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You
may not have ever thought about it, but if you're the woman
of the house, you are the "gatekeeper" of your family's
health — the one your husband and children rely on (whether
they know it or not) for help and advice. You're most likely
the one who shops for healthy foods, prepares nutritious meals
and snacks, encourages the kids' physical activities and tries
to incorporate healthier habits into everyone's day. On top
of that, you may now have older parents depending on you,
too. It's no surprise that you've landed the role of gatekeeper.
"Women are more likely to seek health care than men,"
says Marian Limacher, MD, FACC, director of preventive cardiology
at the University of Florida College of Medicine. "Women
account for far more doctor visits per year than men do, both
for preventive and medical reasons. So it's good for women
to be more aware of the preventive aspects that can reduce
the risk of heart disease not just for themselves, but for
the whole family." Taking care of your family's heart
health is one of the most vital roles you can play.
Know the Risk factors
Women
share many of the same risk factors for heart disease as men.
But, according to C. Noel Bairey Merz, MD, FACC, director
of the preventive and rehabilitative cardiac center at Cedars-Sinai
Medical Center in Los Angeles, "Doctors have come to
recognize that, when it comes to the heart, women are indeed
different from men. It's important that you know the major
heart disease risk factors and where gender makes a difference."
Smoking.
Cigarette smoking is the most important preventable cause
of premature death in the United States. A smoker's risk of
heart attack is more than twice that of a nonsmoker's. If
you smoke, quit — your heart attack risk drops within
24 hours of quitting. If you don't smoke, don't start. And
actively discourage everyone in the family from smoking. "About
3,000 American children start smoking every day," says
Thomas P. Graham, MD, FACC, director of pediatric cardiology
at Vanderbilt Medical Center in Nashville. "Smoking may
be the most important risk factor when it comes to children
and adolescents."
High
cholesterol and triglycerides. Women and men with a total
cholesterol level higher than 200 are susceptible to heart
disease. Men can usually use their total cholesterol to tell
whether they're at risk. But women should learn their LDL
("bad" cholesterol) and HDL ("good" cholesterol)
numbers as well as the total. Low levels of HDL are predictive
of heart disease in women, and appear to be a stronger risk
factor for women over 65 than for men over 65. Triglyceride
levels may also be a significant risk factor for women, especially
older women. Many heart experts now suggest an optimum goal
for women of LDL under 130, HDL over 45 and triglycerides
under 150. If cholesterol levels are high, talk with your
doctor about what to do.
High
blood pressure. Research now suggests treating and controlling
hypertension can reduce heart disease risk significantly for
women as well as men. Aim for blood pressure of 140 systolic
(top) and 80 diastolic (bottom), with 120/80 being optimal.
Know your blood pressure number, and have it checked regularly.
Physical
inactivity. Lack of exercise is a major risk factor at
any age. Over half of Americans don't get enough exercise
to protect their hearts. And today's children are less fit
than ever — and showing more early signs of heart disease.
Obesity.
Obesity is strongly linked to heart disease for men,
women and children. Worse, the prevalence of obesity is increasing,
especially among young people. Studies suggest that preventing
obesity in childhood may reduce the number of adults with
heart disease.
Diabetes.
Diabetes increases a woman's risk of heart disease three to
seven times, compared with a two- to three-fold risk increase
in men. If you have diabetes, work with your doctor to control
heart disease risk. To delay and control diabetes, maintain
a healthy weight, stay active and reduce dietary fat intake.
One way to eat less fat and sugar is with a "citrus swap."
By replacing fats and refined sugar with citrus juice, recipes
not only have less fat but more nutrients as well. Citrus
juices such as orange juice or grapefruit juice are high in
vitamin C, and good sources of folic acid and potassium —
an essential mineral that works to maintain fluid balance
in the body, cell strength and structure, and nerve transmission
— all of which are very important for diabetics.
Age.
Men's risk of heart disease soars after age 45. In women,
the risk rises when they're about 55. Women well past menopause,
especially over 60, are at four times the risk of premenopausal
women of the same age.
 Family
history and race. A family history of heart disease is
more common in women with coronary disease than men. Race
makes a difference, too. "African-Americans have a higher
risk than Caucasian-Americans due to a higher incidence of
risk factors such as high blood pressure and diabetes,"
says Roxanne A. Rodney, MD, FACC, chair of the Association
of Black Cardiologists' committee on cardiovascular disease
in women. "Many people believe that if heart disease
runs in their family, there's nothing they can do. That simply
isn't true. Diet and exercise can significantly lower one's
risk."
You First
If
you're keeping an eye on your family's health, make sure you're
taking care of yourself, too. Now is the time to take charge
of your health and know your individual risk factors to prevent
heart disease.
- A
healthy lifestyle means enjoying foods you like to eat,
not just eating what's good for you. A well-balanced diet
should be low in fat, high in fiber and include at least
five servings of fruits and vegetables a day — that
may seem like a lot but, considering that just one eight-ounce
glass of orange juice equals one serving, it's easy.
- Make
exercise a habit. Find 30 minutes in your daily schedule
and commit to an activity you like to do. (Walking the dog
counts.)
- Talk
with your doctor about your heart, your weight, cholesterol
and blood pressure numbers, and what you should do about
them.
- Get
your antioxidants, and make sure everyone in the family
does, too. Scientists believe antioxidants (found in vitamin
C-rich orange juice, grapefruit juice, green tea, broccoli,
beets, tomatoes and berries) may counteract the harmful
molecules called "free radicals," which may contribute
to heart disease.
- De-stress.
Make time to relax. Take a bubblebath or nap. Have friends
you can talk to (or email).
The Other Half of Your Heart
You're probably going to be more than a gate-keeper to your
husband — you may have to be his health coach, too. When
it comes to heart disease, far too many males think, "It
can't happen to me." You know better, so...
- Talk
with him about heart disease. Get him to know his risk factors,
blood pressure and cholesterol levels and warning signs.
- Explain
the importance of a heart-healthy diet to him. Don't just
focus on what he shouldn't be eating. Let him know what
he could be eating to help protect against heart disease,
such as foods high in folic acid. Folic acid reduces the
body's level of homo-cysteine, an amino acid found in protein-rich
foods that appears to contribute to heart disease by combining
with LDL cholesterol to form plaque on artery walls. Folic
acid can be found in spinach, citrus fruits and juices,
beans, liver and most fortified cereals.
- Make
exercise a partnership. Find something you both enjoy, like
walking or jogging, and do it together.
- Remind
him about an annual physical. He may be used to seeing a
doctor only when something's wrong. With heart disease,
that attitude could be life-threatening.
- Be
a supportive partner. A new study shows that married people
who get a lot of support from their family — especially
their spouse — have better heart and blood pressure
responses to stress.
Keeping Young Hearts Healthy
"Because they know the risk of heart disease can begin
very early in life, health experts are beginning to focus
on children earlier and earlier," says Richard P. Lewis,
MD, MACC, professor of medicine, division of cardiology, at
the Ohio State University Medical Center in Columbus. "By
doing that, a lot of heart disease and stroke can be prevented
as these children grow older." "Parents need to
get children involved in a healthy lifestyle at an early age
or it will never happen," says Dr. Graham. Encourage
variety in their diet. Introduce them to foods that taste
good without a lot of fat. Skip the sodas — according
to the Food and Drug Administration, orange juice, grapefruit
juice and skim milk are the only beverages that naturally
contain the required amount of vitamins and nutrients to be
labeled "healthy." But watch out for "juicy"
product names such as cocktail, punch, drink, sparkler, blend
and beverage. They signify "diluted juice" with
added sweeteners. Look for the words "100% pure"
on the label. Show your kids how to read nutrition labels
on foods, too. And have the kids help prepare meals or snacks
with you. By cooking together, and talking about good foods,
kids develop habits that will last their whole lives. Instill
a love of physical activity early, too. Make exercise a family
affair: hiking, swimming or in-line skating together can make
physical activity fun. Give your children household chores
that are also good exercise, like mowing the lawn, raking
leaves or shoveling snow. And limit the amount of time kids
spend with TV, computers or videogames.
Talking Prevention With Your Parents
If
you're the gatekeeper for mom and dad, the previous advice
— knowing risk factors, a healthy diet and staying physically
active — still applies. But there are some specific areas
to focus on. "There is good scientific evidence that
high blood pressure poses an even greater risk for heart disease
and strokes in older people than in the young or middle aged,"
according to Gerald Berenson, MD, FACC, president of the Society
of Geriatric Cardiology. Dr. Berenson recommends that anyone
over 65 have their blood pressure checked regularly. If it's
high, making healthy lifestyle changes is a priority. Counsel
mom and dad to take an active role in their health, and discuss
medication and other options with their doctor. Cholesterol
is important. Anyone over 65 with heart disease or any risk
factors should have a blood test to measure all their cholesterol
numbers. Make sure your parents know their cholesterol numbers,
and help them out with healthy diet ideas — this is especially
important for older adults since they often eat less and fewer
meals. Ideally they should strive for a low-fat diet high
in the soluble fiber found in cereals, grains, leafy green
vegetables and citrus fruits and their juices. Fiber may help
reduce the risk of heart disease and it aids in digestion
and elimination. Your parents need antioxidants (vitamins
C and E and beta-carotene), too. Some scientists believe those
free radicals mentioned earlier are implicated not just in
heart disease, but in aging itself — they help the body's
healing process, aid in iron absorption, and help strengthen
body tissues, bones and blood vessels. Vitamin C also helps
maintain collagen, the substance that helps the human body
repair body tissue. Help keep your parents active. A well-rounded
exercise program for older people should include aerobic activity
(like walking or cycling), strength training (using light
to moderate weights) and flexibility and stretching exercises.
When to see a cardiologist
Any
time you have a significant heart (or related) condition,
you may require the attention of a cardiologist. Cardiologists
are experts in diagnosing and treating the early signs of
heart disease, heart attacks and other heart-related conditions.
Women's symptoms can be different from men's, and not all
women are aware of those differences. Like men, women may
suffer pressure, squeezing or pain in the chest; pain that
spreads to shoulders, neck, throat, back or arms; and light-headedness,
sweating or shortness of breath. But women may also experience
stomach or abdominal pain, nausea, dizziness, difficulty breathing,
unexplained anxiety, weakness, palpitations, cold sweat, paleness
or profound fatigue.
If you suspect you or anyone in your family has a heart problem,
see a cardiologist.
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