Heart Healthy Q&A

A Discussion of Heart Disease Prevention with Elizabeth Henke, MD, of Triangle Heart Associates

When should women worry about heart disease?

Women shouldn’t worry about heart disease, they should act. Although recommendations say women should get screened at 20 years old, their concern for their heart health should start in childhood. Parents have the ability and responsibility to teach their children to live a healthy lifestyle.

When should women start to do things to prevent heart disease?

Heart disease prevention should start in childhood. However, it is never too late to adopt heart healthy habits. Studies regarding women and exercise have found that no matter what weight category a woman is in, if she exercises, it reduces her risk for a heart attack.

When should you talk to your physician about heart disease?

Every time you have your routine physical, be sure to talk with your physician about your heart health. It is a good idea to bring a list of your health questions to each visit. That way you will be sure to discuss all of your concerns.

Women don’t necessarily have pain as their heart symptoms. Oftentimes women will refer to their heart pain as indigestion, a funny feeling, or shortness of breath. It is important for women to know their bodies. Be alert for any body function changes such as changes in your ability to perform your normal activities (i.e. your job, shopping, housework, exercise, etc). Share any changes, no matter how trivial, with your physician. This information can assist and possibly alert your physician to potential problems.

Are there particular health numbers (i.e. cholesterol levels, blood pressure, etc.) that women should watch?

Yes. There are health numbers that are important for every woman to know. You can get these numbers by asking your doctor during visits or going to health fairs, and some you can measure on your own.

It is important to know your blood pressure and your blood pressure goal. The goal for most people should be 120/80 or lower. Typically if a person has a blood pressure higher than 140/90, physicians advise medication for the treatment for high blood pressure. However, physicians will use medication for a blood pressure higher than 130/80 in certain high-risk patients because the risk for heart disease rises rapidly for blood pressure higher than 120/80.

If you have high blood pressure, take charge. It is not just your physician’s responsibility to ensure that you are heart healthy. Women need to take their health into their own hands. Get a blood pressure cuff and report the numbers to your physician. It is important for women to take control of their health.

Knowing your cholesterol numbers -- and your cholesterol goal -- is important. Physicians focus on a person’s LDL level, which should be less then 100. Your doctor may, depending on risk factors, be OK with 130 but may advise an LDL of less then 70 for some individuals. There isn’t one number, but less then 100 is a good level for most people.

Waist size is another number to keep track of. Women should have a waist circumference of 35 inches or less. It is a good idea for women to know what their fasting blood sugar levels are. The desired level is less then 100.

What can women do to prevent heart disease?

There are several things women can do to prevent heart disease, including reducing their weight, stopping smoking, staying away from secondhand smoke, visiting their physician annually to ensure that their health numbers are in the right range, exercising regularly, and eating healthfully.

Your heart is a muscle and it needs to be worked. Regular exercise means working out every day for a minimum of 30 minutes. Sixty minutes is ideal. The 60 minutes doesn’t have to be in the gym -- it can include cleaning your windows, dancing, or going for a walk. Extra things like parking farther away from stores or work and taking the stairs can make a difference.

Eat right. Everyone’s diet should be high in fruit, vegetables, whole grains, fish and not too much red meat. Eggs and vegetable oils from avocados and olives are good. Keep saturated fats to a minimum and only consume dairy products that are low in fat. Reduce the use of white bread, potatoes, white pasta and white rice. Avoid sodas, desserts, sweet cereals, and foods with trans-fats. Talk with your physician to see if you should include fish oils and omega 3s in your diet. Both can be purchased over the counter.

Are there any medications available to prevent heart disease?

Aspirin is not recommended for women under 65, unless you have a problem.

Are prevention tips different for women with a family history of heart disease then those who do not?

Healthy living tips are for everyone. Heart disease can affect men and women and not just those with a family history of the disease. Heart disease is the leading cause of death for women. One third of women die of cardiovascular disease. It is not just a man’s disease. Men just get it younger. When women get the disease, it is more lethal.

What question should I or any woman ask you about heart disease that I haven't asked?

How can I prevent my daughter and/or son from getting heart disease?

What is the one thing you want women to know about preventing heart disease?

Our nation’s children are progressively more inactive and are gaining weight at an alarming rate. It is predicted that as a result of this trend, they will die younger then their parents, primarily from cardiovascular disease.

Women have a significant impact on their children. It is important for them to lead by example. You cannot expect a child not to smoke if his or her parents do. That is the same for healthy eating and exercise. Women can influence children while they are young and help their children develop healthy lifestyle habits.

Too many children are sitting in front of the TV, computer, and video games. We need to encourage them to be physically active. It is important for their mental and physical health. Eat at home as much as possible -- that way you can have control over what is going into their bodies. Petition schools to provide healthful food. Stay focused and firm.