To recognize the Go Red Campaign, this month we offer a series of articles to increase your understanding of heart disease. In this article, we offer tips on how to improve your lifestyle to support a vital cardiovascular system. The companion article, Eating a Heart Healthy Diet reviews the foods to eat and supplements to take that support heart health.
To learn more, read Cardiovascular Disease: Not Just a Man’s Disease. This article provides an overview of heart disease and how it affects women differently than men. The signs and symptoms of a heart attack and angina are reviewed along with a list of factors that influence your risk.
Your Daily Habits Matter
Your risk of developing cardiovascular disease is dependent upon a number of factors. While some factors like age, sex, race and family history are out of your control, many others can be influenced. In fact, according to the American Heart Association, women’s hearts respond better than men’s to healthy lifestyle changes.
Based on national health statistics, there’s plenty of room for improvement in our lifestyle. For example, only one quarter of adults 20-39 years and just 7.0 percent of adults 40-59 years meet four ideal health factors: non-smokers with optimal cholesterol, blood pressure and fasting blood glucose levels.
Making positive lifestyle changes such as quitting smoking, controlling blood pressure and cholesterol levels, engaging in daily physical activity, maintaining a healthy weight, managing diabetes and limiting stress can reduce your risk of developing heart disease.
Stop Smoking or Never Start
Despite the negative health consequences, 18.3 percent of women smoke. If you have a hard time kicking the habit, keep this in mind: women who smoke increase their risk of having a heart attack 19 years earlier than non-smoking women.
Nicotine constricts your blood vessels and carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis. Smoking also increases the risk of blood clots forming in your arteries. Exposure to second hand smoke also increases your risk.
Quitting smoking is the most powerful risk factor you can control. By stopping, in just one year, you can cut your risk in half.
Control Blood Pressure
Women have a lower rate of high blood pressure than men up to age 45. From 45-64 years, women have about the same rate as men. But, after 65, women’s rate of high blood pressure exceeds that of men. About a third of adult women have high-blood pressure but in black women, almost 45 percent have this condition.
Controlling blood pressure is important as women with hypertension are 3.5 times more likely to develop coronary heart disease than women with normal blood pressure.
A proven way to lower your blood pressure is by following the DASH (Dietary Approaches to Stop Hypertension) diet. This heart healthy diet, promoted by the National Heart, Lung & Blood Institute (NHLBI), emphasizes fruits, vegetables, whole-grain foods and low-fat dairy products. The DASH diet is low in saturated and total fat and cholesterol and limits red meat, sweets, and extra sugars.
In DASH studies, participants following this eating plan not only lowered their blood pressure but the reductions came quickly – within 2 weeks. The greatest reductions in blood pressure came from a diet that reduced sodium intake to 1,500 mg or less per day, indicating the importance of reducing sodium intake to reduce high-blood pressure.
Given that the average sodium intake is 3,400 mg a day, everyone can benefit from making changes to their diet. Since packaged, processed foods contain high amounts of sodium, reducing or limiting their intake will help you to reach this goal.
Finding lower sodium foods at grocery stores and restaurants may get easier. The National Salt Reduction Initiative (NSRI) is a partnership of health organizations, states and municipalities designed to work with food manufacturers and the restaurant industry to lower salt levels in commonly consumed products. The goal is to reduce Americans’ salt intake by 20% over five years.
Be on the lookout for products that contain Solti, a patented microscopic salt crystal that delivers an intense hit of salt thereby allowing manufacturers to reduce the salt content of foods. Currently being launched in Europe, Solti could reach the U.S. within two years.
Manage Cholesterol & Triglyceride Levels
Forty six percent of women have sub-optimal total cholesterol levels (above 200 mg/dL). Almost one-third (31.0%) have sub-optimal LDL cholesterol levels (above 130 mg/dL) and ten percent (9.7%) have sub-optimal HDL cholesterol levels (below 50 mg/dL).
Cholesterol is a waxy-substance that the body uses for a number of purposes. It is the starter material for the steroid hormones estrogen, testosterone and progesterone. Our bodies also synthesize vitamin D from cholesterol.
But, too much LDL or “bad” cholesterol and low levels of HDL or “good” cholesterol can lead to plaque build-ups that can block arteries and prevent blood flow. Low levels of HDL seem to be a stronger risk factor for women than men. For more information on cholesterol, refer to our companion articles, What You Need to Know About Cholesterol.
Triglycerides are a common type of fat in the body. High triglyceride levels are often accompanied with high levels of total cholesterol and LDL cholesterol. Research indicates that high triglyceride levels may increase the risk of heart disease more in women than in men.
You can improve your cholesterol and triglyceride levels by making dietary and lifestyle changes. Following a diet that features fruits and vegetables, plenty of fiber and eating more Omega-3 containing foods can modify your cholesterol levels. For more information, refer to Dietary & Lifestyle Modifications to Improve Cholesterol.
From a dietary standpoint, it is important to limit your intake of saturated fat, trans fats and cholesterol because these unhealthy fats raise total cholesterol and LDL cholesterol thereby encouraging the development of atherosclerotic plaques. Trans fats are the worst because they are pervasive (read labels – anything that says partially hydrogenated is a trans fat) and pack a double whammy – they raise bad cholesterol and lower the good cholesterol. The American Heart Association offers the following recommendations:
- Saturated Fat: Less than 7% of total daily calories
- Trans Fat: Less than 1% of total daily calories
- Cholesterol: Less than 300 mg a day for healthy adults; less than 200 mg a day for adults with high levels of LDL or “bad” cholesterol
If you consume around 2,000 calories a day that equates to less than 140 calories (about 16 grams) from saturated fat and less than 20 calories from trans fat (2.2 grams).
If you need to lower your LDL levels, then you may want to try the Therapeutic Lifestyles Changes (TLC) diet. This diet, designed by the National Cholesterol Education Program, is designed to help lower the amount of fat in your diet. The TLC diet calls for increased physical activity, weight control, and a special eating plan. On the plan, less than 7 percent of your daily calories come from saturated fat and less than 200 mg of cholesterol and just enough calories to maintain a healthy weight.
Stay Physically Active
Only one-third of women regularly engage in physical activity. Physical exercise not only keeps the bones and muscles strong, but helps you to achieve and maintain a healthy weight and control diabetes, elevated cholesterol and high blood pressure – all risk factors for heart disease. Ideally, you should engage in 30+ minutes of moderate to vigorous physical activity on most days of the week.
Maintain a Healthy Weight
Two-thirds of the population is overweight and obese. Overweight refers to a Body Mass Index (BMI) of 25+ and obese refers to a BMI of 30+. Over half of black women are obese compared with one third of white women.
Not sure of your Body Mass Index number? You can easily calculate your BMI by visiting the NHLBI website.
Being overweight increases your risk for heart disease. Importantly, if you’re a woman with a waist measurement over 35 inches, you are more likely to develop diabetes and heart disease.
The key to maintaining a healthy weight is by combining a healthy diet that features fruits, vegetables, lean meats and unsaturated fats with regular physical exercise.
Keep Blood Sugar in Check
Almost 10 percent of women have diabetes but another quarter have prediabetes, a condition that if continues will lead to this disease. Black women have higher rates of diabetes than white or Hispanic women.
Women with diabetes have more than double the risk of having a heart attack than women who are not diabetic. Diabetes also doubles the risk of having a second heart attack in women but not in men.
The most common type of diabetes in adults is called Type 2. You are more likely to develop this disease if overweight or obese. While Type 2 used to be referred to as late onset or adult diabetes, this term is outdated with the increased prevalence of obesity and consequent diabetes in children.
In diabetes, the body’s uptake of glucose into cells is less efficient, leading to high levels in the blood. Unless your numbers are very high (over 200 mg/dL), you may not realize that you have high blood sugars. A simple blood test can determine your blood sugar level with the ideal under 100 mg/dL.
Cope with Stress
As we get older, our lives seem to become more stressful. Stress over long periods of time may damage your arteries as well as worsen other risk factors for heart disease. Stress can trigger your arteries to narrow which can raise your blood pressure and your risk for a heart attack.
Alternatively, how we manage stress– from smoking, overeating and drinking too much alcohol – can increase our risk.
Whether by engaging in physical exercise, taking meditation or practicing yoga, you must find ways to relieve stress on a regular basis. This is particularly important for women as stress along with depression seems to affect women’s hearts more than men’s.
If you are overweight or obese, you may be at risk of developing Metabolic Syndrome, a group of metabolic risk factors that puts you at increased risk of developing coronary heart disease, diabetes and
Based on the American Heart Association’s definition, if you have at least three of the following, you’re likely to have this syndrome:
- A large waistline (over 35” for women; over 40” in men)
- Higher than normal triglycerides (over 150 mg/dL)
- A lower than normal HDL level (less than 50 mg/dL in women and less than 40 mg/dL in men)
- Higher than normal blood pressure (greater than 130/85 mmHg)
- Higher than normal blood fasting level (greater than 100 mg/dL)
What’s the State of Your Heart?
To learn the state of your heart and what you can do to live better, take the American Heart Association’s My Life Check. After taking the brief online quiz, a PDF is generated with your results and an action plan to make improvements.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.