Did you know Latinas are likely to develop heart disease 10 years earlier than white women? And nearly half of black women have cardiovascular disease? We know that men generally have a greater risk of heart disease than women, but it’s also the No. 1 killer of women, according to the American Heart Association.
“Women don’t seem to be as aware of their risk as compared to men, so they may ignore it,” says Dr. Mary Ann Bauman, M.D., Medical Director for Women’s Health and Community Relations at INTEGRIS Health Inc. and Go Red For Women physician spokesperson. The symptoms can be different in women too, according to Bauman. Both men and women may experience chest pain, for example, but women may also have more subtle symptoms, like nausea, pain between the shoulder blades in the back, or even a decrease in exercise tolerance. “Women who are used to running a mile without any problems may all of a sudden have to stop after half of a mile,” says Bauman.
What’s more, women age 45 and younger are more likely than men to die within a year of their first heart attack, according to AHA. To combat these statistics, the AHA’s Go Red For Women movement is encouraging women to schedule their “Well-Woman Visit,” a prevention check-up to review a woman’s overall health and heart disease risk.
The good news is, both women AND men can reduce their risk of heart disease by making lifestyle changes.
HEART DISEASE RISK FACTORS YOU CAN MODIFY
We can’t control our age or our genes, but there is plenty that we can do, in terms of lifestyle choices:
- SMOKING. We know that smoking, even secondhand smoke, increases the risk of heart disease, so if you smoke it’s a good idea to quit. Smoking constricts blood vessel walls, decreases HDL, the good cholesterol, and increases the tendency for blood to clot.
- HIGH BLOOD CHOLESTEROL/HIGH BLOOD PRESSURE/DIABETES. If you have high cholesterol, high blood pressure, or diabetes, it’s important to keep these under control with lifestyle changes or medication.Small changes can go a long way – for example, while ideally blood pressure should be below 120/80, for every 10 mmHg you decrease your systolic pressure (the top number), you decrease risk of heart attack and stroke by 30-50%, according to Bauman. Losing weight, exercising, and decreasing salt intake all help lower blood pressure.When it comes to cholesterol numbers, Bauman suggests the following targets:
Cholesterol ideal <180; Desirable <200
LDL <100
HDL >60
Triglycerides <150
“But these are not absolutes,” she cautions. AHA recommends an algorithm that takes into account age, gender, and other risk factors, as well as cholesterol and HDL levels, in order to determine the 10-year risk of heart disease. A recommendation for statin use (versus lifestyle change) is based on that risk level, says Bauman.
- OVERWEIGHT/OBESITY. Being overweight — especially being apple shaped, or having excess fat around the waist — is another risk factor for heart disease. The good news is, losing as little as 5% of your body weight (for example, 10 pounds if you weigh 200 pounds) can help to decrease heart disease risk factors, including blood pressure, fasting glucose, and CRP, a marker of inflammation, according to Dr. Robert H. Eckel, Professor of Medicine at the University of Colorado School of Medicine and Past President of the American Heart Association. At a 10% drop in body weight, you may start to see improvements in HDL and triglycerides, says Eckel.
- DIET AND EXERCISE. Being physically active and eating a healthy diet play very important roles in decreasing heart disease risk, by keeping body weight, cholesterol, and blood pressure in check. “There is evidence in terms of a benefit (in heart disease risk) of engaging in physical activity for 30 to 45 minutes, at least four times per week, at a moderate intensity – that’s typically associated with some sweating,” says Eckel.
Here are some specific recommendations in terms of diet and heart disease:
EGGS AND FATS
Eggs get the green light according to the most recent report from the 2016 Dietary Guidelines. The reason is, eggs are high in cholesterol, but they’re low in saturated fat, and saturated fat is the bigger culprit when it comes to raising blood cholesterol levels.
So enjoy eggs, but limit your intake of saturated and trans fats, which are found in red and processed meats, fried foods, and full fat dairy foods. Focus instead on heart healthy monounsaturated fats, found in nuts and olive and canola oils, and omega-3 fats, found in fatty fish, flaxseed, and walnuts.
Whatever you do, don’t replace saturated fat with refined carbohydrates, like white bread, white rice, and sugary foods and beverages. According to a recent report from the Harvard School or Public Health, eating refined carbohydrates in place of saturated fat does lower “bad” LDL cholesterol, but it also lowers the “good” HDL cholesterol and increases triglycerides. The net effect is as bad for the heart as eating too much saturated fat.
SALT AND SUGAR
We should all aim to limit our sodium intake to 2,300 mg per day, according to the 2016 Dietary Guidelines. That’s the amount in just one teaspoon of salt – so watch that salt shaker! But if you have high blood pressure or other risk factors, limit your intake to 1,500 milligrams of sodium. If your intake is very high, even getting sodium down a little bit will help, says Bauman.
And when it comes to sugars, the American Heart Association is pretty strict – they recommend that women limit their intake of added sugars to 6 teaspoons per day, or about 100 sugar calories, and men should limit their intake to 9 teaspoons, or about 150 sugar calories. The average American consumes 22 teaspoons of added sugar a day, which amounts to an extra 350 calories.
Interestingly, new research suggests that added sugars may independently increase risk of heart disease. One recent study found that when individuals consumed 25 percent of their calories as fructose or high fructose corn syrup, they exhibited increased bloodstream concentrations of LDL cholesterol, triglycerides and a protein known as apolipoprotein-B, which can lead to plaque buildup in arteries. Other research suggests that added sugars, particularly fructose, may increase blood pressure and heart rate. So read labels and watch out for foods and beverages with fructose, sucrose, high fructose corn syrup, honey, and others.
FISH OILS
We know that consuming fish, especially fatty fish like salmon, trout, halibut, and herring, is good for our hearts, and we should aim to include these kinds of fish in our diets AT LEAST twice per week. Omega-3 fatty acids decrease risk of arrhythmias (abnormal heartbeats), decrease triglycerides, slow the rate of atherosclerotic plaque, and slightly lower blood pressure.
If you include fish in your diet, you don’t need to take a fish oil supplement. But if you do not eat any fish at all, or if you have high triglycerides, then a fish oil supplement can be beneficial, says Eckel. Talk to your doctor if this is the case.
ALCOHOL
Excess alcohol increases blood pressure and triglycerides, and the risk for obesity, among other things. But interestingly, there is a cardioprotective effect with moderate alcohol consumption, which is defined as no more than one drink per day for women, and two drinks per day for men. (Alcohol appears to increase HDL, the “good” cholesterol). If you drink, limit yourself to these amounts.
For more information, check out https://www.goredforwomen.org