Remember: Heart disease is a now problem. Later might be too late.
Your heart beats an average of 70 beats per minute; in an hour that adds up to 4,200 beats. In 24 hours that’s more than 100,000 beats. In a year your heart beats close to 37 million times. And by the time you’re 50 years old, that’s approximately 1,800,000,000 beats. All that time, your heart has been beating 24 hours a day, seven days a week.
An organ that works so unceasingly hard for you deserves the proper attention and care, right?
So what is heart disease really? It’s when our heart doesn’t get enough nutrient-rich blood. Heart disease can become chronic because often we don’t know when trouble has been developing, often over many years. The condition known as atherosclerosis causes our arteries to harden as cholesterol, fat, and other substances build up in the artery walls; blockage can result in a heart attack. If not “fixed” by surgery or medical interventions (such as bypass, angioplasty, or medication), the condition will worsen, which can lead to disability or death. Heart disease can be prevented or controlled. Treatment includes lifestyle changes and, if needed, medication.
Now don’t give up on me here. Stay with me! This is what we have to know. You might be tempted to think, “Oh, I already know this!” But please: Read this chapter as if it were a juicy, gossipy, personal story that someone has e-mailed to you by mistake.
Factors Within Your Control That Increase Women’s Risk of Heart Disease
Listed below are actions that women can take that have the power to prevent or control heart disease.
Smoking: About 22.7 million women smoke. Women who smoke are six times more likely to have a heart attack than those who don’t smoke. Luckily, you can reverse the damaging effects of smoking if you quit now.
High Blood Pressure or Hypertension: About 30% of women have hypertension (the condition’s medical name). Uncontrolled high blood pressure can lead to heart failure, which affects about 2.5 million women. High blood pressure can often be hereditary, but it can be regulated with medication. You can help yourself by:
• following a healthy eating pattern;
• reducing salt and sodium in your diet;
• maintaining a healthy weight;
• being physically active; and
• limiting your intake of alcohol.
High blood pressure, or hypertension, is defined in an adult as a systolic pressure of 140 mm Hg or higher and/or a diastolic pressure of 90 mm Hg or higher. Blood pressure is measured in millimeters of mercury (mm Hg).
High blood pressure can occur in children or adults. It’s particularly prevalent in African-Americans, middle-aged and elderly people, obese people, and heavy drinkers. People with diabetes mellitus, gout, or kidney disease have hypertension more frequently. Of all those who have high blood pressure, 11% are not on medication, 25% are on medication but don’t have their condition under control, and 34% are on adequate medication and have their hypertension under control.
The cause of 90–95% of the cases of high blood pressure isn’t known; however, this disease is easily detected and usually controllable. High blood pressure directly increases the risk of coronary heart disease (which leads to heart attack) and stroke, especially when other risk factors are present. High blood pressure usually has no symptoms. It is truly a silent killer. But a simple, quick, painless test can detect it.
Diabetes: Diabetes is known to raise triglycerides and lower the amount of so-called “good cholesterol,” or HDL. A low level of HDL has been shown to be the most powerful forecaster of heart disease. A high level of sugar in the blood also has a toxic effect on the walls of your arteries. Increased glucose, combined with cholesterol, increases the risk of developing atherosclerosis (also known as hardening of the arteries). This is a normal process of aging, but occurs at an accelerated rate in people with diabetes.
Ninety-five percent of the people I encountered at cardio rehab had diabetes as well as heart disease. So, women with diabetes, take care of yourself, the health of your heart is also at stake!
High Cholesterol: About 55 million women have high total cholesterol. What is cholesterol?
When I was first told I had plaque in my carotid artery, I had to ask the nurses what plaque was. Cholesterol is plaque; it’s a waxy substance produced by the liver. It’s also found in foods we eat that come from animals, such as meats, egg yolks, shellfish, and whole milk dairy products. When our bodies make too much cholesterol or too much is absorbed from the foods we eat, it’s deposited in our arteries as plaque.
There are two kinds of cholesterol:
• “Bad” cholesterol, or LDL (low-density lipoproteins), clogs your arteries and puts you at risk for heart disease. LDL cholesterol is called bad because it’s the type that gets stuck inside the walls of your blood vessels. And I used to think that LDL just stood for Lousy Cholesterol!
• “Good” cholesterol, or HDL (high-density lipoproteins), actually helps to remove bad cholesterol from your body. HDL lipoproteins are called good because they find and pick up stuck cholesterol, and return them to your liver.
• Triglycerides are a separate category. Triglycerides are particles made up of a small sugar-like molecule and three attached fatty acid molecules. They can be dangerous, too. Triglycerides are the chemical form in which most fat exists in food as well as in the body. Triglycerides in blood plasma are derived from fats eaten in foods or made in the body from other energy sources like carbohydrates. Calories ingested in a meal and not used immediately by your tissues are converted to triglycerides and transported to fat cells to be stored. Hormones regulate the release of triglycerides from fat tissue so they meet the body’s needs for energy between meals.
Elevated levels of triglycerides have been linked to the occurrence of coronary artery disease in some people and may also be a consequence of other disease, such as untreated diabetes mellitus. Like cholesterol, increases in triglyceride levels can be detected by plasma measurements (after an overnight food and alcohol fast).
It’s important to know, among other things, that simply taking some form of statin, or cholesterol-reducing medication, doesn’t give us carte blanche to eat anything and everything we want. (As I had personally hoped it would!) We still have to watch what we eat, because non-nutritious delicacies filled with white flour and sugar could raise our triglyceride levels and cause heart disease just the same.
How Do You Know if Your Cholesterol Is High?
Many people simply do not know. High cholesterol is often referred to as a “silent disease.” People with high cholesterol usually don’t have any symptoms. That’s why it’s so important for adults to have their cholesterol screened at least every five years. Yearly, we women are supposed to see a gynecologist. Use that visit to have your cholesterol level checked, too; if it’s high, insist on being referred to a cardiologist.
Be equipped. Know what your numbers mean and what they should be. New women’s heart guidelines urge more aggressive treatment. The new guidelines issued by the American Heart Association (AHA) recommend treatment for women based on their levels of risk: high risk, intermediate risk, and lower risk. These guidelines call for women to have slightly higher levels of HDL, or “good” cholesterol, than men. They recommend a greater use of cholesterol-lowering medicines, especially for women at high risk for heart attacks even with normal cholesterol levels.
The optimal goal for total cholesterol is 200 milligrams per deciliter of blood (mg/dL), but the real bull’s-eye target is your level of low-density lipoprotein (LDL) cholesterol, which nestles in artery walls and blocks blood flow. According to the Adult Treatment Panel III (ATPIII), a set of guidelines developed by the government, optimal LDL levels should be less than 100 milligrams per mg/d, while levels of high-density lipoprotein (HDL) levels should be more than 50 mg/dL. Those with higher cardiovascular risk benefit by even lower LDL-C levels, below 70 mg/dL.
About 45 % of women may need some form of statin, a family of cholesterol-lowering drugs.
Overweight/obesity: About 62% of U.S. women are overweight, including about 34% who are obese. We have been inundated with every diet on the market. We know what we should be doing for ourselves, and we know the many options that are available to us. Sometimes we just need a little trick to get started.
Here’s my trick: for every 10 grams of fruit or cereal fiber you swallow daily, your risk of dying from heart disease falls by 27%. (I found this tidbit in a review of 10 studies from the Archives of Internal Medicine). Shoot for a total of 25-30 grams of fiber from all sources each day. Do this gradually. I became so excited with the facts that I added the 30 grams of fiber to my diet instantly, and my family moved out of the house! Just kidding. But eat fiber—lots of fiber!
It’s amazing: Year after year, heart disease remains the number-one killer of American men and women. Nearly 62 million Americans of all ages have cardiovascular diseases, according to the American Heart Association. And yet a healthful low-fat eating plan, combined with regular physical activity, is the key to heart health. Eat foods low in saturated fat and cholesterol.