Get Heart Smart

Heart disease is the leading cause of death among women—here’s how to minimize your risk

By Leslie Pepper

As an entrepreneur, Yewande Austin, 46, was accustomed to a hectic schedule. Days as long as 16 to 18 hours didn’t faze her, and she only added to that when she began a master’s program in England, necessitating an international flight a few times a year. “My passion for change left little room for self-care,” she says. “Somehow everyone else’s needs just became more important, and my one regret is that choice almost led to my death.”

Several years ago, Austin—founder of the Change Rocks Foundation and the Global Institute for Diversity and Change—was about to appear at an event, when she felt tremendous heart palpitations. “I wish I could say it was the first time that happened, but it wasn’t,” she says. Unwilling to disappoint her host, she convinced herself that the episode would pass. But it only got worse. Ninety minutes later, two strangers called 911. By the time EMTs loaded her into the ambulance, her heart rate had shot up to 230 beats per minute.

About an hour after being admitted to the emergency room, the doctor told Austin the news that no one is ever prepared to hear: “Ms. Austin, you’ve had a heart attack.” To say she was shocked is an understatement. She was 39 years old. How could she have a heart attack?

Austin’s situation is not unique. An estimated 44 million women in the United States are affected by cardiovascular disease. Cardiovascular disease and stroke are the cause of death for one in three women, killing approximately one woman every 80 seconds. Yet nearly half of women have no idea that heart disease is the number one killer of women in the United States, according to a recent study published in the Journal of the American College of Cardiology. African American women are even less likely than Caucasian women to be aware that heart disease is the leading cause of death.

“As a society, we characterize heart disease as a man’s disease,” says Sharonne Hayes, MD, founder of the Women’s Heart Clinic and medical director of diversity and inclusion at the Mayo Clinic in Rochester, Minnesota. “So much of the public health efforts have gone to determining the cure for heart disease in men, so the message that many have gotten their whole lives is it’s a man’s disease,” she says. Although many women think of breast cancer as our biggest threat, heart disease is actually more deadly than all forms of cancers combined.

You don’t have to be destined for heart disease, even if you have high risk factors (see sidebar). You may be able to prevent 80 percent of heart disease and stroke events by making the right lifestyle choices. Here are some important ground rules you should be playing by in your life right now.
Butt out.
If you smoke, you need to quit. Now. Period. Even if you’ve smoked for years, your health will improve by stopping. Quit smoking and you can lower your risk of heart disease as much as, or more than, you would if you took aspirin, statins, beta blockers, or ACE inhibitors. Call 1-800-QUIT-NOW for help.

Eat right.

A healthy diet is one of the best weapons against heart disease.

• Keep portion sizes under control. Most of us rely on external cues (how much food remains on our plate) rather than internal ones (how full we feel) to decide whether or not to keep eating.
• Pile vegetables on your plate. It’s almost impossible to eat too much broccoli. Include a wide variety of vegetables, covering all five subgroups: dark green (spinach, lettuce), red and orange (peppers), legumes (beans, peas), starchy (corn), and others. Feast on them fresh, frozen, canned, and dried. Just be sure to choose low-salt products when buying frozen and canned vegetables.
• Eat plenty of fruits, at least half of which are whole fruits. Fruit juices are acceptable but lack fiber, and drinking too many can add to your waistline.
• Load up on whole grains and limit refined grains.
• Choose fat-free and low-fat dairy products. These include milk, yogurt, cheese, and fortified soy beverages.
• Eat a variety of nutrient-dense proteins. Incorporate foods from both animal and plant sources, including seafood, meats, poultry, eggs, nuts, seeds, and soy products.
• Include such healthy oils as canola, corn, olive, peanut, safflower, soybean, and sunflower.
• Limit added sugars, saturated fats, trans fats, and sodium. Restricting sodium may be even more important if you’re African American, as researchers found that a gene may make African Americans much more sensitive to the effects of salt, which in turn increases the risk of developing high blood pressure.
• If you drink alcohol, do so in moderation.

Move it.
Choose activities you enjoy, whether walking with a friend, swimming, playing volleyball, or gardening. Start slowly, then add more and more time into your workout. Your goal should be at least 30 minutes of moderate-intensity aerobic activity most days of the week. (Always check with your doctor before beginning an exercise program.)

Get tested.

Speak to your doctor about what she or he recommends for you. Leslie Cho, MD, director of the Women’s Cardiovascular Center at the Cleveland Clinic, recommends the following tests.

• Cholesterol test every five years beginning at age 20.
• Blood pressure test at least every 
two years.
• Blood glucose levels at age 45, then at least every three years after that.
• Waist measurement and BMI calculation as needed.
Sleep soundly.
People who don’t get enough zzzs are at higher risk for heart disease regardless of age, weight, smoking, and exercise habits.
• Get into bed and wake up at the same time every day.
• Stop exercising at least a few hours before turning in.
• Don’t toss and turn in bed. If you can’t fall asleep, move to another room until you’re sleepy.
• Power down your electronics at least an hour before calling it a night.

Know the symptoms.
Research has found that the majority of female heart attack victims felt symptoms for months before the attack. Call 911 immediately if you experience any of the following.
• Shortness of breath that doesn’t subside.
• Heavy, continuous chest discomfort some may describe as pressure.
• Unexplained nausea, vomiting, or sweating.
• A sharp pain in the neck, back, and/or jaw.

Stress less.
Easier said than done, sure. But Hayes points out, “Chronic stress—the kind where you never see the end—activates the fight or flight hormones.” While that type of stress is useful if you have to jump out of the way of an oncoming bus, chronic elevation of those hormones makes you more likely to eat poorly, smoke, drink, and not exercise, all of which can raise your risk of heart disease. So take the time to kick back and do some relaxation techniques, such as meditation, yoga, or easy deep breathing. DW

Leslie Pepper is a freelance writer specializing in health, diet, and wellness.

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