Cardiovascular disease risks
Sarah Levin, also a physician in internal medicine affiliated with Vassar Brothers, talked about the risks of heart disease in women. While it is increasing for women, she said, they tend to disregard the symptoms and not get the same vigilant attention from the medical profession as do men.
It’s true that traditionally, cardiovascular disease (CDV) affected more men, but since 1980 there’s been an increase in mortality for women age 30 to 50, and it’s the leading cause of death for women in all age groups, with African-American women being more at risk than other ethnicities.
Levin attributed part of the gender disparity to the fact that women get fewer cholesterol screenings than do men. They are prescribed less betablocker drugs and get fewer referrals to a cardio rehab center. Plus, fewer ICDs — a device implanted in weakened hearts that enables doctors to treat dangerous heart rhythms, a precursor of CVD — are put in women than in men.
Stress of course is a contributor of heart disease. Recent research puts those suffering from marital stress at three times the risk of a heart attack or stroke than those subject to other kinds of stress. Levin said women may feel more stress with many having primary responsibility for children and care of the home as well as working full-time jobs.
One problem is that women themselves tend not to treat a warning sign seriously. New research included in the American Heart Association’s release of new guidelines for prevention of CVD in women, released last February, revealed that only 53 percent of women would call 911 if they were having heart attack, Levin said. “Women tend to be stoic. The medical community also is being a little less vigilant, and there’s a social bias that cardiovascular disease doesn’t affect women as much as it does. Sometimes it pays to complain a bit about the symptoms.”
You have to be your own best advocate, advised Levin. She said the first step was assessing risk, which according to the AHA guidelines falls into three categories: high risk, at risk, and optimum risk. Levin said the vast majority — 72 percent — of women fall into the at-risk category. People in the at-risk category have a 5.5 percent chance of having a CVD event within the next decade. Nineteen percent of American women fall into the high-risk category. Only two percent fall into the optimum category.
Maintaining a healthy lifestyle is key to reducing your risk. “I can’t overestimate how important it is to maintain a healthy diet, not smoke, and exercise,” said Levin. A diet low in saturated fats and devoid of hydrogenated transfats is optimum and helps prevent hypertension. Levin recommends a minimum of 150 minutes of moderate exercise a week. The AHA guidelines recommend no more than one drink per night. Recent research indicates even this may be too much. (The study showed that three to six glasses of wine a day increased a woman’s risk of cancer, although it isn’t clear that the wine itself is the problem — there might other, related indicators.)
The rise in obesity is of particular concern, given that it has led to an epidemic of type 2 diabetes, which is linked with an increased risk of stroke. Another indicator for high risk is family history; if anyone in your family died young from heart disease (under age 55 for men and under age 65 for women), you are high risk. Blood pressure greater than 120/80 also indicates high risk. Indicators for optimum risk is a blood pressure of less than 120/80, total cholesterol of less than 200, and a body mass index of less than 25, plus abstinence from smoking, regular exercise and a healthy diet.
