I recently attended a major benefit performance in New York City aimed at educating women about heart disease. A few days earlier, Oprah had devoted an entire program to this issue. Such outreach is absolutely necessary because women seem blinded by the fear of breast and ovarian cancers, but don't understand the bigger danger of cardiovascular disease. I frequently find a surprising lack of awareness among my new women patients.
I decided to write this article as one way of getting the message out. I hope you will make copies and share it with your women friends and loved ones.
A woman needs to know these hard facts about cardiovascular disease:
- Your chances of dying from heart disease are four-to-six times higher than breast cancer, and almost double that of all cancers combined.
- Cardiovascular disease is the leading killer of men and women older than age 65.
- Within six years after a heart attack, you are twice as likely to be disabled with heart failure.
- Women are less likely to survive a heart attack than men. Probable reasons include: Women have a smaller heart and blood vessels that are more readily damaged, women generally fail to seek treatment quickly and women, on average, are ten years older than men when they have a heart attack.
- Women have a set of cardiovascular symptoms (see heart symptoms sidebar) that can be mistaken for a non-heart-related illness - and not considered as dangerous. In the past, many physicians have neglected to treat women as aggressively or successfully as men.
- Diabetes puts women at a higher risk for heart disease than men with diabetes.
- Metabolic syndrome, a current epidemic of non-symptomatic characteristics, often leads to diabetes and heart disease. Two or three of the following characteristics means you have the syndrome: a waist circumference of more than 35 inches, a fasting blood sugar of more than 100 mg/dl, triglycerides (blood fats) of more than 150 mg/dl, HDL cholesterol (the "good" cholesterol) less than 50 mg/dl, a blood pressure of more than 130/85.
- Weight is more of a risk factor for a woman than a man. An extra 20 pounds doubles a woman's risk for cardiovascular disease.
- As a woman, you are more vulnerable to the ravages of high blood pressure than men. Uncontrolled hypertension is the leading risk factor for heart attacks and strokes.
Through the years, I have found that many women who have experienced heart attacks, especially younger individuals, were living in a state of vital exhaustion. They worked, took care of children or aging parents, and perhaps were going through a divorce. They were stressed, overloaded, burned out and vulnerable.
Stress causes a lot of internal mayhem. With stress, blood pressure increases. Women's blood tends to stick together - even more so than in men. The immune system becomes depleted, increasing the risk of bacterial and viral infections and inflammation throughout the body. Chronic inflammation creates all kinds of nasty chemicals that erode arterial integrity and stoke the development of heart attacks.
As a woman ages and enters menopause, a new problem arises: the gradual loss of estrogen. The female hormone accords protection to the heart, just as testosterone does for a man. As it wanes, the incidence of heart disease in women rises precipitously - by 400 percent.
How to Protect Yourself
Despite the high risks of cardiovascular disease for women, many options are available to help protect yourself.
Eat well. Ensure you eat heart-healthy fish (wild salmon is the best), fresh fruits and vegetables. Avoid sugar and sugary foods, which contribute to inflammation. Is a low-fat diet protective? Studies fail to show that a low-fat diet offers significant risk reduction among healthy postmenopausal women.
Exercise. That's a must. Regular physical activity can neutralize the metabolic syndrome.
Take supplements. Take a good daily multi-vitamin and mineral formula, fish oil (1-2 gm), CoQ10 (60-100 mg), magnesium (400-800 mg) and vitamin C (at least 1,000 mg).
Ask your doctor for the most comprehensive blood test for heart disease - the VAP test. Typically covered by insurance, the VAP test monitors many different components and patterns of cholesterol. It's also more instructional for doctors than standard lipid tests. A VAP test includes a reading for Lp(a), a dangerous lipid with ten times the plaque-producing potential of oxidized LDL. It is highly inflammatory and thrombotic, and causes blood clots. Lp(a) rises in menopausal women, so it's important to watch your level.
In addition, ask to have your levels checked for C-reactive protein (CRP), homocysteine and fibrinogen - important biochemicals that help predict cardiovascular disease. CRP is a marker of chronic inflammation. Homocysteine is a toxic amino acid involved in the early stages of arterial damage. Fibrinogen is a protein in the blood with inflammatory and clot-forming properties. It rises with menopause.
Your doctor may want to prescribe a cholesterol-lowering drug (called a statin) if your cholesterol level is above "normal." Don't do it unless you have evidence of inflammation and serious cardiovascular disease. I only prescribe statins to people with advanced disease. The drugs deplete a body's production of CoQ10, a critical nutrient in the production of cellular energy. Depletion can cause significant problems with energy and muscle weakness. Moreover, statins may increase Lp(a).
Manage your hormones. Today, cardiologists oppose conventional hormonal replacement therapy with the standard chemicalized hormones because of documented danger to the cardiovascular system. As a substitute, many alternative doctors - myself included - often recommend natural plant-based substitutes that have identical chemical structures as the hormones in the body. They achieve excellent results without any serious side effects.
And last but not least, raise the happiness level in your life and definitely lower the stress level. Happiness is a healer. Stress is a killer.
Classic Cardiovascular Symptoms
- Mid-chest pressure or pain
- Shortness of breath
- Dull pain between the shoulder blades
- Achiness in the jaw
- Pain in left arm or elbow
- Profuse sweating
- Dull, aching chest discomfort
- Acute breathlessness
- Sudden, profound fatigue
- Jaw or neck pain
- Pain in left arm or elbow
- Abdominal discomfort, nausea, vomiting
- Dizziness, even blackouts
Common to both genders is chest pain or discomfort. Along with it, women generally experience a wider variety of vague, ill-defined symptoms.
Any of these symptoms calls for a visit to the doctor or an emergency care facility. Every minute could be critical. In the case of severe chest pain, fluctuations of consciousness, slurred speech or profound sudden weakness of one side of the body, call 9-1-1 immediately.