healthy weight, strengthens the heart, and improves your good cholesterol (HDL). Recommendation: 30 min. daily, 5 days a week Choice of exercise FS 66.9 Data Classification: Public Domain VAM.CT.CAD.ALPHA(10/12)

What You Need To Know About Cholesterol Cholesterol comes from food. It is also made by your body. LDL cholesterol is often called bad cholesterol. High LDL levels increase the risk of heart disease. Heart disease can result in an irregular heart beat, heart attack and stroke. Lowering LDL cholesterol can prevent heart attack, strokes, and help prevent surgery. hardened to a solid (such as margarine and shortening). Trans fat increases LDL cholesterol and total cholesterol. To limit these fats use liquid oil instead of tub or squeeze margarine. Eat less snack food such as cookies and crackers that are made up of hydrogenated fats. Lose weight. If you are overweight, limit your calories and get more exercise. Get exercise. At least 30 minutes on most days can help lower LDL cholesterol. It can also help with weight loss. Walking, dancing and swimming are all examples of exercise. Live Well and Control Cholesterol You cannot change some of the risk factors for high cholesterol, such as heredity and age. Current American Heart Association guidelines suggest diet control, regular exercise and weight control to help lower LDL cholesterol. Limit saturated fats. These include animal fats. Some examples are bacon grease, lard, poultry skin, dairy fats and butter. Tropical oils such as palm and coconut oils are also saturated fats. Reduce these fats and replace them with fats that are better for you. Examples of better choices are olive oil, canola oil, nuts, skim or 1% milk and reduced fat foods. Limit trans fats. These are also called partially hydrogenated fats. They are made when oil is Healthy Cholesterol Levels* Type of Cholesterol Total Cholesterol HDL cholesterol ( good cholesterol) LDL cholesterol ( bad cholesterol) Goal Less than 200 (Over 240 is high) > 40 mg/dl (male) > 50 mg/dl (female) Less than 100 mg/dl If you have heart disease, you should have your cholesterol checked at least once a year. * American Heart Association FS 63.7 Data Classification: Public Domain VAM.CT.CAD.CHOL(10/12)

Coronary Artery Disease Guidelines These are important guidelines to follow if you have Coronary Artery Disease (CAD): Take your medications as prescribed by your doctor. Get your cholesterol levels checked at least once a year. Get screened for diabetes. Follow your CAD action plan. If you smoke, quit. Ask your doctor about starting an exercise program if you have not already. Manage your weight. These guidelines are based on guidelines developed by the American Heart Association and the American College of Cardiology. FS 78.3 Data Classification: Public Domain VAM.CT.CAD.GUIDELINES (10/12)

Take Action to Reduce Your Risk of Heart Disease Heart disease is a lifelong condition. But you can control the risk factors for heart disease. By doing so you might prevent a heart attack and increase your chances for a long and vital life. For heart disease, there are some risk factors that you cannot change. You cannot change your family or your age. Age, for women, becomes a risk factor at age 55. Men are at higher risk starting at age 45. Here is a quick review of risk factors you CAN change. High blood cholesterol Too much cholesterol in your blood builds up in the walls of the vessels that supply blood to the heart. This buildup can lead to blockages. You can lower your cholesterol by having a heart healthy eating plan and staying at a healthy weight. It can also help to be active every day and, take medicine, if needed. Physical inactivity Try to do at least 30 minutes of exercise on most, if not all, days of the week. This includes brisk walking, light weight lifting, or even house cleaning or working in the garden. If you need to, divide the 30 minutes into shorter periods of at least 10 minutes each. Smoking Smoking leads to changes in the blood flow that can lead to a heart attack. It is not easy to quit, but make a plan and you can do it. Or try an organized program or medicine. Ask your doctor if either is right for you. High blood pressure There are many ways to get your blood pressure under control. Follow a heart healthy eating plan and reduce your salt intake. Be active every day, and stay at a healthy weight. Your doctor may also give you medicine to lower your blood pressure. Diabetes About 11 million Americans have diabetes. Many more have it and do not know they do. About two-thirds of those with diabetes die of heart attacks or blood vessel disease. Modest changes in diet and level of activity can prevent or delay the development of diabetes. Diabetes can be detected with a blood sugar test. If you have diabetes, it is vital that you keep it under control. Overweight/obesity If you are overweight, even a small amount of weight loss will help lower your heart disease risk. Losing 10 percent of your body weight can help. You will need to make a change in lifestyle to have lasting weight loss. Adopt a healthy, lower calorie eating plan, and be more active. This information is based on NIH Publication No. 06-5715, Your Guide to a Healthy Heart. You can get a copy on the NIH Website (www.nih.gov) or by calling (301) 592-8573. FS 75.6 Data Classification:Public Domain VAM.CT.CAD.RISK(10/12)

Heart Failure Checklist Notify your doctor if: You have fatigue, loss of energy. You have steady weight gain (two to three pounds in one day or more than five pounds in five days). You have swelling of the ankles, legs or abdomen that does not go away after keeping your feet and legs raised. You have decreased urination during the day; extra urination at night. You develop a persistent cough. You have shortness of breath (especially while lying flat or with any type of activity). You notice any side effects from your medications. Ask your doctor whether you should receive a flu shot. The American Heart Association recommends that people with chronic heart disease receive a flu shot every fall. The shot can lessen the chance of serious complications from the flu, such as pneumonia. Because the virus is constantly changing, it is important that you get a flu shot every year. Last year s shot will not protect you this year. You should also ask your doctor about a pneumonia vaccine. FS 68.4 Data Classification: Public Domain VAM.CT. HF.Checklist(10/12)

Heart Failure and a Low Sodium and Salt Diet Why Is A Low Sodium And Salt Diet Important? It is important to reduce your sodium and salt when you have heart failure. Heart failure causes the body to hold onto extra sodium. The extra sodium causes extra fluid to build up in your body. You may notice swelling in your: Feet and ankles Abdomen Face and hands Extra fluid makes your heart work harder. You may notice shortness of breath and weight gain. What Is A Low Sodium Diet? Many people eat more sodium than they need in a day. Healthy adults should have less than 2,300 mg of sodium per day (about 1 teaspoon of salt). If you have heart failure, you should probably have less. You should discuss appropriate sodium intake with your doctor. How Can I Cut Back On Salt And Sodium? Stop adding salt to your food. Buy your favorite foods in a low sodium version. Pick foods naturally low in sodium. Learn to read food labels. Take the salt shaker off the table. Do not add salt when cooking. Experiment with low- or no-salt herbs, spices, and seasoning mixes. Dried and fresh herbs such as garlic, garlic or onion powder (not salt) add flavor, not sodium. Sprinkle fresh lemon juice over vegetables or salads. Season or marinade meat, poultry, and fish with onion, garlic, and your favorite herbs before cooking to bring out the flavors. Avoid spices and seasoning mixes with the word salt or sodium listed in the ingredients. Use low-sodium substitutes for the foods you like, example: use fresh pork loin instead of country ham. You can also remove some sodium from canned foods by rinsing them with water. Remember, this does not remove all of the sodium. Select low-sodium cheeses or yogurt when making sauces. Choose fresh fruit and vegetables whenever possible. Frozen vegetables and fruit are lower in sodium than canned. Dried beans, peas, and lentils are low sodium and contain fiber. Do not add items such as a ham hock or salt pork when cooking. FS 68.8 Data Classification: Public Domain VAM.CT.HF.LOWSALT(10/12) This information should not replace the care you receive from your doctor or other health care provider. Should you have questions,

High Blood Pressure Facts Blood pressure is the force of blood pushing against artery walls. If this force is too strong for a long period of time, you have high blood pressure. High blood pressure or hypertension increases your risk for heart disease and stroke. Healthy Activities Gardening Walking Riding a bike Swimming Aerobics Walking your dog Healthy Food Options What increases your risk? Fruits and vegetables Fish Grains Low fat milk and low fat yogurt Smoking Alcohol Inactivity High fat diet Over weight Low calcium diet Stress Blood Pressure Recommendations What can you do to prevent high blood pressure? Exercise regularly Stay at a healthy weight Avoid alcohol Avoid foods high in fat and salt Check your blood pressure often Keep a food diary Regularly visit your doctor Blood Pressure Category Systolic (top) (Adults - 18 Years or Older) Diastolic (bottom) Normal <120 <80 Pre-hypertension 120-139 80-89 Hypertension 140 or higher 90 or higher *American Heart Association If your doctor prescribes medicine for high FS 68.8 Data Classification: Public Domain VAM.CT.HighBPFacts(10/12)