Tuesday, February 26, 2013

Women's Heart Risks

  Just as an FYI - I got these facts from the Mayo Clinic and from the Harvard Medical School Health Publications.  There are a lot of other good sources out there - but please before you go trolling the internet - think of the commercial with the "french model"  not everything on the internet is accurate - please make sure you are getting information from a reliable source.  One good link that can lead you to a bunch of other trustworthy links to further explore this issue is http://womenshealth.gov/heart-health-stroke/heart-disease-risk-factors/  the page from the US Department of Health and Human Services office of Women's Health. 

Like I said yesterday, many of the risk factors for heart disease are the same for men and women.  Things like high cholesterol, high blood pressure, inactivity and weight affect both men and women's heart disease risk.  But women also have extra risk factors.

  • Metabolic syndrome — a combination of fat around your abdomen, high blood pressure, high blood sugar and high triglycerides — has a greater impact on women than on men.
  • Mental stress and depression affect women's hearts more than men's. Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment, so talk to your doctor if you're having symptoms of depression.
  • Smoking is a greater risk factor for heart disease in women than in men. up to twice the risk factor, and due to hormonal cycles nicotine replacement patches and other smoking cessation aids are less effective in women thatn in men.
  • Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (small vessel heart disease).
  • After menopause, high triglycerides & low HDL are a higher risk factor for women than high LDL.
  • Diabetes increases heart disease risk in women more than in men
  • Women have smaller and lighter coronary arteries than men, this makes procedures like angioplasty, angiography and bypass surgery more difficult and less successful in women than in men.

There are things women can do to try and reduce their risks, and if they already had a cardio occurrence increase the likely hood of a favorable outcome.

  • Exercise 30 to 60 minutes a day on most days of the week. This does not necessarily mean join a gym, or run a marathon.  And studies have shown that it does not have to be 30 minutes in a row.  So walk around the room during commercials, or go up and down the stairs an extra time when you hit the bathroom.  If walking mobility is an issue - check online,  there are a lot of different exercises you can do from a seated position to get your heart rate up, chair aerobics, chair yoga etc.
  • Maintain a healthy weight.  While the BMI has several flaws - most athletes come out as obese by this index - it is a good place to start to determine healthy weight.  The National Institute of Health has an online BMI calculator that I use.  Ideal is 18.5 - 24.9, but studies show that reducing your BMI even by a point or 2 will have a positive effect on your CVD risk.
  • Quit or don't start smoking.  It only takes 1-4 cigarettes a day to double your CVD risk.  and depending on the study second hand smoke is as dangerous or more dangerous, so support your friends and loved ones who want to quit, and have those that still smoke, smoke away from you.
  • Eat a diet that's low in saturated fat, cholesterol and salt.   Fiber from whole grains and vegetables are especially effective in lowering risk.  5 oz of nuts per week - almonds and walnuts especially. Fatty  fish at least 2x a week. (studies show supplements do not work as well as the actual fish) 
  • While a lot of attention is given to the saturated vs mono and polyunsaturated fats, less is given to Omega -3 fats.  These have been shown to help with blood lipid levels, clotting, contraction and relaxation of arterial walls.  Also shown to help, rheumatoid arthritis (which affects more  women than men, and macular degeneration.  Replacing some of our Omega 6 fatty acids - essential but high in Western diets - with Omega 3 fatty acids have many beneficial results in research tests.
  • Supplements - many substances that have positive research outcomes when obtained through food,  do not have the same outcome when research  is done on supplementation.  I"M NOT YOUR DOCTOR!!  don't stop taking supplements she/he wants you on!!  Whenever possible try to get your nutritional needs met through a healthy varied diet  (I actually take several supplements - but these have been recommended for my personal health issues , and based on my personal blood work - and have been agreed upon by my physician and a CDE nutritionist who specializes in diabetes, and who was aware of the issues with my weird form of diabetes.)
  • Get your bloodwork done. At least yearly - more often if health conditions mandate it.  But, make sure you get a copy of your blood work!!  Some labs will send the results directly to you when they send  the results to the Dr.  (mine does)  if not ask your Dr to have his staff make a copy for you.  They are YOUR results, you have a right to have them.  Keep them.  Compare them, see how they trend in different categories.  If your Dr says your cholesterol is good - does he mean one point from too low (apparently this is where mine was for a long time before they dropped below that line) is it right in the middle or is it a point away from being elevated??  These are important things for you to now as you make choices in your everyday life.  The change is important too.  Did you go on a low carb diet and lose weight but your triglycerides went up 10 points?  Even if they are still "normal"  you need to know this.  ASK questions!  You are a health consumer!!  Medical care is expensive - get your $$ worth!!

This is a list of some of the target numbers you should be monitoring for heart risk.  there are 2 other numbers that researchers know are involved in heart disease risk - but they are unsure of the exact mechanism or what the  target numbers should be.  Nonetheless, you can keep an eye on them especially if they start trending upward. They are homocysteine (routine screening not done - but Dr can request on lab work.  elevated levels are often found together with B vitamin deficiencies)  and C-reactive protein ( also not routine - and no target numbers yet exist - but can be an indicator of artherosclerosis in people with normal levels of blood cholesterol... really important for people like me)

One last caveat.  Aspirin gets a lot of press.  There has been a ton of research done on 80mg (baby aspirin) daily for MEN.  The research involving women is less conclusive.  Keep in mind that aspirin is a blood thinner.  Taking aspirin every day does increase your bleeding risk!  Talk to your doctor before starting or stopping an aspirin regimen on your own.  Mayo says it can be good for very high risk female patients, Harvard only recommends it for women who have already had a heart attack.  PLEASE BE CAREFUL WITH THIS!!!

Don't miss tomorrow when I'll go over symptoms in women!!


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