 Take heart: what you need to know
Heart disease is a major health and financial burden throughout the world, especially in developed countries. By 2020 it is estimated that heart disease will become the single leading public health problem for the world. In Australia, heart disease is the leading cause of death for both men and women.
About heart disease
Heart disease affects either the heart or the major blood vessels (arteries) supplying the heart, brain and other parts of the body.
From early in life, fatty cholesterol deposits called plaque gradually build up on the walls of arteries. These cholesterol plaques can rupture at any time and cause blood clots to form in the blood vessels, which block the artery. This blockage of blood supply can lead to chest pain (angina), heart attacks and stroke.
High blood pressure (hypertension) thickens the blood vessel walls and can lead to blockage. The heart may then enlarge and may need to work harder.
About your heart
Your heart is a muscle about the size of your fist that sits slightly to the left of the middle of your chest. The heart muscle works as a pump to send blood through the body to provide you with oxygen and nutrients, as well as to carry away waste. The right side of your heart receives blood from the body and pumps it to the lungs. The left side receives blood from the lungs and pumps it out to the body. Before each heart beat, your heart fills with blood, then contracts to move the blood along the arteries.
Think you know the truth about women and heart disease?
It is so important for individuals, community and health practitioners to understand the realities of heart disease in women in order to prevent disability and death in these women. Foundation Director of Research Professor Helena Teede says that health practitioners may underestimate a woman’s risk factors. “It’s important for women and their healthcare team to work together. The more women know the warning signs, and their risk, the more they can do to help themselves,” she says. Professor Teede has a tough warning for women: “Make sure you know your blood pressure, your cholesterol and your blood sugar levels as they do not show symptoms. If you don’t check you won’t know and these factors will continue to damage blood vessels until it’s too late.”
Signs you may be having a heart attack
The risk factors for women are similar to that of men, but there are some important differences. Many heart attacks start slowly, as mild pain or discomfort in the chest. While men typically experience tightness in the chest, arm pain and shortness of breath -- the ‘classic’ signs of a heart attack -- women may have some of these symptoms accompanied by other signs including nausea, overwhelming fatigue and dizziness.
Because a woman’s symptoms may be atypical and vague, and may have many other possible causes, she and her health practitioner may not immediately think the symptoms are heart-related. If you don’t consider your heart risk, Professor Teede says, it can creep up on you. “Awareness of heart disease risk means you can work towards prevention and better health.”
A woman’s risk
Professor Teede says that most women do not identify heart disease as the number one killer of women. A report from the Australian Institute of Health and Welfare shows that only one in four women correctly identify heart disease as the major cause of death.Women tend to have have poorer outcomes after heart attacks, so it is just as important for women as it is for men, to control the risk factors that lead to heart disease. |
Myth
- Women aren’t really that affected by heart disease.
- A woman’s experience of heart disease will be the same as that of a man.
Reality
- Heart disease is the number one killer of women, as well as men.
- When women get heart disease it often presents differently than it does in men.
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Healthy heart tips
- Stop (or don’t start) smoking
- Make regular physical activity part of your everyday life
- Watch your serving size
- Eat a wide variety of healthy foods that are low in saturated fat, sugar and salt, and high in fibre
- Include plenty of serves of grains, pulses, vegetables, fruit and fish
- Maintain a healthy weight
- Know your cholesterol, blood pressure and blood sugar (glucose) numbers
- Reduce stress with physical activity and relaxation techniques
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“Women tend to develop heart disease later in life than men, with hormones appearing to play a protective role prior to menopause,” says Professor Teede. The number of deaths may be higher in women because they are generally older than men when symptoms develop.
Risk factors we can’t control:
- Family history of coronary artery disease or stroke
- Age 55 or older
- Being post-menopausal
- Having your ovaries removed early in life
A family history of premature cardiac disease (less than 60 years), especially in a sister or brother, may be a particularly important risk factor in women.
Women with a family history should be aggressive in controlling heart disease risk factors.
Controllable risk factors:
- Obesity
- Inactive lifestyle
- Smoking
- Hypertension
- High total cholesterol, and/or reduced HDL (good) cholesterol
- Diabetes
- Metabolic syndrome – a group of risk factors for heart disease, including obesity, high blood pressure, blood fats and blood sugar and high cholesterol
There is good news
According to Professor Teede the majority of risk factors are within our control. “The lifestyle choices we make every day can have a big impact on, and can delay or possibly even reverse, our risk of heart disease at any age.”
“Aggressively managing risk factors can prevent or delay the onset of heart disease,” she says. “In those who already have heart disease, control of risk factors can delay or even stop the progression of the disease, and strongly improve health.”
Finding out your risks
Talk to your healthcare practitioner to determine your risk of developing heart disease. It’s important to be aware of the effects of being overweight and/or being inactive, and very important to have your risk factors checked and managed if they are a problem. Talk about your lifestyle and discuss whether you are incorporating enough physical activity into your daily and family life. Ask for guidance if you need it.
Questions to ask your health practitioner
- What are my risk factors for heart disease?
- What are my blood pressure, cholesterol and sugar levels?
- What can I do to lower my risk?
- What kind of physical activity is right for me?
- How do I stay healthy?
Important points to remember
- A woman’s experience of symptoms may be quite different and more vague than a man’s.
- Overwhelming fatigue, dizziness or nausea may indicate heart disease in women.
- One in 10 women have three or more risk factors for developing heart disease.
- Excess body fat greatly increases your risk, even if you don’t have any other risk factor.
- Maintaining an active lifestyle can reduce your risk by 30 to 50 per cent.
- Losing just four to five kilos or five to 10 per cent of your body weight can make a big difference.
- At 40 your risk of developing heart disease at some time in the future is one in three.
- Smoking causes 50 per cent of heart disease in women at midlife – it is the leading preventable cause.
- Older women who smoke and use birth control pills are at increased risk.
- Visit your health pracititioner regularly, have appropriate blood tests and talk over your health concerns.
- Keep track of any changes in blood pressure, cholesterol and blood sugar.
- Keep on top of your stress levels and find ways to help you relax.
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Resources
For a fact sheet on women and heart disease call tollfree on 1800 151 441 or log on to www.jeanhailes.org.au
The National Heartline provides information on leading a healthy lifestyle, heart surgery and life after a heart attack. Call 1300 36 27 87 for the cost of a local call or log on to http://www.heartfoundation.com.au/
Smart eating
Nutritionist Catherine Saxelby answers your questions on nutrition.
What can I use instead of salt to add flavour?
The healthiest way to substitute salt is to cook with lots of garlic, onion, ginger, spices, lemon and fresh herbs. It won’t be long before you begin to enjoy food’s true flavours – unmasked by salt. Alternatively you can buy a salt substitute based on potassium chloride, rather than sodium chloride. Check with your GP however, as too much potassium can be harmful if you have kidney problems or are taking certain medications.
Which is better, honey or sugar?
Although natural, honey has no significant nutritional advantages over sugar. Spoon for spoon they are similar, having around 300 kilojoules or 20 grams of carbohydrates per tablespoon, which must be counted if you have diabetes – unlike a sweetener.
Honey contains about 75 per cent sugars (mainly glucose and fructose) which is lower than refined white sugar at virtually 100 per cent sucrose. Water, traces of minerals and some B vitamins make up the remaining 20 per cent; but the amounts present are tiny – too small to make a useful contribution to your intake. Unlike bread or breakfast cereal, there are not enough B vitamins in honey to metabolise the kilojoules it supplies.
Resources
For more questions and answers on nutrition log on to www.jeanhailes.org.au
Content updated May 14, 2007
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