Heart to Heart

What You Know About Heart Disease May Save Your Life Quick Links Signs of a Heart Attack Hormone Therapy    and Heart Disease Women, it’s time for a heart-to-heart talk. Did you know that heart disease and stroke kill far more American women each year than any other disease, including cancer? If, like most women, you worry more about breast cancer than heart disease, then you may not be taking the necessary steps to keep your heart healthy. “Heart disease should be every woman’s concern,” says Suzanne Haynes, Ph.D., senior science advisor for the Office of Women’s Health, Department of Health and Human Services. Although women tend to develop heart disease later in life than men, “a woman is less likely to survive a heart attack,” Haynes says. Know Your Risk Factors Why has heart disease become the number one killer of women? Experts say that as women age, they tend to develop more heart disease risk factors. While some risk factors can’t be controlled, others can be reduced with lifestyle changes. Find out your risk by checking the box next to each statement that applies to you. I have a family history of heart disease. If you have a parent, grandparent, brother, or sister who had a heart attack or developed heart disease at an early age, then your own risk of developing heart disease is higher. I am African American. African American women have a greater risk of heart disease than white women. That’s mostly because African Americans tend to have higher blood pressure, which can lead to heart attack. I have reached menopause. Before menopause, women may have some natural protection from heart disease, thanks to the estrogen their body produces. At menopause, however, estrogen levels begin to decline, and a woman’s risk for heart attack begins to rise. I have diabetes. Women with diabetes are three to seven times more likely to suffer heart disease or heart attack, compared to women who do not have diabetes. In fact, diabetes seems to “erase” the protection that younger women naturally have from heart attack. I’ve already had a heart attack or a stroke. Women who have had a heart attack or a stroke are more likely to have another. Women who have had a heart attack are more likely to die within a year of the attack than men who’ve had a heart attack. My total cholesterol is high. High levels of the “bad” cholesterol (LDL) and, especially for women, low levels of the “good” cholesterol (HDL) increase your risk for heart attack. I have high blood pressure. In three out of five cases of heart failure in women, high blood pressure is the cause. High blood pressure makes your heart work harder and contributes to fatty deposits in the arteries. I am 20 pounds overweight or more. “Obesity may be the first risk factor to affect a woman’s biological system, since extra weight can lead to diabetes, high blood pressure, and high cholesterol. These risk factors can lead to heart disease,” Haynes says. I smoke or am exposed to secondhand tobacco smoke. Heavy smokers are twice as likely to suffer a heart attack as nonsmokers. Both smokers and nonsmokers regularly exposed to secondhand tobacco smoke are at increased risk. Smokers who take birth control pills are 39 times more at risk for having a heart attack. I don’t get much exercise. Inactive people run nearly twice the risk of heart disease as those who exercise regularly. Inactivity makes it easier to gain weight, which may lead to other health problems that strain the heart. What You Can Do If you checked even one box, keep in mind that you have the power to take action to keep your heart healthy and strong. Chances are you’re already making heart-friendly choices and laying the groundwork for better health. Now is the time to build on that foundation. Here’s what you may already be doing right: I see my doctor regularly. This probably means you’re getting your blood pressure and cholesterol checked, and if your levels are too high, you’ve been prescribed any necessary medications. Take the next step: Take medications exactly as directed. Find out how your blood pressure and cholesterol readings compare to healthy standards. Since both cholesterol and blood pressure rise with age, it pays to follow recommended diet and lifestyle changes now. For more information: American Heart Association, www.americanheart.org I pay attention to what I eat. You know the difference between junk food and healthy food. You also understand that foods high in fat and calories lead to weight gain. Take the next step: What you eat has a huge impact on your weight and cholesterol levels, and can even affect blood pressure. Choose an eating plan you can stick with that is low in saturated fat and salt and high in fiber and nutrition. For more information: National Heart, Lung, and Blood Institute, www.nhlbi.nih.gov/chd I don’t smoke or I am considering quitting. Quitting smoking is the very best thing you can do for your heart. Take the next step: If you smoke, talk to your doctor or local heart or lung association about methods of quitting. For more information: Tobacco Information and Prevention Source, www.cdc.gov/tobacco Just reading this article shows that you are taking steps to protect your heart. A healthier heart comes from making the right choices one step at a time. Signs of a Heart Attack Would you know if you were having a heart attack? The “classic” sign you’ve heard about—crushing chest pain—doesn’t always apply to women. Some women may experience certain symptoms such as indigestion, abdominal or back pain, dizziness, and nausea or vomiting without any chest symptoms. Other heart attack symptoms that women may experience include: uncomfortable pressure, fullness, squeezing, or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back pain that spreads to the neck, shoulders, upper back, jaw, or arms fainting, sweating, dizziness, or shortness of breath accompanied by chest discomfort cold, sweaty skin unexplained anxiety, weakness, or overwhelming tiredness swelling of the ankles and/or lower legs If you think you are having a heart attack, call an ambulance or get to a hospital emergency room right away. To prevent blood clotting, chew a full-strength aspirin with water. Hormone Therapy and Heart Disease After menopause, should women take hormones to cut their risk of heart disease? “It’s a tough decision,” says Suzanne Haynes, Ph.D., senior science advisor for the Office of Women’s Health, Department of Health and Human Services. “Hormone replacement therapy is not the magic bullet they thought it would be.” An important national study, the PEPI (Postmenopausal Estrogen/Progestin Interventions) Trial, showed that hormone replacement therapy (HRT) increases a postmenopausal woman’s good cholesterol (HDL) and reduces her bad cholesterol (LDL). Since low HDL and high LDL cholesterol levels can lead to heart disease, this is good news. Another benefit: HRT helps protect a woman’s bones from osteoporosis. However, HRT has been linked to cancers of the breast and uterus. And as Haynes notes, “While HRT improves your cholesterol levels, it may not keep you from dying of heart disease.” Talk with your doctor about whether HRT is right for you. (c) 2001 Premier Medical Insurance Group, Inc., and its subsidiary, Dean Health Plan, Inc. All rights reserved. Reproduction with attribution permitted.