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Ladies, know about your heart

Heather Swales, M.D. [February 17 2011]

It can be a shock when a woman learns she has heart disease. Recently, a family member called me, shocked and alarmed that a female friend was diagnosed with atrial fibrillation. My relative had many questions, wondering why the friend has heart disease. As a female who gets paid to “know about hearts,” herein lies an opportunity to share some information about heart conditions and heart health for women.

Atrial fibrillation, for example, is among several diseases grouped in the category of cardiovascular disease (CVD), the leading cause of death for women in the United States. CVD also includes congestive heart failure, stroke, and coronary artery disease, the major cause of heart attacks. With atrial fibrillation the top chambers of the heart (atria) beat chaotically and irregularly, increasing the risk of developing a stroke from blood clots that form in the heart and sometimes causing the heart to beat too fast.

Heart disease in women is all too common. Yet a recent study by the American Heart Association (AHA) found that only 54 percent of women knew CVD is the leading cause of death for women. Compared to men, women also have a higher mortality rate following a first heart attack and are more likely to develop a recurrent heart attack.

Consider this: A 40 year old healthy woman has a 50 percent chance of developing CVD in her lifetime compared with a 12.5 percent chance of developing breast cancer or 5.9 percent chance of developing colon cancer. By the time she is 70, she still has a 50 percent lifetime risk of developing CVD while her risk of developing dementia is 20 percent and her risk of developing breast cancer drops to 7.1 percent.

Surprisingly, in the AHA study, most women listed antioxidant and vitamin therapy as effective CVD prevention strategies despite a plethora of data that to date have shown no proven benefit. Fortunately, there are many well-studied and effective actions women can take to help prevent CVD. These include:
• exercising regularly, ideally doing moderate intensity aerobic activity for 30 minutes seven days a week or a minimum of five days a week;
• maintaining a healthy weight, with a body mass index (BMI) between 19 and 25 kg/m2;
• refraining from tobacco use and exposure to secondhand smoke;
• keeping alcohol use in moderation; and
• obtaining routine blood pressure, cholesterol and diabetes screenings, and if necessary, treatment. A normal blood pressure is less than 120/80 mmHg and prehypertension or early high blood pressure is between 120-139/80-89 mmHg; aim for a total fasting cholesterol level below 200 mg/dl with an LDL (bad cholesterol) below 160 mg/dl if you have one or less cardiac risk factors; and a fasting glucose level below 100 mg/dl.

Some types of CVD risk factors are initially silent, like high blood pressure and high cholesterol, but detectable through various tests, like cholesterol screening. And, all too often, CVD symptoms can manifest themselves through a heart attack or stroke, for example. Warning signs of a heart attack can be different in women compared to men but can include pain in the chest, neck, jaw or back, fatigue, weakness, shortness of breath, and nausea. Warning signs of a stroke can be remembered with the acronym FAST: Face is uneven, Arm is weak, Speech is strange, Time to call 911. If you are worried you may be having a heart or stroke, call 9-1-1 right away.

February is American Heart Month, an ideal time to start doing for CVD what women have already done so well with breast cancer: raise awareness about the disease through talking, sharing, asking and learning.

Cardiologist Heather Swales, M.D., is a member of The Hospital of Central Connecticut (HCC) medical staff. For referrals to HCC physicians, please contact our free Need-A-Physician referral service by phone at 1-800-321-6244 or online, www.thocc.org. Learn more about cardiovascular medicine at HCC