Expert Q&A: Women and heart disease
Listen to your bodies: Heart disease in women is a major problem.
Many of us are aware that heart disease is a major problem in America, but how do we begin to address this problem? Esther S.H. Kim, MD, MPH, a cardiologist and vascular medicine specialist for Vanderbilt University Medical Center, spent some time with us and discussed women, heart disease and how it can be prevented.
Question: Why is heart disease in women an epidemic in America?
Answer: One thing that is really important to understand is that women can get heart disease. In fact, it’s the biggest killer of women and more women die from it than men because we tend to live longer. So just because you’re a woman, you can’t ignore your symptoms. You are at risk.
Question: What are some of the risk factors for heart disease in women?
Answer: There are some things that we can modify and there are some things that we can’t. Obviously, we can’t change our gender or genetics. If you have a strong family history, you will especially have to focus your efforts to aggressively change the modifiable risk factors. Those are weight, blood pressure, cholesterol and how much you exercise. If you have diabetes, also a very important risk factor for heart disease, controlling weight and getting enough exercise is especially important.
Question: How do we modify our cholesterol?
Answer: We modify our cholesterol in three major ways: what we eat; how much we exercise and weigh; and what medications our doctors might recommend.
Question: Can that make a difference on whether you develop heart disease?
Answer: Absolutely. There are several large epidemiologic studies that have shown that people who have high levels of the bad cholesterol are at higher risk for developing heart disease.
Question: What about exercise? How much activity do we need?
Answer: You don’t have to train for a marathon. One of the easiest things you can do is get 30 minutes of exercise a day — start to sweat, get your heart rate up. That can be brisk walking. You don’t have to do it all at once if you don’t have the time. You can do 10 minutes in the morning, 10 minutes in the afternoon and 10 minutes at night. Now that everyone has a fitness monitor, it’s much easier to track how active you are or how much you’re not doing. You think, “Oh, I walk at work,” but then you look at your monitor and you’ve clocked 4,000 steps that day. It’s recommended that we all get at least 10,000, but for someone who’s starting out, 10,000 is a lofty goal. To start, say, “I’ll do 5,000 a day this week, then 6,000 a day next week” and then get yourself up to 10,000 a day.
Question: What about smoking? Is that something that just needs to stop?
Answer: Yes. There is no such thing as healthy cigarette. After you stop your first cigarette, the health benefits start immediately.
Question: What about e-cigarettes?
Answer: There are some differences between e-cigarettes and regular cigarettes. There have been studies in which patients have used e-cigarettes as a bridge to stop smoking but they become dependent on the e-cigarettes. Talk to your doctor about what method is best for you because there are medicines and therapies out there to help. It’s very hard thing to quit smoking so getting the right help is key.
Question: Are there any other things that we should be thinking about related to women and heart disease?
Answer: Women, particularly as we get older, are as susceptible as men for developing heart disease. There are some protective benefits of having the female hormones when we’re younger but not necessarily taking the female hormones when we’re older. If you have heart disease, you should talk to your doctor about whether it’s still healthy to continue with those hormone therapies. Women also tend to be very stoic about their symptoms, and tend to take care of others above themselves. It’s very important to listen to our bodies. Not all people have chest pain as their first sign of heart disease. It doesn’t always have to be an elephant on the chest. For some, it may be jaw pain or arm pain or extreme fatigue or shortness of breath. If you are concerned it may be symptoms related to the heart, it is best to discuss with your doctor.