Page 6 2011 Winter
The beat on heart health
True or false?
Women are four times more likely to die from heart disease than breast cancer.
In 2003, heart disease was the leading cause of premature death in women. But it's not all bad news.
"To a large extent, we know what causes heart disease and can account for 70 to 80 per cent of risk with lifestyle factors," says Austin Hospital cardiologist Dr Jennifer Johns. You can take positive action towards better heart health!
What is heart disease?
Coronary Heart Disease (CHD) is a disease of the arteries of the heart caused by a build-up of fatty deposits in the artery wall lining. These deposits can thicken, harden and narrow the arteries, so the flow of blood to the heart is constricted. This may cause chest pain known as angina. If a blood clot forms in the narrowed artery and blocks the blood supply to part of the heart, it can cause a life-threatening heart attack. CHD may also cause sudden stopping of the heart (cardiac arrest) or gradual failure of the pumping action of the heart (heart failure).
Who is most at risk?
People who have a family history of heart disease and/or who smoke, have hypertension (high blood pressure), are overweight, are diabetic or have high cholesterol, are most at risk of heart disease. The more risk factors you have, the greater your risk.
Alarming but little known facts
- In Australia, heart disease accounts for 16 per cent of all deaths (cardiovascular disease, which includes heart disease, stroke and vascular diseases, accounts for about 34 per cent).
- On average, heart care expenditure is 20 per cent less for women than men. Women who are hospitalised are less likely to receive certain treatment options and tests, although more investigation is needed to explain why this is the case.
- One in five women aged 20-29 years continue to smoke daily.
- 90 per cent of women have at least one risk factor for heart disease and 50% have two to three risk factors.
- More women die of heart attacks than men.
Are symptoms different for women vs. men?
Women may be less likely than men to feel central chest pain during a heart attack. In a study of 515 women who experienced a heart attack, 43 per cent did not experience any type of chest pain or pressure. "Generally, women are older than men when they develop heart disease, and have a higher incidence of diabetes," Jennifer explains. "Long standing diabetics feel pain quite differently - a heart condition may exhibit as breathlessness, nausea, back pain, tightness or discomfort in the arms; fatigue or feeling generally unwell, rather than classic chest pain. Women with diabetes are also at much greater risk of experiencing 'silent' (no pain or other symptoms) heart disease."
Heart disease awareness
Heart Foundation national manager for engaging women, Hannah Baird, says women are aware of the warning signs of heart disease, but are more likely to call '000' for their husbands than themselves. "Many women think of heart disease as an 'older man's' disease and therefore irrelevant to women in middle age," she says.
"Only 31 per cent of women are aware that heart disease is the leading cause of death in women."
Tips for keeping your heart healthy....
Under 40 – focus on prevention
If you have a family history of heart disease, high cholesterol, high blood pressure or depression, it is even more important that you speak to your doctor about how you can change your lifestyle to improve your heart health.
- Enjoy healthy eating. Choose low or no fat dairy foods, trim fat from meat and chicken, swap butter for margarine, make vegetables the main part of your meal and be sure to eat five serves of vegetables and two serves of fruit every day. Enjoy fish and pulses twice a week and choose mainly water to drink.
- Talk to your doctor or dietitian about ways to achieve and maintain a healthy weight.
- A brisk walk for 30 minutes a day or more can reduce your risk of cardiovascular disease by as much as half. And it doesn't have to be 30 minutes all at once, three lots of 10 minutes is just as good.
- Quit smoking. For assistance, call the Quitline on 131 848 or talk to your doctor.
- Small changes can make a big difference. Choose one area of your life and set small, achievable goals.
- If you have high blood pressure and are on the contraceptive pill, you are at higher risk of stroke, so see your GP regularly.
40-55 years – focus on lifestyle modification
- A full GP check-up at 45 years is recommended to assess heart disease risk.
- Depression, anxiety and unrealistic goals can
- interfere with making lifestyle changes. Ask your health professional for support.
- If you are over 50, have your cholesterol checked every two years. Risk of heart disease increases after menopause.
- High blood pressure and diabetes become more common after 40, so ask your GP to check your blood pressure and blood sugar levels.
- A heart risk calculator can assess your risk of heart disease by looking at risk factors such as age, lifestyle, blood pressure and cholesterol.
55+ years – stay in touch with your GP
- This is typically when women start to think more about their health and advancing age – it's an important time to be monitored by your GP.
- Have your cholesterol checked every two years, along with blood pressure and other risk factors.
- A heart risk calculator may be useful. Note: Some tools will not calculate heart disease risk for women over 74 years.
A word on salt
A diet high in salt can increase your blood pressure and risk of heart disease. The Heart Foundation recommends consuming less than 6g of salt (listed as sodium on nutrition panels) per day to reduce blood pressure and lower the risk of cardiovascular disease.
If you have high-blood pressure, choose foods labelled 'no added salt' or 'reduced salt' and choose foods containing less than 120mg/100g.
Aspirin: to take or not to take?
Studies show that women at low risk of a heart attack or stroke do not benefit from regular aspirin use. However, evidence suggests that low-dose aspirin reduces heart attack and stroke for women at high risk and for those over 65 years. "In women with known heart disease, there's a clear-cut benefit of taking daily, low-dose aspirin," says Hannah. "However the evidence is still unclear for other women." Jennifer stresses that the benefit compared to the risk of stomach, intestinal or intracerebral (head) bleeding needs to be considered for each individual by a healthcare professional.
A message for young women
Jean Hailes Research Director Professor Helena Teede, says those young women who are at risk of heart disease can be more easily detected than men. "Overweight and obese young women are at higher risk of diabetes, high cholesterol and heart disease," she explains. "Problems may be picked up in women early when they have fertility issues or when transient diabetes is detected during pregnancy." Also, 12 to 18 per cent of reproductive age women will have polycystic ovary syndrome (PCOS).
"These women are at much higher risk of diabetes and have higher heart disease risk," Helena reports. "Fortunately, small changes in lifestyle can prevent diabetes progression and limit heart disease risk factors. For example, a 3-5 per cent decrease in body weight can decrease incidence of diabetes by 60 per cent."
National Heart Foundation www.heartfoundation.org.au
Fact sheet on Heart Disease available at www.jeanhailes.org.au
Content updated June 2011