Cardiovascular Curiosities

By Diane Schlindwein

November 20, 2008 6 min read

CARDIOVASCULAR CURIOSITIES

Men and women have different issues approaching heart disease

Diane Schlindwein

Creators News Service

When it comes to having a healthy heart, both women and men should be equally diligent about taking good care of themselves. In fact, according to statistics released by the American Heart Association, coronary heart disease is the number one cause of death in the United States.

Up until recently, heart disease was thought to be a man's problem, said Dr. Nieca Goldberg, cardiologist, associate professor of medicine and the medical director of New York University's Women's Heart Program, as well as a national spokesperson for the American Heart Association's "Go Red" campaign.

However, as death rates of women who suffer heart-related disease have increased in recent years, it has become apparent that women especially need to be aware of heart-related symptoms, said Goldberg, who treats mostly women in her New York City practice.

It's important to realize that heart disease involves a great deal more than heart attacks, Goldberg wrote in her most recent book, "Dr. Nieca Goldberg's Complete Guide to Women's Health" ($26, Ballantine Books). It also involves structural issues such as valve problems, heart muscle problems such as heart failure, plumbing problems such as clogged arteries that supply the heart and problems of the electrical system such as arrhythmias. Some people have cardiovascular disease, which refers not only to heart disease, but also to diseases of the blood vessels throughout the body.

When it comes to your heart, it's important to keep an eye on your cholesterol. Those who have seen a physician recently -- or even those who haven't -- have probably heard quite a bit about both HDL (high density lipoprotein, or "good" cholesterol) and LDL (low density lipoprotein, or "bad" cholesterol). Jessica Forman, an exercise specialist in cardiac rehabilitation at the Prairie Heart Institute at St. John's Hospital in Springfield, Ill., said the optimal HDL level is 60 mg/dL (milligrams/deciliter) or more, while the optimal LDL level is 100 mg/dL or less.

"There is much you can do to increase your HDL and decrease you LDL cholesterol through lifestyle improvements," Forman said. "In fact, government health officials recommend that most adults with cholesterol problems first change their health habits for three to six months before resorting to medication."

Moderate to vigorous aerobic exercise, maintaining a lean body weight and quitting smoking can increase HDL, Forman said. To lower LDL, she recommends reducing dietary saturated fat intake to less than 10 percent of calories, reducing body weight if it is high, reducing dietary cholesterol to less than 300 milligrams a day, increasing carbohydrates to more than 55 percent of calories, and increasing dietary fiber to more than 20 grams a day. Fruits, vegetables, beans and whole-grain high-fiber foods are best.

"When women have a low HDL, is it bigger problem for them," Goldberg said.

Both men and women do share some risks for heart disease, she added. Those risks are obesity, lack of exercise and smoking. In fact, smoking triples a woman's chance of having a heart attack.

Goldberg recommended that both men and women take out a tape measure and check their waist sizes. "Women should have a waist size of 35 inches or less and men should have a waist size of 40 inches or less," she said. Any measurements greater than those can put individuals at risk for heart trouble.

High blood pressure and diabetes can also affect heart health for both sexes. The optimal blood pressure for both men and women, no matter what their age, is 120/80 or less, Goldberg said. Meanwhile, men who have diabetes are three times as likely to have heart problems, while women with diabetes are five times as likely to suffer from heart disease.

Goldberg recommended people see a doctor regularly, follow healthy eating and exercise habits and pay attention to the important "numbers" -- namely cholesterol, triglycerides, blood pressure, glucose levels and waist size. "They might be a pain, but those numbers are important," she said.

So when should a person suspect that he or she is having a heart attack? That answer may depend on whether you are a man or a woman, Goldberg said.

When men have a heart attack they usually feel pressure or pain in the middle of the chest, chest pain that spreads to the neck, shoulder or jaw, or chest pain with a feeling of faintness, sweating, nausea or shortness of breath.

Although women can have these same symptoms, Goldberg said women who are having a heart attack can experience unusual fatigue, shortness of breath -- especially during low levels of activity or even at rest -- nausea, dizziness, lower chest pain, back pain or upper abdominal discomfort.

Anyone who has symptoms of a heart attack should get help right away. "If you think you have heart symptoms, what you want to do is get medical attention immediately," Goldberg said. "What's the worst thing that can happen? You'll be wrong and be sent home."

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