Nevada Department of Corrections

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Nevada Department of Corrections

• NDOC Wellness Refresher Training

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Heart Lung Program

• What is the Heart Lung Program?
• Who is Covered?
• Conclusive Presumption
• Predisposing Factors
• Lifetime Medical Benefits
• NRS Statute
• Pursuant to NRS 617.455-457, Sub. 6. Failure to
  correct predisposing conditions which lead to
  heart or lung disease when so ordered in writing
  by the examining physician subsequent to annual
  examinations excludes the employee from benefits
  of this section if the correction is within the
  ability of the employee.
• New Additions to Yearly Physicals
• BMI plus Waist measurement
• Cholesterol
• LDL If there is a family history of heart
  disease target LDLlt100
• Follow up with Primary Care Physician is now
  included on the report of results

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Heart Disease Risk Factors

• Risk factors are those behaviors that can cause
  the development of heart disease
• Risk factors can cause damage in the lining of
  the arteries this is important in the
  development of plaque
• The function of the coronary arteries is to
  supply the heart with oxygen. Built up plaque
  eventually ruptures followed by the formation of
  a blood clot leading to a blocked artery or heart
  attack.

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7 Primary Risk Factors of Heart Disease

• Abnormal Blood Cholesterol
• Cholesterol is a fat like substance used for
• bodily functions such as cell and
• hormone production.
• Cholesterol is made in the liver and obtained
  from diet. The liver typically makes all the
  necessary cholesterol.
• (HDL) High density lipoprotein is the good
  cholesterol responsible for cleaning out
  arteries. LDL or low density lipoprotein is known
  as the bad cholesterol, which is responsible
  for blocking arteries. LDL is a major component
  of plaque.
• An HDL value lt40 is a high risk value. An HDL of
  60mg/dl or higher is considered protective
  against heart disease.
• Genetics, diet, physical activity, body fat ,
  stress, age and gender are all factors that
  determine blood cholesterol levels.

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Lifestyle Factors Can Affect Cholesterol Levels

• Factors that Decrease LDL Levels
• Increase activity levels
• Decrease saturated fat intake
• Increase fiber intake
• Decrease body fat
• Practice stress management
• Control diabetes

• Factors that increase HDL cholesterol
• Increase activity levels
• Decrease body fat
• Quit smoking
• Increase monounsaturated and polyunsaturated fat
  intake
• Reduce simple and refined carbohydrates

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Foods That Fight Cholesterol

• Almonds
• Studies have found that eating just a quarter cup
  of almonds a day can lower your LDL by 4.4
  percent
• Oatmeal
• Reduction in cholesterol are due to the high
  levels of soluble fiber found in oatmeal
• Fish
• Omega 3 fatty acids are widely considered to be
  the best of the good fats (you can also use
  flaxseed fish oil supplements and walnuts
• Red Wine
• A glass of red wine, which contains flavanols,
  has been shown to have anti-inflammatory
  properties that may help lower cholesterol and
  stave off heart disease.
• Men 2 drinks/day
• Women 1 drink/day

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Foods That Feed Cholesterol

• Whole Milk Dairy Products
• Saturated fat, which clogs arteries and increases
  LDL levels, is the No. 1 cholesterol-boosting
  culprit. Foods like ice cream and cheese are
  where youre likely to find them.
• Processed Meats
• Bacon, sausage, liverwurst and the like are
  sources of artery-clogging saturated fat. Look
  for lower-fat options, like bacon and sausage
  made from turkey and other lean protein sources
• Fast Food
• Even worse than saturated fats are trans fats.
  The main source of trans fats are partially
  hydrogenated oils - exactly what most fast-food
  restaurants are using to cook. Trans fats raise
  your LDL and simultaneously lower your HDL.
• Tropical Oils
• Palm kernel and coconut oils are two of the
  fattiest of oils. Use olive oil instead
• Baked Goods
• All baked goodseven those that are homemadeare
  high in saturated fats, thanks to the butter and
  shortening. Eat high-fat baked goods
  occasionally, opting more often for low-fat
  sweets like sorbets.

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7 Primary Risk Factors of Heart Disease

• 2. Hypertension
• High blood pressure
• Blood pressure (BP) is the force of blood against
  the walls of arteries during the contraction of
  the heart. Blood pressure is recorded as two
  numbersthe systolic pressure (as the heart
  beats) over the diastolic pressure (as the heart
  relaxes between beats).
• Causes
• Narrowing of the arteries
• Greater than normal volume of blood
• Most of the time the cause is not known
• High blood pressure usually cannot be cured, in
  most cases it can be prevented and controlled
• Others at risk for developing high blood pressure
  are the overweight, those with a family history
  of high blood pressure, and those with
  pre-hypertension

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7 Primary Risk Factors of Heart Disease

• Preventing Hypertension
• Maintain a Healthy Weight
• Be Physically Active
• Follow a Healthy Eating Plan
• Reduce Sodium in Your Diet
• Drink Alcohol in Moderation
• Take Prescribed Drugs as Directed

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7 Primary Risk Factors of Heart Disease

• 3. Tobacco Use
• Smoking and tobacco use in general is a major
  risk to an individuals health.
• Harms nearly every organ in your body
• Tobacco use also increases risk for CHD, stomach
  cancer, lip and throat cancer, emphysema,
  pancreatic cancer and chronic pulmonary disease.

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7 Primary Risk Factors of Heart Disease

• 4. Diabetes
• Diabetes is a disease in which the body does not
  produce or properly use insulin.
• Insulin is a hormone that is needed to convert
  sugar, starches and other food into energy needed
  for daily life.
• The cause of diabetes continues to be a mystery,
  although both genetics and environmental factors
  such as obesity and lack of exercise appear to
  play major roles.
• Type 1 diabetes is usually first diagnosed in
  children, teenagers, or young adults. In this
  form of diabetes, the pancreas no longer makes
  insulin because the body's immune system has
  attacked and destroyed them.
• Type 2 diabetes is the most common form of
  diabetes. People can develop type 2 diabetes at
  any age -- even during childhood. In type 2
  diabetes, the pancreas does not make enough
  insulin, and the fat, muscle, or liver cells do
  not use it properly.

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7 Primary Risk Factors of Heart Disease

• 5. Family History
• There is a strong genetic link to CHD. If you
  have an immediate male blood relative with a
  history of CHD, or bypass surgery prior to the
  age of 55, or a female blood relative with a
  history of CHD prior to the age of 65, you may be
  at an increased risk.

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7 Primary Risk Factors of Heart Disease

• 6. Sedentary Lifestyle
• Sedentary individuals can be described as those
  who do not participate in meeting minimum
  physical activity requirement.
• Low fitness has been shown to be as important a
  predictor of premature mortality as tobacco use,
  high BP, or abnormal cholesterol levels.

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7 Primary Risk Factors of Heart Disease

• 7. Obesity
• Currently 65 of American adults (and 15 of
  children) are classified as obese or overweight.
  These statistics have been determined by using a
  calculation called BMI (body mass index).

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7 Primary Risk Factors of Heart Disease

• Why Is a Healthy Weight Important?
• If you are overweight or obese you are at risk of
  developing the following diseases
• High BP
• High Cholesterol
• Type two Diabetes
• Coronary Heart Disease
• Stroke
• Gallbladder Disease
• Arthritis
• Sleep apnea
• Some cancers (breast, prostate, colon)

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Risk Factors for Heart Disease

• As you review the major (and contributing) risk
  factors, it should be clear that with the
  exception of family history (genetics) all other
  risk factors can be controlled though lifestyle
  choices. In many instances coronary heart
  disease is a disease of choice. It is widely
  accepted in the medical field that a large number
  of heart attacks that occur yearly could be
  prevented (or at the very least delayed) should
  individuals develop healthy lifestyles. Major
  risk factors are responsible for approximately
  85 of all coronary events.

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PPO/HPN/HMO Wellness Services

• PPO
• The PPO Wellness benefit provides a 2500 (per
  person, per plan year) benefit to participants
  and their covered dependent. The services for
  preventive care are not subject to co-payment or
  deductible. Services provided include (but are
  not limited to)
• Hypertension Screening
• Tobacco Cessation programs
• Stress management Programs
• Weight Loss Programs (medically supervised)
• Prostate screening
• Well-Child Examinations
• Contact Information Health Benefit Planners
• 877-963-8232

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PPO/HPN/HMO Wellness Services

• HPN Health Plan of Nevada
• Education is an important part of preventive
  health. Health Plan of Nevada provides programs
  dedicated to promoting lifelong wellness. The
  Health Education and Wellness Division offers a
  variety of health education classes and disease
  management programs.
• Programs and resources include, but are not
  limited to
• Diabetes The Balancing Act
• The Balancing Act is designed to provide you with
  basic knowledge of preventive care healthy food
  and activity choices and stress management
  techniques
• Heart Health Blood Pressure Cholesterol and
  Triglycerides
• This program is designed to help you keep your
  heart health in control by reducing your weight,
  exercising, eating from a balanced food plan.
• Weight Management
• Develop a personal plan to make positive changes
  in your eating and exercise habits to achieve
  healthy and permanent weight loss.
• Contact Information 702-877-5356 or 800-7207253

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PPO/HPN/HMO Wellness Services

• HMO
• Preventive Services provided through Blue
  Advantage from HMO Nevada Plan
• Services include
• Physical Exams
• Gynecological exams
• Vision and Hearing Exams
• Well Baby/Well child care

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Resources

• Heart Disease Risk Assessment
• This tool will help you assess your risk of
  having a heart attack or dying from coronary
  heart disease in the next 10 years.  It will also
  check to see if you may have metabolic syndrome,
  a group of risk factors that greatly increase
  your chances of developing cardiovascular
  disease, including stroke and diabetes.  
• After you have finished using the tool, you can
  print a copy of your risk assessment results,
  risk factor summary report, metabolic syndrome
  assessment and action plans for those areas you
  need to work on in order to reduce your risk.
• http//www.americanheart.org/presenter.jhtml?ident
  ifier3003499

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Resources

• Health Finder
• Healthfinder.gov is a Web site for consumers,
  developed by the U.S. Department of Health and
  Human Services together with other Federal
  agencies.  Since 1997, healthfinder.gov has been
  recognized as a key resource for finding the best
  government and nonprofit health and human
  services information on the Internet. 
  Healthfinder.gov links to carefully selected
  information and Web sites from over 1,500
  health-related organizations.   
• http//www.healthfinder.gov/

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Resources

• American Heart Association
• The mission of the American Heart association is
  to build healthier lives, free of cardiovascular
  diseases and stroke. That single purpose drives
  all they do. The need for their work is beyond
  question and their resources are available to
  you! The American Heart Association contains
  information about specific conditions and
  lifestyle improvement.
• http//www.americanheart.org/

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Resources

• Nevada Tobacco Users Helpline
• The Nevada Tobacco Users' Helpline was developed
  to as a free resource to 1) Provide innovative,
  evidenced-based, confidential and individualized
  treatment of nicotine dependence through
  telephone-based professional counseling,
  education, and with medication to its clients,
  and 2) Provide innovative, evidenced-based
  nicotine dependence training to healthcare
  providers, counselors, and community partners.
• The Helpline provides a range of treatment and
  support programming services to meet the needs of
  its clients. Its program services include (not
  limited to)
• 'Quit' Kit Clients are tobacco-users who receive
  telephone-based nicotine dependence assessment,
  intensive 1-year nicotine dependence treatment
  counseling, and programming support services.
  Treatment is free and confidential.
• http//www.livingtobaccofree.com/

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Resources

• National Heart, Lung and Blood Institute
• The National Heart, Lung, and Blood Institute
  (NHLBI) provides leadership for a national
  program in diseases of the heart, blood vessels,
  lung, and blood blood resources and sleep
  disorders. The Institute plans, conducts,
  fosters, and supports an integrated and
  coordinated program of basic research, clinical
  investigations and trials, observational studies,
  and demonstration and education projects.
• The NHLBI provides resources to the public in
  areas including (but not limited to) Heart
  Disease, Blood Diseases, Lung Disease, Sleep
  Disorders, and healthy Recipe Collections. The
  NHLBI also provides Health Assessment Tools such
  as a menu planner, body mass index calculator and
  portion size quizzes.
• http//www.nhlbi.nih.gov/

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Resources

• Mayo Clinic
• Mayo Clinic's three main Web sites provide
  information and services from the world's first
  and largest integrated, not-for-profit group
  medical practice. Manage your health with
  information and tools that reflect the expertise
  of Mayo's 2,500 physicians and scientists, learn
  how to access medical services, and discover
  Mayo's medical research and education offerings.
• http//www.mayoclinic.com/

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Resources

• State of Nevada Risk Management
• The state of Nevadas Risk Management Department
  believes that most risks can and must be
  identified and effectively managed. Provided in
  the Heart/Lung section of the risk management
  website are links to risk factor reduction
  information, heart disease risk assessment tools,
  smoking cessation resources, as well as a great
  deal of information and resources regarding the
  heart lung program.
• http//www.risk.state.nv.us/HeartLungProgram.htm

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Let Us Know of Your Improvements!

• If you are making headway to alter some of your
  predisposing risk factors please dont hesitate
  to contact us. Risk managements wants to know of
  your successes so that this documentation can be
  placed in your personal file to indicate that you
  are attempting to improve your health status.
• Contact Information
• Vicky Fry - Occupational Health Nurse
• Email vfry_at_risk.state.nv.us / Phone (775)
  687-3194
• Josh Wilson - Health/Wellness Coordinator
• Email josh.wilson_at_willis.com / Phone
  775-323-1656
• Jim Muth - Exercise Physiologist
• Email jmuth_at_kbomanmd.com / 702-383-0677