Women's Wellness
Know Your Risk for Developing Heart Disease
Brought to you exclusively from the women physicians at The Cooper Clinic
February is Heart Month. What a great opportunity for each of us to take inventory of our own risks for developing heart disease and then work together with our health care providers to modify those risks.
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If you are a regular reader of this newsletter, you might not be surprised to learn that cardiovascular disease is the leading killer of women. You may be disheartened to learn that despite the tremendous advances in the science and technology to diagnose and treat cardiovascular disease, the mortality trends in women over the last two decades are flat compared to modest improvements in men. This is illustrated on the graphic (left), which is taken from the Heart Disease and Stroke Update 2003, written by the American Heart Association. |
High blood pressure or hypertension is very common. In women ages 55 to 64, high blood pressure is present in 40 percent of Caucasian women and 63 percent of African-American women. A diagnosis of hypertension is made when blood pressure is measured on several occasions and is consistently found to be 140/90 mmHg or higher. Up to one third of people who have high blood pressure do not even know it! High blood pressure is an important risk factor for stroke, heart attack, and kidney failure. About half of the people who have a first heart attack and two thirds who have a first stroke have blood pressures higher than 160/95 mmHg.
Despite the well known risks of cardiovascular and lung disease, cigarette smoking is more prevalent than you might think – in Americans age 18 and older, 26 percent of men and 21 percent of women are smokers. Cigarettes are addictive. Quitting smoking takes a group effort – partnering between the smoker, their family and friends and their health care providers is critical to success. According to the World Health Organization (WHO), 1 year after quitting, the risk of cardiovascular disease risk decreases by half, and within 15 years, the relative risk of dying from cardiovascular disease for an ex-smoker approaches that of a long-time (lifetime) nonsmoker. So even if you have been a life-long smoker, it does not take many years of abstinence to pay off!
High cholesterol is also on the rise. It is easy to diagnose with a fasting blood sample. Beginning at age 50, a higher percentage of women than men have total blood cholesterol of 200 mg/dL or higher. Using the newest guidelines for cholesterol treatment (NCEP III), 36 million Americans would be eligible for treatment of high cholesterol. About half are men and half are women. One third of those eligible are under the age of 45! Are you in the group that needs treatment? You may be because almost 50 percent of all women have cholesterol above 200 mg/dL and almost 20 percent have cholesterol above 240 mg/dL.
In 1997-98, over one-third of Americans age 18 or older reported no physical activity and two thirds engaged in at least some physical activity. Physical inactivity is more common among women than men, among African-Americans and Hispanics than Caucasian, among older than younger adults and among the less affluent than the more affluent. Less-active, less-fit persons have a 30-50 percent greater risk of developing high blood pressure. Are you physically active? If you are not a regular exerciser (30 minutes of moderate intensity activity 5 to 7 days per week), a wonderful way to gauge your activity level is by wearing a pedometer to measure the number of steps you take a day. The current recommendation is 10,000 steps per day. The pedometer is a great motivator. If you look down and see that you are just at 3,000 steps, it inspires you to walk laps around the house while on the telephone or to park far away from the store so you can add some steps!
Exercise is a great way to combat weight gain that can lead to overweight and obesity. Overweight is defined as body mass index (BMI) 27.8-31.0 for men and 27.3-32.2 for women; obesity is defined as BMI 31.1 or higher for men and 32.3 or higher for women. The BMI takes into account your height and weight. You can calculate you BMI using a calculator found at http://www.nhlbisupport.com/bmi/bmicalc.htm. The prevalence of overweight and obesity are: 57 and 30 percent respectively in Caucasian women, 77 and 50 percent in African-American women and 72 and 40 percent in Mexican-American women. The prevalence of overweight adolescents is now at 16 percent. This has increased almost 300 percent from the early 1960s.
Diabetes is present when the sugar level in the blood is elevated in a fasting sample. Diabetes is defined as a fasting blood glucose of 126 mg/dL or more and pre-diabetes is a fasting blood glucose of 110 to less than 126 mg/dL. The prevalence of diabetes and pre-diabetes are: 7 and 5 percent respectively in Caucasian women, 14 and 7percent in African-American women and 15 and 7 percent in Mexican-American women. The presence of diabetes increases cardiovascular risk dramatically in women. The risk of death from cardiovascular disease among women with diabetes is two to four times higher than that for women without diabetes.
What is your risk factor profile? To know your risk, you need to know your numbers: good cholesterol (HDL), bad cholesterol (LDL), triglycerides, blood pressure, BMI, fasting blood sugar (glucose) and steps per day. If you don’t know your numbers, talk with your health professional today about measuring them and putting together a plan to bring each and every one of those numbers to goal!