Caroline V. Charonko, RN, MSN, MA
Women’s greatest fear is often breast cancer, yet heart disease
kills more women each year than all forms of cancer combined. The
death rate for women with breast cancer is about 1 in 25, but the
death rate for women with heart disease is 1 in 2. Heart disease is
often diagnosed in women later than in men. The American Heart Association
calls heart disease in women a "silent epidemic" since it
is often unnoticed in the early stages of development. Once symptoms
become apparent in women, the disease is often severe. It seems women
need to learn more about heart disease.
Many factors are known to increase the risk of developing heart disease.
Some cannot be controlled, but many can. If any uncontrollable risks
are present, lifestyle choices become even more important. The same
risk factors that cause coronary artery disease can also lead to blockages
in other areas of the body like the carotid arteries, resulting in
increased risk of stroke, the kidneys, increasing the risk of high
blood pressure, and legs, resulting in pain with activity. The risk
of disease goes up as the number of risk factors increases.
Some risk factors for heart disease in women are uncontrollable.
These include a family history like a male relative with disease before
the age of 45 or a female relative with disease before age 55. Greater
age is a factor and so is ethnicity. African Americans and Hispanics
are more likely to be affected. High Blood Pressure and a total cholesterol
over 175 contribute to developing heart disease. If the low density
LDL, the “bad” cholesterol, is above 100 or if the high
density HDL, the “good” cholesterol is below 45, the risk
increases. A third Very Low Density cholesterol contributes to the
total cholesterol level and should be below 30. Triglyceride levels
over 150 are a factor and so is a blood sugar level above 110.
The use of oral contraceptives, especially in smokers, raises the
risk for heart disease. So does regular consumption of more than two
alcohol drinks daily or routine exposure to second hand smoke. Early
onset menopause, stress and depression are also risk factors. Chronic
anger, hostility and even cynicism have a negative effect. Social
isolation, obesity and inactivity increase the risk.
Some emerging risk factors, determined by blood tests, should also
be considered. These include: high homocysteine levels, insulin resistance
syndrome, the presence of lipoprotein (a) and/or C-reactive Protein,
fibrinogen and platelet levels, sleep apnea and periodontal (gum)
disease.
It’s important to know about risk factors, but more important
to do something with the information.
The risk of developing heart disease can be reduced by 30 minutes
of aerobic activity every day and by lowering cholesterol levels and
blood pressure with diet, exercise, stress management, and/or medications.
Losing weight helps. Stopping smoking, or using any other form of
tobacco products helps, too. Counseling and/or medications can help
control emotions. A diet with more whole grains, vegetables, and fruits
and less animal protein is healthier. Limiting alcohol intake is also
recommended.
Diabetes control is essential.
Even with no apparent symptoms, it is important for women to get
adequate rest and sleep, have regular dental exams, and talk to their
doctor about heart disease risks and a plan for lowering them.
Doing something for others or talking to friends, a minister or a
counselor is a painless way to reduce heart disease risk. Health professionals
say patients who enjoy life and remember to laugh live longer lives.
If heart disease is present, it’s important to recognize the
symptoms and seek help early. Women often have indirect symptoms like
a burning feeling in their chest area, shortness of breath, especially
with activity, dizziness, extreme tiredness, pain between the shoulder
blades, or a racing heart which may be diagnosed as anxiety or panic
attack. Because women’s symptoms are often not the same as men’s
-chest pain, pain down the left arm, feeling like there’s an
"elephant on my chest", upset stomach -sometimes they’re
harder to recognize.
It’s common for women to "feel that something is very
wrong" yet not be able to say exactly what is wrong. Any of these
symptoms should result in a talk with a doctor. If the symptoms persist,
don’t drive to the hospital.
Make the call to 911.
Caroline V. Charonko is a Family Nurse Clinician, CS and Licensed
Professional Counselor, NCC in Charleston. For more information, contact
your doctor or the American Heart Association 1-800-242-9721. Helpful
publications: Women Are Not Small Men by Nieca Goldberg, MD, The Female
Heart by Marianne Legato, MD and Carol Colman and Her Healthy Heart
by Linda Ojeda.
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