الفهرس 
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Abstract
Obesity Risk Factors among patients with heart disease in several ways, including increased levels of cholesterol in the blood, obesity increases levels of harmful cholesterol (low-density lipoprotein) and triglycerides in the blood, in addition to reducing levels of beneficial cholesterol (high-density lipoprotein), which play a beneficial role in ridding the body of harmful cholesterol, which leads to Exposing the patient to heart disease. increased blood pressure, obese patients need to supply oxygen and food to the body’s organs in larger quantities, and this leads to the body’s response to raising arterial pressure to achieve this, and high blood pressure is considered one of the main risk factors for heart disease. Metabolic disorders, the enlargement of adipose tissue cells leads to physiological changes in the body that stimulate the occurrence of metabolic disorders, which are a risk factor for heart disease (American Heart Association, 2019).
Aim of the study:
The aim of this study is to assess obesity risk factors among patients with heart disease through.
1- Assessing health status of patients with heart disease based on medical records.
2- Assessing level of knowledge of patient with heart disease regarding obesity and it is risk factors.
3- Assessing life style practices (eating behavior, dietary intake, physical activity, attitude toward diet and health, reducing energy intake, sleeping, Smoking, resting, exercises, medication and follow-up) as reported among patient with heart disease related to obesity risk factors.
Research questions:
1- Is there a relation between sociodemographic characteristics of patient with heart disease and their life style related to obesity risk factors?
2- Is there a relation between occurrence of obesity and its effect on patient’s with heart diseases?
3- Is there a relation between patient with heart disease level of knowledge and their life style practices related to obesity risk factors?
Research design:
A descriptive analytical research design will be used in this study
Research setting:
The study will be carried out at the outpatient clinics of heart diseases in air force Specialized hospital in South 90th Street, Cairo most updated equipment and advices in diagnosis and treatment.
Subjects of Study:
Purposive sample was be conducted in the study.
Size: the sample contains all available patient’s with heart disease and suffering from obesity within six months, it constitute 50%from total attendances through year They number (498) patient with heart disease which was recorded by cardiology clinic at the air Force specialized hospital in south 90th street, new Cairo governorate.
Tools of Data Collection:
Data were collected using the following tools:
First tool: interviewing, questionnaire will be written in the simple Arabic language and will be developed by the investigator based on body mass index on literature review.
• Part 1: Assess of patients with heart disease about Socio demographic characteristics as Age, gender, Educational level, Occupation, Marital status, monthly income, residence (Egyptian Heart Association, 2019).
• Part 2: Assess patient’s level of knowledge about obesity as definition, causes, facts, signs, Symptoms, complication and Treatment (WHO, 2019).
• Part 3: Assess life style practices of patient with heart diseases as eating behavior, dietary intake, physical activity, sleeping pattern, Smoking, resting and exercises (WHO, 2019).
• Part 4: Assess of the class and stage of obesity for the heart patient through body mass index, Waist circumference (WHO, 2019).
Second tool
Assess health status of patient with heart disease through medical recorded will be include (Laboratory examination, Radiological tests, Family history, compliance of treatment and compliance of follow-up)
The results of the present study showed that:
▪ Table (1) reveals personal characteristics of the studied patients, it shows that more than half (61.6%) of the studied patients were aged 60 years and more with Mean ± SD48.95±9.36 and more than two third (67.1%) of the studied patients were female, while less than half (45.8%) of them had secondary education, less than half (49.8%) of them were government employee. In addition to; more than two third (69.3%) of the studied patients were married and the majority (80.7%) of them were lived in city and more than half (61.6%) of the studied patients had not enough income
▪ Table (2) reveals that, less than one third 30.9%-23.3% of the studied patients had complete answer about the symptoms of obesity and digestive system complication respectively. Also, 72.9%-72.9%-72.9% of them had incomplete answer about complication of obesity, respiratory system complication and prevention of obesity. In addition to; 84.6%- 76.7% of them didn’t know about the management of obesity and neurology system complication respectively.
▪ Table (3) reveals that, 92.2%- 92.2% of the studied patients didn’t reduced the percentage of saturated fats in meals and didn’t ate five different types of fruits and vegetables daily. While, 84.3%-80.7% of them pushed for short periods of time while eating and didn’t change the place of eating respectively.
▪ Table (4) reveals that, 92.4%- 92.2% of the studied patients didn’t eat high-value foods such as broccoli, kale, spinach, red peppers, eggs, potatoes, and mussels and didn’t limit consumption of salt, sugar and soft drinks respectively. While, 30.9% of them drank a lot of water.
▪ Table (5) reveals that, 92.2% of the studied patients didn’t do sports and (7.8%) of patient who do sports (n=39) were walking. While, 76.9% of them want to work by transport and 80.9% of them were sited constantly at work.
▪ Table (6) reveals that, 69.5% of the studied patients didn’t smoke and 37.5% -37.5% of patient who were smoking (n=152) have been smoked for 8 and 10 years. While, 100% of patient who were smoking (n=152) smoked cigars and 100% of patient who were smoking (n=152) were smoked twenty cigars per day.
▪ Table (7) reveals that, 50.2% of the studied patients preferred rest and sleep at noon time. Also 50.3% of patients were sleeping for 2hrs.
▪ Table (8) reveals that, 76.9% of the studied patients were practice moving upper and lower limbs. Also 50.4% of patient were practiced exercise twice a week and more than half (50.4%) of patient were practiced the sport 15 minutes.
▪ Table (9) showed that, 92.2%- 84.7% of the studied patient had abnormal level related cumulative glucose and total lipid respectively. While, 30.9%- 23.3% of the studied patients had normal level related triglycerides and high density lipid respectively.
▪ Table (10) showed that, 84.5% of the studied patients had abnormal ECHO. While, 26.9%- 23.3% of the studied patients had normal ECG.
▪ Table (11) reveals that, 92.2% of the studied patients didn’t suffered from congenital heart defects, 92.2% of the studied patients suffered from hypertensive, 92.2% of the studied patients suffered from diabetic mellitus, 92.2% of the studied patients were take medication and 78.9% of them take hypertensive medication. Also 57.4% of patient had no family member suffering from congenital heart defect, 73.3% of the studied patients had family member suffered from hypertensive, 77.1% of the studied patients had family member suffered from diabetic mellitus and 61.0% of patient had no family member suffering from heart diseases and 79.9% of family member who had heart disease (39%) was the father.
▪ Table (12) in addition to; 73.3% of patient had family member taking medication and 99% of family member who were taking medication 73.3% were taking hypertensive medication.
▪ Table (13) reveals that, 53.8% of the studied patients were know the dosage of treatment were taking, 65.3% of the studied patients were know the benefits of the medication. Also, 53.8% of the studied patients were regular for taking treatment and 75.2% of the patient who unregularly for taking treatment 46.2% reported took treatment of schedule if forget to take treatment. Also, 65.5% of the studied patients didn’t follow the health condition regularly and 64.4% of patients who didn’t follow the health condition regularly 65.5% reported laziness was the reason for not coming to the follow up.
▪ Table (14) shows that, there were highly statistically significant correlation between patient demographic characteristics and their total knowledge level score.
▪ Table (15) shows that, there were highly statistically significant correlation between patient demographic characteristics and their total lifestyle practices level score except age there was no statistically significant correlation.
▪ Table (16) shows that, there were highly statistically significant correlation between patient total health status and classification of obesity.
▪ Table (17) shows that, there were highly statistically significant correlation between total knowledge score level and total life style practices score level.
The result of the current study concluded that:
from the results of the current study, it was concluded that obesity has risk factors for heart patients, and that there is a strong relationship between demographic characteristics and lifestyle practices among heart patients, the study that The stage of obesity affects the heart, the higher the stage of obesity, the greater the risk to the heart. the study that Knowledge and levels of lifestyle practices lead to improving the health status of heart patients, especially those who suffer from obesity, as changing the lifestyle leads to the prevention of many diseases such as heart disease and obesity. Obesity contributes to the occurrence of many complications for heart patients and affects their health status, as found according to the researcher’s evaluation
The present study suggested the following recommendations:
1- Improve the patient’s heart disease level of knowledge of obesity in terms of definition, causes, facts, signs, symptoms, complications and treatment.
2- Help to improve the lifestyle practices of the patient with heart disease, such as eating behavior, diet, physical activity, sleep patterns, smoking, rest and exercise.
3-provide Patients’ knowledge the category and stage of obesity for a heart patient through body mass index and waist circumference.
4- Provide educational programs for heart patients who suffer from obesity to reduce weight, quit smoking, healthy habits and healthy foods.
5-Encouraging heart patients who suffer from obesity to reduce the proportion of saturated fat in their meals and to eat five different types of fruits and vegetables daily
6-Encourage heart patients to reduce saturated fat in their meals ,eat five different types of fruits and vegetables daily high-value foods and Reduce consumption of salt, sugar and soft drinks.
7-Encourage heart patients who suffer from obesity to exercise and walk to reduce obesity.