Dear Doc

What is heart disease?

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels. Coronary artery disease (CAD) is actually one of the most common of cardiovascular diseases and it refers to the narrowing of the arteries supplying blood to the heart blocking the flow of oxygen-rich blood to the heart muscle.

Heart disease is often termed cardiovascular disease (CVD), and coronary artery disease (CAD) and, is the leading cause of death worldwide. Heart disease has traditionally been referred to as a man’s disease.

However, according to the 2013 World Health Assembly, heart disease was identified as the largest killer of women.

Unfortunately, despite public awareness of heart disease over the years, many women underestimate their risk of developing heart disease and subsequently, its serious complications (heart attack, stroke).

What are some of the major risk factors for developing heart disease?

Traditional risk factors for developing heart disease include age, high blood pressure, smoking, diabetes, and, abnormal cholesterol levels.

The older a woman gets (age >55years), her risk of developing heart disease increases. Research has shown that due to woman’s higher life expectancy, her overall mortality rate from heart disease is higher. Even though older women are more at risk, women of all ages who have risk factors such as obesity and type 2 diabetes should be concerned about heart disease.

The risk of heart disease is strongly associated with family history. Like age, family history of heart disease is non-modifiable. In other words, an individual’s genetic makeup can not be changed. Therefore, if an individual’s first-degree relative (father, mother, and sibling) has heart disease or premature coronary artery disease, that individual may be at an increased risk of also becoming affected.

High blood pressure or hypertension, a common medical condition, is a significant risk factor for heart disease. At age 65 and older, women are more likely than men to get high blood pressure.

Often times, the risk of hypertension is underestimated and elevated blood pressure readings are either not aggressively managed, or, in some instances, ignored. High blood pressure is often times referred to as the silent killer because many people do not know that they have it. And, if left untreated, it may lead to heart attacks and strokes.

Diabetes is also a significant risk factor for heart disease as women with diabetes compared to men with diabetes, have a 40% increase in the risk of coronary heart disease.

Obesity is known as a typical risk factor for heart disease. However, according to the American Heart Association, studies have proven that the distribution of body fat more than BMI is a stronger predictor of heart disease. These studies demonstrate that women who carry fat in their upper bodies and bellies were more likely to develop cardiovascular disease than women who carried fat mostly in their legs.

High cholesterol can increase your risk of heart disease as it can lead to plaque buildup in the arteries leading to narrowing and subsequent blockage of the affected blood vessels.

Another unique risk factor for heart disease include oral contraceptive use in women who smoke.

Collagen vascular disorders such as systemic lupus erythematosus (SLE) and rheumatoid arthritis are more prevalent in women. Cardiovascular events are the major cause of death in women affected by these diseases. These inflammatory conditions tend to accelerate the hardening and blockage of the arteries. As a result of this aggressive process, women with SLE in the 35- to 44-year-old age group are more than 50 times more likely to suffer heart attacks than those not affected by this disease.

What are some of the symptoms and signs of heart disease?

Often times, early symptoms of heart disease are not recognized until they become more serious. Compared to men, warning signs of CVD in women are often regarded as ‘atypical’ and tend to go ignored, unrecognized or misdiagnosed.

Women may actually have a heart attack without the typical chest pain or pressure. Instead, shortness of breath, fatigue, dizziness, and, even upper abdominal pain may be presenting symptoms of heart disease. Swelling in the legs can also be a sign associated with heart disease. Nausea, and, vomiting, often diagnosed as gastroesophageal reflux, may be atypical presentations of heart disease as well.

What can be done to prevent heart disease? General prevention of heart dis-

ease largely involves lifestyle modification. Making smart choices such as maintaining a healthy weight, engaging in regular aerobic exercise, smoking cessation, aggressive blood pressure control, and diabetes and cholesterol management can prevent heart disease.

Avoidance of sugary drinks, adequate consumption of vegetables, fiber-rich whole grain foods, fruit, fish, nuts, legumes, low fat dairy products and lean meats can decrease the risk of heart disease.

A proper diet and physical activity will prevent obesity, and, maintain healthy blood sugar and cholesterol levels. Smoking cessation and avoidance of second hand smoke can reduce the risk of heart disease.

Awareness of a family history of heart disease can lead to actions to reduce an individual’s risk of heart disease.

Lastly, it is important to seek regular preventative medical care. Regular wellness exams identify risks and incorporate important and appropriate health screenings in order to prevent heart disease and its subsequent complications.

To submit questions to Doc, please email deardoc@theevolvingwoman.co