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[HEALTHTRACK]

How to Care for Your Heart of Gold

HEALTHTRACK - JUL/AUG 97
A SUPPLEMENT TO THE PHYSICIAN AND SPORTSMEDICINE FOR THE WAITING ROOM


Nearly 500,000 women in this country die of heart disease each year—more than twice the number who die from all types of cancer combined. Who knew?

Some risk factors—such as getting older or having a family history of heart disease—you can't control. But there are several positive and realistic steps you can take to reduce your risk. Maybe it means making a trip to the farmers' market each week to round out your diet with fresh, healthful vegetables. Or maybe it means taking a walk with your family each night after dinner.

A Feminine Profile

Heart disease might sound like a vague, generic term. When we're talking about the No. 1 health threat to women, it's good to know the condition by its more specific name: coronary artery disease, the most common type of heart disease. It occurs when the arteries that supply blood to the heart muscle become narrowed or blocked by fatty deposits. This reduces blood flow to the heart. The result can be angina (chest tightness, discomfort, or pain) or a heart attack. That, of course, can be fatal.

While both men and women are affected by coronary artery disease, it is not necessarily in the same way. Coronary artery disease may have different symptoms in women than in men—and many women don't know what those symptoms are. Women tend to have fatigue and chest tightness, rather than the pain many men feel. Heart fluttering is another symptom, as are sweating, dizziness, nausea and vomiting, and shortness of breath.

Before age 50 or so, women are slightly less likely than men to develop the condition, although women with risk factors may. (Diabetes, obesity, high cholesterol, and smoking are some risk factors.) After menopause, however, the risk for coronary artery disease increases dramatically. By the time the average women is in her 70s, her risk is equal to a man's of the same age.

Researchers think that the estrogen women produce in their childbearing years may have a protective effect on the heart and blood vessels. But when estrogen production drops at menopause, that protection is gone. That's one reason many doctors recommend hormone replacement therapy for postmenopausal women.

Special Concern for Black Women

When it comes to women and coronary artery disease, it's black women who have the greatest risk. Black women between the ages of 35 and 74 are twice as likely to die of a heart attack as white women are. Also, heart disease strikes black women at an earlier age than white women. One study showed that black women have angina at twice the rate of white women.

Researchers aren't sure why heart disease is more common in black women. But they do know that black women tend to score high on certain heart disease risk factors. For example, the American Heart Association estimates that about half of black women have high cholesterol levels (over 200). Also, high blood pressure is a problem for many black women.

If you're a black woman, your best hedge against heart disease is to talk to your doctor about your heart health—even if you're not having any symptoms. He or she will probably want to closely monitor your cholesterol level and your blood pressure.

Protect Yourself

It's hard to get motivated to reduce your heart disease risk until you take stock of your heart health habits. Though your doctor is your best source of information, the survey on the left can give you an idea of the areas you need to work on. There are some risk factors that you can't control, such as having a family history of heart disease, diabetes, or high blood pressure. Other factors you can control. Here are the four most important things you can do to reduce your risk:

  • Don't smoke. Among women, smoking is the biggest risk factor for heart attacks. Long-term exposure to second-hand tobacco smoke can also increase your risk. Women smokers who take some types of oral contraceptives can run a much higher risk of heart disease. Even if you are a longtime smoker, by quitting now you can reduce your risk of heart disease by 50% in the first year. And the risk will continue to decline the longer you stay away from cigarettes.
  • Give your diet a makeover. That means reducing your fat intake, selecting low-cholesterol foods, including more vegetables, and watching your portion sizes.
  • Exercise regularly. There is overwhelming evidence that physical activity dramatically lowers the risk for heart disease. In fact, inactive adults are almost twice as likely to develop heart disease as are those who are active. You don't have to pump iron or run marathons. Instead, adopt a regular program of aerobic exercise like walking, running, swimming, biking, or rowing for 20 to 30 minutes three to five times per week. Remember not to overdo it in hot weather, and if you are over 35 or have serious health problems, check with your doctor before starting your exercise program.
  • Keep your blood pressure down. High blood pressure can increase your risk of heart disease, stroke, and kidney disease. Women who are over age 65, have a family history of high blood pressure, or who are overweight are particularly susceptible. You can reduce your blood pressure by exercising, reducing your salt intake, and, if necessary, taking blood pressure medication prescribed by your doctor.


How Well Are You Caring for Your Heart?

To see how well you're taking care of your heart, decide whether these statements are true or false, then fill in the number next to your response. Total your points to find out how you score. NOTE: This test is not designed to rate your risk of heart disease, but to give you some idea which specific behaviors you can change to help your heart.

True False
1. I don't smoke. ___20 ___ 0
2. For smokers only: I plan to stop smoking this month. ___ 1 ___ 0
3. The last time I had bacon and eggs for breakfast was years ago. ___ 2 ___ 0
4. I had bacon and eggs this morning. ___ 0 ___ 1
5. I rarely eat fresh fruit and vegetables or whole grains.___ 0 ___ 1
6. I eat several servings of fresh fruit and/or fresh vegetables and whole grains every day.___ 2 ___ 0
7. I avoid foods that contain lots of animal fat such as red meat, bacon, and sausage.___2 ___ 0
8. I often have a hamburger and fries for lunch or dinner. ___0 ___2
9. I avoid foods that contain a lot of saturated fat from dairy products.___2 ___0
10. I often eat foods with lots of butter, cheese, or rich sauces and/or heavy desserts like ice cream or cheesecake.___ 0 ___ 2
11. I avoid foods that contain lard, palm, or coconut oil. ___ 2 ___ 0
12. I often eat fried foods, potato chips, doughnuts, and other high-fat foods.___ 0 ___2
13. I get some form of exercise several times a week (for example, walking, running, swimming, or biking).___4 ___ 0
14. I rarely exercise. ___0 ___2
15. I plan to be more active this week. ___1 ___0
16. I know my total cholesterol level. ___ 2 ___ 0
17. I know my HDL cholesterol level. ___ 2 ___ 0
18. I know my blood pressure. ___1 ___0
What's Your Score?
0 to 12 Uh-oh. Look at your health habits and quit smoking!
13 to 31 Lots of room for improvement. What's holding you back?
32 to 40 Pretty good. Congratulations on being a nonsmoker. Now, how about your eating and exercise habits?
41 to 46 Great. You're taking good care of yourself.
47 to 50 Wonderful! Keep up the terrific work!


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