PREVENTING HEART ATTACKS

AND STROKES

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2013 A. Barbey

Introduction
Over the past 10 years an average of one Schlumberger employee has died every
month from heart attacks or strokes!
Worldwide, 20,000 people die each day from a heart attack.
Heart attacks and strokes kill 10 times more than road vehicle accidents.

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Heart attacks and strokes

A heart attack, or myocardial infarction, is the clogging of a coronary artery the
arteries that nourish the heart. A heart attack can be fatal.

A stroke is the clogging of an artery going to the brain. A stroke can lead to
paralysis, speech impairment, loss of vision or memory. It can be irreversible.

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Heart Attacks
What are the symptoms of a heart attack?
The typical symptom of a heart attack is severe chest pain, most often persistent and
described as tightness, squeezing or crushing. The pain is usually located in the
center of the chest, behind the sternum. The pain:
can spread to the jaw, neck, shoulders, back and left arm or hand
lasts more than 15 minutes
occurs at rest or during activity
is often accompanied by palpitations, fainting, cold sweats, nausea, vomiting,
shortness of breath
may be accompanied by fear, anxiety or a feeling of
imminent death
may be accompanied by signs of shock and loss of
consciousness.
Chest pain lasting more than 15 minutes
Possible Heart Attack
=> Emergency Medical Services
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Heart Attacks
What to do if a heart attack is suspected?
Immediately call for emergency medical service or transport the victim to an
emergency medical facility.
Have the person sit, rest and stay calm.
Loosen any tight clothing (collar, tie, belt)
Have the person chew a tablet of aspirin (if not allergic)
If the victim is unconscious and not breathing
Probable cardiac arrest (heart no longer beating)
Cardiopulmonary Resuscitation [CPR] (30 external chest compressions and 2
ventilations or 100 chest compressions per minute)
Use of an Automatic External Defibrillator (AED) if one is available.
Do you know how to perform CPR and use an AED?

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Strokes
What are the symptoms of a stroke?
Early recognition of a stroke is essential to reduce the severity and increase the
chance of recuperation.
Rapid recognition of stroke is based on the Act FAST rule:
F for face. Ask the person to smile. Does one side of the face droop?
A for arms. Ask the person to raise both arms. Does one arm drift down?
S for speech. Ask the person to repeat a simple phrase. Is their speech slurred
or strange?
T for time. If you observe any of these signs, immediately call for emergency
medical service.

Facial asymmetry

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Poor lifestyle habits are responsible for the clogging of the arteries
resulting in cardiovascular risk factors.
The more cardiovascular risk factors an individual has, the greater the risk of
clogging the arteries and having a heart attack or stroke in the years to come.
The major cardiovascular risk factors are:
high blood pressure
tobacco use
high blood sugar (diabetes)
physical inactivity
overweight or obesity
high blood cholesterol
inappropriate alcohol use
Other factors to a lesser degree are:
lack of sleep
poor stress management

A clogged artery

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Are you at risk of having a heart attack or stroke?

Answer the questions on the next slide.
The more yes answers - the higher your cardiovascular risk !
If you cannot answer a question, it is highly recommended that you see a doctor and
get that answer.

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Are you at risk of having a heart attack or stroke?

1-Has anyone in your family had a heart attack or stroke?
2-Are you over 55 years of age?
3-Are you a smoker?
4-Have you ever been told that your blood pressure was over 140/90 mm Hg?
5-Has a blood test ever found an elevated cholesterol level?
6-Do you know if you have diabetes or if your fasting blood sugar is elevated?
7-Are you overweight?
8-Are you getting less than 30 minutes of moderate physical activity daily?

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High Blood Pressure

What is Blood Pressure?
Blood pressure is the pressure exerted by the blood on the walls of the arteries.
Blood pressure is described with two numbers such as120/80 mm Hg
the first number is the systolic pressure corresponding to the pressure in the
arteries when the heart contracts
the second number is the diastolic pressure corresponding to the blood
pressure in the arteries when the heart rests between heart beats.
Blood pressure is measured in millimeters (mm) or centimeters (cm) of mercury (Hg)

Pressure!

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High Blood Pressure

What is Normal Blood Pressure?
Ideal blood pressure should be less than 120/80 mm Hg or 12/8 cm Hg.
High blood pressure is defined as 140/90 mm Hg or higher.
Blood pressure should be measured in a lying down position after a 10-minute rest
period, at both arms and should be confirmed over two or three different
consultations.
Blood pressure between 120/80 and 139/89 mm Hg is considered as prehypertension. A person with pre-hypertension will often develop high blood pressure.

Pressure!

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High Blood Pressure

What are the symptoms of high blood pressure?
Most people who have high blood pressure have absolutely NO SYMPTOMS
whatsoever and can only know that they have high blood pressure by having it
measured by a health care professional.
When symptoms appear they can include:
headaches
dizziness
nose bleeds
buzzing in the ears
vision defects
palpitations and breathlessness upon slight exertion

It may take years for symptoms to appear.

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High Blood Pressure

What are the causes of high blood pressure or hypertension?
95% of all cases of hypertension have no known cause. All medical investigations
are normal. This is known as primary or essential high blood pressure.
Treatment of high blood pressure
High blood pressure is rarely an acute medical emergency and it takes years to
cause a serious problem. Treatment usually requires taking medication for life. This
will avoid the severe complications of high blood pressure.
Lifestyle improvements are important but will reduce blood pressure only slightly.

Medication to treat high blood pressure must be taken daily and for the
duration of your life! If you stop medication for high blood pressure, it will
reoccur within a few weeks.
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Tobacco Use
Worldwide 1 billion people smoke. 500,000 die each year in the USA alone.
In Schlumberger, 35% of employees smoke.
Smoking is a major cardiovascular risk factor that increases bad cholesterol, raises
blood pressure and increases the risk of heart attacks and strokes.
All forms of tobacco increase the cardiovasular risk:
cigarettes
pipes, cigars
sheesha (1 sheesha session = 40 cigarettes!)
chewing tobacco

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Tobacco Use
It is never too late to stop smoking.
There are many techniques to reduce the undesirable symptoms of nicotine
withdrawal: nicotine patches, gums, lozenges and sprays.
Tips to stop smoking:
MOTIVATION is essential. Once you have decided, stop completely.
Get rid of smoking paraphenalia (ashtray, lighter, matches)
Tell your friends, colleagues and family.
Set a target date. Vacations are a great time to stop.
If possible, stop with a friend, colleague or your spouse.
Exercise walk or jog relax, invest in a hobby or intellectual activity to keep
your mind off smoking.
Avoid temptation. Associate with non-smokers.
Each time you want to light up, drink a glass of water.
Avoid coffee and alcohol.
Once you stop, never, never light up again.

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High Blood Sugar

People with diabetes have levels of blood sugar (also called blood glucose)
that are too high.
Blood glucose is necessary for the body energy but too much sugar in the blood
corrodes the arteries and over time provokes heart attacks and strokes.
Type 2 diabetes is the most common form of diabetes in Schlumberger.
It is mainly diagnosed in overweight or obese people over 35 or 40 years of
age.
Symptoms are often nonexistent with diagnosis made during a medical exam
through a blood or urine test.
When symptoms do exist there may be increased thirst, urination, fatigue,
irritability and nausea, along with repeated infections, impotency in men and
menstrual irregularities in women.

A simple urine or blood test can detect type 2 diabetes.

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High Blood Sugar

Although eating sugar doesnt cause diabetes, sweet foods and beverages can make
managing blood glucose levels difficult.
Make healthful food choices. It is recommended to reduce the following:
sugar, candy, chocolate
ice cream
soft drinks
jam and jelly
cookies and cake

Do you know your fasting

blood sugar level?

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Physical Inactivity
Physical inactivity, also called sedentary lifestyle, is a major cause of heart
attacks and strokes.
We spend hours sitting in front of the computer, the television or in the car.
Physical activity burns calories, a major factor in weight loss.
Even modest, but regular, levels of physical activity improve a persons health and
reduce heart attacks and strokes. The more you move, the better it is for your health.
walk instead of taking the car
use the stairs instead of the elevator
reduce screen time in front of the computer, television screen and video games
shop, wash the car, play with the kids, get out and MOVE!

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Physical Inactivity
In the course of a normal day, most people rarely walk more than 3,000 steps.
Anything below 5,000 steps is considered sedentary.
6,000 steps daily reduces blood pressure, heart rate, diabetes risk, bad cholesterol,
stress and anxiety.
10,000 steps = 5 miles = 7 kilometers = 1 hour of walking
If you walk one hour every day of the year, you will consume calories and lose
weight without any additional dieting.

A minimum of 30 minutes of brisk walking each day is recommended. The

ideal is one hour of walking per day. Of course nothing stops you from
jogging, running, bicycle riding, swimming, playing tennis, etc.

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Overweight and Obesity

Overweight and obesity, as measured by a persons body mass index (BMI) is
a major health problem worldwide.
At Schlumberger more than 45% of the employee population is overweight or obese
and 1% is morbidly obese.
BMI =

weight in kilograms
or
height in meters x height in meters

Examples:
100 kg and 1.75 m = BMI 32.6

weight in pounds x 703

height in inches x height in inches

221 pounds and 69 inches = BMI 32.6

BMI
<18.5
= Underweight
18.5 to 24.9 = Healthy Weight
25 to 29.9 = Overweight
>30
= Obese
>40
= Morbidly Obese
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Overweight and Obesity

Overweight and obese people have excess body fat which in turn increases:
clogging of the arteries
blood pressure
blood levels of bad cholesterol and triglycerides (another body fat) and blood sugar.
In addition, overweight and obese people have an increased risk of:
certain cancers
respiratory problems and sleep apnea
osteoarthritis of the knees and hips

Do you know your height and weight? Calculate your BMI now.

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How to reduce excess weight?

The solution = healthy eating + more physical activity
There are no miracle solutions. One does not lose weight overnight.
Some simple advice to get started:
Reduce or avoid fried foods such as fried fish, chicken or fries.
Reduce or avoid sauces, butter and margarine.
Reduce consumption of sugar, pastry, cake, chocolate, candy, jams, jelly,
ice cream.
Avoid energy drinks usually high in sugar content.
Reduce or avoid soft drinks and colas. Replace with water or fresh fruit juice.
Prefer baked, grilled, steamed or poached foods.
Prefer low- and nonfat milk, cheese, yogurt and dairy products.
Eat all the fish you want - not fried.
Eat vegetables, whole grains, salads, beans and fruits in abundance.

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How to reduce excess weight?

More advice:
Do not skip breakfast or any other meal.
Eat small meals frequently.
Reduce portion size.
Avoid seconds.
Snacking is acceptable between meals but be careful what you nibble on.
Drink a glass of water before each meal. It will reduce appetite.
Reduce or completely avoid alcoholic beverages.
Reduce salt intake.

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How to reduce excess weight?

A few more tips:
Take a photograph of yourself before you start.
Set realistic goals. Losing 1 to 2 kg. (2.5 to 5 pounds)/ month is a realistic objective.
Friends, family and colleagues need to be informed that you are changing your
eating habits.
Avoid temptation. Do not buy high-calorie, fat-rich and sugar-rich foods.
Read food labels and look at the calorie levels of foods. An eye opener!
Reduce screen time.
Increase physical activity.

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High cholesterol
Too much cholesterol clogs the arteries.
Cholesterol can be divided into good and bad.
Foods that promote good cholesterol include:
fish
vegetable fats and oils (olive, peanut, colza, corn, sunflower)
whole grains, beans, nuts
vegetables and fruits
Foods that increase bad cholesterol include:
whole-milk dairy products (butter, cream, cheese)
certain meats pork, lamb and beef
egg yolks
certain tropical oils (coconut, palm)
Do you know your cholesterol level?

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Other issues that increase cardiovascular risk

Alcohol - Alcohol contains only calories. Nothing of nutritional value.
Sleep - Sleep-deprived people have a higher risk of cardiovascular disease. On the
average people sleep 1.5 to 2 hours less per night than their grandparents. Lack of
sleep can increase weight gain, type 2 diabetes and blood pressure.
Stress Poor stress management can increase blood pressure and heart rate,
however, stress alone DOES NOT provoke heart attacks.

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For more information read the Preventing Heart Attacks and

Strokes Schlumberger brochure.
A pdf version is available in numerous languages at:
www.healthhub.slb.com / Schlumberger Health Publications.

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