I was recently invited to speak about Heart Disease Prevention at an event to celebrate ‘Go Red for Women Day’ at a local Senior Center. Right before my talk, one of the organizers asked the audience whether or not they had made advanced healthcare directives. She went on to ask them if they were, in fact, ready for their next fall or if they were ready for their next hip fracture. I pondered the idea for some time and, in turn, asked the audience in the beginning of my talk whether or not they were ready for their next heart attack or whether or not they have prepared themselves to avoid having their next heart attack. My question was, unsurprisingly, met with blank yet eager stares.
Cardiovascular Disease (CVD) remains the number one cause of death in the United States and around the world1. The fact is: Heart disease is the No. 1 killer of women, causing 1 in 3 deaths each year. That’s approximately one woman every minute! While the number of CVD-related deaths in males has been steadily declining over the past 15-20 years, cardiovascular deaths for women remained flat or increased slightly during the 1980s and 1990s. The number of deaths for women has exceeded those for men over the past 20 years.2 Recent studies have revealed, in fact, that women receive fewer interventions to prevent and treat heart disease. Interestingly, women receive less cholesterol screening and fewer lipid-lowering therapies when compared to men3.
Most individuals will experience no symptoms for a long period before their first heart attack. Chest pain, discomfort, pressure or squeezing are the most common symptoms for men and women. Nonetheless, women are more likely than men to experience other atypical symptoms including shortness of breath, nausea/vomiting, unusual upper body pain or discomfort. Due to the fact that women experience less classical symptoms of heart attacks, it becomes extremely important for the public to be educated about the warning symptoms of a heart attack. Patient are always reminded to ‘Make The Call. Don’t Miss a Beat’. In one study, only 53% of women said they would call 9-1-1 if experiencing the symptoms of a heart attack. 4
This takes us back to our initial question: how do you prepare to prevent your next heart attack? Women, like men, are encouraged to follow the four cardinal rules of heart disease prevention: 1) Look before you eat, 2) Increase your physical activity and exercise, 3) Stop smoking and 4) Know your numbers.
Look Before You Eat. Weight gain of approximately 45 pounds or more after you turn 18 confers a greater than seven times the risk of death from heart disease5. In fact, losing as little as ten pounds reduces your blood pressure. Reducing the amount of calories and carefully reading nutrition facts on nutritional labels will make it easier for you to lose those extra pounds. Consuming a low fat diet that is rich in fruits, vegetables, and low fat dairy products and following eating plans such as the Dietary Approaches to Stop Hypertension (DASH) diet even without weight loss can also reduce your blood pressure6.
Exercise. Research has shown that, after controlling for other factors that affect heart disease risk, women who walk the equivalent of three or more hours per week have a risk of coronary events that is 35% lower than women who walk infrequently7.
Stop Smoking. In one study in the United States, over 40% of coronary events in women were found to be attributable to smoking8. Compared to nonsmokers, the risk of coronary events for those who smoke 1-14 cigarettes is about 3 times the risk of those who didn’t smoke at all8.
Know your numbers. Keep of track of your weight, blood pressure, blood glucose and cholesterol measurements and ask your doctor about your target numbers and about how frequently you should test them. The only thing worse than finding out that you have one of these conditions is NOT finding out that you have it.
Ultimately, remember that prevention remains key. Do not wait for a heart attack to take action; don’t wait for a second chance or a second life. Raising awareness about the alarming statistics about heart disease in women has been the focus of organizations like the American Heart Association through the Go Red For Women Campaign. Together, we can all join forces and work towards making heart disease take fewer lives away during our lifetime.
By: Imad Hariri, M.D.
Cardiovascular Disease Fellow at Mercy St. Vincent Medical Center.
References
Centers for Disease Control and Prevention, National Center for Health Statistics, Health Data Interactive, 2005-2007. Available at: http://www.cdc.gov/nchs/hdi.htm
Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, Hailpern SM, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O’Donnell C, Roger V, Sorlie P, Steinberger J, Thom T, Wilson M, Hong Y, for the American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2008). AHA Statistical Update, Heart Disease and Stroke Statistics—2008 Update, A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 117, e25-e146.
Act in Time Heart Attack Awareness Messages – DHHS Office on Women’s Health, 2011.
Mosca L, Mochari-Greenberger H, Dolor RJ, Newby LK, Robb K. (2010). Twelve-Year follow-up of American Women’s Awareness of Cardiovascular Disease (CVD) Risk and Barriers to Heart Health. Circulation: Cardiovascular & Quality Outcomes, 3,120-127.
Manson JE, et al. (1995). Body weight and mortality among women. New England Journal of Medicine, 333, 677-685.
The Seventh Report of the Joint National Committee on Prevention, Evaluation, and Treatment of High Blood Pressure. U.S. Department of Health and Human Services. National Institutes of Health. National Heart, Lung, and Blood Institute, NIH Publication No. 04-5230, 2004.
Manson JE, et al. (1999). A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. New England Journal of Medicine, 341, 650-658.
Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. (2000). Primary prevention of coronary heart disease in women through diet and lifestyle. New England Journal of Medicine, 343(1), 16-22.