By Debbie Gardner
debbieg@thereminder.com
According to the American Heart Association’s Go Red for Women Campaign, heart disease and stroke cause one in three deaths among women annually – more than all cancers combined. With this in mind, Prime asked Mary Ann Burns, director of communications for the Connecticut and Western Massachusetts chapters of the American Heart Association, for help finding an expert who could talk about women and heart health. Dr. Sunjata Holman, a board certified specialist in internal medicine and cardiovascular disease at Pioneer Valley Cardiology in Springfield, Massachusetts, graciously agreed to answer our questions.
Here’s what she told Prime about women and their hearts:
Q: Though breast cancer gets more attention, heart disease is the #1 killer of women. How can menopause – and aging in general – affect a woman’s risk for heart problems?
“Menopause is around the time where we start to see women’s risk of heart disease start to rise considerably. Increases in lipid levels – specifically bad cholesterol (LDL) and triglycerides with plateauing of good cholesterol (HDL) – and blood pressure – both of which are known risk factors for heart disease – are seen. In addition, we start to see change in the patterns of fat distribution – with more belly fat – which in turn can contribute to insulin resistance and the development of prediabetes or diabetes.
“We think estrogen decline is a significant contributor to these changes. However, it’s not quite as simple as that either. One would think that if decline in estrogen were the cause, then supplementing estrogen would be the cure. Unfortunately, this theory really hasn’t panned out. There was a large Women’s Health Initiative study that in fact did not show this to be the case. As a result, the American Heart Association has recommended against the use of hormonal therapy at menopause to reduce risk of heart attack and stroke. We really aren’t certain how many of the above-mentioned changes are related to menopause versus aging itself. This is a great avenue for future research.”
Q: Actress Carrie Fisher died of a heart attack at age 60. What can this tragedy teach women about heart attacks?
“That clearly, heart attacks can happen to ANYONE. However, that being said, much of heart disease is entirely preventable. Our research to date has taught us that a healthy diet (one with low saturated/low trans fat, low sugar, high fiber, that is largely plant based), regular exercise, and controlling risk factors – specifically diabetes, hypertension or high blood pressure, and high cholesterol – is very important for disease prevention. But in order to do this, one has to be very vigilant and motivated. In other words, some of this stuff is easier said than done.
“Additionally, I think this tragedy has really reiterated to us that we really need to listen to our bodies. I believe that intuitively, you know when something just isn’t right. I think the downfall of us as humans with our huge intellects is that sometimes we overthink things. As an example, if a month ago, you were able to rake the leaves in your yard for an hour straight, and this month, you can barely go 10 minutes before becoming short of breath – this isn’t normal for you. But you have to listen to yourself.
“I think as women, we are sometimes so distrustful of ourselves. We just don’t want to be a bother, or we don’t have time to deal with something. But unfortunately, our symptoms aren’t always the ‘classic’ crushing chest pain travelling to your arm or jaw. Sometimes we are just overly exhausted or short of breath.”
Q: What’s the biggest thing a woman over age 50 can do to lessen her heart attack risk?
“Be mindful of your risk factors. Common risk factors include smoking, sedentary lifestyle/obesity, high cholesterol, family history in a first degree relative, high blood pressure, and insulin resistance/diabetes. Ask questions at your doctor’s office visits. Be prepared to have a discussion with your doctor about how you can reduce risk. Sometimes, it may be just be a matter of diet and lifestyle changes. Sometimes, it may be medications.
“Ultimately, every medical decision takes into account risks and benefits. We try to optimize the benefit while minimizing risk. Knowing which risk factors to target goes a long way towards prevention.”
