I know February is American Heart Month, but with the recent deaths of two beloved stars, I wanted to add to the conversation. Do you know your risk for heart disease?
Although Debbie Reynolds seemed “unsinkable” as Molly Brown, and Carrie Fisher had “The Force” with her, the mother-daughter duo both suffered from cardiac-related deaths last month.
What is even sadder, cardiovascular diseases are the No. 1 killer of Americans, and they run in families.
Women are especially at risk — heart disease is the No. 1 killer of women, claiming more lives each year than all forms of cancer combined. Yet we, as women, still put off going to the doctor. We still put off going in for routine tests that could point to the early signs of trouble.
We grab foods that we know aren’t healthy for us, as we run around taking care of everyone else — to the detriment of our own health.
I know this isn’t news to anyone. We’ve read the articles before, we’ve had friends and loved ones pass away.
We think, “I’ll schedule an appointment next week.” Next week turns into next month, and then before you know it a year has gone by and we still haven’t taken steps to be an advocate for our own health.
The time is now. Today. I mean it.
You can finish this article later. Put down the paper and schedule a checkup with your doctor.
It doesn’t matter if you are 18 or 81. Start taking control of your health. Ignoring the problem won’t make it go away.
If you are young and have the mindset that nothing will happen to you, great. Go in anyway. If you start having checkups at a young age, it will make it easier for your doctor to spot a problem later on, because he or she will be able to look back and see what is normal for you.
I encourage you to make our national conversation a personal one, to spark important, difficult interactions that help more people understand the threat these diseases pose. In our mourning, let’s embrace some teachable moments.
Ask your wife, your mom, your grandmother, your sister, your aunt — any and all of the women who matter most to you — when they last had a physical. If it wasn’t in 2016, challenge them to make scheduling a well-woman visit among their New Year’s resolutions. (Reminder: This is free under most insurance plans, including Medicare.)
If the women you love received a checkup in the past six months, ask whether they’re following their health care provider’s recommendations. This includes everything from taking medicines to scheduling follow-up appointments, from changing their diet, to other lifestyle changes such as exercising more and quitting smoking.
And while you are on this subject, be sure to ask whether they know that heart attack symptoms are often different for women than men.
Let us not forget the men in our lives. It’s important to remember heart disease is their No. 1 killer too. Obviously, this means they also should regularly get a checkup — so schedule one for you sweetheart when you schedule yours. Remind them to follow doctor’s orders and all best practices when it comes to a healthy lifestyle.
This year I encourage you to “be the force” — the force to be reckoned with when it comes to taking charge of your health.
Heart disease in women
In men, a heart attack typically begins with the sudden rupture of a cholesterol-filled plaque in a coronary artery, which then precipitates a blood clot. In younger women in particular, a plaque is more likely to erode into the vessel wall rather than to burst. “Women are also more likely to have smaller, nonfatal heart attacks,” say experts.
Women are also more likely than men to develop small vessel disease, a condition where blockages occur in the tiny vessels within the heart muscle rather than in the large, surface arteries.
“We see a lot of women who have classic angina [heart-related chest pain], but their major coronary arteries look normal, so they are told it’s not their heart. But you might have a heart attack if the condition is not treated,” experts say.
Postmenopausal women are also subject to a sudden and unusual change in the shape of the heart muscle known as Tako-tsubo cardiomyopathy that occurs in response to severe emotional stress. Also called “broken heart syndrome,” the condition is characterized by chest pain and changes in the heart’s electrical activity that mimic a heart attack. However, the arteries appear clear of plaque. During the initial event, these women are still at risk of heart rhythm problems, shock, or even death.
The myth of atypical symptoms
Some attempts to tease out gender-related differences have led to misconceptions about the nature of angina symptoms in women. Specifically, women were thought to have subtler, “atypical” symptoms that diverged from the classic pattern of chest pain — the tightness and crushing pressure described by men. But a recent analysis published in Journal of the American Medical Association Internal Medicine revealed that men and women experience similar forms of discomfort when having a coronary blockage. Women, however, are more likely to have a “silent” heart attack, which has no overt symptoms at all. This variation may be due to women being older when the heart attack occurs, and also may be more likely if they have diabetes.
Stroke risk also differs between the sexes. Each year, about 425,000 women have a stroke — 55,000 more than men.
This can partly be explained by women’s longer average life span, since advancing age is a key element in stroke risk. However, women face unique stroke threats due to hormones, reproductive health, pregnancy and childbirth. This understanding prompted the American Heart Association and American Stroke Association to issue Guidelines for Preventing Stroke in Women in 2013.
“Pregnancy is like a stress test for your cardiovascular system,” experts explain.
A history of eclampsia or pre-eclampsia — a pregnancy complication characterized by high blood pressure, high urine protein levels, and sometimes seizures — doubles a woman’s risk of having a heart attack or stroke within the next five to 15 years.
Because birth control pills are known to raise blood pressure, women should be checked for high blood pressure before starting this medication.
Women who experience migraine headaches with aura (visual disturbances) also have a greater likelihood of having a stroke and therefore should avoid both smoking and birth control pills so as not to boost their risk further.
Other stroke risk factors such as atrial fibrillation, diabetes, depression and emotional stress also tend to be stronger or more common in women than in men.
Moreover, women tend to suffer more after a stroke. Three months following the event, female stroke survivors are more likely to struggle with mobility problems, pain, anxiety and depression than their male counterparts. Women also report a lower quality of life a year after having a stroke.
The well-known culprits
Men and women alike can protect their cardiovascular health by paying attention to their personal heart risks. Lifestyle basics such as getting regular physical activity, eating a healthy diet, and maintaining a normal body weight apply to everyone.
In addition, increasing your awareness of how gender differences shape your personal cardiovascular risk profile can give you an added edge in staying healthy.
American Heart Association and
About the author
Christine Bollier is a health and nutrition writer and lecturer who has spoken to groups all over the Rim Country, including making presentation at the Women’s Wellness Forum for several years.