By Jessica Babare D.O.
CardioVascular Solutions Institute –
As a doctor who specializes in the treatment of heart and blood vessel diseases, I am often surprised by the number of women I encounter who do not know about the dangers of heart related illnesses or that most American women will die as a consequence of heart disease. Despite the wealth of knowledge available to us in today’s modern life, most women do not know that heart disease is their own greatest health risk. Most people are surprised to learn that heart disease is the number one killer of American women. Ask most women what disease she is most at risk for, and she will likely reply, breast cancer. In actuality, however, heart disease kills more women than all forms of cancer combined.
Learning about the risks of heart disease is important because it can permanently damage a person’s heart, shorten ones life, and rob a person of years of health and vitality. In spite of the severe complications that can arise if heart disease occurs or goes untreated, the good news is that heart disease is largely preventable. The goal of this article is to educate women, and the men who care about them, about the risk and prevalence of heart disease so that more women might take action to protect their hearts.
Although there are many forms of heart disease, coronary artery disease is the most common type. Coronary artery disease begins with atherosclerosis, a process whereby plaque builds up inside the arteries, eventually limiting the flow of blood to the heart and other organs. Atherosclerosis has been shown to begin in our youth, and is a disease that usually develops over many years. In severe cases, atherosclerosis progresses to significant narrowing in the artery, resulting in chest pains called angina or, in the most severe cases, heart attack.
Heart attacks occur when blockages formed in the heart arteries and cut off blood flow, preventing oxygen and nutrient-rich blood from reaching heart tissue. Heart attacks often lead to damage of the heart’s muscle, and, in some cases, other heart structures like the heart’s valves or electrical conduction system. Heart attacks can predispose a person to a weak heart and a condition called congestive heart failure, a disease which occurs when the heart cannot pump blood effectively, sometimes leading to severe disability and loss of life.
You may be aware that procedures like coronary stent implantation or bypass surgery can reopen a blocked artery, but it is very important to understand that procedures do not “fix” a damaged heart. All currently-available procedures meant to open heart arteries can do is to help stabilize the heart’s blood supply despite the atherosclerosis and are not able to make the atherosclerosis go away. It’s critical to realize that there’s no quick fix for heart disease and that a diagnosis of coronary artery disease will require ongoing medical care and lifestyle modification in order to prevent further heart artery blockages from forming.
There is excellent news, however, in that heart disease can be prevented and controlled. Prevention includes healthy lifestyle changes, and, sometimes, medications prescribed by a doctor. Women of all ages should take steps to protect their heart health, but young women especially so, since heart disease develops gradually and can start at a young age. Beginning to live heart-healthy in our youth, gives us the greatest power of prevention!
As it turns out, atherosclerosis begins to form in our arteries when we are still young, and, even in our youth, we can make healthy lifestyle choices that will positively affect us for the length of our life. It often takes many years of accumulation for the blockages to become severe, causing our risk for coronary heart disease to rise in women ages 40 to 60. Risks increase when estrogen levels drop during menopause or following surgical removal of the ovaries, leading to even greater risk of heart disease and heart attacks in post-menopausal women. It is also during these years of life that many women develop one or more risk factors for heart disease, further compounding their risk for heart disease
Risk factors for heart disease are health problems that, especially when grouped together, work to synergistically alter the health of the coronary arteries, leading to atherosclerosis and, eventually, blocked arteries and heart attacks. There is a synergy or multiplier effect when it comes to risk factors for coronary artery disease. Having one risk factor doubles your risk. Having two risk factors quadruples your risk, and three or more risk factors can increase your risk even more than tenfold. Risk factors are described as either modifiable or non-modifiable, based on whether or not the patient can control the problem.
The good news is that, by doing just four powerful things-– eating right, being physically active, not smoking, and keeping a healthy weight -– you can lower your risk of heart disease by as much as 82 percent!
Modifiable risk factors for coronary artery disease include:
• High blood pressure
• High blood cholesterol and high triglycerides
• Being overweight or obese
• Physical inactivity
• Diabetes and pre-diabetes
• Metabolic syndrome, a condition where a person has elevated blood glucose, blood triglycerides, and an enlarged waist line.
• Sleep apnea, a problem often caused by obesity
• Stress or depression
• Too much alcohol
• Birth control pills (particularly for women who are over age 35 and smoke)
• Unhealthy diet
Non-Modifiable risk factors for coronary artery disease include:
• Family history of early heart disease in a close relative such as a parent or sibling.
• Advanced Age (55 and older for women)
• History of preeclampsia during pregnancy
What else should you do in order to learn more about your risk for heart disease and heart attacks? First of all, schedule an appointment with your doctor to discuss your risks. Ask your doctor which risk factors you have and whether or not you are up to date with screening tests to look for health problems.
Ask whether your weight and blood pressure are in normal range, and what you can do to get them under control if they are not. To make the most of your time with the doctor, prepare a list of questions to ask while the doctor is with you, and take a pen and note paper so that you can write down what the he or she says. Talk to your health care provider about lifestyle behaviors, such as smoking or being physically inactive and ask for recommendations about how you might lead a healthier lifestyle.
In many cases, your doctor will need to do some basic tests to evaluate your risk for heart disease. At every visit, your doctor will check your blood pressure and guide you about your risk for hypertension, one of the most common, and easily treated cardiovascular risk factors. In adulthood, we need to have our blood cholesterol (total: HDL, LDL, triglycerides) checked at least once a year. Our healthcare providers will screen us for diabetes by checking a fasting plasma glucose level. By assessing our weight and height, our doctor can determine our body mass index (BMI) and waist circumference, both indicators of our cardiometabolic risk.
If indicated, our doctor can do other, more advanced, testing to evaluate the function of our cardiovascular system, such as perform an Electrocardiogram or even send us for a stress test. If the risk appears great enough, your health care provider may even recommend that you see a Cardiologist, a doctor like myself who specializes in the care of heart and vascular diseases.
So, despite the tremendous power that women have over controlling their risk for the development and progression of heart disease, you may wonder why many women don’t take action about heart their disease risk. For some women, they may think that heart problems are just a man’s disease. Unfortunately, for a lot of women, they don’t make their health a top priority, often putting the needs of their families and others above their own. Some women don’t think that they are old enough to be at risk, not realizing that the first stages of atherosclerosis begin in our youth. Women often feel too busy to make changes in their lives or feel overwhelmed and confused about what steps to take.
I hope that this article has been for you a wakeup call to help you realize that you and your health are a top priority. It is only when you take good care of yourself that you can be there for your loved ones. As leaders in their households and workplaces, women can set an example for others that they care about so that they too might live heart-healthy lives. By taking steps to improve the quality of their own heart health, women often influence the health of the people they love the most.
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