February: The Heart Month In More Ways Than One
What’s the first thing that comes to your mind when you think of February? If you’re like me, it’s hearts, love and the colors red, white and pink: Valentine’s Day! And although there are many notable events that occur in the shortest month of the year, it’s the heart holiday that rings most important to me, and not because it makes me all gushy with romance for my betrothed, rather it is a poignant reminder of how important it is for me to love my heart.
February 1st has been deemed Go Red For Women’s Heart Health. What a great way to bring awareness to such a serious women’s issue. Did you know that heart disease is the #1 killer of women? Cardiovascular Disease (CVD) kills more women than all forms of cancer combined, yet, only 55% of women know that CVD is their greatest health risk. Until recently, heart disease in women has gone largely unnoticed or under treated for the most part in the world of medicine. This is due to the fact that women’s biology is different than men and that the majority of heart and vascular health studies performed to date have included only men. Doctors now readily admit that women are biased against when it comes to recognizing heart disease. Women who report to the hospital or doctor’s office suspecting they are having heart issues are often misdiagnosed or not diagnosed at all. Sadly, women are frequently told its just "stress" or "anxiety" and to go home, rest and get the stress under control. A scary proposition especially since medicine knows that more women die of heart attacks than men. Again, a fact due to a lack of awareness of what CVD looks like in women both on the side of women and science.
Armed with all these stats now, how do we as women take control of our heart health care? For this I will share my personal experience. It goes back to my days in Physical Therapy school when I realized one day in a Cardiopulmonary lecture that heart disease was not any disease process that I wanted to experience and vowed to do whatever I could do to keep myself healthy and that starts with the what the inside of my body looks like.
Tools that I use to know my risk of CVD include:
Know your blood pressure (BP): I use a home monitor and check it at least once a month. New guidelines now define high blood pressure (HBP) Stage 1 as a reading of 130/80.
Know your blood sugar also known as blood glucose: I have a home monitor and check it at least once a month. Normal range for fasting blood sugar (not having eaten anything for at least eight (8) hours) is less than 100 mg/dL and less than 140 mg/dL two (2) hours after eating.
Know your cholesterol levels: There are home cholesterol test kits, which are purportedly quite accurate if the directions are followed precisely. I have never used a home testing kit. Testing cholesterol levels is a standard test your MD will usually order at your yearly physical. If you are not a fan of going to the MD on a regular basis, there are free standing labs that will run these tests without the need of an MD order, but you will have to pay for the tests out of your own pocketbook. Cholesterol is a naturally occurring waxy material that the body produces in the liver and is used to protect the nerves, produce hormones and make cell tissues, but too much cholesterol can be a bad thing because it lands in the blood where it can start to "gunk up the works" so to speak by forming areas of plague build up resulting in a narrowing of the vessels. The cholesterol level test is a simple blood test which measures 4 types of fat in the blood – total cholesterol which = HDL + LDL + (0.2 x Triglycerides), HDL (high density lipoprotein aka the “good” cholesterol), LDL (low density lipoprotein aka the “bad” cholesterol) and triglycerides. Desirable levels for total cholesterol = under 200 mg/dL, HDL for women = 50–59 mg/dL, LDL = less than 100 mg/dL, triglycerides = less than 150 mg/dL. Another number you will want to know and one, which is usually not calculated on the lab report is your cholesterol ratio, which is the total cholesterol number divided by HDL. The higher the number, the greater the risk of CVD. Cholesterol ratios are different for women than men because women often have higher levels of the good cholesterol. Cholesterol ratio ranges for women are: 4.4 = an average risk for CVD (vs. 3.5 for men), 7 doubles the CVD risk (vs. 9.6 for men) and a ratio of 3.3 signifies half the risk of CVD (vs. 3.4 for men).
Know your BMI (body mass index): BMI is an attempt to measure the amount of tissue mass (muscle, fat and bone) in an individual to categorize the person as underweight, normal, overweight or obese based on the value. It is achieved by dividing the body mass by the square of the body height and expressed as kg/m2. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
Know your C-Reactive protein level: This is a blood test that measures the amount of inflammation in the body. This is not a standard test done with a yearly physical so you need to ask your MD to perform it. It is also one that can be done at a freestanding clinic. Optimal level is lower than 1.0 mg/L which is a low risk of CVD; a level between 1.0 mg/L – 3.0 mg/L is a moderate risk of CVD and a level greater than 3.0 mg/L is a high risk of CVD.
The warning signs of CVD in women are different than in men. Take a look at this list of symptoms and memorize them!
1. Pressure or discomfort in the chest
3. Overwhelming fatigue (which may occur for days or weeks before a heart attack)
4. Shortness of Breath (SOB)
5. Nausea/light headedness
6. Sleep disturbances
Acute symptoms of CVD in women are also different from men. We don’t get the classic constricting chest pain rather pain is experienced in other parts of the body. An acute cardiovascular event in us can look like:
1. Tightness in the upper back, shoulders, neck, arms and sometimes the jaw or throat
2. Burning sensation in the upper back, shoulders, neck, arms and sometimes the jaw or throat
3. Pressure in the upper back, shoulders, neck, arms and sometimes the jaw or throat
4. Tingling, dizziness and cold sweats can also occur
If you experience any of these symptoms or things just don’t seem “right”, don’t hesitate, seek medical care immediately. It’s better to be safe than sorry.
Now, here’s the good news. It takes only seven (7) simple steps to turn around and reverse your CVD risk, and here they are:
1. Manage your BP (goal: 120/70 *a note of exception, a systolic BP = 150 is a goal for most “seniors” which is defined as 65 y.o., the age one may start to utilize Medicare)
2. Control your cholesterol
3. Reduce your blood sugar
4. Stop smoking
5. Get active
6. Eat better
7. Lose weight
Now that you have the “recipe” for decreasing your CVD risk, get going, and no, don’t wait till after the Valentine’s candy is all gone.
Stay tuned for future posts about how I achieve my goals for reducing my CVD risk through exercise, diet and education.
Let me know how your heart healthy month is going!