Women and Heart Disease

In the past, heart disease was believed to be a man’s problem; when it happened to a woman, it was thought to be just bad luck. In fact, nothing could be further from the truth. So what makes heart disease such a pressing problem for women? “A big part of the issue is that women tend to focus more on preventing breast or ovarian cancer,” says cardiologist Michael Weinrauch, MD. “What they don’t realize is that heart disease is much
more common.”

What’s more, when a woman falls victim to heart disease, her symptoms can sometimes present atypically (meaning they don’t appear like a heart attack), so she’s more likely to write them off as stress, indigestion, or fatigue. But it’s crucial to pay attention to what your body is telling you. “Any new symptom that even remotely suggests heart disease should be evaluated,” says Steven Sheris, MD, chief of cardiology at Overlook Hospital. If this seems a bit dramatic, consider this: Research has shown that women are more likely than men to die from a heart attack or have worse outcomes after an attack, mainly because they get to the hospital later (on average, almost two hours later), when the damage has already been done. “In addition, a woman’s arteries are smaller, which makes them more vulnerable to blockage,” explains Sheris. “When a clog forms, it becomes obstructive
much faster.”

The Buzz on CRP

“Heart disease is really a disease of the blood vessels, caused by inflammation of the vessel wall,” explains William Tansey, MD, a cardiologist at Overlook Hospital and a member of the board of the American Heart Association. “Although for years we’ve known how to diagnose and clear blocked arteries, that doesn’t really get to the root of the problem.” Here’s what happens: Rising levels of bad cholesterol can infiltrate blood-vessel walls, causing inflammation and leaving the vessel frail and prone to cracking. When cracks occur, a clot forms to repair the damage—just like when you cut your finger—but in this case the clot can lead to a heart attack or stroke. “The body’s natural way of healing itself actually works against you here,” says Tansey.

Recently, however, a new test known as CRP (which stands for C-reactive protein) has been used to measure vessel inflammation and give doctors a chance at treating the condition before the worst happens. The test works by measuring the amount of C-reactive protein in the blood. An elevated level can indicate the presence of inflammation. When used in conjunction with other tests, the CRP can also be useful in suggesting the best course of treatment for a patient. For example, a high CRP coupled with a diagnosis of high cholesterol may prompt a doctor to prescribe statins, like Lipitor, which lower bad cholesterol and ease swelling.

Although there has been some controversy over the definitiveness of CRP testing, it certainly can be a valuable tool for assessing a patient’s risk and identifying heart disease in its early stages. If you would like to know your CRP score, talk to your doctor.

A Healthy Heart is Up to You

Fortunately, there is plenty you can do to safeguard your heart. Plus, research has shown that when you start looking after your own heart health, your whole family benefits. “The fact is that women tend to direct the lifestyles of their families,” says Tansey, “so when we educate women about the importance of monitoring their cardiac health, we also reach their husbands, aging parents, and growing children as well.”

The best way to start is by first assessing your risk for heart disease. Although no one is completely immune, a whole host of factors make you more vulnerable. Consider yourself at elevated risk for heart disease if you are overweight or have a sedentary lifestyle; have diabetes, high blood pressure, high cholesterol, or a high CRP score; smoke; or have a family history of heart disease.

The next step is to make the necessary lifestyle changes. Here, doctors Weinrauch, Sheris, and Tansey offer their Top 10 suggestions for taking care of your heart.

1. Be aware of your risk at all times: This means having your blood pressure, blood sugar, CRP, and cholesterol checked regularly—especially after menopause.


2. Get moving. Regular exercise (at least three times a week for 30 minutes) has been proven to cut the risk of heart attack and stroke in both men and women. And it may seem trivial, but be sure to wear good sneakers when you work out. Even a minor sports injury could sideline your fitness regimen for weeks.


3. Eat right. This doesn’t mean limiting yourself to lettuce for the rest of your life, but adhering to a healthy, balanced diet that includes fruits, vegetables, whole grains, low-fat dairy products, beans, lean protein, and fish that are rich in omega-3 fatty acids (think salmon, tuna, and trout).


4. Don’t smoke, plain and simple. And if you live with a smoker, encourage him to quit by reminding him that each puff compromises the health of everyone in the house.


5. Maintain a healthy weight. For most adults this generally means a BMI (body mass index) of less than 25. If it turns out that you need to shed a few pounds, do it with the help of a sustainable weight-management program, not a crash diet. Your doctor should be able to suggest a program or nutritionist in your area.


6. Get regular checkups with your primary-care physician. The same blood-vessel inflammation that causes heart attacks can also affect your brain and kidneys, so don’t neglect the rest of your body. (And of course you still need that mammogram, colonoscopy, and annual Pap smear.)


7. Keep stress at a manageable level or seek counseling to help you cope effectively.


8. Find out about your family’s health history once and for all (if not for yourself, then do it for your children). Although you can’t change your genetics, you can arm your doctor with useful information that could lead to more effective treatment and even save your life.


9. Stay on top of the latest developments in heart-disease treatment and speak to your doctor about how these might benefit you. Don’t wait for your doctor to take the lead on this one—be proactive in your own health care.


10. If you do suffer from heart disease, diabetes, or high blood pressure, take all your medication exactly as your doctor instructed and never skip a dose—no matter how good you feel or how inconvenient it is to remember during the day.
    

For a referral to a cardiologist, call (866) 798-6712.