A matter of the heart

By Dr. Gina P. Lundberg

February 05, 2008 12:04 pm

— February is heart month and a great time to talk about the number one killer of women, heart disease. Many women are surprised to find that heart disease outranks all forms of cancer combined.
Many women are unaware of their heart disease risk. They do not know that their blood pressure, cholesterol and even their body mass index can indicate a heart disease risk.

The Heart-Stopping Truth
Women’s heart disease is under treated because of two important problems: poor patient awareness and poor physician awareness.
The American Heart Association and the American College of Cardiologists outlined guidelines for the prevention of heart disease in women in 2004. The next year, a poll of physicians and patients showed interesting results with less than one in five physicians aware that more women die each year of heart disease than any other cause. The women themselves did much better.
According to the American Heart Association, women’s information on heart disease had increased dramatically; African-American and Hispanic women had not reached the same understanding as white women. Of concern, was that these ethnic groups have the highest risk.
Most women under the age of 50 consider their obstetrician/gynecologist their primary care physician. However, most gynecologists and obstetricians were the most unaware and were the most uncomfortable at implementing the guidelines.
The good news is that as patients are becoming more aware of their risk factors of heart disease, they are seeking preventative care.
Two risk factors are getting worse: obesity and diabetes. An evaluation of women’s health care in the United States showed that obesity had increased in all 50 states and 46 states had worsened in diabetes. Since these are strong and powerful risk factors for heart disease, there is great concern that these reductions and lives saved will not continue for long.
In Georgia, we are far behind in many areas of women’s health care. The Peach State ranks 43rd in obesity, 28th in smoking, 44th in stroke death rate, 34th in controlling hypertension and 39th in diabetes. These are all areas where as health care providers we can work harder to improve our women’s’ futures.

What Can You Do?
It is very important to know your risk factors and take them seriously. About 30 percent of women who have heart attacks will have no risk factors whatsoever, so even one risk factor can be very important.
A lifestyle that reduces risk factors is to maintain a healthy diet that does not include junk food or sodas. We propose seven to 10 fruits and vegetables daily, and generally following a Mediterranean diet. Exercising at least 30 minutes six days a week is considered maintenance. If a person is overweight, she may need to exercise 45 to 60 minutes daily.
We recommend maintaining an ideal body weight, which is considered a body mass index (BMI) less than 25. A body mass index of over 30 is considered obese and over 40 is considered morbidly obese. Your physician can advise you on the BMI. The physician should routinely follow any sign of hypertension, high cholesterol, and diabetes, as these are contributors to heart disease.
We suggest salt, or sodium, reduction for all people to 2.3 grams per day and we recommend women of all ages quit smoking.
The family history genetic factors are very strong, so check into first-degree relatives who have had heart disease in women before the age of 60 and men before the age of 50.
Take time to do your own heart health inventory and get your check up. If you have multiple risk factors, seek your physician’s guidance but make sure that your physician is aware of the American College of Cardiologists and the American Heart Association guidelines and is comfortable using them.
Prevention saves lives.

Please note the statistics and figures in this report are from the American Heart Association.