Foreword Get Ready to Go Red
Red is the color of passion and strength. It is also the color of your body’s lifeline—your cardiovascular system.
As a medical student I was fascinated by the heart, pumping blood into a network of blood vessels throughout the body, and then later the blood returning to the lungs for oxygen and then getting pumped around again—the ultimate plumbing system. One day in anatomy class, when I was a student, I noticed that the artery I was studying felt stiff instead of rubbery and smooth. My professor informed me that the artery was atherosclerotic, that is, it was hardened because of cholesterol deposited in its walls. He also told me that it was a man’s artery because heart disease was a man’s disease.
I was reminded of this inaccurate and chauvinistic lesson some years ago when a publication from the American Heart Association reported that more women than men were dying for cardiovascular disease.
Today we know more. Although heart disease is still the leading killer of women, we know a lot more about prevention of heart disease in women. The American Heart Association launched the Go Red For Women movement to educate women and their health care providers about the risks and symptoms of heart attacks.
But awareness is only half the battle. Information is power, but using that information is even more powerful. That’s why as a cardiologist, the author of a highly acclaimed women’s health book, and the spokesperson for the Go Red For Women campaign, I speak to lots of women about heart health.
When I tell them that 1 in 3 women will die of heart disease, they look interested.
When I tell them that 64 percent of women who die suddenly of coronary heart disease had no previous symptoms and that many of those women had at least one risk factor that could have been treated, their jaws drop.
When I tell them that making healthy changes in their lives will reduce their risk for heart disease by 80 percent, they look at me in disbelief.
But it’s all true, and it’s important information to act on.
Sometimes statistics like these are enough to motivate you to make changes in your life, like starting an exercise program, eating a healthier diet, or quitting smoking. But most of us have trouble getting started and sticking with a program because we have busy lives, including working and caring for children and sick parents. Who has the time? How do you begin? All you need is to Go Red; adopt a way of life to protect your lifeline- and you can begin by turning the pages of this book. Nieca Goldberg, M.D.Clinical Associate Professor of Medicine New York University School of Medicine WHAT EVERY WOMAN NEEDS TO KNOW
Chapter 1. Your Heart’s Health Is in Your Hands
One in every three women dies of heart disease . . . but you don’t have to be the one.
Cardiovascular disease is the greatest health risk for women. It causes more deaths than all
forms of cancer combined! The good news is that although these grim statistics exist today, they don’t have to—because heart disease is largely preventable!
Women today can benefit from the huge advances made by medical research. So much more is known and understood about prevention and the incredible importance of a heart-healthy lifestyle than was the case even 20 years ago. Statistics show that if a woman reaches her 50s without developing the major risk factors for heart disease, she will face only an 8 percent lifetime risk of developing cardiovascular disease- as opposed to a 50 percent risk if she develops two of more risk factors. Young women today—if they choose a heart-healthy lifestyle—may live their entire lives without getting heart disease!
Our deepened understanding of the long-term impact of the food and activity choices we make every day is an enormous breakthrough. Today’s young women can benefit from the lifesaving information your mothers and grandmothers didn’t have. You can protect yourself against heart disease for a lifetime. The science on prevention is so powerful¾and so simple.
It’s never too early to make your heart’s health a priority. The earlier you start, the greater the benefit. An entire lifetime without heart disease is quite a payoff for eating your vegetables and exercising regularly.
Because heart disease is progressive and starts early in life and slowly escalates, older women also benefit from a healthy lifestyle. Controlling risk factors, eating right, being active, and working closely with your doctor can bring additional vitality and energy to your life.
With so much at stake, why isn’t every woman leading a heart-healthy lifestyle? Because there are so many myths and misconceptions about heart disease that many women just don’t understand they’re at risk. Myth #1: Heart disease only happens to men.
Wrong. Cardiovascular disease, which includes coronary artery disease and heart attack—is the leading cause of death for both men and women
Heart disease in men has been well researched, and most men are aware it could happen to them, especially by the time they reach their 40s. But women are at risk, too. This myth that women don’t suffer from heart disease has persisted, in part, because women tend to have heart attacks about 10 years later than men do, in their mid to late 50s. By the time women reach that age range, they may have coexisting medical conditions that complicate the diagnosis.
Women’s hearts are biologically different from men’s—and so are their symptoms of heart disease and heart attack. In fact, the classic Hollywood heart attack—a man clutches his chest in extreme pain and falls to the ground—is not consistent with the reality of many women’s heart attacks.
Women’s symptoms can be less dramatic but no less deadly. In women, heart attacks may manifest themselves as back pain, indigestion, breathlessness, weakness, dizziness, a general feeling of malaise, or “just not feeling well,” as well as pain in the chest, the left arm, and the jaw—or any combinations of these symptoms. (For more information on that warning signs of a heart attack, see Appendix E.)
The many ways these symptoms can vary have caused confusion for women and for their doctors, at times even leading to misdiagnosis or nondiagnosis of heart attack and heart disease. The vague nature of her symptoms often can cause a woman to delay seeking medical help—and may make her condition more difficult to diagnose after she has gone to the doctor or the emergency room. These delays may be the reason heart attacks are deadlier for women than for men.
Gender-specific research and improved practices throughout the medical community have led to gains in fighting cardiovascular disease, but women and their healthcare providers need to be vigilant about symptoms that could signal developing heart disease or a heart attack and then take action immediately. Myth #2: Heart disease is just part of getting old.
Wrong. Hearts do age, just as hair turns gray, but heart disease isn’t an inevitable part of aging.
Older women often do develop heart disease because of the risk factors that started accumulating in their youth. High cholesterol, high blood pressure, obesity, diabetes, and other risk factors build and compound with age.
The plaque narrowing a 50-something woman’s arteries probably started building up when she was in her 20s. The high blood pressure of the 60s may have started with slightly elevated readings in her 30s.
Many of the conditions that escalate and compound to become heart disease can be prevented by making good lifestyle choices, especially eating a healthy diet, being physically active on a regular basis, and not smoking.
And if you are diagnosed with heart disease or have a history of heart disease in your family, don’t give up! Your life isn’t over. Medicine has made huge advances in treating heart disease. You can still benefit from a heart-healthy lifestyle; eating well and exercising regularly may slow the progression of your heart disease. Follow your doctor’s directions, take all medications exactly as prescribed, and choose a healthy lifestyle. Myth #3: There’s nothing I can do.
Wrong again. Because many of the risk factors that lead to heart disease are lifestyle related, you can make an enormous difference in your health by making good choices every day. Stay away from cigarette smoke. Have the fish instead of the burger. Pick the baked chicken instead of the fried. Take the stairs instead of the elevator.
The simple healthy choices you make daily will compound, and you’ll be healthier overall just as consistently making unhealthy choices will add up over the years and may show up as risk factors for heart disease.
The most important thing you can do is to accept that you’re at risk and then act on that knowledge:
· Be smart about your lifestyle.
· Be vigilant about changes in your body and its condition.
· Be an active partner with your doctor¾make sure you ask questions, tell everything, and understand what your test results mean.
Although the medical treatment of heart disease is constantly improving, prevention
is truly the “magic bullet” for this vital women’s health issue. Heart disease develops gradually and progresses steadily.
You can gradually but steadily add heart-healthy habits to your lifestyle. You may think that doing the things that are good for your health on a regular basis—shopping for fruits and vegetables, cooking heart-healthy meals, developing a sustainable exercise program—seems like work. Well, it is work. It’s the work of creating a healthy lifestyle, and that won’t happen by chance.
The road to a heart-healthy lifestyle really is traveled one step at a time, one meal at a time, one day at a time. Not very dramatic, perhaps. Not nearly as alluring as the claims for “super” foods or “miracle” drugs or “power” exercises. But the dramatic reward you are working toward¾a longer, healthier life¾really does begin with your very next choice. From the Hardcover edition.
Excerpted from American Heart Association Complete Guide to Women's Heart Health by American Heart Association. Copyright © 2009 by American Heart Association. Excerpted by permission of Clarkson Potter, a division of Random House LLC. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.