PREVENTIVE STRATEGIES FOR WOMEN
Shafali’s Jariwala’s also known as the “Kanta Laga girl” sudden demise has alarmed the country especially those who had heard about her or seen her on the screen, music videos and as a reality TV personality. Married to actor Parag Tyagi she apparently was a fit person yet died suddenly and the cause ascribed is a cardiac arrest. The commonest cause of a sudden cardiac attack is a heart attack. Ironically it is said that she was taking anti-ageing treatments of many kinds. The claims made of looking young basically are directed to skin but at times hormones are also used, which can cause premature heart events. The stress of maintaining a top-ranking artist could also be a contributing factor.
As a cardiologist, I see several incidents of full-blown heart attacks in ladies between the ages of 30 and 45 years before their attaining menopause. It is a fact that women underestimate their risk of developing cardiovascular disease, even though at least half of the deaths in women occur due to heart disease and related problems.
It is a general belief that heart disease especially heart attack is a disease of men. This is not true if one looks at the entire data, cardiovascular disease is the commonest cause of death in both men and women in the entire subcontinent. More women will have a second heart attack within 6 years of their first heart attack. Diabetes which is a common and increasing problem in our society makes women 3 to 4 times more prone to heart disease and doubles the rate of a heart attack.
One of the common problems is delay in recognizing a heart attack. Women often do not have classical tell-tale symptoms. Some women do not experience chest pain during heart attack. They are more likely to have a typical warning symptoms like back ache, abdominal pain, shortness of breath, nausea and vomiting. It is for these reasons there is a delay in recognizing heart attack in women leading to more complications and a higher mortality. T
he reliability of an electrocardiogram in diagnosing a heart attack is somewhat compromised in females who often have non-specific changes even when they are healthy. Denial is the most often cause. These are some of the reasons that treatment gets delayed and the golden period of first 4 to 6 hours when the treatment is most beneficial is lost.
Important Causes of “Heart attacks in Women”
Bad life style leading to weight gain, high blood pressure, elevated cholesterol and smoking which often in our women is passive “second hand smoking from their family members especially husbands”.
Physical inactivity and sedentary life style often leads to weight gain, higher chances of getting diabetes or even pre diabetes and high triglycerides and cholesterol. When asked the answer is often “I hardly sit and am all the time working, cooking, washing clothes and sweeping home”- well these activities do not consume enough calories to have a favourable effect. Exercise means going out and walking at least 8000 to 10,000 steps a day frequently (at least 5 times a week).
Chronic stress especially in working women “Dual Stress”, stress of home combined with stress of place of work. All this can lead to inflammation of the arteries of the heart, high BP which combine to damage the blood vessels and make the blood more coagulable leading to clot formation and finally blockage of the artery leading to a frank heart attack.
Early removal of the uterus combined with ovary removal below the age of 46 without hormone therapy can lead to 25 % increase in cardiovascular disease. It is therefore recommended women considering hysterectomy should discuss their individual risk factors with their health care providers.
Non -Drug Strategies to Prevent Heart Attacks in women:
Getting regular, daily exercise can reduce the risk of fatal heart disease. If combined with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater. Physical activity helps you control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes. It also reduces stress, which may be a factor in heart disease.
Try getting at least 30 to 60 minutes of moderately intense physical activity most days of the week. However, even shorter amounts of exercise offer heart benefits, so if you can’t meet those guidelines, don’t give up. You can even break up your workout time into 10-minute sessions. Getting some regular, daily exercise can reduce your risk of fatal heart disease. And when combining physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.
Eat a heart-healthy diet
Eating a heart healthy diet can help protect heart. Eating foods that are low in fat, the diet which is rich in fruits, vegetables, whole grains and low-fat dairy products can help protect your heart. Beans, other low-fat sources of protein and certain types of fish also can reduce your risk of heart disease. Poly and mono unsaturated fatty acids as a cooking medium is recommended. Good examples are olive oil, mustard oil and sunflower oil. All are easily available.
Over cooking and deep frying is bad as it destroys the healthy properties of food. Consuming 3 to 5 servings of fresh seasonal fruits, mildly cooked vegetables and salads are heart healthy and prevent heart attacks significantly especially when combined with other healthy measures. In terms of non-vegetarian food remember fish is the best and protective, poultry like chicken follows, red meat is the bad cholesterol increasing food and needs to be minimized.
Periodic health screenings
High blood pressure and high cholesterol can damage your heart and blood vessels. But without testing for them, you probably won’t know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action.
- Blood pressure. Regular blood pressure screenings should start in early life. Adults should have their blood pressure checked at least every two years. You may need more-frequent checks if your numbers aren’t ideal or if you have other risk factors for heart disease. Remember optimal blood pressure is less than or 120/80 millimetres of mercury and anything more than 140/90 needs medicines. Lower it is the better it is
- Cholesterol levels. Adults should have their cholesterol measured at least once every five years starting at age 20. Total cholesterol should be less than 150 and the bad cholesterol less than 100 mgs. Women with multiple risk factors should have the LDL cholesterol less than 70 mgs/dl and less than 50 mgs/dl if there is a history ofprevious heart attack.
- Diabetes screening. Since diabetes is a risk factor for developing heart disease, it should be ruled out by all. It is simple to do by just measuring a fasting blood sugar which should be less than 126 mgs/dl. Those with higher levels need to see a doctor to get more tests like HbA1c done to confirm the diagnosis or find out if they are pre-diabetics (more prone to get it).
Take Home Message:
Preventing a heart attack and recognizing the earliest symptoms is very important. Women should not be under an impression that it is a disease predominantly of males. Healthy women are the gatekeepers to the health of the family and a key influence in keeping the hearts of our families healthy.
(The Author is a renowned Interventional Cardilogist, Recipent of Padmashiri and DR BC Roy Award. Founder of Gauri kaul foundation)
