Women, love your hearts

Consumer Reports News: May 24, 2010 04:59 PM

The leading cause of death for women in the U.S. is not breast, colon, or lung cancer, but heart disease. Each year, more than 400,000 women have heart attacks and, alarmingly, the majority (64%) never experience the classic symptoms.

In the movies and on TV, heart attacks tend to be sudden and intense, but in real life they usually start slowly, with mild pain or discomfort. Women in particular often delay getting help because they are less likely than men to experience the typical chest-clutching pain. While smokers and women with diabetes are at especially high risk, heart attacks also occur in women without any traditional risk factors.

The good news is that myself and many experts, like Walter Willett M.D., Dr.P.H, a nutrition expert and professor at the Harvard School of Public Health, feel that most heart attacks can be prevented by lifestyle modification of risk factors, heart testing, and medical therapies. Here is a quick guide to primary prevention, which includes learning of risks factors, recognizing symptoms, and making lifestyles changes that can dramatically improve the health of your heart.

RISK FACTORS: These include a family history of heart disease, high blood pressure, diabetes, smoking, obesity, poor diet, lack of exercise, dyslipidemias (high cholesterol and high triglycerides), and possibly chronic anxiety, depression, stress, and lack of social support. It is important to note that 20 percent of woman experiencing heart attacks do not have any of these risks.

SYMPTOMS: As with men, the most common symptom in women is chest discomfort, including pain, pressure, squeezing, or a feeling of fullness in the center of the chest. The pain or discomfort may radiate to one or both arms, the back, neck, jaw, or stomach. Women are more likely then men to experience sudden shortness of breath, even without chest discomfort, and a cold sweat, lightheadedness, or nausea.

SCREENING TESTS: Blood work to check lipid values for cholesterol and triglycerides, blood sugar for diabetes, anemia, or thyroid conditions. EKG (basic electrocardiogram) for high-risk patients and stress testing and cardiac catheterization for those with heart symptoms.

MEDICAL/SURGICAL: If you are diagnosed with these conditions, your doctor may initiate secondary prevention with medication to lower your blood pressure, cholesterol, or blood sugar. In advanced cases you may require surgical intervention such as angioplasty with the placement of a coronary stent or heart bypass surgery. You may also be placed on blood thinners to reduce clotting risks. Ask your doctor if a daily aspirin is appropriate for you. Studies show a substantial reduction in repeat heart attacks when taking daily low-dose aspirin.

Now let’s go over three important lifestyle changes you can make at home to prevent heart disease and optimize your heart health!

1. Nutrition/Diet. Multiple studies have confirmed the benefit of the Mediterranean or anti-inflammatory diet which can help to prevent the buildup and rupture of plaques in the coronary arteries by lowering cholesterol and chronic inflammation. The focus of this diet is on whole grains, legumes, nuts , fruits, vegetables, fish, and use of garlic and olive oil. The idea is to limit the intake of saturated fats and processed foods; too much of these increase your LDL (bad) cholesterol, and increase sodium and sugar ingestion while lowering the needed daily fiber and nutrients for general health. Fish like salmon and sardines are especially valued with their high contents of omega 3 fatty acids, vitamin D, and many other heart healthy nutrients. Whole soy, nuts and beans are excellent protein, fat, and fiber alternatives to animal meat. I would urge you to learn more about the Mediterranean Diet and discuss with your doctor if it's a right choice for you.

2. Exercise. Sedentary lifestyle or lack of physical activity is clearly another risk factor for a heart attack. Most experts recommend 30-45 minute daily of aerobic activity and light weight-training. Brisk walking, treadmill work, or elliptical training will all provide similar results. The key is recognizing that your heart is a muscle that needs daily "toning." If you have any of the risk factors or are over 50 years of age, ask your doctor before embarking on an exercise program. If you are more than 30 percent overweight, I would recommend a consult with a health coach expert in nutrition and exercise.

3. Mind/Body. Chronic stress and depression must be addressed and managed. They have been shown to be significant contributors to heart disease. I would begin by learning simple breath work exercises such as those available on many CDs. Learning mindfulness meditation, and self-hypnosis can also be very empowering and beneficial. Various forms of yoga, Tai Chi, and Pilates may also help. Acupuncture offers some benefits as well. Finally seeing a psychologist or psychiatrist who can offer valuable discussion and effective medication are excellent resources. If you smoke, your chances of quitting are greatly increased by a multiple approach, which include any of these options mentioned above.

As a woman use that marvelous intuition: Listen to your body and listen to your heart.

Joseph Mosquera, M.D., Integrative Health Expert

For answers to all your questions about heart disease risks, prevention, and treatment, take a look at our special section on heart health.

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