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Friday, February 22, 2008
Excerpt from the February/March 2008 Boston Women's Journal
Heart disease isn’t just for men anymore. Although many women don’t realize it, heart disease is in fact the number one killer of American women, more lethal than all forms of cancer combined.That’s the bad news. But Kate Traynor, RN, MS, Director of the Cardiovascular Disease Prevention Center at the Massachusetts General Hospital Heart Center, has some good news. “There are specific things a woman can do in every decade of her life to help prevent heart disease. February is Go Red for Women month, a perfect time to make or renew a commitment to your heart.”
Even young women can start taking steps to manage their health and protect their hearts. Know your family history. Know who in your family has experienced heart disease and talk to your doctor about how your family history may affect your own risk profile.Take stock of your health habits. The eating and exercise habits you learned growing up can be either a boon or a burden to you. According to Traynor, “These habits are a part of your cardiac inheritance as surely as your DNA, but unlike your DNA, you can change your habits. Now is an excellent time to take stock of and reinforce what you are already doing well and change some behaviors that aren’t so helpful.” Don’t smoke. If you don’t smoke, congratulations! If you do smoke, stop now. Of all the things you can do to protect your heart, smoking cessation is perhaps the most beneficial. And conversely, continuing to smoke can negate the benefits of an otherwise healthy lifestyle and put you at elevated risk to develop heart disease.Develop healthy eating and exercise habits. Many young women have an unrealistic body image, and trying to achieve that image can lead to unhealthy and even dangerous dietary and exercise habits. Learn how to eat and exercise in a way that supports your heart health now and in the future.Kathleen Gallen, RN, Outpatient Access Nurse for the Heart Center, adds “Many women in their twenties are focused on building their careers, but it is important not to overlook the development of positive self-management skills and healthy eating, exercise and non smoking behavior.”Discuss your birth control choices with your gynecologist. This is particularly important if you have a family history of heart disease. Oral contraceptives, even in the new lower estrogen formulations, are associated with an increased risk for blood clots, and may not be the best choice for you.
For many women, these are the childbearing and child-rearing ages - busy years, with new responsibilities and less time for yourself.Pay attention to your numbers. This is a good time to know your cholesterol, blood pressure, and ideal weight. If your numbers are within normal limits, you have a good baseline for comparison as you get older. If your numbers put you at elevated risk for future heart disease, now is the time to work with your health care provider to manage your numbers and lower your risk.Be aware of cautionary signals in pregnancy. Gestational diabetes and hypertension have some predictive value and may signal an elevated risk for developing these diseases later in life. Be sure to share this information with your doctor and follow his or her recommendations for continuing surveillance and management.Set a good example for your children. Children are influenced much more by what you do than what you say. Model good eating, exercise, and stress reduction strategies for them, and start them off on a lifetime of heart-healthy habits.Take care of yourself. The demands of managing a family and sometimes a career as well can seem like an excuse to put ourselves last and to abandon our good health habits. But Traynor reminds women, “You can’t help your family if you’re disabled from heart disease yourself.”
Many women in their forties and early fifties are entering perimenopause. Estrogen levels begin to dip and risk for heart disease rises.Continue to monitor your numbers. It is wise to check your cholesterol at least every five years, annually if you are being treating for high cholesterol. Also continue to monitor your weight and blood pressure and follow your doctor’s recommendations for optimum management.Continue to model heart healthy behavior for your children. Bring good food choices into the house, limit TV and computer time, and get plenty of exercise. If you haven’t yet adopted a heart-healthy lifestyle yourself, it is not too late to do so. However, you should check with your doctor before embarking on a new exercise program.
After menopause, your risk of heart disease increases regardless of family history. Your risk of developing heart disease now equals that of a man, and your risk of dying from heart disease is higher than a man’s. A renewed focus on your heart-healthy lifestyle is critical to help you protect your heart- and it’s never too late to make changes.Maintain good sleep habits. Uninterrupted sleep becomes more difficult with menopause, but it is important to your general and cardiac health to aim for 6 to 8 hours of good quality sleep every night.Be aggressive about investigating cardiac concern. Even if they are not “typical”, new or unusual symptoms could herald trouble and need to be discussed with your physician. Symptoms, evaluation, and treatment of heart disease are different in women and men. If you believe your cardiac concerns are not being adequately addressed, it is important to find a physician who understands the unique aspects of cardiovascular care for women.Traynor concludes, “Clearly, although women’s heart disease is more common in the later decades of life, the habits we develop as young women have a tremendous impact on our cardiac health in later years. And it is not enough simply to know how to prevent heart disease; making plans, putting them into action, and making them stick is the hard part. If you’re having difficulty sustaining a hearthealthy lifestyle, please contact the Massachusetts General Hospital Heart Center. We can help identify resources to support you in your efforts to lead a heart-healthy life.”
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