| Don’t believe you’re not at risk; do believe you can improve your odds |
WOMEN HAVE A MEASURE of built-in protection against heart disease — as long as their ovaries are producing estrogen. Although estrogen may delay the onset of heart disease until the sixties or seventies, women’s risk eventually is the same as men’s.
• Don’t believe heart disease is a man’s disease.
• Don’t believe high blood pressure will resolve itself once you are past menopause.
• Don’t believe your systolic blood pressure — the high number — will lower as you age, unless you address the issues behind it.
• “Don’t expect to play a waiting game,” advises Dr. Octavio Cosme, an interventional cardiologist at Winter Haven’s Bond Clinic. “If the risk factors are there, they should be addressed.”
One of every three women who die each year die of heart disease or stroke, although it is preventable 80 percent of the time, according to the American Heart Association (AHA). AHA is holding its annual National Wear Red Day on February 6; its goal is to encourage women to wear red and increase awareness about women’s risk of heart disease.
Risk factors include high blood pressure, high cholesterol, diabetes, poor diets, excessive alcohol consumption, physical inactivity, smoking, being overweight or obese, and a family history of the disease.
Signs of a heart attack include uncomfortable pressure, squeezing, fullness or pain in the chest; pain or discomfort in either or both arms, the back, neck, jaw or stomach; shortness of breath; and a cold sweat, nausea or lightheadedness, according to the AHA. The signs of a stroke occur suddenly and include numbness or weakness in the face, arm or leg; confusion or difficulty speaking or understanding; trouble seeing and walking, and a severe headache, the AHA reports.
In Polk County, the age-adjusted average annual death rate from heart disease was in the mid-range for women 35 and older between 2008 and 2010, according to the National Vital Statistics System and U.S. Census Bureau. Between 279.7 and 315.3 deaths per 100,000 were logged.
“Heart disease in women is not really different than in men. They (women) should be treated with the same intensity and promptness,” Dr. Cosme asserts. The truth is women may not come in for treatment as fast as they should. “Once they have symptoms … the outcomes are actually worse,” Dr. Cosme says. Women should get treated early, and have access to aspirin therapy, plus blood pressure, cholesterol, and diabetes medications. If they treat these risk factors, they may prevent more serious issues.
Part of the reason for delayed treatment is the way heart disease presents itself in women. They may not have the classic symptoms of chest pain; instead they may feel fatigued or short of breath, Dr. Cosme points out. Another reason is a false sense of security. While estrogen levels may offer some protection, after levels drop women have the same chance of dying and the same chance of disability. “You get 10 years of protection, so to speak,” he says.
Prescribing estrogen for cardiac protection alone is not recommended; it can actually cause harm, according Dr. Cosme. When it is prescribed for osteoporosis or gynecological issues, it must be administered with care.
As women age, they cannot count on lower systolic blood pressure, the measure of force on the blood vessel as the heart beats and pumps blood out of the heart. Neither can they anticipate a rise in their diastolic blood pressure, the measure of force in between beats. “It (the systolic) may actually go up,” Dr. Cosme warns. “You can’t expect it to resolve unless you do something about it.”
Lifestyle changes like losing weight, cutting fat and salt, and exercising can help reduce blood pressure and reduce the risk of heart disease. A study by the University of Minnesota’s Division of Epidemiology shows postmenopausal women who walk have a much lower rate of heart disease. After excluding those who initially reported heart disease, two out of 96 walkers and 11 of 100 controls developed the disease in the next decade, according to Archives of Internal Medicine.
“Just put on your walking shoes,” suggests Debbie Zimmerman, who chairs Polk Wellness Professionals, an organization promoting wellness in the workplace. “We’re not talking about a huge commitment.”
She suggests parking at the far end of the parking lot, using stairs, walking to the farthest bathroom, and using your work break to walk. “Polk County has so many beautiful trails and lakes with walkways around them,” says Zimmerman, the Polk County School Board’s wellness manager. “Gosh, enjoy the Florida sun. Put on your sunscreen, of course.”
Maintaining a healthy weight is an important factor in keeping healthy blood pressure, cholesterol, and sugar levels, says Jamie Moore, a dietitian and certified wellness coach at Lake Wales Medical Center. That can be trickier as women age; dropping estrogen levels and the loss of muscle mass may mean more fat. “After 40 things start to decline,” she says.
Keeping weight down can be a challenge for women 45 to 55 who are usually working full time and caring for children, aging parents, and/or grandchildren. “You are not always focusing on your health, as you’re trying to take care of everybody else,” she says. “A lot of people think they don’t have time to take care of themselves.”
But women need to be proactive about their own health and vitamin pills aren’t the solution. “Keep your weight and your blood pressure down,” she says. She suggests fresh fruits and vegetables, plus whole grains. “You actually have to plan out your meals,” she says.
An important step is grocery shopping so you’ll have healthy ingredients to cook at home and take to work. That way you can avoid the temptations waiting in restaurants and office vending machines. She suggests preparing food in advance when you have time. Cook double portions, and freeze one for future use.
Spoilage can be a problem with fresh produce, but frozen vegetables provide a solution. Boost your vegetable intake by adding more veggies to soups and chili, pastas, potato, and rice dishes. Reduce the amount of meat with vegetables and/ or beans, she suggests.
If you like pasta, add spinach, broccoli, mushrooms, and onions to increase bulk. “You get that full sensation whether you’re eating carrot sticks or whether you’re eating macaroni,” she says. Wherever you are eating, chose the lower fat meats and avoid fried foods.
More information on heart disease in women is available at:
article by CHERYL ROGERS