Her Heart

…is im­por­tant too. Women, take risks se­ri­ously.

Health & Nutrition - - CONTENTS -

It’s es­ti­mated that al­most half of the women don’t re­al­ize that heart dis­ease is the top cause of death in women – just as it is for men. For women, un­der­stand­ing heart-health risks can pro­vide the knowl­edge and mo­ti­va­tion to take se­ri­ously the med­i­cal steps and life­style changes that can greatly re­duce this risk.

Large And Small

Coro­nary artery dis­ease (CAD) is a process in which the in­ner layer of ar­ter­ies is dam­aged. In­flam­ma­tion may be one of the fac­tors that start the dam­age, and fatty de­posits (plaques) tend to ac­cu­mu­late at the site over time. This process is called ath­er­o­scle­ro­sis. It can nar­row ar­ter­ies and re­duce – or some­times even­tu­ally block – blood flow.

CAD can set the stage for even­tual heart at­tack, heart fail­ure or po­ten­tially deadly heart rhythm prob­lems. Ath­er­o­scle­ro­sis can also oc­cur in other ar­ter­ies, such as those that sup­ply the brain with blood, in­creas­ing the risk of stroke. As the name sug­gests, coro­nary artery dis­ease oc­curs in the ar­ter­ies that sup­ply the heart with blood. Tra­di­tion­ally, CAD has been as­sumed to af­fect only the larger ar­ter­ies that sup­ply blood to the heart. In­deed, women and men most com­monly ex­pe­ri­ence CAD in the largest heart ar­ter­ies. But there’s an­other way CAD can oc­cur that’s more com­mon in women than in men. It’s called coro­nary mi­crovas­cu­lar dis­ease, and it in­volves clog­ging and nar­row­ing – or im­proper func­tion – of the heart’s tini­est blood ves­sels. If your doc­tor sus­pects CAD but large ves­sel di­ag­nos­tic test­ing shows clear ar­ter­ies, ad­di­tional di­ag­nos­tic test­ing may be per­formed to de­tect coro­nary mi­cro va­suclar dis­ease.

Subtle Symp­toms

Chest pain, pres­sure or tight­ness is the most com­mon symp­tom of heart at­tack in men and women. Women are more likely than men to have non­typ­i­cal heart at­tack signs and symp­toms that don’t in­clude chest pain, but may in­clude symp­toms such as: Neck, shoul­der, jaw or ab­dom­i­nal dis­com­fort Short­ness of breath Unusual weak­ness or fa­tigue Light­head­ed­ness or dizzi­ness Sweat­ing Nau­sea or vom­it­ing A heart at­tack oc­curs sud­denly, but symp­toms may have been present prior to the acute event, oc­cur­ring hours, days or weeks be­fore the heart at­tack. Women some­times fail to seek im­me­di­ate eval­u­a­tion of heart at­tack symp­toms. Sus­pected rea­sons for this in­clude the some­times­non typ­i­cal symp­toms, a gen­eral lack of aware­ness of heart at­tack risk, and a re­luc­tance to be a bother or to sound a false alarm.

In women, smok­ing – when par­tic­u­larly com­bined with oral con­tra­cep­tive use – ap­pears to in­crease risk of CAD by about 25%.

Fa­mil­iar Risks – With A Twist

Com­pared with men of a sim­i­lar age, pre­menopausal women have less than half the risk of de­vel­op­ing heart dis­ease. How­ever, this gap in risk be­gins to rapidly nar­row af­ter menopause for rea­sons that may be par­tially – but not fully – ex­plained by re­duc­tions in es­tro­gen af­ter menopause. The pri­mary causes of artery dam­age that starts and sus­tains the de­vel­op­ment of CAD are well-known. How­ever, these risk fac­tors can af­fect women in dif­fer­ent ways than they af­fect men. Pri­mary risk fac­tors in­clude: Smok­ing – In women, smok­ing – when par­tic­u­larly com­bined with oral con­tra­cep­tive use – ap­pears to in­crease risk of CAD by about 25% over the al­ready high risk of CAD that male smok­ers ex­pe­ri­ence. It also ap­pears that women also have a greater de­gree of risk at less cig­a­rette use com­pared with men. High blood pres­sure (hy­per­ten­sion) – There’s a higher preva­lence of high blood pres­sure in women older than 60 than in men older than 60. In ad­di­tion, blood pres­sure is of­ten less well-con­trolled in women than in men. Un­de­sir­able choles­terol lev­els – Younger women tend to have health­ier choles­terol lev­els than do younger men, but af­ter menopause, un­healthy choles­terol lev­els in women rise to higher lev­els than in older men. Di­a­betes – Com­pared with men with di­a­betes, women with di­a­betes have heart at­tacks that oc­cur sooner over the course of the dis­ease and are more deadly. Women with di­a­betes are also at greater risk of heart fail­ure and stroke than are men with di­a­betes. Obe­sity – Some re­search in­di­cates that the risk of CAD in obese women is higher than in obese men, with fat that’s stored in the belly be­ing a more po­tent risk fac­tor than fat lo­cated on the hips, thighs and but­tocks. Lack of phys­i­cal ac­tiv­ity – Women are of­ten less ac­tive than are men.

Fe­male Risks

Sev­eral ad­di­tional risk fac­tors are more com­mon – or oc­cur ex­clu­sively – in women, in­clud­ing: Re­pro­duc­tive is­sues – Preg­nancy is­sues that can pre­dict in­creased risk of CAD

Chemo­ther­apy drugs, and ra­di­a­tion per­formed very close to the heart, can in­crease CAD risk.

later in life in­clude pre-term de­liv­ery, high blood pres­sure disor­ders such as preeclamp­sia, ges­ta­tional di­a­betes or weight gain with preg­nancy that doesn’t go away within a year af­ter birth. Hav­ing poly­cys­tic ovary syn­drome can also in­crease CAD risk. Au­toim­mune dis­eases such as rheuma­toid arthri­tis – These dis­eases, which are as­so­ci­ated with higher lev­els of in­flam­ma­tion, raise CAD risk. Treat­ment of breast can­cer – Chemo­ther­apy drugs, and ra­di­a­tion per­formed very close to the heart, can in­crease CAD risk. Early menopause – CAD risk ramps up af­ter menopause. If you have an early menopause, this ramp-up starts sooner than in women who ex­pe­ri­ence menopause later. De­pres­sion – This is a risk fac­tor for men and women of all ages, but de­pres­sion is more com­mon in women.

Take It Se­ri­ously

The list of risks above high­light two im­por­tant points: Heart dis­ease needs to be at the top of the health con­cern list for many women, and in par­tic­u­lar older women. Take se­ri­ously the risks that you can con­trol or mod­ify. Don’t wait for signs of trouble. About 64% of women who die sud­denly of heart dis­ease have no pre­vi­ous symp­toms. Rather, fol­low the main tracks for re­duc­ing risk, which in­clude: Life­style changes – Fo­cus­ing on the ba­sics is key. Re­search has demon­strated that by not smok­ing, main­tain­ing a fairly healthy body weight, con­sum­ing a healthy diet, drink­ing al­co­hol in mod­er­a­tion if at all, and get­ting reg­u­lar ex­er­cise can re­duce the risk of heart prob­lems by greater than 80%. Work­ing with your doc­tor – Med­i­ca­tions or other ther­a­pies may be needed to help ad­dress risks, such as con­trol­ling di­a­betes, man­ag­ing de­pres­sion, or keep­ing your choles­terol or blood pres­sure at healthy lev­els. If you have con­firmed CAD, these steps may be ap­proached more ag­gres­sively and a car­diac re­ha­bil­i­ta­tion plan may be adopted. Ad­di­tional steps – such as surgery to im­prove blood flow to the heart – also may be con­sid­ered.

Con­sum­ing a healthy diet, drink­ing al­co­hol in mod­er­a­tion if at all, and get­ting reg­u­lar ex­er­cise can re­duce the risk of heart prob­lems.

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