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Barbara L. Patrick MD, Facog Gynecology Services
mail clinic@womantowomangyn.com

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Keeping Your Heart Healthy

Many women are not aware of the risk of heart disease. In the United States, it is the leading cause of death of women. Each year, more than 300,000 women die from heart disease. This compares to about 40,000 deaths from breast cancer.

A number of factors can increase your risk of heart disease. Most of these risk factors can be prevented. This article explains causes of heart disease, who is at risk, and steps you can take to reduce your risk.

Your Heart

Your heart is a muscle that pumps blood through your body. Your heart and blood vessels (the cardiovascular system) carry oxygen-rich blood to the cells in your body. The cells need oxygen to work well. There are 2 different types of blood vessels: arteries and veins. Arteries carry oxygen-rich blood from the heart to the body. Veins carry blood back from the body to the heart.

Heart Disease

The vessels that supply blood to the heart are called the coronary arteries. The most common cause of heart disease is coronary artery disease. This disease is a narrowing of blood vessels to the heart by the buildup of plaque. Plaque is a fatty substance that forms in the arteries when too much cholesterol is present.

Cholesterol serves as a building block for cells and hormones.The liver makes most of the cholesterol in your body. Some comes from foods, such as meat and dairy products. There are several types of cholesterol. The 2 main types are:

1. HDL

2. LDL (low-density lipoprotein) tends to stay in the body and build up on artery walls. This "bad" cholesterol causes plaque to form in the arteries and makes it harder for blood to flow through them.

Over time, plaque formed by cholesterol causes the arteries to harden and narrow. This is called atherosclerosis. Atherosclerosis can begin when a person is young. However, it may take decades before signs of heart disease appear.

When the blood vessels narrow, the supply of blood and, therefore, oxygen to the heart may be reduced. This can cause chest pain (angina). It also can lead to a heart attack, from which the heart tissues are damaged. Chest pain can be a sign that the heart may not be getting enough oxygen. However, not everyone with atherosclerosis has this symptom.

Who Is At Risk?

Certain factors increase a person’s risk of heart disease. Some of these risk factors, such as age, cannot be changed. Other factors, such as one’s cholesterol levels, can be changed. A womens risk of heart disease is higher is she is 55 years of age or older, has a family history of heart disease or heart attack, has a high total cholesterol or high LDL level, has high blood pressure, smokes cigarettes, does not exercise regularly, is obese, or has diabetes.

The risk of heart disease grows as the number of risk factors increases.

What Can You Do

You can make lifestyle changes to keep your heart healthy. For instance, changing your diet, not smoking, and getting daily exercise can help. These changes can reduce your risk of atherosclerosis and heart attack.

Lower Your Blood Pressure

Blood pressure is the force of blood against the walls of the blood vessels. When arteries are narrowed by plaque, blood pressure increases. Untreated high blood pressure (hypertension) can lead to heart disease. Your blood pressure can be checked at your doctor’s office. An inflatable cuff is wrapped around the arm to read your blood pressure.

A blood pressure reading includes 2 numbers:

1. The systolic blood pressure (the top or first number) is the force of blood in the arteries when your heart contracts.

2. The diastolic blood pressure (the bottom or second number) is the force of blood in the arteries when your heart relaxes.

A blood pressure reading of less than 120/80 is best. A reading of 140/90 or more is considered high and needs attention.

Exercise, weight control, and not smoking can help reduce your blood pressure. If these steps do not keep your blood pressure in the normal range, medication also may be needed.

Watch Your Cholesterol

High levels of LDL (bad cholesterol) in the blood increases your risk of heart disease. High blood cholesterol has no symptoms.

Your doctor can test your cholesterol levels. If you are aged 45 years or older, have your cholesterol checked at least every 5 years. If you have risk factors for heart disease, your doctor may suggest this test earlier or more often.

If your total cholesterol level is high, you can take steps to decrease it. For instance, you can reduce the amount of saturated fat in your diet. Saturated fats include animal fat and some vegetable fats. Butter, lard, palm oil, and partially hydrogenated oils are saturated fats. Cheese, whole milk, and red meat also can be high in saturated fat.

Eating more fiber, such as oats, beans, fruit, and vegetables also can help reduce your total cholesterol level. Exercise, weight control, and not smoking can help too. If these diet and lifestyle changes don’t lower your cholesterol enough, your doctor also might suggest medication.

Stop Smoking

Smoking is a major cause of heart disease among women. A woman’s risk of heart disease increases the more she smokes and the longer she smokes.

Women aged 35 years and older who smoke and use oral contraceptives have an even greater risk of heart attack. If you smoke, talk with your doctor about how to quit. The sooner you quit, the lower chance of developing heart disease.

Stay Physically Active

Lack of physical activity can increase your risk of heart disease. Routine exercise helps control high blood pressure and weight.

Exercise also helps improve cholesterol levels. It can help increase HDL cholesterol and decrease LDL cholesterol levels. Try to be physically active for at least 30 minutes on most, if not all, days of the week.

Control Your Weight

Obesity increases your risk of heart disease, high blood pressure, and diabetes. A woman is obese if she is more that 30% above her ideal weight.

The BMI compares a person’s height to their weight to see if they are overweight. Having a BMI of 20-24 is normal, and 25-29.9 is overweight. A woman with a score of 30 or higher is obese.

The shape of your body is also a factor in keeping a healthy weight.  Women with fat around the abdomen are at higher risk for heart disease than women who have extra weight around their hips and thighs.

Maintaining a healthy weight can decrease your chance of heart problems. If you need to lose weight, talk with your doctor about a diet and exercise plan that is best for you.

There are exercise plans designed especially for certain women or those with health problems. Some type of exercise is almost always of benefit. Rarely does a condition exclude you from all exercise.

If it has been some time since you’ve exercised regularly, it’s best to start slowly. Begin with as little as 5 minutes a day, add 5 more minutes per day per week until you can stay active for 30 minutes a day.

Plan your exercise program to suit your interests and lifestyle. If you choose activities that you like, you’re more likely to stick to it, which is most important. For example, gardening and dancing are great forms of exercise. Don’t forget to count everyday chores and activities, such as climbing stairs, carrying bags, and washing the car. The harder you exercise, the more calories you burn.

Manage Your Diabetes

Diabetes increases a woman’s chance of developing heart problems. Diabetes causes increased levels of glucose in the blood. Women with diabetes often have other risk factors for heart disease. These included high cholesterol, high blood pressure, and obesity.

If you have diabetes, have your glucose level checked often. Try to keep it at a normal level. Diabetes can be controlled with diet, exercise, and sometimes medication.

Treatment

Lifestyle changes can help keep your heart healthy. These changes include lowering the amount of fat and cholesterol in your diet. They also include staying active, not smoking, and controlling your weight. Talk with your doctor about how to make lifestyle changes.

If lifestyle changes alone are not enough, your doctor may suggest medications. They could help decrease your cholesterol or blood pressure levels. Your doctor also may prescribe medications if you have diabetes.

Heart Attack Warning Signs

Many heart attack signs in women go unnoticed because women’s symptoms are sometimes different from men’s symptoms. Most men get a crushing pain in the chest. Some women have chest pain as their first symptom. Others have nausea along with chest pain.

Know the warning signs of a heart attack:
-Sudden, intense pressure or pain in the chest.
-Shortness of breath.
-Chest pain that spreads to the shoulders, neck, or arms.
-Feelings of light-headedness, fainting, sweating, or nausea.

If any of these symptoms lasts more that 5 minutes, you could be having a heart attack. Call an ambulance and go to the hospital. While you are waiting, take an aspirin, lie down, and breathe slowly. This may help limit the damage to your heart muscle

Finally...

Heart disease is as much a threat to women as it is to men. Women should be aware of their risks for developing heart disease so they can take steps to reduce them.

Talk with your doctor about getting your cholesterol levels and blood pressure checked. Watching your cholesterol levels and blood pressure can help you know if you should make needed lifestyle changes. All women who smoke should try to quit. They also should try to eat a low-fat diet, stay physically active, and maintain a healthy weight.