Providers target heart disease in women

Prevention ranks higher than treatment when it comes to addressing heart disease in women.

With the disease ranking as the No. 1 cause of death for women in the United States — accounting for one in three deaths — reasons for prevention merit a high ranking as well.  Trusted resources, including the American Heart Association and the Centers for Disease Control and Prevention, report that about 80 percent of heart disease is preventable.

To punctuate that fact, the CDC reports that only 54 percent of women recognize heart disease as their No. 1 killer.   In the past, heart disease and heart attack have been predominantly associated with men, according to Go Red for Women, an AHA national movement to end heart disease and stroke in women.   The social initiative focuses on empowering women to take charge of their heart health.

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Go Red for Women points out another shocking statistic in addition to more than half of the U.S. population of women being unaware of the risks that heart disease poses for them.  An equal number doesn’t know what healthy levels are for cardiovascular risk factors such as blood pressure and cholesterol.

Those levels are a large part of the equation included in the prevention of heart disease quotient, which focuses on decreasing risks.  Other factors include eating a balanced diet, maintaining a healthy lifestyle and having an aggressive attitude about tending to symptoms.

“Know your numbers” is a directive the AHA stresses for women. The top four categories to know are blood pressure (ideal equals less than 120/80); cholesterol (talk to your doctor because ideal numbers depend on various factors); fasting blood sugar (ideal equals less than 100); and body mass index (ideal equals less than 25).

“Everyone in their early adult life should have these numbers checked out, and although a lot of women get Pap tests and breast exams, they don’t get their cholesterol levels checked,” said Ruchika Husa, cardiologist with SCL Health.  She pointed out that management for all of the top four categories is dependent on a woman’s risk factors such as the addition of diabetes. 

Telling your provider about bloodline-family health issues as well as any other risk factors is vital.

If tending to diet, healthy lifestyle and aggressive attitude toward symptoms fails to get these four categories of numbers into a healthy range, medication can generally balance the scales.

Diet matters

“I preach balance,” Husa said.  “That means fruit, vegetables, grains and protein.”  She gives patients flexibility in what form the foods come.

“When you go to the grocery store, make sure you look at the sodium content, the sugar content and the fat content.  People don’t realize how much sodium is hiding in canned vegetables,” she said.  “If you can’t afford fresh, get frozen and control the amounts.”

A Mediterranean  diet has evidence of being the best preventative diet, according to Vitale Battaglini, cardiac nurse practitioner at Longmont United Hospital. The diet emphasizes eating more plant-based foods such as fruits and vegetables, whole grains, legumes and nuts. It also replaces butter with healthy fats such as olive oil and canola oil and uses herbs and spices instead of salt to flavor foods.

“Call us for more information if you’ve heard about a supplement or a type of food that is supposed to be good for you,” she added.

Healthy lifestyle lessens risk

The AHA describes lifestyle as the best defense against heart disease and stroke.  Making it a healthy one starts with a list of things to eliminate from your life.  There probably isn’t a person in the United states who doesn’t know how bad smoking is and after that comes the warning about obesity. Both put a heavy load on the heart.

The list of things to do includes staying on top of blood pressure, blood sugar and cholesterol numbers and getting active.

The AHA recommends spending 200 minutes a week on moderate intensity exercise.

“That works out to about 30 minutes a day doing things like walking or swimming,” Battaglini said.  “It doesn’t have to be 30 minutes all at once — you can take three 10-minute walks a day.  For heart health, you should be able to carry on a conversation — about three to five words at a time — without gasping.”

Aggressive attitude

Women will call 911 if their father or brother are having symptoms of a heart attack, but they fail to notice their own symptoms, Husa said.

“My preach is that you have to be your own advocate — you have to do it for yourself and get aggressive with treatment.

She recalled one woman “who presented with a huge heart attack and said it was from a pineapple she had eaten.”

Women tend to blame their symptoms on stress or something they ate to explain heart disease and heart attack signs such as dizziness, fatigue and indigestion.

Molly Ware, cardiologist with Boulder Heart, addressed these atypical symptoms that women tend to present with a general directive: Act fast.

“If indigestion, profound fatigue or weakness aren’t your usual symptoms, you need to be seen,” she said. “It sounds out there, but I’ve heard people say that it just seems like something is wrong — so that sense of impending doom combined with these other symptoms is reason to see the doctor right away.”

Support from family and friends can help women sidestep their tendency to delay going to the emergency room, which also delays diagnosis and treatment in time to save their lives.

“We see men do better sometimes because their partners drag them to the doctor,” Ware added.

Because heart disease and heart attacks in women can present with symptoms that don’t fit society’s general understanding — left arm, jaw and chest pain as well as shortness of breath — they don’t tend to take it as seriously.

“It’s easy to misdiagnose, but if your doctor thinks it’s heartburn the first two visits, but you think it’s more than that — it’s time to see someone else,” Battaglini said.

Factors that contribute to greater numbers of women than men dying from heart disease are also attributable to physiological differences.  Those contributors include hormonal changes from pregnancy and menopause.

Local education and prevention resources include public lectures by Boulder Community Health, fitness and lifestyle assistance through the Wellness Center at Longmont United Hospital and information from Go Red for Women online.

Editor’s note: This report has been changed to correct the spelling of Molly Ware’s name.