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Guest Column

Women, make heart No. 1

By DR. RAO MUSUNURU
Published February 1, 2008

Since the beginning of the human race, the heart has been closely associated with the mind, life and love, expressed as such frequently in day-to-day spoken and written language. February is designated heart month and Feb. 14 is Valentine's Day. Today is "National Wear Red Day," a day when Americans nationwide are asked to wear red to show their support for women's heart disease awareness.

Cardiovascular disease has remained the No. 1 killer in the United States. Most people are aware of this fact but even today, the majority still think that heart disease is mainly a "man's disease." The fact is heart disease is also the No. 1 killer of women, far exceeding not only breast cancer but all cancers combined.

The National Heart, Lung and Blood Institute started "The Heart Truth" campaign years ago and the American Heart Association picked up with the "Go Red" campaign to increase the awareness of this deadly disease in women. The purpose is to get the word out to women about their risk of heart disease and, most importantly, the ways to lower it.

Educating women helps not only themselves but their entire family. Women - in spite of how many jobs they do outside the house - mostly remain the caretakers of the household, especially when it comes to health problems. Ironically, that is one of women's main problems. Women often tend to ignore their own health, caring for everybody else in the family. But of course it is just as important to be a real role model, if one expects to influence others positively.

Women account for 51 percent of the heart disease deaths in the nation. Even though heart disease is often perceived as an older women's disease, heart disease is the third leading cause of death among women ages 25 to 44 and the second leading cause of death among women ages 45 to 64.

Even though natural estrogens (in contrast to contraceptives or postmenopausal supplements) protect women to some extent against heart disease at a younger age, the women do much worse compared to men at a later age.

Most of the major risk factors for development of coronary heart disease, for women and men, are well known and are very much preventable or treatable: high blood pressure, diabetes mellitus, high cholesterol levels, smoking, being overweight, inactivity and depression. Most of these are interrelated, exist in clusters and have an additive risk effect. The only risk factors that cannot be modified are age and heredity. A person can do much better, even at an advanced age and in spite of adverse hereditary factors, if she or he can control the modifiable risk factors mentioned here.

The blood vessels that supply blood to the heart are the size of a strand of spaghetti and it is easy to see how they can easily get clogged. Most people already have heart disease and do not know it, either because they don't have any symptoms (partial blockages do not cause symptoms) or they did not recognize the symptoms.

People can even have so-called silent heart attacks, meaning they survived the heart attack (which they ignored as indigestion or food poisoning or viral illness, etc.) without any medical intervention. These are the fortunate few, and they may not survive the next time.

The majority of the people who die suddenly from the heart never had any clue that they had a heart problem. In other words, the first (and the last, unless promptly rescued by cardiopulmonary resuscitation and a defibrillator) manifestation of heart disease can be sudden death from ventricular fibrillation - the result of electrical irritability of the heart muscle when it loses its blood supply suddenly and completely because of a clot on the top of the cholesterol plaque in the coronary artery.

All the risk factors promote the formation of cholesterol plaques in the blood vessels in the heart and other organs, causing partial blockages without any symptoms. These same risk factors also promote sudden rupture of the cholesterol plaque. This releases chemicals prompting the formation of a blood clot on the top of the cholesterol plaque, causing sudden and total blockage of that blood vessel. It results in heart attack (with sudden death sometimes) or stroke.

It is difficult to recognize, diagnose and treat heart disease in women, compared to men, even for the best of the clinicians, which makes it even more important to be vigilant in preventing heart disease in the first place by controlling or modifying the risk factors with a heart healthy diet, regular physical activity, maintenance of ideal body weight, control of blood pressure and diabetes and cholesterol, and cessation of cigarette smoking. Also, it is very important to seek medical care immediately, if there is any suspicion. The embarrassment of false alarm is always better than the risk of being dead.

Preventing heart attack is the best treatment you have. Your heart will love you for it and your family will thank you for it. If you treat your heart right, why would it attack you?

Dr. Rao Musunuru practices cardiology at Regional Medical Center Bayonet Point in Pasco County. He is a member of the Advisory Council for the National Heart, Lung and Blood Institute in Bethesda, Md., and a member of the National Leadership Committee of the Clinical Cardiology Council of the American Heart Association.

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[Last modified January 31, 2008, 22:22:12]