Dr. Prasanna Yelamanchili, Cardiologist, The Heart Group
Women sometimes think that they aren’t at risk for heart disease, but that simply isn’t true. More women die of heart disease and stroke than all cancers combined. One in four women die of heart-related problems compared to 1 in 30 by breast cancer. Also, 2/3 of women who die of a heart attack had no prior symptoms of heart disease, and women die twice as often after a heart attack as compared to men.
Because of these concerning statistics, I want to spend some time discussing women’s heart issues—how to keep a woman’s heart healthy, and to know the signs of heart disease in women.
How can a woman know if she is at risk?
The first step in keeping your heart healthy is to know your risk factors and to modify those that can be or need to be modified.
Examples of modifiable risk factors include:
Non-modifiable risk factors include:
High blood pressure
Sedentary life style
Another important fact about risk factors is that the more you have, the more their effect is multiplied. Two risk factors can be a four-fold increase, while three risk factors can lead to a 10-fold increase. So you need to control what you can.
Family history (a history of heart disease in a male relative younger than 55, or a female younger than 65)
What should women do about the modifiable risk factors?
Blood pressure: work with your doctor on your medications, lower the salt in your diet, exercise, keep BMI (body mass index) less than 25.
How important is exercise for having a healthy heart?
High cholesterol: a heart-healthy diet and exercise are important, as is medication if needed.
Diabetes: a low-carbohydrate diet, exercise, HbA1C below 6.5, and taking medication/insulin as directed.
Smoking: STOP! Smoking causes so many different problems for your heart. It increases the risk of strokes, heart attacks, high blood pressure, damages circulation, and causes lung damage, cancers and numerous other health issues.
Sedentary life style: Get up and move. That’s sometimes easier said than done with today’s busy lifestyle, but you need to fit in exercise. A walk after dinner with your family, a brisk walk during lunch, or visiting your workplace fitness center before going home at night are all good ways to get in longer chunks of exercise time. Smaller--but significant--ways to increase exercise include taking the stairs instead of the elevator, parking far away from shopping centers or work, etc. People who sit many hours per day are at increased risk of heart disease, and so those hours need to be broken up.
Diet: Keep fat calories as less than 20-30% of your diet, and minimize saturated fats (7% or less), and less than 1% should be transfats. Increase whole grains, fruits and vegetables, and decrease sugary and fried foods.
Obesity: Your BMI should be 18-25. Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.
It’s important to get your heart rate up and keep it up. Minimum exercise time per day is 30-40 minutes per day of aerobic exercise 5 days per week. Aerobic means to increase the heart rate to a rate that you can still speak, but you’re becoming a little breathless.
If you can’t do 30-40 minutes at a time, you can break it up into smaller chunks of time.
Does dietary fat have an effect on heart health?
Fat requirements overall should be 20-30% of your total diet. So, if you have 2,000 calories per day, about 400 - 600 calories should be from fat. Fat has 9 calories per gram, so you want less than 60 grams per day.
The vast majority of that fat should be non-saturated. Examples of good fats would be olive oil or canola oil, rather than butter, margarine, shortening, etc. Avoid transfats as much as possible.
If a woman is having a heart attack, what are some of the symptoms?
We often think of crushing chest pain, gasping for breath, etc. as symptoms of a heart attack. But often times in women, a heart attack may present differently. Women are more likely to have “atypical” symptoms of a heart attack compared to men.
These atypical symptoms could include:
Those with diabetes are more likely to have heart attacks with no symptoms.
Upper back pain
Shortness of breath
An overwhelming feeling that “something is wrong”
Truly, the lesson to take from this is that prevention is key! Your doctor is your partner in your health, so talk with him or her about your heart disease risk factors, and work together to improve your heart health.