From the Heart

February is Heart Disease Awareness Month

Most women are obsessed about breast cancer. And it's true one in eight women will develop breast cancer in their lifetime. But what should really concern women is that heart disease accounts for one in three deaths in women. So if you take away anything from this article, it should be that heart disease is the number one killer of women! Heart disease should not be thought of as a "man's disease" any longer by the medical community nor by women.

A pap smear is first performed at 21 years to check for cervical cancer, mammograms begin at 40 years to check for breast cancer and colonoscopies begin at 50y to check for colon cancer. There are really no set guidelines for screening women for heart disease even though it affects 33% of women.

A heart attack occurs when blood flow, which is delivering oxygen to the heart, is reduced, limited or completely restricted. When the coronary arteries are narrowed due to high cholesterol, high blood pressure or diabetes, blood flow to the heart is compromised which can ultimately lead to a heart attack.

The warning signs for heart disease in women are much different than described in men.

Classic symptoms of a heart attack include pain in your chest, shortness of breath and cold sweats, but this is not always the case in women. Women often present with pain, pressure or discomfort in the chest, but it may not be severe or significant. Women may also have right arm pain, nausea or vomiting, sweating, dizziness or fatigue. A silent heart attack, which affects both genders, can present with less specific signs including flu-like symptoms, indigestion, fatigue, jaw or upper back or arm pain and these types of signs are more common in women.

Risk Factors for Heart Disease include:
• High blood pressure (140/90 - either one of those numbers consistently is a risk factor)
• High Lipid panel (Cholesterol)
• Obesity BMI>30
• Tobacco Use
• Genetic influences
• Physical Inactivity

Tests to Diagnose Heart Disease include:
• Exercise stress test
• Electrocardiogram (ECG)
• Holter Monitoring
• Echocardiogram
• Cardiac Catheterization
• Cardiac Computerized Tomography (CT) Scan
• Cardiac Magnetic Resonance Imaging (MRI)

Here's how to be proactive against heart disease.

1. Eating a Healthy Diet
A diet focused on fresh fruits, vegetables, whole grains and fish, limited alcohol intake and little red meat similar to the Mediterranean diet shows health benefits that include:
• Reduced risk of cardiovascular events
• Lowered risk of Type 2 Diabetes
• Reduced risk of a stroke
• Improved cognitive function
• Slowed progression of carotid plaque
• Cardiovascular protection with its reputation for lowering total carotid plaque, LDL cholesterol, HDL cholesterol, triglycerides, blood pressure and blood sugar.

The Mediterranean diet is associated with the highest life expectancy and lowest heart disease rates in the world.

2. Regular Exercise - It's been shown that you need to exercise 2.5 hours a week. A study at Cleveland Clinic showed that only 34% of Americans were aware of this benchmark, with 40% getting less exercise than they should.

3. Avoid Obesity and Being Overweight -The rise in obesity in the US by 27 % is a key factor in increasing your risk for Type 2 Diabetes which affects more than 12 million women. Hispanics are at twice the risk. Women want to maintain a healthy body weight with a BMI <25.Obesity is directly associated with high blood pressure, high cholesterol and diabetes, which all increase risks for heart disease.

4. Managing High Lipid Profile - Keeping LDL, aka "the bad cholesterol", low is the main way to control high cholesterol through lifestyle choices and medications. Help that by limiting saturated fats, increasing fresh fruits and vegetables, limiting salt intake to <1gram/day, reducing alcohol consumption, increasing physical activity and keeping your BMI<25.

Recommended levels of lipids include the following:
• LDL<100mg/dl (bad cholesterol)
• HDL>50mg/dl (good cholesterol
• Triglycerides <150mg/dl (most common type of fat in the body)
• Total cholesterol <200 mg/dl
• Total cholesterol/ HDL ratio should be below 5:1

5. Ideal blood pressures should be <120/80mmHG. If blood pressure reading are consistently >than 140/90 medication is recommended.

6. Baby Aspirin Confusion - If you have any evidence of heart disease, taking low dose aspirin (75mg daily) is recommended, but of course, check with your physician first. If you don't have any evidence then you do not need to take baby aspirin.

7. Omega 3-Fatty Acids are recommended through dietary fatty fish or supplements for women who have high cholesterol or high LDL levels. If you have heart disease or other risk factors, taking 1 gram of Omega 3-fish oil is recommended. If you are healthy or do not have any risk factors for heart disease, it's still recommended to take 300-500mg of Omega 3-fish oil every day.

Women need to be educated and proactive in finding out their risks of developing heart disease. There has been improvement based on a recent study which found that 56% of women knew heart disease was the #1 cause of death amongst women compared to only 30% awareness in 1997, but that still leaves too many women unprepared.

The medical community needs to do more in educating younger women on ways of reducing their risk factors for future heart health protection. Screening women for smoking, obesity, high blood pressure, high cholesterol and diabetes should be a part of women's annual medical assessment.

Here's the crucial take home message: Increasing your awareness and taking preventive steps to reduce your risk is your best protection against the number one killer of women.

What is your risk of heart disease?