| Extensive
medical research has identified the major heart disease
risk factors for women. Some, like aging or heredity,
are things you can't change. But there are many other
factors affecting women that you can do something about.
According to Richard Pasternak, MD, FACC, director of
preventive cardiology at Massachusetts General Hospital
in Boston and associate professor of medicine at Harvard,
"There is compelling evidence from studies and clinical
trials that coronary heart disease is largely preventable."
Dr. Pasternak emphasizes you should know your heart
disease risk as an individual. "Talk with your
doctor to assess your specific level of risk. If your
risk is high, find out which risk factors you should
concentrate on. Finding out you're at low risk, on the
other hand, can eliminate a lot of worry."
Smoking.
Cigarette smoking is the most important preventable
cause of premature death in the country. Women who
smoke increase their heart disease risk two to four
times. If you smoke, quit. If you don't smoke, don't
start. Evidence also indicates that exposure to secondhand
smoke at home or work increases your risk and the risk
of respiratory disease in your children.
Physical
inactivity. Physically active women have a 60 percent
to 75 percent lower risk of heart disease than inactive
women. Try to get at least 30 minutes of moderate-intensity
exercise (like brisk walking) every day. This can even
be performed in intermittent or shorter bouts (at least
10 minutes) of activity throughout the day. When it
comes to exercise, the more the better!
|
Obesity
and overweight. Being more than 30 percent over
your ideal body weight makes you more likely to
develop heart disease, even with no other risk factors.
New guidelines recommend your waist circumference
should be less than 35 inches. |
Stress and depression. Studies show your body's
physiological reaction to high levels of sustained stress
— increased blood pressure, an outpouring of adrenaline,
and other changes — makes you more susceptible to
serious disorders like heart disease. Depression, more
likely suffered by women, is also dangerous to the heart
in both women and men.
High
blood pressure. High blood pressure increases the
hearts workload, weakening it over time. It also increases
the risk of stroke, heart attack, kidney failure and
congestive heart failure. Aim for a blood pressure of
under 140 systolic (top) and 90 diastolic (bottom),
with 120/80 being optimal. Have your blood pressure
checked at least every two years.
High
cholesterol and high triglycerides. Women with total
cholesterol over 200 are more susceptible to heart disease.
The goal is to have an LDL ("bad" cholesterol) lower
than 160, HDL ("good" cholesterol) over 45, and to keep
triglycerides to 200 or even lower. Triglycerides are
emerging as a significant predictor of risk in women.
If yours are high, talk with your doctor about what
to do.
Diabetes.
"Diabetes is a more powerful risk factor in women than
men," says C. Noel Bairey Merz, MD, FACC, director of
the preventive and rehabilitative cardiac center at
Cedars-Sinai Medical Center in Los Angeles. Regardless
of her age, a woman with diabetes has a risk of heart
disease three to seven times higher than a non-diabetic
woman. To help delay and control diabetes, maintain
a healthy weight, stay active, and reduce dietary fat
and calories. If you have diabetes, work with your doctor
to control your risk factors.
Estrogen
replacement therapy (ERT). The risks (and benefits)
of ERT are a little less well-defined, although studies
are in progress that should help clarify this area.
Currently, this decision should be made between you
and your doctor.
Why exercise?
Regular physical activity and maintaining the proper
weight are essential to reducing your risk of heart
disease and improving quality of life.
- Studies
have shown repeatedly that exercise improves your
heart health. "It can cut your cholesterol and triglyceride
levels, raise your HDL cholesterol, and lower your
blood pressure," says Dr. Bairey Merz.
- Exercise
fights the aging process. The ability of muscles and
other tissues to utilize oxygen decreases naturally
as you age. Exercise can slow the rate of loss. Basal
metabolic rate (the rate at which calories burn at
rest) also drops as you get older. But regular exercise
can compensate, helping you burn more calories, even
at rest.
- Bones,
muscles, and the fibers that tie them together work
better when they're used. Exercise can help prevent
injuries — today and tomorrow.
- Exercise
and eating go together. "Exercise helps you process
your food, and it allows you a high enough calorie
intake to ensure proper nutrition — without putting
on weight," explains Dr. Limacher.
Are
you getting enough fluids when you exercise?
"Most
women don't drink enough fluids when exercising," says
Dr. Pasternak. "You should drink fluids before you get
thirsty. By the time you feel thirsty, you may already
be dehydrated." To prevent dehydration:
- 2
hours before exercise: Drink at least 16 oz.
- 1
hour before: Drink at least 8 oz.
- During
exercise: Drink at least 4 to 8 oz. every 15 to 20
minutes.
- After
exercise: Drink at least 16 oz.
Drink water or fruit juice, such as orange juice or
grapefruit juice. Avoid caffeinated beverages. If you're
watching your diet, orange juice is fat-free, cholesterol-free,
and nutrient-rich.
Sneak
exercise into your life
If
you have trouble fitting in long walks or regular exercise,
try "sneaking" it in:
|
- Walk
to work if you're close enough. If you're not,
park your car one-half mile away.
- Get
off the bus before your stop and walk the rest
of the way.
- At
the mall, park your car far from the entrance.
- Use
your bike for errands.
- Take
the stairs instead of the elevator.
|
Coping with stress
Women are under more stress than ever, experts say,
and it's certainly not heart-healthy. Here are some
ways to relieve it:
Take
a moment to relax. Stress is most damaging if it's
unrelenting. Even a few moments of relaxation —
mini-breaks, stretching, talking with a friend —
can help.
Talk
it out. Poor communication is often a source of
stress. If you have concerns about your job, your workload,
your partner, or your children, discuss them.
Exercise
helps. Exercise strengthens your heart so that it
can withstand stress. Aerobic activities like tennis,
volleyball, running, swimming, and walking are ideal.
Make
social connections. Not having others to talk with
only adds to the stress in your life, and can even lead
to depression. Become involved in church, social or
volunteer activities.
When to see a cardiologist
Any time you have a significant heart or related condition,
you may require the attention of a cardiologist, a doctor
who is highly trained in diseases of the heart. "Women
often report that symptoms of heart disease began as
pain in an adjacent area, such as an arm, shoulder,
the back, or stomach, not in the chest," advises Dr.
Pasternak. Symptoms like shortness of breath, chest
pain, or dizzy spells often require special testing.
Most importantly, cardiologists are experts in diagnosing
and treating heart attacks, heart failure and other
heart-related conditions.
Your primary-care physician may recommend a cardiologist
or you can choose one yourself. If you suspect you have
a heart problem, visit your doctor.
Back
Copyright ©
1999 American College of Cardiology
|
