It's the last week of February, and you didn't think I forgot about women's heart health, did you?
February, of course, is not only the month of love and the heart, but also the women's heart and heart health.
Perhaps you didn't know that the number one cause of death in women in the U.S. is heart disease. It's true, not breast cancer, but cardiovascular disease.
But as always, there is good news here because heart disease in women is very preventable, or at least the risk factors can be managed and mitigated by the way we live our lives.
In this episode, Dr. Adrienne Youdim delves into the importance of women's heart health, shedding light on the unique risk factors and symptoms that women may experience.
From discussing the differences in heart disease presentation to providing practical tips for prevention, this episode empowers listeners to prioritize their heart health.
Join us as we explore the intersection of physical, mental, and emotional well-being in the context of women's heart disease prevention.
What You’ll Learn From This Episode
- Understanding the unique symptoms of heart disease in women
- Identify and manage the risk factors for women to significantly reduce their chances of developing heart disease
- Explore the various risk factors for heart disease in women, including common factors like high cholesterol and diabetes, as well as female-specific factors like early menopause and certain pregnancy conditions.
- Gain physicians practical tips to safeguard women's heart health
"Managing stress is an important way to help prevent heart disease." - Adrianne Youdim
Connect with Dr. Adrienne Youdim
Connect with Dr. Adrienne Youdim
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Its the last week of February and you didnt think I forgot about womans health did you? Febuary is of course not only the month of love and heart but also womans heart health.
Perhaps you didnt know that the number one cause of death in woman in the US is heart disease?
Its true, not breast cancer but cardiovascular disease. But as always there is good news here because heart disease in woman is very preventable or at least the risk factors can be managed and mitigated by the way we live our lives.
Welcome back to Healthbite, I'm your host Dr Adrienne Youdim. I am triple board certified as an internist, obesity medicine and physician nutrition specialist and I help people redefine nutrition to include not only the food that we eat well but all the ways we can nourish ourselves physically, mentally and emotionally.
So here are some statistics:
-CV disease accounted for 22 percent of all-cause mortality in women in 2013 in woman Between the ages of 45 and 64,
-one in nine women develop symptoms of of cardiovascular disease. After age 65, the ratio climbs to one in three women, according to the National Center for Health Statistics.
There are many reasons why this information is not known. For one, the majority of studies done on heart disease until very recently have been in men and the information was lumped onto woman. But we now know that womans hearts act differently than men.
For example, While woman heart attack can present with chest pain usually described as crushing/pressure/squeezing/tightness on the left-sided that radiates to the neck or jaw
women are much more likely than men to present without chest pain- in fact nearly 20% of woman in one study had no chest pain during an active heart attack.
Some symptoms described in woman include:
- Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, dizziness, and shortness of breath
- Fluttering feelings in the chest (palpitations)
- Shortness of breath, sudden fatigue, or swelling of the feet, ankles, legs, or abdomen
If these symptoms are new or abrupt, the recommendation is actually that you call 911 for help.
WOman are also different when it comes to risk factors:
There are common Risk factors that are seen in both sexes. These include:
- High LDL (low-density lipoprotein) cholesterol
- Smoking
- Diabetes
- Excess weight
- An unhealthy diet
- Physical inactivity
- Drinking too much alcohol
- Stress and depression
But there are also many that are woman-specific. For example:
- Early first period (before age 11)
- Early menopause (before age 40)
- Polycystic ovary syndrome
- Diabetes during pregnancy (gestational diabetes)
- Preterm delivery
- Delivery of a low birth weight or high birth weight infant
- Hypertensive disorders of pregnancy
- The presence of chronic inflammatory diseases like autoimmune diseases lupus and RA
We know that woman who have some or many of the above are at higher lifetime risk for heart disease. You can use risk tools and calculators found on line to determine your lifetime risk (although many do not include the female specific variables above. In which case I recommend speaking to your physician or perhaps a cardiologist or even a womans heart health specialist. They can help you review your risk factors and together you can decide how aggressive you need in terms of additional testing and managing your risk.
In terms of testing, here is another shocker. The classic ways of testing for heart disease in man do not necessarily apply to woman. For example…Treadmill exercise testing has a higher false-positive rate in woman and troponin, the blood marker that is diagnostic of an acute cardiac event can be normal in woman despite having a heart attack while this is less commonly the case in men. And in some cases diagnostic tests do not pick up athlerosclerotic disease becuase the mechanism of heart disease is different in men vs woman. For example, the classic understanding of heart disease is the formation of a plaque in the lining of the arteries that narrows the vessel over time preventing blood flow to the heart- causing a heart attack or a plaque rupture- when the plaque suddenly breaks open and occludes the passage blood flow. This narrowing or obstruction can be easily seen on coronary angiography, a study in which die is injected into the large arteries and viewed as it passes thru the arteries feeding the heart.
While woman can have this kind of disease course, woman have a higher percentage of MINOCA or Myocardial infarction with NON OBSTRUCTIVE coronary artery disease. This is can be caused by a whole host of things like spasm in the arteries or other processes that do not get picked up by a classic angiogram because a classic obstruction is not present.
Now this can get seriously scientific and into the weeds. And I dont want to do that. But I do want to share that these differences exist adn are not super well known in the general medical community. So if you are having chest pain or if you have other nonspecific symptoms like shortness of breath or reduction in exercise tolerance or ability to move and exercise you may need to be your own health advocate if the usual tests are not helping make a diagnosis.
Ok so back to the regular gal. The one who has not had a heart attack but perhaps has some risk factors and wants to reduce her risk. Here are some ways that you can manage your risk (and these are not limited to females BTW-we can all benefit from this!):
Screen for Diabetes (more common in people with a family history or those who are overweight)
HTN
Cholesterol
Smoking
Diet-
(DASH/Mediterranean
-low salt
-low saturated fat- replaced by mono/polyunsaturated fats
-high quality high fiber carbohydrates
-lots of fruits and veggies
-lean animal protein in moderation
-limited red meat and alcohol
Movement/Exercise
Sleep (including sleep apnea)
Manage Stress
Increase Connection
-platonic
-romantic
MindBody Practices
Breathing practices
Meditation
Nature
Among others
emotional regulation, reduces stress hormones and blood pressure
I want to end with this- Heart health is very feasible for woman and heart disease is very preventable. The beauty is what is good for the heart is also good for your spirit and for your soul. I hope this knowing will encourage you to engage in your own heart health and adopt some of the guidance I have provided which will undoubtedly benefit you mind, body and soul.