Ladies' Guide to Life-Saving Heart Advice

Women truly have a lot of catching up to do when it comes to awareness and information about heart disease -- even in the face of the fact that heart disease is the number one killer of American women, claiming more lives each year than all cancers combined. Thankfully, that's changing, and attention is at last being paid, largely due to the efforts of the American Heart Association's (AHA) annual campaign for women's heart health. This year, the AHA released its 2007 guidelines for preventing cardiovascular disease in women to address and, it is hoped, change the fact that today nearly one in three women die of cardiovascular disease (CVD). The really good news about the new guidelines is that they focus on prevention of heart disease in women, not merely on the differences in how it manifests and should be treated.

SETTING THE BAR REALLY HIGH

While the guidelines are replete with good-health recommendations including don't smoke, exercise regularly and eat a heart-healthy diet, they are also complex, lengthy and ambitious, aimed at encouraging women to view lowering CVD risk as a life-long pursuit. With this goal in mind, the guidelines urge women as young as 20 to make the effort to determine their personal risk and, if necessary, take action to lower it. They advise women to get at least 30 minutes of exercise most days of the week or every day -- no news there -- but then they go further, recommending 60 to 90 minutes most days or every day for those who need to lose or maintain weight loss (which is many women since two-thirds are overweight). Nutrition advice includes consuming fruits and vegetables... whole-grain, high-fiber foods... and fish (especially oily fish) at least twice a week. Then it gets complicated, advising restriction of saturated fats to no more than 10% of daily caloric intake and limiting cholesterol to 300 mg a day, plus more.

There is general agreement that the AHA guidelines are a noble effort, but some fear their complexity and scope may overwhelm many women who will, as a result, give up entirely and return to the couch with their potato chips.

HERE'S HOW TO DO IT

No question, simplifying and prioritizing the information would increase the odds that more women will incorporate enough of these guidelines to lower CVD risk and enhance their overall health. To get suggestions on how to do that, I called cardiovascular specialist Kelly Anne Spratt, DO, clinical associate professor of medicine at the University of Pennsylvania Health System. Dr. Spratt shares the concern that women will find the guidelines overwhelming, but she says they are nonetheless vital -- if for no other reason than to reinforce the importance of building health-enhancing habits while you are still young.

Regarding nutrition and exercise, Dr. Spratt believes that everyone, whatever age, should start with the easiest possible improvements and make gradual positive changes. She suggests starting an exercise program by walking 10 minutes each day (we can all fit this in). Once that becomes a habit, increase your daily walking time by five minutes each week until you're up to at least 30 minutes per day.

Her nutrition advice is equally straightforward. Avoid high glycemic foods, she says, but there's no need to memorize the charts: Just cut back on all white foods -- white bread, white rice, pasta and sugar -- and eat more whole grains and a variety of brightly colored fruits and vegetables. You'll be well on your way to improved heart health.

DOES YOUR DOCTOR DO THIS?

Many women, young and middle-aged, rely on their gynecologists for health exams. That's fine, as they are able to perform the routine screenings the AHA recommends -- just make sure they are being done. In Dr. Spratt's opinion, here are the health screenings that even 20-year-olds should have at least annually...

• Blood pressure check, along with a discussion about the reading.
• Women should be weighed at regular exams and they should also get a height measurement, so they can calculate their body mass index (BMI) and figure out if weight needs to be modified through diet and exercise. Though BMI is thought to be an imperfect measure of weight-related health risk, it's the best we have at present -- and better than no measure at all. To calculate body mass index, go to the Centers for Disease Control and Prevention's Web site at www.cdc.gov/nccdphp/dnpa/bmi/index.htm.
• Moving beyond basics, Dr. Spratt suggests women in their 20s should also have lab tests for cholesterol and glucose levels -- not because heart problems are apt to show up at this young age, but again, because this helps raise awareness of these health measures for heart disease risk factors (diabetes and high cholesterol) and build lifestyle habits that will protect them down the line.

JUST REMEMBER THIS...

Dr. Spratt has one final and important point: Women's symptoms of heart disease and heart attack are often more subtle than those of men, typically including shortness of breath (especially in association with exertion), persistent fatigue and any pain or dull ache in the arm, jaw and/or neck, shoulder or back (most especially if in more than one location, won't go away and can't be connected to any other obvious cause). Other symptoms include chest pain, nausea, indigestion and feeling faint. These may be signs of a serious problem, and should always be investigated by your doctor, she says. If you suspect a heart attack, call 911 immediately. Dr. Spratt says that women tend to call for help three hours later than men, losing priceless time that doctors could use to save heart muscle, and perhaps even your life.

Source(s):

Kelly Anne Spratt, DO, clinical associate professor of medicine, University of Pennsylvania Health System.