Tobacco Use and Cholesterol and Blood Pressure

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Hello, everyone my name is Jennifer Youngblood, and I’m the tobacco cessation educator with the health and preventive services team at Optima Health. Every November we participate in the Great American Smokeout event held by the American Cancer Society. This year, although different from any other, we wanted to create a great presentation for this event.

Since most, if not All, of you participate in a yearly wellness event, I'm sure you've all heard the term biometric screening. Because a lot of you inquire about how to improve those biometric screening numbers each year, we decided to incorporate one big influencer of these results or these numbers: Tobacco use. Did you know that tobacco use affects your weight, Your body mass index, cholesterol and blood pressure as well as blood glucose and A1c? Yes, it sure does. Who knew that, right?

So, let's get started on today's agenda. We are going to talk about workplace wellness programs and then we're going to touch on biometric screenings. And then what I have done is I have created one big presentation and I divvied it up into 3 smaller ones. So, the one we're going to focus on in this presentation is how tobacco use affects cholesterol and blood pressure.

So, here we are with workplace wellness programs. Workplace wellness programs have become increasingly popular as employers have aim to lower healthcare costs and improve employee health and productivity. In 2018, 82% of large firms and 53% of small employers in the United States offered some sort of wellness program. This group has been aided by public investment, such as the affordable care act, which included funds to promote the development of workplace wellness programs. These workplace wellness programs tend to focus on modifiable risk factors of disease such as nutrition, physical activity and smoking cessation. Workplace wellness programs include a coordinated set of activities that support employees and making changes to health behaviors that may reduce their risk for certain chronic conditions. And enable employees with existing diagnosis to manage them more effectively. Comprehensive multi-component programs typically include health assessments and biometric screening to quantify risk factors and education and coaching for lifestyle behavior modification for things like tobacco cessation, physical activity promotion, stress reduction and weight management. And in some cases, employers offer chronic disease management.

So, let's take a look at biometric screenings since that's our focus today - how tobacco use affects our biometric values and more specifically our cholesterol and blood pressure. A biometric screening is a clinical screening that's done to major certain physical characteristics. It can be used to assess your height, your weight, your body mass index (or BMI), your blood pressure, cholesterol and blood sugar. The goal of a biometric screening is to give a snapshot of your health and alert you to any changes in your health status. The screening may be offered by your employer, your union, a public health organization or nonprofit groups. Tt may also include wellness counseling and education, risk assessments and exercise programs. Biometric screenings Aren't necessarily a substitute for a regular physical examination by your health care provider as it doesn't diagnose disease, but it may indicate possible risk factors. Let's take a closer look.

Again, a biometric screening aims to alert you to any possible health risk. It also provides an easy way to keep track of changes in your vital statistics from year to year. The screening process is quick, and it usually takes place at your workplace. Your test results are often available right away and can alert you to potential health conditions such as diabetes, high blood pressure and heart disease. Employers use biometric screenings to get a sense of employee health risks. Sometimes employers offer incentives to encourage employees to participate in the screening and improve their health. During a biometric screening, your vital statistics are measured and bloodwork may be done as part of the screening also. A biometric screening is typically used to measure and assess your weight, your height, your waist measurement, your body mass index (BMI or which is an estimate of your body fat based on your height to weight ratio), your blood pressure and pulse measurement, Fasting blood glucose and A1c levels, blood cholesterol and triglycerides. Some screening programs may include a measure of your aerobic fitness or ask about your tobacco use or exercise habits.

So, now, for the nuts and bolts of our presentation - how tobacco use affects cholesterol and blood pressure. Despite a constant flow of messages reminding Americans of the health risks of tobacco use and despite a steady decline in the proportion of Americans who used to back during the last 50 years, more than 20% of Americans can continue to use tobacco on a regular basis. You probably already know that tobacco use is bad for your lungs. Did you know it also makes you more likely to get high blood pressure and heart disease? The nicotine and cigarette smoke is a big part of the problem. It raises your blood pressure and heart rate. It narrows your arteries and hardens their walls and makes your blood more likely to clot. It stresses your heart and sets you up for a heart attack or a stroke.

Tobacco use causes about 1 in every 5 deaths in the United States each year. It's the main preventable cause of death and illness in the United States. Tobacco use harms nearly every organ in the body Including the heart blood vessels, lungs, eyes, mouth, reproductive organs, bones, bladder and digestive organs. This section focuses on how to use effects the heart and the blood vessels. The chemicals in tobacco smoke harm your blood cells. They can also Damage the function of your heart and the structure and function of your blood vessels this damage increases your risk of atherosclerosis. And that's an awful big word. What in the world is atherosclerosis? It’s a disease in which a waxy substance called plaque builds up in your arteries. Overtime, plaque hardens and narrows your arteries. This limits the flow of oxygen rich blood to your organs and other parts of your body.

Ischemic heart disease occurs if the plaque builds up in your arteries that supply blood to the heart called your coronary arteries. Overtime heart disease can lead to chest pain, heart, attack, heart failure. Um, arrhythmias, or even death. Tobacco use is a major risk for heart disease. When combined with other risk factors such as unhealthy blood cholesterol levels, high blood pressure and overweight or obesity, tobacco use further raises the risk of heart disease. Any amount of tobacco use, even light tobacco use or occasional tobacco use, damages the heart and blood vessels. Secondhand smoke also can harm the heart and blood vessels. Secondhand smoke is the smoke that comes from the burning end of the cigarette, cigar or pipe. Secondhand smoke also refers to the smoke that's breathed out by a person who is using tobacco. Secondhand smoke contains many of the same harmful chemicals that people inhale when they smoke. Secondhand smoke can damage the heart and blood vessels of people who don't use tobacco in the same way that active tobacco use harms people who do use tobacco. Secondhand smoke greatly increases adults’ risk of heart attack and death. Researchers know less about how cigar and pipe smoke affects the heart and blood vessels than they do about cigarette smoke. However, the smoke from cigars and pipes contains the same harmful chemicals as the smoke from cigarettes.

Also, studies have shown that people who smoke cigars are at an increase for heart disease. When it comes to cholesterol, there are 2 terms worth knowing: (1) hyperlipidemia – means your blood has too many lipids (or fats such as cholesterol and triglycerides). One type of hyperlipidemia called hypercholesterolemia means there's too much LDL or too much bad cholesterol in your blood. This condition increases fatty deposits in your arteries and the risk of blockages. Another way your cholesterol numbers can be out of balance is (2) your levels of good cholesterol can also be too low. With less good cholesterol to remove the cholesterol from your arteries, your risk of atherosclerotic plaque and blockages increase. The good news is high cholesterol can be lowered: (1) by reducing the risk of heart disease and stroke, (2) by stopping tobacco use. Tobacco smoke can raise levels of blood fats also known as triglycerides and make your good (your HDL) cholesterol go down. So, because of this, it's important to know your numbers.

It's important to know where your cholesterol falls. And there's a picture on here that gives us a little bit of a guide. Overall about our cholesterol: high cholesterol would be considered 240 or higher, borderline high cholesterol would be between the 200 - 239 range, And the desirable range would be less than 200. Now, we can even go a little bit further and break down our good cholesterol and our bad cholesterol but I just wanted to give you a basic understanding of pretty much anything 200 and lower is good. We also want to know our blood pressure number. High blood pressure, also referred to as hypertension, is when your blood pressure (the force of blood during through your blood vessels) is consistently too high. Your blood pressure is recorded as 2 different numbers. Your top number, or the first number, is called the systolic number. This indicates how much pressure your blood is exerting against your artery walls when the heart beats. Your bottom number, or lower number, is called the diastolic number. This indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats. If you want to think about it in more general terms, the top number is when your heart is contracting and the bottom number is when your heart is relaxing. Typically, more attention is giving to that top number (or the systolic number) as a major risk factor for cardiovascular disease for people over 40. In most people, systolic blood pressure rises steadily with age due to increasing stiffness of the larger arteries, Buildup of plaque and an increased incidence of cardiac and vascular disease. However, either an elevated systolic (or top) or an elevated lower (or diastolic) blood pressure reading may be used to make a diagnosis of high blood pressure. And since tobacco use can elevate these numbers, I provided a chart here just to let you know where you should fall. Blood pressure categories here on the left. It gives you your systolic numbers there in the middle and your diastolic numbers on the right side. This is provided by the American Heart Association. So, by looking at this chart here, it's best to have a blood pressure of 120 over 80 or less. And you can take a further look at those charts once we have the PowerPoint up and you can go back and view that if you want to copy those numbers down or write those down for reference.

So, in conclusion on the effects of tobacco use on our cholesterol and blood pressure, we know that nicotine raises blood pressure and heart rate, narrows arteries and hardens their walls. Nicotine also stresses your heart and set you up for a heart attack or stroke. Chemicals and tobacco smoke harm our blood cells, More specifically, our red blood cells. They can also damage heart function and blood vessel structure and function. Both nicotine and chemicals in tobacco smoke increase the risk of atherosclerosis (or the hardening of those arteries). Tobacco cessation reduces the risk of atherosclerosis hyperlipidemia and hypertension. On November 20th, I'm sorry on November 19th, 2020 this year, it's typically the 3rd Thursday in November, the American Cancer Society has an event called the Great American Smokeout. and I've taken a graphic here and a quote of theirs for this year's event. And they say: “you don't have to stop in 1 day, start with day 1”. And how true that is. A lot of people become overwhelmed with smoking and not sure how they're going to do it. And they say: “okay, I cannot stop smoking in 1 day”. But, that's not necessarily the case. Let's take it one day at a time. So, again, you don't have to stop in one day, start with day one. So again, on November 19th, start your journey towards a tobacco free life during the Great American Smokeout event. This is going to improve your health immediately at any age. And quitting is hard, but you can increase your chances of success with help. So I have some resources listed here. To all available Sentara employees, you have access to WebMD telephonic coaching - a 12-week program with trained individuals and tobacco cessation methods. And of course, there’s also available on the optimahealth.com/mylifemyplan There's a self-paced program called, Get Off Your Butt: Stay Smokeless for Life that has other resources as well. But with those two resources, that would increase your chances of quitting and what a better day to just start that plan would be on November 20th, I'm sorry, November 19th 2020.

And thank you for watching today's presentation on the effects of tobacco use on your cholesterol and blood pressure.