Sunday December 5, 2010
There are many risk factors that increase the chances of heart disease in women.
DOES cardiovascular disease (disease affecting the heart or blood vessels) only affect men? If you agree with this statement, beware and take note that women can, and do get cardiovascular disease. In fact, heart disease is the number one killer of women in Malaysia, accounting for about 25% of all female deaths in government hospitals.
The most common cause of heart disease is the narrowing or blockage (by fatty deposits) of coronary arteries, the blood vessels that supply blood to the heart. This is called coronary artery disease and happens slowly over time. It is the major reason people have heart attacks. Prevention is important as studies have shown that two-thirds of women do not fully recover from a heart attack.
Control your blood sugar levels ... diabetes puts you at a much
higher risk of developing heart disease if you don’t exert tight control over
your sugar levels. Another complication of cardiovascular disease is stroke. A stroke happens when there is interruption of blood flow to a part of the brain, causing loss of function associated with that particular part of the brain. This can be due to the rupture of a small blood vessel of the brain or when a clot or fatty deposit blocks a small blood vessel in the brain. Both these events can be triggered by uncontrolled blood pressure. Stroke is a significant cause of lifelong disability in women above the age of 55 years.
Risk factors for cardiovascular disease include increasing age, menopause, hypertension, diabetes, a family history of cardiovascular disease, high cholesterol levels, smoking and a high-fat diet.
Menopause
The older you get, the more likely you are to get heart disease. As a woman, you are likely to develop heart problems later in life compared to men, typically seven or eight years later. However, by about the age 65, your risk is actually almost the same as that of a man. It is known that women have a higher risk of cardiovascular disease after menopause. This is because women no longer enjoy the cardio-protective benefits of oestrogen upon attaining menopause.
In addition to being at risk of cardiovascular disease when you start to undergo the transition to menopause, you may also experience uncomfortable symptoms such as hot flushes, mood swings, and insomnia. For such symptoms, hormone therapy containing both oestrogen and progesterone is an effective treatment option, not only for the relief of menopausal symptoms, but also for the added benefit of preventing osteoporosis. It may also improve cholesterol and blood pressure levels.
Growing medical evidence suggests that there is a window of opportunity of up to five years in the early menopausal stage, in which women can enjoy the benefits of hormone therapy without an increased risk of hormone-related conditions. You should however, not consider hormone therapy if you have a history of hormone-dependant conditions such as breast cancer or a history of blood clots in the leg or lungs.
Your suitability for hormone therapy can be determined in consultation with your doctor.
Hypertension
Hypertension or high blood pressure also increases your chances of developing heart disease. There are usually no symptoms of high blood pressure, so it can easily go undetected. If you have high blood pressure, you should monitor it frequently, and more importantly, seek medical treatment to control it.
There are many drugs available today that can treat hypertension. They differ from one another by working in different ways to lower blood pressure. Doctors will often start treatment with one class of drug and then combine it with others as combination therapy is more effective than using one drug alone at maximum dose.
Medical progress has improved the availability of treatment options for hypertension. However, this does not diminish the need for the older generation drugs that have long established effective properties or are better tolerated in some patients. An example is the older generation calcium channel blocker nifedipine, which still remains very promising for its cardiovascular protection.
The right choice of drug is essential to keep blood pressure levels as consistently close to normal limits (130/90mmHg) as possible in order to prevent cardiovascular complications such as stroke.
Diabetes
Diabetes is a disorder of glucose metabolism. When food is digested, the glucose makes its way into our bloodstream in order for our cells to use the glucose for energy and growth, a process which requires the hormone insulin. A person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). Type 2 diabetes mellitus, which is the most common type of diabetes worldwide, occurs when the cells become less responsive to insulin.
If you have diabetes, this puts you at a much higher risk of developing heart disease. You are also more likely to have high cholesterol levels and high blood pressure. Diabetes can also increase the effect of other risk factors for heart disease, such as smoking and being overweight.
As with hypertension, drugs for the treatment of diabetes work to control blood sugar levels, either in a fasting state or that after a meal. Both these areas are important if you are diabetic, and your blood sugar levels can be managed with either oral drugs or in combination with injectable insulin.
It is common to use a combination of oral drugs in order to achieve consistent control of both the fasting and the after-meal rise of blood glucose. A commonly used oral agent to control the fasting state is metformin, while drugs such as acarbose specifically work to reduce the post-meal glucose level component. Drugs such as acarbose are also safe to be used in combination with all other diabetic drugs and will not lead to complications such as low blood sugar (hypoglycaemia), which can be fatal.
Consistent control of diabetes can be effectively measured by using HbA1c levels. It is a simple blood test that acts as an indicator of long-term blood glucose control and a guide for physicians to gauge if treatment is sufficient in preventing cardiovascular complications of this progressive disease.
If you have diabetes, it is even more essential to ensure that other co-existing diseases such as hypertension and cholesterol levels are well controlled to minimise your risk of developing heart disease.
High cholesterol levels
Another risk factor for cardiovascular disease is high cholesterol levels, specifically LDL (low-density lipoproteins). High LDL levels will contribute to fatty plaque deposition, which will increasingly block the coronary arteries.
A diet low in saturated fats is recommended and if your cholesterol levels are not controlled with diet and lifestyle changes, your doctor can prescribe medication to lower your cholesterol levels.
Cholesterol-lowering drugs include statins, niacin, bile-acid resins, fibric acid derivatives, and cholesterol absorption inhibitors.
Lifestyle changes
In addition to controlling the significant risk factors of hypertension, diabetes, and high cholesterol levels, it is essential to also adopt a healthy lifestyle.
Eating healthily can help you prevent heart disease. It is advisable for you to observe a low-fat and low-salt diet that includes plenty of fruit and vegetables Choose healthy cooking methods (grill, bake, steam, or microwave instead of frying), trim fat off meat, and remove skin from chicken.
A healthy diet will lower the likelihood of you being overweight, which is yet another factor that increases your chances of developing heart disease.
Regular exercise is one of the best things you can do for your heart. With just 30 minutes of moderate intensity activity at least five days a week, you can halve your chance of developing heart disease.
Moderate-intensity physical activity makes you feel warm and slightly out of breath, but you should still be able to talk without difficulty.
Giving up smoking not only reduces your risk of developing heart disease, but also reduces the risk of many other serious illnesses such as cancer and obstructive airway diseases. As exposure to passive smoking (inhaling smoke from nearby smokers) may also increase your risk of heart disease, you should also try to prevent your exposure to this.
It is evident that a healthy lifestyle is important in preventing cardiovascular disease. However, for those who have significant risk factors such hypertension, diabetes, and abnormal cholesterol levels, it is essential to seek appropriate treatment for each of these risk factors in order to prevent heart attacks or strokes.
As the saying goes, an ounce of prevention is worth a pound of cure. Take care of your heart and it will see you well into your golden years
http://thestar.com.my/health/story.asp?file=/2010/12/5/health/7537269&sec=health
