Being a female primary care doctor means that I see quite a few women in my practice. Many women feel more comfortable talking with another woman about their health concerns, because they are often unique, and sometimes difficult to discuss. Menopause, libido concerns, menstrual problems; these can be embarrassing to discuss, and knowing that you are talking with someone who may have similar experiences is helpful. Don’t get me wrong, men have unique problems as well such as prostate cancer screening and erectile dysfunction. It’s safe to say that in the course of my medical practice, I’ve had quite a number of surprising conversations! I always tell my patients who may feel shy about bringing up a topic not to worry, chances are I have heard worse!
There are however many topics that I discuss with both my male and female patients. Unfortunately diabetes, high blood Pressure, and colon cancer (just to name a few) do not discriminate based on sex. One of the most important conversations that I have with my patients involves prevention of heart disease. Can you guess the number 1 cause of death in women in the United States? (If you read my most recent blog post on the Zika virus you may remember!) When I ask this question of my patients, the response I usually get is breast cancer. While that is an important cause of mortality in women in this country, and certainly gets a lot of press, the most common cause for death in women is heart disease! Heart disease causes 1 out of every 3 deaths in women each year, compared with 1 in 31 for breast cancer. The reason why this conversation is so important for me, and for my female patients, is that we often don’t pay as much attention to the screening, prevention, and detection of heart disease in women. The vast majority of women in this country are religious about their screening mammograms. How many are as diligent about cholesterol screening and treatment, smoking cessation, and identifying the symptoms of a heart attack? Only 1 in 5 women thinks that heart disease is her greatest health threat.
So, what are the causes for heart disease, and how can we prevent it? Heart attack is caused when the blood vessels that feed the heart muscle are blocked with cholesterol plaque, called atherosclerosis. This is the most common type of heart disease. However, there are other heart problems as well including heart arhythmias like atrial fibrillation, congestive heart failure, and heart valve problems. Regardless of the cause, the preventive strategy for most of these is similar: healthy lifestyle choices. Studies have shown that healthy lifestyle choices have resulted in up to 330 fewer women dying from heart disease every day. So what are the things that make the biggest difference?
• Don’t smoke or use tobacco products
• If you have diabetes, make sure your blood sugar is controlled
• If you have high blood pressure, make sure it is controlled
• Make sure your cholesterol levels are normal. If not, talk to your doctor about how to lower them, possibly with prescription medication.
• Know your family history
• Exercise 30 minutes every day
• Maintain a healthy weight
• Eat a healthy diet, including lots of fruits, vegetables, and heart healthy fats like those found in fish, nuts, avocados, and olive oil. Avoid processed and junk foods.
It’s also important to make sure that you are getting regular preventive exams with your doctor. At your appointment, don’t hesitate to ask about your own risks for heart disease. Your doctor can also talk with you about the lifestyle changes listed above, and help you come up with a plan.
So what happens if the preventive strategies listed above don’t work? It happens sometimes. We have all heard the stories about those people who were the picture of health who suffered a heart attack or other heart related problem. The truth is that heart disease is tricky, and we don’t completely understand all of the causes. Many people also ignore the warning signs until it’s too late, particularly women. We ladies don’t always like to play by the rules! So, we can often get atypical symptoms of heart problems. These include:
• Indigestion and heartburn
• Feeling out of breath after exertion or exercise
• Pain in the upper back, jaw, shoulders, arm (left in particular)
• Upper abdominal pain
• Unexplained fatigue
• Chest tightness or discomfort
It’s important to point out that we should not panic. If you have heartburn, it’s safe to assume that it’s probably just heartburn. However, if any symptom persists for a while and doesn’t go away, it means we need to pay attention to it. That’s the time to contact your doctor and schedule an appointment for evaluation.
Bottom line, it’s all about awareness and prevention! The American Heart Association has a campaign called “Go Red for Women” dedicated to increasing awareness of heart disease in women. They have a great website at www.goredforwomen.org with tons of great information.
Interested in finding out your personal risks for heart disease? Go to the American Heart Association Go Red for Women website and take this test to find out!