In the Heart of the Galaxy

Carrie Fisher was 60 years young when she suffered a fatal heart attack. If she would have known heart disease was the #1 killer of both men and women she may have been an advocate in educating women of this under acknowledged medical catastrophe. She was 1 in 3 women who die of heart disease everyday.

Most women are obsessed about breast cancer and Alzheimer’s. And it’s true 1 in 8 women will develop breast cancer in their lifetime. Heart disease kills more women each year than all female cancers combined. It 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 21y to check for cervical cancer, mammograms begin at 40y 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. Some cardiologists believe every woman over 50 year should routinely get a screening evaluation for heart disease. Frankly I agree!

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 that you would see in the movies include pain in your chest, shortness of breath and cold sweats, but this is not always the case in women. Women often present with jaw or arm 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, heartburn and an upset stomach 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.

· High blood pressure (140/90 – either one of those numbers consistently is a risk factor)

· High Lipid panel (Cholesterol and Triglycerides)

· Being Overweight or Obesity BMI>30

· Smoking

· Family History of heart disease

· Lack of Exercise

· Uncontrolled diabetes

· Increasing Age

Here are lifestyle choices you can make to prevent a heart attack.

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 to reduce your risk of heart disease. A study at Cleveland Clinic showed that only 20% 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 less than 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. Ideally you want to keep the LDL less than 100mg/dl and the “good cholesterol” or HDL greater than 50mg/dl. Help that by limiting saturated fats, increasing fresh fruits and vegetables, limiting salt intake to less than 1gram/day, reducing alcohol consumption, increasing physical activity and keeping your BMI less than 25.

5. Ideal Blood Pressures should be less than 120/80mmHG. If blood pressure reading are consistently greatethan 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 risk factors for heart disease 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. It was also found that more women compared to men are likely to delay going to the emergency room when some of the unsettling symptoms are noticed.

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 #1 killer of women.

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