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A Short Guide to Heart Disease in Women, part 1 of 2
Sue Fredrickson, a 55-year-old successful professional woman, thought she was playing by the rules. She had recently had both a Pap smear and a mammogram. She ate right, exercised regularly, didn't smoke and had a body mass index well within the normal range.
But in December, 2004, she felt tired and run down. A visit to her chiropractor revealed her blood pressure, 180/120, was Stage 3 hypertension, the highest, most dangerous level of hypertension. At the suggestion of her chiropractor Sue went to her internist who found that her cholesterol profile was every bit as ominous. She was, as they say, a walking heart attack.
"Other than feeling a little tired, I had no symptoms," Sue said.
Every single day heart disease earns its reputation as a silent disease. According to the American Heart Association, almost a third of women age 45 to 54 have cardiovascular disease-but most, like Sue, don't know it. For far too many women, the first and only indication of any heart disease is a full-on heart attack.
Though Sue Fredrickson discovered her heart disease before she had her first heart attack, she was not spared major surgery. Within four weeks of discovering that she had high blood pressure, Sue was in an operating room having triple bypass surgery. Today she is recovering well. She's making heart healthy lifestyle changes and she's volunteering at her hospital to help others learn about this silent disease.
Heart Disease: A Woman's Greatest Health Threat
Sixty-two percent of women believe that cancer is a woman's greatest health threat. But in fact heart disease is six times more likely to cause a woman's death than breast cancer. Indeed heart ailments disable and kill more women than all cancers combined.
Simply put, heart disease, not cancer, is a women's greatest health threat.
The good news is that much can be done to prevent or heal from heart disease. Awareness is the first step. Action is the second step.
Certainly one of the awareness challenges is to remove the gap between perception and reality. Contrary to popular beliefs, heart disease is not a man's disease, it's much more common than cancer and even in its advanced stages, heart disease does not loudly announce its arrival. It can sneak up on you without so much as a clue.
If you're willing and able to make lifestyle changes, much can be done to reduce your risk of heart disease. Improving your diet, getting regular exercise, saying goodbye to cigarettes, reducing stress and taking appropriate medication can all significantly reduce one's risk of getting heart disease.
To help you better understand heart disease and know what steps to take to prevent it, this Solanova Heart Health Report will come to you in two installments. Part one focuses on understanding heart disease: its dangers, symptoms, myths and realities. Part two, available in July, will focus on the action steps you and others you know can take to prevent the onset of heart disease or reduce your existing risk factors.
Learn the Truth about Heart Disease
- FICTION: Heart disease is a man's disease.
FACT: Heart disease is as threatening to women as it is to men. Among those with heart disease 52% are men and 48% are women.
FICTION: Women should be more worried about breast cancer than heart disease.
FACT: This year 42,000 women will die of breast cancer while 366,000 women will die of heart disease.
FICTION: Heart disease is an older woman's disease.
FACT: Heart disease begins in women under 20, many years before they have symptoms.
FICTION: Women and men experience heart disease similarly.
FACT: A woman's heart and arteries are smaller than a man's which can require different treatments. And symptoms of heart disease typically occur 10 years later for a woman than for a man.
FICTION: The symptoms for a heart attack are the same for men and women.
FACT: While men often complain of chest pain during a heart attack, many women experience no chest pain whatsoever. What they do experience is sleeping problems, unusual fatigue, indigestion, anxiety or shortness of breath. The symptoms can also be as vague as a backache, nausea, pressure in the upper abdomen, or jaw pain.
FICTION: If you think you're having a heart attack, you should wait a while to see if the systems continue.
FACT: If you "think" you're having a heart attack, time is of the essence. Call 911 immediately. Do not drive yourself to the hospital; use an emergency vehicle. Each minute that your heart is failing to get oxygen can be causing great damage.
Get in Touch with Your Heart
There's a certain irony that what keeps the heart safe and protected (tucking it behind the breastbone) might also be what makes it vulnerable: It's not a body part that gets much attention. Maybe if we actually did wear our hearts on our sleeves, we'd take better care of them.
For now, though, try this. Put your fingers at a pulse point, the inside of your wrist or at your neck. Don't count the beats; instead for a moment think about the miracle of what's really happening.
With each pulse, your heart is pumping the blood that feeds your entire body. So important is this constant supply of food that there is not a living cell in the body (except in bone, cartilage, cornea, testicles, and the inner ear) that is more than 20 microns away from a capillary-a distance one-third the diameter of a human hair.
Every part of your body depends on this miraculous pulse that enables your organs, muscles and cells to get the nourishment they need to do the job they were assigned to do. So think of your heart as the mother organ, the miracle worker that gives life and nourishment to all the other organs, muscles and cells.
Tiny but Mighty
Your heart is roughly the size of your fist and it weighs less than a pound. This small but very capable muscle contracts about 80 times every single minute. While you're sitting or resting, your heart is pumping at least a gallon of blood each minute; when you're exercising, it shoots to as much as six or seven gallons of blood per minute. (If you live to be 75 it'll beat about 2.5 billion times and pump out a million barrels of blood)
Your heart differs from other muscles in that it can't function without oxygen. (Leg muscles, for example, can continue to perform without oxygen as in anaerobic exercise.) For your heart to keep beating, it's got to have a steady supply of oxygenated blood.
What Is a Heart Attack?
Very simply put, a heart attack is when the blood supply to the heart is blocked, and the heart muscle, because it's not getting the oxygen it so desperately needs, is being damaged. The severity of the heart attack depends on how much of the heart is injured or dies during the heat attack.
What Causes a Heart Attack?
You'll understand a heart attack more easily if you think about the plumbing in your home. You have multiple water lines coming into your home. Sometimes debris can get stuck in these lines causing the flow of water to diminish or stop completely.
It's nearly the same with your heart. The lines leading to your heart, called coronary arteries, can become hard and narrow and lose their ability to support the heart's constant need for oxygen-rich blood. When the flow is diminished because of hardened, stiff arteries, it's called atherosclerosis.
Lots of things can make your arteries stiff and narrow: cholesterol which forms a crusty buildup on the inside of your arteries; fats called triglycerides; high blood pressure which causes arteries to be less flexible; and smoking which causes your arteries to constrict.
What Does a Heart Attack Feel Like?
Men and women can have very different symptoms. Typical symptoms of a heart attack include a heavy chest pain or tightness often moving out to the left shoulder or arm, shortness of breath, nausea, sweating, clamminess, and a feeling of general weakness or tiredness.
Women often experience very different symptoms when having a heart attack--symptoms such as unusual fatigue, nausea, dizziness, lower chest discomfort, back pain, or pressure in your upper stomach.
The rule of thumb, though, is if you think you might be having a heart attack, act quickly and assertively. Every minute counts. About half of all heart attack victims delay two hours or longer before deciding to get help. This can be serious, even fatal. Heart attacks have a 50% death rate if they happen outside of the hospital. Your best bet is to call 911 and have an emergency vehicle take you to the hospital. You'll get earlier treatment and also get faster help in the hospital.
Are You At Risk?
Because a heart attack can result in damage to the heart muscle, the heart attack you want to prevent is the first one. Knowing what puts you at risk is key to avoiding that first heart attack. The following list includes some (but not all) of the heart disease risk factors.
- Family History: Your family history is strongest as a risk factor for heart disease if first-degree relatives like your father, mother, sisters, or brothers were stricken at a young age.
Smoking: Smoking raises blood pressure, causes the arteries to constrict, and increases the likelihood of clots to form and obstruct the arteries. Smokers also have higher levels of bad LDL cholesterol and lower levels of good HDL cholesterol. Most dangerously, smoking more than triples a woman's chance of having a hear attack.
Diabetes: It's a serious risk factor for heart disease and more women than men have it. Women of color have a higher risk of type 2 diabetes, especially Native American, Latina, and African American women.
Excess Weight: Women who have excess body fat, especially in the waist area, are more likely to develop heart disease and stroke, even if they have no other risk factors. Excess weight increases the work of the heart, raises blood pressure, boosts LDL (bad) cholesterol and triglyceride levels and lowers HDL (good) cholesterol levels.
Hypertension: High blood pressure increases the risk of heart attack and coronary heart disease by about 25%. More than half of all women over age 45 have it.
Life After Heart Disease Diagnosis
Sue Fredrickson got the wake-up call of her life when she found out that her arteries were so blocked that she would need triple bypass surgery. In just four weeks' time she went from thinking of herself as healthy to needing immediate open-heart surgery.
In the months since her surgery, Sue has made a number of changes in her life. She's modified her diet (less salt, more seafood, more grains and fiber-rich foods, less high-saturated fat foods). Sue has reduced the levels of stress in her life. She has a new, less stressful job and she is seeking more balance in her life.
"I see myself as lucky," says Sue. "My disease was discovered in time. Physically I'm nearly back to where I was. Mentally, I'm happy to say, I'm well ahead of where I was. I take nothing for granted. I'm heading off this weekend to my daughter's graduation from Furman University in South Carolina. I can't begin to say how happy it makes me feel to be able to be here for her."
"I want the next phase of my life to be about wisdom, the wisdom to be and do what matters most. I'm beginning a new business for women, volunteering at my hospital to help others who can gain from my experience and hopefully avoid the onset of heart disease, and focusing on becoming a living example for my children and the people in my life who I care about. I want to take good care of myself and live with purpose, balance and heart."
Part 2 of this article will appear in the July Heart Health Report.
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