Health Topics

Expert Q&A: Women and heart disease

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December 20, 2023

Heart disease can affect women at any age. Know your own risk factors.  

Many of us are aware that heart disease is a major problem in America, but how do we begin to address this problem? Dr. Jessica Duran, a cardiologist who specializes in advanced multimodality cardiovascular imaging and women’s cardiovascular health at the Vanderbilt Women’s Heart Center, spent some time with us and discussed heart disease in women and how it can be prevented.

Question: Why is heart disease in women an epidemic in America?
Answer: Heart disease continues to be the leading cause of death for women in the United States. It is estimated that nearly half of all women in the United States are living with some form of heart disease, but unfortunately the underestimation of risk, under-diagnosis, and under-treatment of heart disease in women continues.

Heart disease can affect women at any age and it is important for women to know if they have risk factors and also be able to recognize the associated signs and symptoms. Although chest pain is the number one symptom for heart disease in both men and women, women may experience alternative symptoms. Some of these nonspecific symptoms include fatigue, shortness of breath, dizziness, nausea, indigestion or back pain. These symptoms may even occur in the absence of chest pain. If a woman has any risk factors and/or signs or symptoms of heart disease, she should seek prompt medical attention for further evaluation.

Question: What are some of the risk factors for heart disease in women?
Answer: It is very important for women to know if they have risk factors for heart disease as many are modifiable with targeted lifestyle changes and/or medications. These modifiable risk factors include high blood pressure, high cholesterol, diabetes, smoking, obesity, eating an unhealthy diet, drinking too much alcohol, living a sedentary lifestyle, sleep deprivation and stress.

Although you cannot change your genetics, it is also important to know if you have a family history of heart disease. Women also have some unique risk factors for heart disease related to their reproductive health and pregnancy. These risk factors include hypertensive disorders of pregnancy (for example, gestational hypertension or preeclampsia/eclampsia), gestational diabetes, delivery of a low birth weight baby, preterm delivery (less than 37 weeks), polycycstic ovarian syndrome, early age of first period, and early menopause.

Question: Are there any things that women can do to lower their risk of developing heart disease?
Answer: Absolutely! There are many lifestyle changes that a woman can make in her daily life to lower her risk of developing heart disease and improve her overall health. First, knowledge is power and it is important to know your risk and identify personal risk factors for heart disease with the help of your health care provider. Check your blood pressure. Find out if you have high cholesterol or diabetes. Focus on eating a diet that is rich in fruits, vegetables, whole grains, legumes, poultry, fish, nuts and heart-healthy fats. Avoid sugar, processed foods, and sweetened beverages. Move your body and make physical activity a priority in your daily life. Maintain a healthy weight. Limit your intake of alcohol. Do not smoke, vape, or use any tobacco products. Make sure you get 7-9 hours of high quality sleep every night. Visit your doctor on a regular basis.

Question: How do we lower our blood pressure?
Answer: There are many lifestyle changes that can lower your blood pressure. First, be checked to see if you have high blood pressure, also known as hypertension, which is defined as higher than 130/80 mmHg. If you have high blood pressure it is important to get in the habit of checking it regularly at home and monitoring your numbers over time.

Focus on eating a heart-healthy diet that is low in salt, limit your alcohol intake, quit smoking, maintain a healthy weight and pursue regular physical activity. Effectively managing stress in your daily life is also very important. If you are unable to lower your blood pressure sufficiently through lifestyle interventions alone, your health care provider can prescribe medications to help lower your blood pressure to a healthy level.

Question: How do we lower our cholesterol?
Answer: A heart-healthy diet can help lower your cholesterol. Focus on eating a diet that is rich in fruits, vegetables, whole grains, legumes, poultry, fish and nuts. Limit your intake of red and processed meats, saturated and trans fats, and full-fat dairy products. Also, minimize your intake of sugar-sweetened foods and beverages. You should also quit smoking, lose weight if needed and make physical activity a part of your daily routine. Based on your cholesterol level and personal risk, your health care provider may also recommend cholesterol-lowering medications to help you achieve a healthy cholesterol level.

Question: What about exercise? How much activity do we need?
Answer: Get in the habit of moving your body every day and sitting less. Every bit of physical activity counts –just focus on breaking a sweat and getting your heart rate up. You do not necessarily have to join a gym or buy any special equipment. You just have to find a form of exercise that you enjoy and can incorporate into your daily life.

The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity (like brisk walking, biking or dancing) or 75 minutes of vigorous aerobic activity (running, cycling or hiking), or a combination of both, spread throughout the week. You should also incorporate muscle strengthening activities such as weight lifting into your routine several times per week. In order to prevent injuries, slowly ramp up your exercise regimen until you have successfully achieved your physical activity goals.

Question: What about smoking? Is that something that just needs to stop?
Answer: Most definitely. Smoking, vaping, and the use of tobacco products continues to pose major health threats. They are responsible for heart disease, stroke, lung diseases, cancer and many other serious medical problems. Deciding to quit smoking, vaping or using any form of tobacco is one of the best decisions you can make to improve your health and extend your life. Talk to your health care provider to learn more about available resources, therapies and medications to help you successfully quit.
Question: What about e-cigarettes or vaping?
Answer: Although e-cigarettes have the potential to be less harmful than regular cigarettes, they are still not safe. Many e-cigarettes contain nicotine which can be highly addictive. Additionally, e-cigarettes also contain many toxic chemicals that have been linked to heart and lung disease as well as cancer.

Question: Are there any other things that we should be thinking about related to women and heart disease?
Answer: A woman’s risk for heart disease changes throughout her lifetime. Women experience unique life stages including pregnancy and menopause that place them at an increased risk for heart disease. The good news is that you can lower your risk for heart disease at any age by making dedicated lifestyle changes and taking certain medications if needed. I encourage women to find out their risk for heart disease and take a proactive role in achieving and maintaining a healthy lifestyle to protect their hearts. Priortize self-care above all else and never forget that you have the power to be in control of your heart health.

Vanderbilt Women’s Heart Center

Heart disease is the leading cause of death in women in the U.S., yet it often goes under-diagnosed and under-treated. Vanderbilt Health offers a specialized program tailored to women’s heart health needs, spanning from adolescence and childbirth to menopause. Women’s Heart Center experts work together to treat heart disease with the special needs of women in mind.

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