February has traditionally been designated Red Dress month to raise awareness of the issue of heart disease in women. Now there is a special day and a website as well. The stereotypical heart patient is an older man who may have high cholesterol and high blood pressure. However the leading cause of death in women in the United States continues to be heart disease. Women tend to get their heart disease later in life, especially after menopause, but heart issues are a large cause of morbidity and mortality for women overall. What can we do about this? The biggest step is to try to prevent a heart attack or stroke. As we all have all heard at one time or another, “An ounce of prevention is worth a pound of cure.” This old adage is certainly true when it comes to heart attacks. It would be much better to lower blood pressure, lower cholesterol, prevent diabetes, and exercise regularly, then to have to have a stent, bypass or other type of invasive procedure.
How can we prevent heart disease? The American Heart Assocation (AHA) and the American College of Cardiology (ACC) have devised a Cardiac Risk Calculator that will give you a risk for developing heart attack or stroke over the next 10 years for people ages 40-80. Go to the AHA Cardiovascular Risk Calculator with the following information:
- Total cholesterol
- HDL cholesterol (high density lipoprotein=good cholesterol)
- Blood pressure
- Fill in questions for whether or not you are treated for high blood pressure, diabetic, or smoke
- Press Calculate and you will have a number for heart attack/stroke risk over the next 10 years.
If your risk is 7.5% or above, then the AHA and the ACC would recommend that you take a statin medication that lowers cholesterol and reduces your risk of having a heart attack or stroke. If you are below that cutoff but you have diabetes, or the cholesterol or blood pressure are high, you should institute lifestyle modification for lowering cholesterol. Great ideas for lowering cholesterol are on the AHA website. A Mediterranean style diet with plenty of whole grains, lean protein, fruits, and vegetables can be helpful for lowering cholesterol and preventing diabetes. Regular daily exercise for ½ hour has been shown in studies to effectively lower cardiovascular risk.
Another important point about cardiovascular disease in women is that the symptoms of a heart attack can be very different from the classic fist clenching pain in the chest called angina. Women can have symptoms of fatigue, nausea, shortness of breath and the pain can be radiating up the neck. The cause of the heart attack can be very different from the classic plaque problem that causes male heart disease. Small vessel disease, coronary artery spasm and even “broken heart syndrome” where significant emotional distress can cause a heart attack are more common in women than men. A recent well-written Washington Post article highlights these differences.
Although Red Dress Day is over, the heart healthy daily habits need to continue to the rest of the year and incorporated into our daily routines for both men and women. We can and should do better to decrease our country’s rates of heart attack and stroke.