Don't Miss a Beat

Do you know what poses the greatest health risk in women? It’s hard to fight an enemy if you don’t know what it is. Yet 54 percent of women asked to identify the number one killer of women thought it was cancer. In fact, it’s heart disease.

“Cardiovascular disease kills more women than the next seven causes of death combined,” says Soma Sen, MD, medical director of the Park Nicollet Women’s Cardiovascular Center in St. Louis Park. “There is a big discrepancy between the reality and the fact.”

The Women’s Cardiovascular Center opened in October 2006, just two years after North Memorial opened its Women’s Heart Clinic in Plymouth. These centers are two of the most visible community efforts to build awareness of the urgency of heart health for women. They are part of a nationwide trend of medical centers opening women’s heart centers to improve the delivery of cardiovascular care for women, provide gender-specific care and information relating to women and heart disease (e.g., the effects of estrogen on the heart), and offer a comfortable place where women know their concerns will be taken seriously.

Heart disease, traditionally thought of as a “man’s disease” until rather recently, actually kills more women than men—in part because women live longer, but also because for many years research, prevention, and treatment was targeted to men, and thus women have had a somewhat unfavorable outcome with treatment compared to men.

However, according to Mary Heintz, MD, a cardiologist at the Minnesota Heart Clinic in Edina, that trend may be changing for the better as more and more women are getting the message. “Things have improved significantly over the last five years, and we are seeing women who are at risk much, much earlier,” she says. “In my early career, women had a pretty poor prognosis by the time they were diagnosed.”

Get Personal
Women need to know the risk factors for heart disease—and there are many. These can include age, sex, ethnicity, and a family history of heart disease or diabetes. Other factors to consider are an unhealthy body mass index (an assessment of your body weight relative to height), smoking, high blood pressure, high cholesterol, high blood sugar, a sedentary lifestyle, a stressful lifestyle, and a high-fat diet. But simply being aware of the global risk factors is not enough, experts say.

Women need to take a closer look at their own lifestyle and family history and begin to figure out which risk factors may be specific to them personally. Having a better understanding of this will in turn help women, and their doctors know how aggressive to be when it comes to prevention and treatment, says Victor Tschida, MD, medical director of the Nasseff Heart Center at United Hospital in St. Paul. While women have learned a great deal in the last several years, they haven’t really personalized this information to the point where they think, “this is something I have to do for me,” Tschida notes. “Women need to be looking at heart disease, and they need to be talking to their doctors about it.”

If you’re looking for a quick way to calculate the risk of having an adverse heart event during the next ten years, use a tool based on the Framingham Heart Study (that takes into consideration factors such as age, sex, and blood pressure), Tschida advises. A “one-stop shop” for this tool and other heart information can be found at the American Heart Association’s website.

Take Control
Certain risk factors for heart disease cannot be controlled, such as age, ethnicity, or a family history of heart disease or diabetes. But 80 percent of heart disease is preventable through lifestyle factors such as regular exercise, a healthy diet, smoking cessation, knowing your risk factors, and open doctor-patient communication, says Pam Paulsen, MD, medical director of the North Memorial Women’s Heart Clinic.
Here are some smart steps you can take starting today:

Exercise regularly: The goal for both men and women is thirty to sixty minutes of moderately vigorous exercise five or six times a week. But Paulsen says to remember that’s a goal. “It may take time to get to the goal,” she says. “Start out with twenty minutes, then twenty-two minutes the next week.”

In general, she says, any kind of exercise is good, but cardiovascular exercise such as walking or swimming is key. Strength training such as Pilates, yoga, or weight training should be considered a great adjunct to aerobic exercise rather than a substitute for it.

Exercise lowers blood pressure and cholesterol, strengthens the heart muscle, boosts mood, and relieves stress. “As we are stressed in our lives, certain hormones and chemicals build up in our bloodstream, and the only way to burn up those chemicals is to exercise,” Paulsen says.

Eat healthy: With the almost daily, sometimes contradictory media reports on which foods are healthy and which aren’t, it can be difficult to tease the truth from the reality, Heintz says. “I think the best thing for women is to eat a well-varied diet,” she says.

That means getting plenty of fresh fruits, vegetables, and fiber and avoiding saturated fats and trans fats, sodium, and too many carbohydrates. “I never tell someone ‘You can never eat this,’” she says. “I say, ‘Just don’t eat it every day.’”

Don’t smoke: Women need to do whatever it takes to quit smoking—today, says Luis Pagan-Carlo, MD, medical director of the Ridgeview Heart Center in Waconia. “Their risk is worse for vascular complications, as opposed to men who smoke,” he says.

Know your numbers: Each year, women should have a physical exam, which includes measurement of their blood pressure, cholesterol and blood sugar levels, body mass index, and waist circumference, Sen says. These measurements are an indication of a woman’s individual risk factors, and optimizing these numbers can help cardiovascular health in the long run.

Talk with your doctor: A woman with a family history of premature coronary artery disease or stroke (in male family members diagnosed at age fifty-five or younger or in female family members diagnosed at age sixty-five or younger) should start talking to her primary care physician about heart health in her thirties, Sen says. If she has no family history of these diseases, she can probably wait until her forties.

Women need to become more aware of the symptoms of a heart attack, Tschida says. “Women need to be aware that heart attack, for example, presents differently in women,” he says. Men tend to experience crushing chest pain radiating down the left arm, while women may have more subtle, vague symptoms, such as breathlessness, nausea, vomiting, and fatigue, he says. “Women haven’t been tuned into this as a likely diagnosis,” he says. And as a result, he notes, “They haven’t sought help when they should have.”

Many women who have experienced these symptoms sometimes hesitate or forget to bring them up with their doctor, Paulsen says. “Any person, when they come to medical care, tends to downplay their own symptoms,” she says. “We forget what questions we want to ask, because people feel vulnerable in health care.”

Paulsen recommends that patients take a friend or family member with them to an appointment to listen, take notes, and remind the patient of issues they wanted to address. If that isn’t possible, she suggests that patients write down their top few concerns and bring the list with them.

In the end, you are the key to combating and winning the battle against heart disease. Life doesn’t come with a guarantee, but why not stack the odds in your favor? Start managing your heart health today.