Women's Heart Advisor July 2016 Issue

Are You Doing Everything You Can to Prevent Heart Disease?

If not, itís time to start. Learn what are the key factors that can make the difference for your cardiovascular health.

Cardiovascular disease (CVD), the disease that leads to heart attack and stroke, is the Number One killer of women in the U.S. Although deaths from CVD have dropped 29 percent in the past two decades, the disease kills as many U.S. women every year as cancer, accidents, COPD, diabetes and Alzheimer’s combined.

A big concern for women is coronary artery disease (CAD), which accounts for about 290,000 deaths a year from heart attack and heart failure. The American Heart Association (AHA) estimates 80 percent of CAD could be prevented by reducing certain risk factors. This spring, they issued a scientific statement on preventing and managing CVD in women, using evidence-based advice on how this can be done.

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Are You at Risk?

Most women (70 percent) between the ages of 50 and 79 are at risk for CVD. This means they have one or more of the following major risk factors:

- Obesity, particularly with the “apple” body shape. Obese women are at particularly high risk of CAD.
- High levels of total cholesterol, LDL cholesterol or triglycerides and low levels of HDL-cholesterol
- Diabetes. Women with diabetes have more than six times the risk of dying from CAD.

Untreated blood pressure greater than 120/80 mm Hg. “However, it’s not normally necessary to treat blood pressure until it reaches 140/90 mm Hg,” says Leslie Cho, MD, Director of the Women’s Cardiovascular Center at Cleveland Clinic.

- Physical inactivity
- Smoking
- Depression and other forms of psychological stress, including loneliness and social isolation.

Steps to Prevent CAD

CAD is a complex disease, and there’s no single way to prevent it. Rather, there are many ways to lower the risk.

If you have any of the above risk factors, ask your doctor how you can reduce the likelihood you will develop CAD. You may need to take medications or make some lifestyle changes. Remember that any step you take will lower your risk. Your goal should be to achieve:

- Total cholesterol level less than 200 mg/dL
- Blood pressure level less than 120/80 mm Hg
- Fasting blood sugar level less than 100 mg/dL
- Body mass index (BMI) in the “normal” range (less than 25 kg/m2)

To reach these goals, you will need to:

- Quit smoking.
- Exercise. Get at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. Whatever form of exercise you choose should include sustained aerobic activity for at least 10 minutes per episode and strengthening exercises involving all major muscle groups at least two days a week.
- Eat a diet that includes more than 4.5 cups of fruits and vegetables, 30 grams of fiber, 3 servings of whole grains and 4 servings of nuts every day. Also, your diet should contain less than one tablespoon of sugar, less than one teaspoon of sodium and less than 150 mg of cholesterol. No more than seven percent of total calories should come from saturated fats.
- Consume 1,800 mg per day of omega-3 fatty acids in fish or capsule form if you have high cholesterol, high triglycerides or both.

You may also need to:

- Take high blood pressure medication as prescribed. It may take a period of trial and error to find the right medication or combination of medications that lower your blood pressure to goal. Don’t give up.
- Test your blood sugar regularly and take your diabetes medication faithfully.
- Take a statin or other cholesterol-lowering medication as prescribed. If you experience any side effects, such as muscle cramping or weakness, tell your doctor right away, so a new medication can be tried.

Non-Modifiable Risk Factors

Some things that increase the likelihood a woman will develop CAD simply can’t be changed. These include a family history of cardiovascular disease; history of preeclampsia, gestational diabetes or pregnancy-induced hypertension; an autoimmune disease such as lupus or rheumatoid arthritis; and previous treatment for breast cancer.

If you have one of these so-called nonmodifiable risk factors, you should work closely with a preventive cardiologist to watch for signs that your risk is increasing.

The Role of Age

In all women, the risk of CAD jumps after menopause. The older you are, the greater your risk of CAD. You can’t change your age, but you can change the effect of age on your cardiovascular risk. Ideally, this means taking control of your risk factors when you are young and maintaining control throughout life.

However, it’s never too late to start taking an interest in protecting your heart. Accept that you have some risk of CAD and take control of your health. Keep in mind that most cases of CAD are preventable.

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