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Alive and Ticking

Medics have proclaimed heart disease to be the No. 1 killer of women the world over. Enough of thinking with our hearts; it’s time to start thinking for our hearts now.

The way a woman perceives her vital statistics should ideally change after a certain age. No, we aren’t referring to your hour-glass 36-24-36 body measurements. Your body mass index, cholesterol levels and blood pressure are numbers that are truly vital when it comes to keeping your heart healthy and pumping for long.

A common misconception is that heart disease is a man’s illness. The American Heart Association cites cardiovascular disease claims far more women than cancer or any other serious ailments do. Read on to know more about this silent killer of women and how to keep it at bay.

A Woman’s Heart: An Overview
Our Expert: Dr Saad Al Tamimi, consultant internist and cardiologist, Noor Specialist Hospital

June-2014_Wellbeing1_1The female hormone, oestrogen, protects a woman against heart disease. However, when production of oestrogen dwindles after menopause, women are at great risk of developing cardiovascular diseases. They are usually characterised with arteriosclerosis and/or hypertension.

“Arteriosclerosis is the process of thickening and hardening of arteries caused by deposition of cholesterol and calcium.

Over time, these plaque deposits grow large enough to narrow the arteries, decreasing the flow of oxygen-rich blood to the heart muscle. If the plaque becomes unstable and ruptures with superimposed blood clots, the artery will be blocked, resulting in a heart attack,” explains Dr Saad.

Besides the most obvious risk factors of heart disease, like high cholesterol, blood pressure and obesity, other factors play a bigger role in the development of heart disease in women.

“Diabetes increases the risk of cardiovascular disease significantly more in women than in men. Similarly, what we call the metabolic syndrome — the combination of abdominal fat, high blood pressure, high blood sugar and triglycerides — has a greater impact on women than men,” says Dr Saad.

Other factors like depression, smoking and lack of physical activity all contribute to heart trouble in women. The symptoms of a heart attack between men and women greatly differ. Women may not experience the clichéd gripping chest pain associated with heart attacks. They are more likely to have symptoms such as discomfort in the neck, jaw, shoulder, upper back or abdomen. There might also be shortness of breath, pain in the right arm, nausea/vomiting, sweating, dizziness and unusual fatigue.

Prevention and Management
Our Expert: Dr Amany Serag, consultant cardiologist, International Hospital Bahrain
Although heart troubles are more likely to hit women after menopause, Dr Amany advocates taking preventive steps much earlier.

“From the start, women must watch their weight and maintain an ideal body mass index of below 25. For this, the DASH lifestyle is imperative,” says Dr Amany.

The DASH (Dietary Approaches to Stop Hypertension) plan is a heart-healthy lifestyle plan centred on reaching and maintaining a healthy weight by reducing fat and salt intake, increasing regular exercise, stopping smoking and limiting alcohol intake.

Along with making healthy dietary choices, regular exercise is crucial to maintaining a healthy ticker. Any form of cardio goes a long way to keep the heart healthy; it could be as simple as brisk walking or swimming.

“Exercising for 15 to 20 minutes every day is more beneficial than exercising for an hour per week,” Dr Amany explains.

It is a myth that cardiovascular diseases are hereditary. Cases in women are on the rise due to lifestyle factors, such as smoking, diabetes and high levels of stress. In any case, women must consciously aim to maintain their BMI below 25, waist-to-hip ratio below 0.9, blood pressure below 120/180 and triglycerides below 150 as these are major risk factors for heart disease.

“Women must take their health seriously. A lot of them say that they work a lot at home or walk in the mall, but that definitely does not count as exercise,” says Dr Amany.

“Early diagnosis of heart troubles helps save lives. Even something as minor as jaw pain should not be ignored. It could be a warning sign to an underlying heart problem.”

Secondary prevention comes into play for those already diagnosed with heart disease. Besides regular medical follow-ups and taking medications as prescribed, it is a must to inform the doctor of any new symptoms that may be experienced.

The DASH plan should be followed, with a nutritious diet replete with natural foods and eliminating processed foods laden with saturated fats, sugar and salt. Smoking and alcohol should be completely avoided for secondary prevention.

As part of their rehabilitation programme, heart patients must exercise regularly under the guidance of a physiotherapist, but steer clear of lifting weights, competitive sports and any strenuous physical activities.

Dr Amany cautions against hormonal medications for women. Doctors do not prefer to prescribe oral contraceptives to women over 35 years with a family history of heart disease. Similarly, high doses of hormonal therapy taken to cope with menopause over a long time also increase the risk of heart problems.

Heart Attack SOS
Our Expert: Dr DT Subhash, consultant cardiologist, Ibn Al Nafees Hospital
During a heart attack, the lack of blood flow results in the death of heart muscles, rendering that particular area of the heart dysfunctional.

“Immediate medical care is paramount for the victim. Every minute counts,” says Dr Subhash. “Symptoms should never be dismissed as indigestion out of doubt. It is worth getting them checked even if it is a
false alarm.”

It is imperative to remove the blockage from the artery and to re-establish the blood flow ideally within an hour of attack symptoms. The longer the time between the attack and treatment, the lesser the chances for the dead heart muscles to be restored.

While waiting for medical aid, the administration of clot-busting medication, like aspirin, can be a potential life-saver and stave off irreparable heart damage.

“Aspirin is a small, low-cost medicine, but it very effective in the event of a heart attack. High risk patients must have it at hand at all times,” the expert adds.

Better knowledge and a few good changes can keep your heart feeling its very best.

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