Women and Heart Disease: The Good News!
Now for the Good News about women and health disease: (“Whew, L.J., it’s about time!” I can hear you saying. ;-)) There is so much we can do to keep our hearts healthy. Some of the choices I am suggesting for heart disease prevention may be familiar, and some will be new.
Bottom line — the more healthy changes we make at any age, the better our hearts, and lives, will be. It seems that we have heard this all before, yet more women die from heart disease that the next four types of diseases put together. It makes me want to rent billboards around the country with this fact!
Strategies for Heart Disease Prevention in Women
I will skip recounting the statistics on this single most important life change. Please understand there is no greater health-enhancing choice you can make at this very instant, regardless of age or any other factor, than to stop smoking ASAP. You are worth it.
Take GREAT Care of Your Teeth
Sadly, I have first-hand experience with this one, as dental issues may well have contributed to the early death of my father at 68 from a massive heart attack. I was 35 when he died and thought I was taking good care of my teeth. But, after learning about the relationship between my heart and my teeth, well, I doubled-down on dental care.
What is the dental-heart connection? The same bacteria that causes plaque on our teeth can seep from our mouths into the bloodstream and trigger clots that increase our risk of heart disease and heart attacks. If we suffer from gingivitis and periodontal disease, or bleeding gums, the risk of developing heart disease increases. On-going research is stacking up evidence that gum disease plays a role in not only heart disease but other diseases, due to increasing the number one deterrent to being and staying vibrant—inflammation.
The best prescription for dental health heart disease prevention at the moment to keep our pearly whites in sparkling shape. Brush for two minutes (ideally with an electric toothbrush) twice a day, floss twice a day, and have our teeth cleaned and checked twice a year. I have mine cleaned three times a year for good measure, and because I drink coffee, tea, and the occasional glass of red wine. ;-0
Get Your Beauty Sleep
Getting enough sleep will literally change our lives. Extensive research now tells us that seven to eight hours of good quality sleep must become one of our top priorities. The benefits form a long list, but for our discussion here, people who slept less than six hours a night have a 20% higher risk of developing heart disease and/or having a heart attack.
Our bodies need time to repair themselves and detox, and our brains must be allowed to process our days. This all takes time. Reorganizing my life to go to bed earlier has taken me years to finally manage, and I can honestly say, it ranks as one of the smartest things I have done for myself. Try going to bed earlier so that you can get in those eight hours for say, three weeks. Notice how you feel and how your brain functions. You’ll be hooked.
The evidence is rock-solid: meditation is good for what ails us. It slows down our heart rate and lowers our blood pressure, both of which give our heart a break from working so hard.
So many different ways of meditating exist: traditional sitting-on-a-cushion or chair, closing one’s eyes and repeating a word or phrase while letting all other thoughts go, to one I sometimes do, a walking meditation—walking outside in nature and taking in my surroundings while listening to my feet fall on the pavement; staying in the present moment, free of attaching to any thoughts that might come to me. Sometimes I just sit quietly, close my eyes, and listen to the air conditioner run.
Science also tells us we can up the benefits of meditation by focusing on things we are grateful for. Feeling gratitude and appreciation not only rewires the brain, but soothes and smooths the heart rhythms which can help heal the damage stress does to this vital organ. I feel so strongly about the power of gratitude to heal us that I created a free Gratitude MeditationSM App which you can download on your iPhone or Android:
Your Table is Ready
Drawing on the recommendations of Dr. Mark Hyman*, Dr. Andrew Weil**, and Dr. Tieraona Low Dog*** – all leaders in the field of nutrition – here is a heart health-enhancing eating plan. It looks very much like the Mediterranean diet, so there aren’t too many surprises! Remember to try and choose organic products whenever possible.
- Fiber: Aim for 40 grams of fiber a day
- Non-gluten grains like quinoa, amaranth, buckwheat, millet, oats, wild rice (not white)
- The rainbow spectrum of fruits and veggies
- Good fats: Clarified grass-fed butter, olives and olive oil, avocados and avocado oil
- Low-mercury fish https://www.nrdc.org/sites/default/files/walletcard.pdf
- Occasionally lean beef or chicken
- Goat and sheep’s milk products (instead of cow’s milk)
- Free-range eggs
- Nuts and seeds of all kinds (limit to 3 oz. per day)
- Green and white tea
- Dark chocolate as an occasional treat (at least 70% cocoa content)
- Red wine 3-4, 4oz. glasses per week
- Sugars (use sparingly): Molasses, honey, coconut sugar, palm sugar
- Limited coffee
To Round Out Our Eating
Tapping again into our trio of experts, here are the key supplements they recommend for heart disease prevention. Before adding these to your regime, always check with your doctor or, if possible, work with a trained nutritional specialist, a DIFM: Dietitians in Integrative and Functional Medicine or an RDN: Registered Dietitian Nutritionist.
- High-Quality, High-Potency, Complete Multivitamin: The right multivitamin will contain all the basic vitamins and minerals. An optimal dose usually requires 2 to 6 capsules or tablets a day.
- Vitamin D3: Our vitamin D deficiency is now epidemic. Depending on what is in your multivitamin, Dr. Hyman recommends taking additional vitamin D.
- Omega-3 Fatty Acids (EPA and DHA): From fish oil supplements. Look for molecularly distilled products certified to be free of heavy metals and other contaminants.
- NAC (N-acetyl Cysteine): Great antioxidant and especially supportive of lung tissue.
- Alpha Lipoic Acid: ALA is a powerful antioxidant, supports liver function, boosts metabolism and helps turn calories into energy in the muscles among other things.
- CoQ10: CoQ10 has potent antioxidant properties to help support cell function, healthy BP and overall cardiovascular health.
Dr. Low Dog adds for women:
- B Complex: B1, B3, B6, B9 and B12
- Vitamin K
- Vitamin E
Of course exercise has to be on the heart disease prevention list. Turning to the advice of Joanna Chikwe, MD, the Chair of the Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai Hospital in Los Angeles, her recommendation is simple: exercise one hour a day, most every day—brisk walking, cycling, running, or anything else aerobic that keeps your heart rate in the 85% zone for most of the 60 minutes. I will add, do some weight bearing exercises a couple times a week, in addition to, or on the off days from the hour of aerobic exercise. You will feel and look like someone just handed you a billion dollars!
I hope these tips will inspire you to make some positive choices to help keep your heart, and your health, purring.
Until next time…Be Vibrant!
***Fortify Your Life: Your Guide to Vitamins, Minerals, and More by Tieraona Low Dog, MD
Women and Heart Disease: The Good News!
Since my focus is always retention and prevention, today I will talk about some important tests that will help women avoid a heart attack – a silent or not-so-silent one – and help prevent heart disease. My goal is to keep you well informed, and hopefully, urge you to speak up, and then step up to take control of your heart and your life.
As I mentioned in Women and Heart Disease Part I, over eleven hundred women were surveyed by the Women’s Heart Alliance about their knowledge of and experience with discussing heart disease with their physicians.
Heart Disease Discussions
While a majority of the women in the survey had a routine physical or wellness exam sometime in the previous twelve months, only 40% of those exams included a heart health assessment, despite 74% of these women having at least one risk factor for heart disease. A tiny number – only 16% – were told by their doctors that they were at risk.
Please take a moment to let that sink in, only 16% were told they were at risk.
To confound me even more, I learned only 22% of primary care physicians, and 42% of cardiologists, felt they were comfortable and prepared to assess cardiovascular risk in women!
The last distressing fact: Only 16% of primary care physicians, and 22% of cardiologists discussed giving their patients life-saving tests I will cover below. They also failed to suggest preventive choices to safeguard a woman’s heart health. This makes my head explode! How can this be true in the twenty-first century, with women being the majority of folks in the U.S. (and around the world)?
The short answer: We seem to care more about how we look, and the medical profession may be reinforcing that idea. A full 63% of the women responding admitted to putting off a doctor’s visit at least some of the time, and 45% of women canceled or postponed an appointment until they lost some weight. (The reasons they gave were difficulty losing weight or finding time to exercise.)
With our primary care physicians spending on average 17.5 minutes with us, we don’t feel safe enough to reveal additional information about any heart symptoms we may be having or call further attention to what might be wrong with us. We are embarrassed to talk to our doctor, family, and friends about heart health because we think it’s tied to solely to our weight, and not a combination of many other important factors—stress level, emotional health, diet choices, sleep, other medications, and dental hygiene. Adding to that burden, many of our doctors are men, and the bias some of them carry about women compels them to discount the importance and risks of heart disease and concentrate primarily on how much a woman weighs.
Heart disease is the number one cause of death for women. It kills twelve times as many women as breast cancer, which gets much more press. Heart disease must be addressed first. Of course, we must also remove the stigma and stereotype of “weight gain equals heart disease.” The good news is that those of us who had our hearts checked by a doctor in the last year were twice as likely to feel comfortable discussing the topic with our family and friends.
Now that all the right cards are in my hand, here are three key tests to ask for the next time you see your physician. Together with ways to prevent heart disease, which I will cover next time, I will lay down my Royal Flush in hearts!
Tests for Heart Disease
A Stress Test
The most familiar of the three, a stress test takes less than an hour and serves as the baseline for understanding the health of your heart. It is done on a treadmill – in sneakers and street clothes – with complete supervision. You set the pace, and no one will ask you to do more than you can.
Coronary Calcium Test
This easy and painless test assesses your level of risk for a heart attack by measuring the amount of calcium deposit(s) in your arteries. This is a coronary CT scan, done with the same equipment as a CT scan.
CIMT: Carotid Intima-Media Thickness Test
Another easy, painless and quick test, a CIMT measures the thickness of the inner two layers of the carotid artery, the artery located at the side of your neck. This test can let doctors know if there is any thickening in the artery walls long before you might experience symptoms of a cardiac incident. This test is a sonogram of the carotid artery in the neck—Gel on the neck, quick scan, off the table in fifteen minutes!
If the results of the CIMT are concerning, your doctor will request further tests such as a Doppler Ultrasound—an ultrasound to watch blood flow through the vessels and heart, a MRI angiogram or MRA—which allows her to see inside your blood vessels, or a Cardiac CT scan—a dye-free, multiple x-ray that provides images of the heart and blood vessels. All of these will give defining information about the state of your arteries and risk level for a heart attack.
I often print out the list and give it to women to take to their routine exams. Knowledge is power and in this case, very possibly life-saving.
I will wrap up my in-depth discussion on women and heart disease next time with the best things we know – this red-hot minute – that will keep our hearts healthy and humming.
Until next time…Be Vibrant!
Women and Heart Disease: The Facts May Surprise You Part II
“Cardiovascular disease is the number one cause of death for men and women in this country,” says Jennifer Haythe, MD, Director of Cardio-Obstetrics, an internist at NYPH/Columbia and co-director of the Women’s Center for Cardiovascular Health at Columbia.”
Before I went back to school, I wouldn’t have known this fact: My first thought, especially for women, would have been cancer, and therein lies a big part of the problem. A 2017 survey conducted by the Women’s Heart Alliance interviewed 1,011 U.S. women aged 25-60 years and collected physician survey data from 200 primary care physicians and 100 cardiologists, as well. The goal of the surveys was “to determine knowledge, attitudes and beliefs regarding heart disease in women.” The results mirrored my own thinking.
Let’s separate the various strands of this knotty problem. First, the researchers found that 45% of women twenty-five to sixty, and 35% percent of women fifty to sixty– that included me—were unaware that heart disease annually kills 500,000 women in the U.S. Add to that, another 15.2 million women, worldwide, who die from the disease every year. Even more surprising– only 13% of Americans know how great a woman’s risk is for developing heart disease. That percentage of awareness falls even more in women with lower levels of education and income, and women of color.
The next shocking fact: 71% of women almost never discussed heart health with their physicians, assuming their doctors would ask if there were a problem. To further curl your hair, physicians often didn’t or don’t, discuss cardiovascular disease with their female patients because in spending only 17.5 minutes per patient, according to studies, either the patient had a more immediate health issue, or she didn’t fully report her symptoms. This reflects a wholesale lack of interest (or knowledge) in making prevention a priority before a woman experiences symptoms, or worse, has a cardiac incident.
We all have seen someone in a TV show or movie pretending to have a heart attack (usually a man). He clutches his chest, his breath becomes short and shallow, his eyes bug out, and he makes some dramatic yelp as he falls onto the floor, or into a chair, if he’s lucky.
Realistically, heart attacks come in several different flavors and their symptoms vary. Let’s begin with maybe the most dangerous —The Silent Heart Attack.
The symptoms of a silent heart attack can be subtle, and often dismissed as sudden fatigue, nausea, or shortness of breath that occur when exercising or just out and about. Those symptoms disappear when resting, according to cardiologist Suzanne Steinbaum, MD, director of Women’s Heart Health at Lenox Hill Hospital in New York City.
Additionally or differently, especially in women, there might be nontraditional signs like unexplained fatigue, pain or discomfort in the throat, neck, or jaw, or what seems like heartburn — symptoms so mild, they’re barely noticed, or that go completely unnoticed during times of heightened stress.
The damage from these silent attacks is usually only discovered accidentally while testing a woman’s heart for other reasons. If we have had a silent heart attack, we are 3x more likely to die from heart disease.
One might also experience the following heart attack symptoms:
- Feeling very full, as though you have eaten a large meal, even if you haven’t eaten recently
- Followed by feelings of indigestion and a large person sitting on your chest
- Ribs tightening and becoming short of breath
- Pain in your right shoulder and arm (not left, as many believe)
- Pain in the front of your neck and up into your jaw
I suggest you memorize all possible heart attack symptoms. Make a copy and keep it on your phone or pin it on your fridge. I have!
In Part Two of this discussion, I will talk about some empowering choices we can make to keep a heart attack a thing of fiction.
Until next time…Be Vibrant!