It Won't Happen to Me ...

There is overwhelming scientific evidence that far greater women die of heart disease than breast cancer.  Women lack the understanding of their risks.  A 2003 American Heart Association study of over a 1,000 women, revealed the lack of understanding women have of the dangers of heart disease and stroke. A study by Erlich et al. 2003, found that even when women were genetically predisposed to CVD but not to breast cancer, women were more afraid of getting breast cancer.

No one disputes that women need to appreciate that they are at risk for breast cancer and be screened appropriately.  However, many in the scientific world are concerned with the emphasis on breast cancer may undermine a women’s understanding of their CVD risk and over shadow the necessary steps they can take towards prevention.

Get the Facts:  The Heart of the Matter

Cardiovascular disease is the leading cause of death among both men and women in the US.  This accounts for nearly half of all deaths.  Type II diabetes is a major risk factor for cardiovascular disease (CVD) and is a very strong indicator of CVD in women.

• Cardiovascular disease ranks first among all disease categories in hospital discharges for women.

• Nearly 39% of all female deaths in America occur from CVD which includes coronary heart disease, stroke and other cardiovascular diseases.

• In 2003, CVD claimed the lives of 483,842 females; cancer (all forms combined) 267,902.

• In 2003, coronary heart disease claimed the lives of 233,886 females compared with 41,566 lives from breast cancer and 67,894 from lung cancer.

• 38% of women compared with 25% of men will die within one year after a heart attack.

• Misperceptions still exist that CVD is not a serious health concern for women.

These are very powerful statistics.  The most important point is that you can take control of your heart health.  Epidemiologic data, or the science that studies causes and the control of disease in populations, indicates that cardiovascular disease and type II diabetes share common risk factors and are largely preventable.  The Nurses Health Study suggest that 74% of cardiovascular disease cases, 82% of coronary heart disease cases, and 91% of diabetes cases in women could be prevented by not smoking, engaging in regular physical activity, maintaining a healthy weight, eating healthier food, and drinking moderate amounts of alcohol.

The Power of Prevention

A healthy lifestyle is a powerful predictor of the incidence of and mortality of CVD and diabetes.  Women can and should become educated and pro-active about what they can do to reduce their risk for CVD. 

• STOP SMOKING!  Join a smoking cessation program or talk to your doc.  Ask for help.  This is the leading preventable cause of CVD. 

• Weight Loss and Type 2 Diabetes.   As visceral or tummy fat is associated with insulin resistance, the findings from a study reported in JAMA 2007, indicate that exercise does improve insulin resistance and may delay the onset of diabetes.  The women in this study who exercised 192 minutes per week did not loss overall weight but did decrease the circumference of their waist. 

• Get Moving.  According to the recently published public health standards (ACSM & AHA 2007) for physical activity programs recommend 5 days per week for a minimum of 30 minutes per day.  This does not include activities of daily living.  It is also recommended for vigorous activity, breaking a sweat and increasing your heart rate, 20 minutes for 3 days per week.  Your exercise routine needs to be reasonable and attainable.  You should enjoy the activity!  Get a pedometer and try to do 10,000 or more steps per day.

• Reach for the Fruits and Vegetables.  Pass on the processed foods and enjoy the wide variety of fruits and vegetables…..and this doesn’t mean potatoes.  The latest dietary guidelines call for five to thirteen servings of fruit and vegetables a day (2.5 to 6.5 cups per day), depending on ones caloric intake.  For a 2,000 caloric intake per day, this is about nine servings or 4.5 cups per day.  The Harvard –based Nurse’s Health Study and Health Professionals Follow-up Study indicated that the higher the average daily intake of fruits and vegetables, the lower the chances of developing CVD.  The vast majority of US adults fail to meet these guidelines.  Just 36% of women eat at least 2 servings of fruit daily, and 32% eat at least 3 servings of vegetables. 

• Saturated Fats. It’s the type of fats that you eat.  Avoid foods high in saturated fats, such as fatty meats, full-fat dairy and processed and fried foods.  According to the Women’s Health Initiative Dietary Modification trial, those that had the greatest reduction of saturated and trans fat did have a suggestion of coronary benefit. The type of fat is the important factor. Use liquid plant oils for cooking and baking.  Dump the trans fats.  These are found in processed foods and baked goods.  Make sure that your soft tub butter does not contain partially hydrogenated oils.  Eat at least one serving of omega-3 fats each day.  These are essential fats – the body cannot make them but must get them from food.  Fatty fish, walnuts and canola oils provide omega-3 fatty acids. 

• Stress.  According to Williams et al 2000, how women mange or express stress can also decrease CVD risk.  Being prone to anger, independent of other risk factors, has been associated with increased risk for CVD in middle-aged men and women.  Strategies for stress in our fast-paced, multi-tasking, multi-challenged lives is easier said than done.   These include thinking rationally about a situation, increasing physical activities, finding a support system, learning to relax, improve sleep habits and searching for the humor in life ( Women are Not Small Men: Life –Saving Strategies for Preventing and Healing Heart Disease in Women (Goldberg 2002). 

Getting to the Heart of the Matter

It seems that the evidence is continually coming in from the research community on the importance of women being pro-active when it comes to their heart health.  By changing variables in our life style and becoming educated on diet and exercise, women can take control of their cardiovascular health.  A reasonable exercise program that takes into account any health concerns and attention to the foods that we consume can put us on the path to optimizing our health.  The providers at FirstHealth of Andover are able to provide these tools for you.  A visit with our naturopathic doctor or exercise and nutritional consultant will help with questions and concerns with diet and exercise.  The team of massage therapists and acupuncturists can help with stress and a multiple of other health concerns.  It is the Power of Prevention when it comes to women and cardiovascular health.

References

 2002 National Center on Health Statistics, National Heart, Lung and Blood Institute, and American Heart Association’s 2002 Heart and Stroke Statistical Update.

 2005 Dietary Guidelines for Americans. Center for Nutrition Policy and Promotion, US Department of Agriculture. 

 2008 American Heart Association, Inc.

 2008 Heart Disease and Stroke Update. Circulation.

Barnes PM. Physical Activity among adults: United States, 2000 and 2005.  Available at:  http://www.cdc.gov/nchs/products/
pubs/pubd/hestats/physcialactivity/physcialactivity.htm.

Centers for Disease Control and Prevention.  Fruit and vegetables among adults – United States, MMWR Morb Motal Wkly Rep.  2007;56213-217.

Haskell WL, Lee IM, Pate RR et al.  Physical Activityand public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association.  Circulation.  2007;116:1081-1093.

He FJ, Nowson CA, Lucas M, MacGregor GA.  Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: meat-analysis of cohort studies.  J HumHypetens.  2007;21717-28.

He FJ, Nowson Ca, MacGregor GA.  Fruit and vegetable on consumption and stroke; meta-analysis of cohort studies. Lancet. 2006; 367:320-26.

Hu FB, Manson JE Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women.  N Engl J Med  2001;345:790-797.

Hung HC, Joshipura KJ, Jiang R, et al.  Fruit and vegetables intake and risk of major chronic disease. J Natl Cancer Inst. 2004;96:1577-84.

Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000;343:16-22.

US Department of Health and Human Services.  Physical Activityand Health: A Report of the Surgeon General. Atlanta, GA:US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.

- Donna Schneider, BS, AHFS, LWMC, CPT