June 2001 // Volume 39 // Number 3 // Tools of the Trade // 3TOT5

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Empowering Cooperative Extension Educators for Heart Health Education

Extension continues to be guided by its mission of helping people improve their lives through science-based education focused on issues and needs. A current need of Americans is extensive education to reduce the alarming death rate from heart diseases, the leading cause of death in the country. This article provides tools to empower the Extension professional in their role as front-line interventionist to actively participate in the national initiative to reduce the burden of heart diseases among Americans.

Youmasu J. Siewe
State Specialist for Health Education
Oklahoma Cooperative Extension Service
Oklahoma State University
Stillwater, Oklahoma
Internet Address: Siewe@okstate.edu


Among the diseases feared the world over are those involving the heart and blood vessels, also called "cardiovascular diseases" (CVD). Heart or coronary artery disease is a form of CVD that accounts for more deaths in the United States, than cancer, unintentional injuries, and other diseases combined.

The ever-expanding role of the Cooperative Extension professional and his or her proximity to grass-root clientele make this professional one of the most valuable interventionists in reducing the risk factors of heart disease, eliminating related disparities, and improving the quality of lives for Americans. Knowledge of the etiology and risk factors of heart disease is crucial in empowering the Cooperative Extension professional to partner with other agencies to reduce the risk factors of heart disease among Americans.

Etiology and Risk Factors of Heart Disease

Heart problems are either acquired at birth (congenital) or acquired later in life. Those acquired later in life are often due to one or more of the following anatomical or physiological alterations:

  • Narrowing or blockage of the coronary artery that nourishes the heart muscle, as seen in angina and heart attacks.
  • Compromising of the muscles and valves of the heart-lung system, which leads to weakening of the heart muscle, as seen in congestive heart failure and heart-valve disorders.
  • Compromising of the electrical activities of the heart, leading to forms of heart-rhythm alterations, or arrhythmias.

Understanding health risk factors of heart disease and practicing heart-healthy behaviors can significantly reduce heart diseases. Health risk factors are behaviors or conditions that increases one's chance of having a specific health condition or problem. Heart disease risk factors can be classified as controllable and uncontrollable. Controllable risk factors are lifestyle-related and include cigarette smoking, high blood pressure, high blood cholesterol, obesity, physical inactivity, stress, and diabetes.

Tobacco Use

Tobacco contains nicotine, tar, and other ingredients. The use of these ingredients causes an increase in blood pressure and heart rate, displaces oxygen, damages linings of arteries, and reduces beneficial levels of high density fats and thus contributes to heart disease.

High Blood Pressure

This is caused by hardening of the arteries, and it leads to a higher than normal pressure exerted against the walls of arteries. When this occurs, the heart has to work harder, enlarges, and eventually weakens.

High Blood Cholesterol

Cholesterol is a waxy substance and member of the fat family. It is obtained in food and also produced in the body and performs the following functions in the body:

  • Digests fat,
  • Helps the skin produce Vitamin D,
  • Helps develop adrenal and sex hormones, and
  • Insulates nerve tissue in the brain and spinal cord.

In excess, cholesterol can clog arteries and increase risk of CVD. Cholesterol is conveyed through the body as lipoproteins and can either be low or high in density.

Low Density Lipoprotein (LDLs) carries cholesterol from the liver to organs and tissues that require it. It is also called "bad cholesterol" because it clogs arteries.

High Density Lipoprotein is called "good cholesterol" because it carries unused cholesterol back to the liver for recycling. A total blood cholesterol level below 200 milligrams per deciliter (mg/dl) indicates a relatively low risk of CVD. Levels over 240 mg/dl indicate a high risk of CVD. Lowering blood cholesterol levels reduces heart attack risk and helps to clean out diseased arteries.


Body weight of more than 30% over recommended weight contributes to high cholesterol level and high blood pressure, and increases the strain on the heart. The pattern of fat distribution is an indicator of heart disease risk, because fat collected in the upper body is more dangerous than that collected around the hips.


This is a condition that results in an increase of blood sugar level and the body's inability to use glucose for energy. Diabetes is a heart disease risk factor partially because it increases cholesterol levels in the blood.

Psychological and Social Factors

High levels of stress, hostility, cynicism, and anger are heart disease risk factors because these feelings add stress on the heart and blood vessels. Depression, anxiety, social isolation, low socioeconomic status, and low educational attainment are also risk factors of heart disease.

Protecting Yourself Against Heart Disease

  1. Follow a heart-healthy diet to reduce coronary artery disease risk.
  2. Limit total fat consumption to no more than 30% of total calories, and limit intake of fat from animal sources.
  3. Increase intake of dietary fiber. This helps prevent cholesterol production and may interfere with the absorption of dietary fat.
  4. If you are a salt-sensitive individual, limit your intake of salt.
  5. Increase intake of fruits, vegetables, and low-fat dairy products.
  6. Increase physical activity to 20-30 minutes per session for three or more times per week.
  7. Avoid smoking, other forms of tobacco, and exposure to environmental tobacco smoke.
  8. Monitor blood pressure at least once a year, or as advised by a health care provider
  9. Monitor blood cholesterol level annually, and manage or treat cholesterol-related problems as advised by a health care provider.


Extension professionals can be among the most valuable interventionists in reducing the risk factors of heart disease. But this can only happen if they acquaint themselves with the basic facts about heart disease, heart disease risk factors, and protective behaviors so that they can incorporate this information into their programming as appropriate.