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From PEKN 1P93 Winter 2014: Group 23: Disease Prevention
Humans are vulnerable to a variety of illness and disease, and obtaining the knowledge to prevent these diseases now, will reduce the risk of these problems affecting the future. In particular, heart attacks in the middle aged, specifically those of the male gender have been a major issue throughout history. Despite this fact, only recently has the condition been researched as increasing human longevity and obesity rates have caused it to become one of the leading causes of death worldwide. When comparing myocardial infarction rates between men and women, men are seen to be at a prominently higher risk. One cause of this, may be because middle aged men generally have a higher level of cholesterol creating atherosclerosis (plaque buildup) within the coronary arteries of the heart. Another cause is the higher obesity rates in the male population, 60% of men compared to 50% of women. Both of these have been proven to be major risk factors of heart attacks. Bearing these facts in mind, it is evident that the public should be well informed of research and knowledge of prevention of myocardial infarction. Knowledge of prevention and risk factors of heart attacks could assist in individual survival as well as cut or even negate the amount of deaths this devastating disease can cause.
The first person in history to contribute to the anatomy of heart was Claudius Galenus. Galen preformed dissections on animals to better understand the circulatory system during his life time from 129-217 AD. Since it was against the law to use human cadavers, he used animals for his research. However, the use of animals presented flaws in his research about the human body because humans and animals have various differences. Nevertheless Galen is now recognized as the first scientist to realize that there were two parts to the heart and distinct differences in the venous and arterial blood. Although his research was somewhat flawed he recognized the heart pumps blood in a cycle to the body organs.
During the 15th century Leonardo da Vinci investigated the coronary arteries and the different pathways of the heart; which lead to William Harvey’s discoveries of the heart during the late 1500’s.  Harvey comprehended that the blood flows through the body in one continuous circle though veins and arteries going from larger to smaller. He also discovered that the blood also passed through the lungs where oxygen was added to the blood then it returned to the heart to be pumped out again. His final discovery was that the heart beat so that the blood could be pumped and forced to all the organs in the body.
The last significant heart discovery was done by Friedrich Hoffmann during the 1700’s. He made the connection between heart disease and the decreased levels of blow that flowed through the coronary arteries. Finally, during the 20th century heart diseases became more common especially in people who drank, smoked or were inactive. James Herrick, a cardiologist, decided upon the common name “heart attack” for what was medically known as myocardial infarction.It was around this time that scientist realized that a decrease in physical activity effected a person’s chances of having a heart attack. Dr. Bhatt stated that the more physical activity a person had the better off they were. With the increase of technology heart attacks have become more common throughout history. People are beginning to relying on this technology to provide them with entertainment and therefore people are not getting as much physical activity at those in previous years.
 Target Audience
Cardiovascular (heart) disease remains the leading cause of death for men in the United States. The target audience being focused on is middle-aged men because men are two to three times more likely to have a heart attack than women and the older you get, the more likely you are to develop some degree of heart disease. Men over the age of 40 have nearly a 50% chance of developing heart disease during their lifetime. Men aged between 30 and 50 years are often not very physically active because they are busy with work and family commitments. Lack of physical activity or exercise is linked to a range of health problems including heart disease and heart attacks.
Many studies have concluded that physical activity can reduce the risk of heart disease. Specifically there are five studies that have proven physical activity to reduce the risk of coronary heart disease in men.
In 2011 Japanese scientist first analyzed the significance of starting early to reduce the risk of heart failure in the future. 51 healthy and physically active young men had blood samples taken which were examined for high cholesterol and body measurements were taken. It was found that even though men have a higher metabolism at a younger age, age does not play a significant role in overall body health. They concluded that high cardiorespiratory fitness from an early age can result in a reduced risk of cardiovascular disease in the future.
Similar to Japan, Poland had a 25 year prospective study to investigate the influence of lifetime physical activity on middle aged men in regards to cardiac health. In the study, 101 men free of cardiovascular symptoms were separated into three groups:
1. Low to moderate intensity physical activity
2. High level physical activity
3. Very high level of physical activity
Each week for 25 years (1984/1985 – 2011/2012) each group was allotted a specific amount of physical activity and it was concluded that those with high and very high physical activity had a more favorable cardiovascular health profile than men with a lower physical activity lifestyle.
Another study in 2008 was funded by the National Heart, Lung, and Blood institute to discover what levels of physical activity were required for the prevention of incident heart failure and other cardiovascular events in older adults specifically men. Out of the 5503 participants 2311 were men and of these men for two weeks each of them were subjected to no, low, medium, and high levels of physical activity.. Similarly another short term study was conducted in the Republic of Serbia. For three weeks 60 men who were suffering from myocardial infarction took part in an organized exercise program. Again for three weeks each participant participated in the program and had to exercise for 60 minutes daily varying intensity. The obtained results indicated that even short term exercise programs proved to be effective in increasing the cardiorespiratory fitness of those suffering from myocardial infarction.
Finally the last significant study was conducted at Harvard University in 1977 in which Harvard alumni students examined the impact of the quantity as well as the intensity of physical activity on those who were at risk to coronary heart disease as well as the impact of other coronary risk factors. The team of students followed 12516 middle aged and older men from 1977-1993. Each week participants were subjected to various levels as well as various lengths of physical activity. They had concluded that total physical activity and vigorous activity showed the strongest reduction in risk of coronary heart disease this results also extended to men who already had multiple coronary risk factors.
 Existing Physical Activity Programs
1. Walk of Life 
The Toronto Walk of Life offers a choice of six different events to actively participate in and support the cause of prevention, education and cardiac rehabilitation. Take part in any 1KM, 3KM & 5KM walk; 5KM & 10KM run. A percentage of the proceeds are donated to the Cardiac Health Foundation of Canada.
2. Fit for Heart 
Being physically active is vital for good health and well-being; regular physical activity can lower your risk of heart disease and stroke. The Heart&Stroke Fit for Heart event raises money for critical heart and stroke research and education that continues to protect and save lives. Fit for Heart enables the community to participate in a fun, fitness-based, fundraising activity, while learning about the benefits of heart healthy choices.
3. Big Bike 
Bike Bike is a heart-pumping 15-20 minute ride aboard a bicycle built for 30. It is a great way for family and friends to get together for a memorable and meaningful team building experience. Everyone will feel the joy and excitement of living, and giving from the heart. Teams made up of 29 riders with a goal to raise $50 or more. Bike Bike events take place in over 200 communities with close to 70,000 participants that are helping to make a difference to the heart health of all Canadians.
4. Active for Life 
Active for life is a 10 week flexible program that encourages employees in the workplace to become more active on a regular basis. Middle aged men are usually more focused on their career than their health and the amount of physical activity they get each day keeps decreasing as they work longer hours. Increasing physical activity reduces the risk of heart diseases. This program helps employees stay healthy, be more productive and improve their job performance. Physical activities can range from walking at lunchtime, taking the stairs rather than the elevator, doing chores and yard work after their workday, to more vigorous activities like swimming, running, or playing tennis. This program is successful because it can be adapted to each employee depending on his or her abilities.
5. Heart at Work 
Being healthy on the job is essential. The healthier employees are, the fewer days they will be absent from work and the more they will have a sense of belonging to their organization. They are also more likely to feel happy and enjoy a good quality of life, both at work and at home. Heart at Work is a program offering simple, effective ideas for encouraging healthy eating and regular physical activity in the workplace. Geared to all types of businesses, Heart at Work gives workers information on different risk factors for cardiovascular disease and encourages them to adopt healthy eating habits and to engage in regular physical activity.
 Best Practice Activity Suggestions
1.Warm up Games
Warm up games are good for individuals because it allows the participants to ease into any demanding physical activity. Men with the risk of a heart attack cannot start at their maximum potential since it could be detrimental to the heart. However, warm up slowly allows individuals to move into more extreme workouts. For example, playing capture the flag as a warm allows individuals to slowly start running and building their heart rate, when they feel ready, it is easier to engage in more demanding tasks.
2. Circuit Training
Circuit training can be beneficial for patients who have experienced a heart attack, most circuits involve cardiovascular exercises which are crucial when helping decrease the risks and symptoms of heart attacks states cardiovascular exercise can help reduce high blood pressure, LDL cholesterol and body weight which all contribute to the aid of reducing the risk of a heart attack. Circuit training can include exercises such as jumping jacks, wind sprints, step ups etc. Any exercise that increases heart rate can be used in this form of circuit.
3. Strength Training
Strength training is beneficial to one's health as it allows the body to grow stronger and develop at a faster rate. Using strength training such as weightlifting, aids the body in both muscle and bone growth, the more you exercise, the healthier the body will become. Strength training helps reduce body weight which is beneficial for those at risk of a heart attack because it takes stress off the the heart. With a smaller area the heart has to send blood to, there is no need for the heart to have to work as hard which decreases the likelihood of a heart attack.
4. Recreational Sports
Recreational sports such as hockey, soccer and basketball are great ways for an individual to participate in physical activity. Playing a sport allows individuals to get their daily need of physical activity while having fun. Recreational sports are not as physically demanding as training, however it is still beneficial from a health standpoint. Using sports is as exercise is still able to raise the heart and fulfill the needs to reduce the risk of having a heart attack.
5. Cool Down
Cool downs are imperative after a physically demanding workout, it allows the body to regain resting state. Especially for individuals at risk of attack seeing as how it gives the heart a chance to slow down properly and a moderately decreasing rate. For example, when running, it is favourable to go from a running state, to a jogging state, to a walking state and finally a resting state. This gives the heart a chance to slow down at a moderate speed instead of drastically reducing. This is important for individuals at risk of heart attacks since it does not put extensive stress on the heart.
 Future Directions
In order for the rate of heart attacks in middle aged men to decrease, it is imperative for the men to be educated on the effects a heart attack can have on the body. The best way for anyone to become educated on any situation involving the body would be to visit their family doctor. Family physicians are able to provide information for anyone's well-being. Additionally, there are many programs that have developed in order to educate and help bring awareness to the ongoing concerns related to heart attacks and heart disease in general. The Heart and Stroke Foundation is a prime example of an organization who's primary goal is to raise awareness on heart attacks and how to prevent problems from occurring. There are multiple resources on a global level that are available to further educate an individual on how to keep their heart healthy. Moreover, the most beneficial way men can reduce their risk of having a heart attack would be to include physical activity in their daily life. Exercising allows the body to stay strong and healthy in order to fight off diseases such as heart attacks. The more physical activity in an individuals life, the better off they will be.
 External Links
Heart&Stroke Foundation http://www.heartandstroke.com
Cardiac Health Foundation of Canada http://www.cardiachealth.ca/index.php
American Heart Association http://www.heart.org/HEARTORG/
National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov
World Heart Federation http://www.world-heart-federation.org
 Notes and References
- ↑ Cooper R., Cutler J., Desvigne-Nickens P., Fortmann S., Friedman L., Havlik R………. and Thom T, (2000). Trends and Disparities in Coronary Heart Disease, Stroke, and Other Cardiovascular Diseases in the United States.
- ↑ Krucik, George. (2012, April 6). The History of Heart Disease. Retrieved from http://www.healthline.com/health/heart-disease/history#1
- ↑ Ribatti, Domenico. (2009, Sept 21). William Harvey and the discovery of the circulation of the blood. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776239/
- ↑ Krucik, George. (2012, April 6). The History of Heart Disease. Retrieved from http://www.healthline.com/health/heart-disease/history#1
- ↑ A heart attack prevention checklist. (Cover story), (2013). Harvard Men’s Health Watch, 17(12), 1-7.
- ↑ International Heart Institute of Montana. (2012). Men’s Heart Health Program. Retrieved from http://www.ihimontana.org/Mens_Heart_Health_Program
- ↑ Yagura, C., Takamura, N., Goto, Y., Sugihara, H., Sota, T., Oka, S., Shimoda, T., & Yoshizumi, K. (2012). Cadiorespiratory fitness and metabolic markers in healthy young men. Journal of Physical Therapy Science, 23(6).
- ↑ Kwaśniewska, M., Jegier, A., Kostka, T., Dziankowska-Zaborszczyk, E., Rębowska, E., Kozińska, J., & Drygas, W. (2014). Long-Term Effect of Different Physical Activity Levels on Subclinical Atherosclerosis in Middle-Aged Men: A 25-Year Prospective Study. Plos ONE.
- ↑ Patel, K., Sui, X., Zhang, Y., Fonarow, G. C., Aban, I. B., Brown, C. J., Ahmed, A. (2013). Prevention of heart failure in older adults may require higher levels of physical activity than needed for other cardiovascular events. International Journal of Cardiology, 168(3), 1905-1909.
- ↑ Pantelić, S., Popović, M., Miloradović, V., Kostić, R., Milanović, Z., & Bratić, M. (2013). Effects of short-term exercise training on cardiorespiratory fitness of male adults with myocardial infarction. 25(8).
- ↑ Sesso, H., Paffenbarger, R., & Lee, M. (2000, April 7).Physical activity and coronary heart disease in men. Retrieved from https://circ.ahajournals.org/content/102/9/975.full
- ↑ Myres, J(2014). Exercise and Cardiovascular Health. American Health Association. http://circ.ahajournals.org/content/107/1/e2.full