What Does Your Heart Mean?


	-To your family? -To your husband? -To your children? -To your community? -To your quality of life? -To your parents? -On a scale of 1-10? -How do you take care? -How do you feed it what it likes and needs?

How do I read my blood test results?


	When you have a blood test, ask to see the results! Here’s what to look for: LDL: Standard optimal levels for women are 70–100 mg/dL. But we’ve seen healthy patients with higher levels. HDL: Standard optimal levels for women are 70–80 mg/dL. VLDL: Very low-density lipoproteins that carry triglycerides (dietary fat) but convert to LDL after they deposit their store. The lower the ratio of VLDL to HDL, the better. CRP: In a new test, the optimal range is <1mg/L. Called a high-sensitivity C–reactive protein test (hs–CRP), it is ultra-sensitive. This test is not yet widely used. For more information, visit the website of Genova Diagnostics. Fasting glucose: Tests blood sugar levels and insulin sensitivity. Optimal range is 75–80. Homocysteine: Our optimal range is 5–8 µmol/ L. Information provided by WomentoWomen.com

Why does having Diabetes give me a higher risk for heart disease?


	Evidence is mounting that high levels of insulin in the blood are related to chronic inflammation and cardiovascular disease. As a precursor to obesity, type 2 diabetes and high blood pressure, insulin resistance clearly plays a role in fat storage and cholesterol function. Since metabolism involves hormonal function, it’s possible that there’s an association between insulin resistance and the estrogen loss and lower HDL levels that occur after menopause. For this reason, it’s always a good idea to eat foods that have a low to moderate reading on the glycemic index scale — and avoid those with high readings, such as sugars and simple carbohydrates.

What do my cholesterol and triglyceride numbers mean?

Total cholesterol level - Lower is better. Less than 200 mg/dL is best.

Total Cholesterol Level	Category
Less than 200 mg/dL	Desirable
200 - 239 mg/dL	Borderline high
240 mg/dL and above	High

LDL (bad) cholesterol - Lower is better. Less than 100 mg/dL is best.

LDL Cholesterol Level	Category
Less than 100 mg/dL	Optimal
100-129 mg/dL	Near optimal/above optimal
130-159 mg/dL	Borderline high
160-189 mg/dL	High
190 mg/dL and above	Very high

HDL (good) cholesterol - Higher is better. More than 60 mg/dL is best.
Triglyceride levels - Lower is better. Less than 150mg/dL is best.

Information provided by WomensHealth.gov

If I already have heart disease, what questions should I be asking my doctor?


	What likely caused my heart problem, and is there an underlying illness we can treat? How severe is my heart problem? What are my treatment options? Should I enroll in a cardiac rehabilitation program to strengthen my heart? What should I do if my symptoms suddenly get worse? What lifestyle changes can I make to feel better? How will this affect daily activities, such as having sex, playing golf or babysitting my grandkids? What can I do to reduce stress and anxiety? How do I explain my condition to my friends, family, and co-workers? Am I eligible for any clinical trials?

Will medicine lower my risk of heart disease and heart attacks?


	Cholesterol-lowering medicines lower the risk of heart attacks in men. However, there is not enough evidence to show that these medicines work as well in women who have never had a heart attack. If you have already had a heart attack, cholesterol-lowering medicines can lower your risk of another attack. Taking an aspirin every day may lower your risk of problems if you have coronary artery disease, a heart attack or angina. Aspirin makes your blood thinner, so it is less likely to make a blood clot. However, aspirin can cause gastrointestinal bleeding and other problems. Talk to your doctor about your risk factors for heart disease and whether you should consider taking aspirin. Angina is chest pain caused by a sudden decrease in the blood supply to the heart. Medicines called statins, beta-blockers and ACE inhibitors may also help if you have heart problems. Ask your doctor if any of these medicines are right for you. Information from FamilyDoctor.org

How do I calculate MY risk?


	Here is a quiz on cardiac risk factors tailored especially for women. By Richard N. Fogoros, M.D., About.com For each "true" statement, give yourself the number of points indicated. 1. My parents or siblings have had a premature (before age 55 for men, or age 65 for women) heart attack, stroke, bypass surgery or angioplasty. (2 points) 2. I am age 55 or older, or post-menopausal. (1 point) 3. I am a smoker. (2 points) 4. I do not routinely exercise for at least 30 minutes, 4 times per week. (1 point) 5. My blood pressure is over 120/80. (1 point) I have diabetes or take medication for my blood sugar (2 points) 6. My HDL cholesterol is less than 50 mg/dl, or my total cholesterol is greater than 240 mg/dl, or I don't know my cholesterol levels (1 point) 7. I am 20 pounds or more overweight (1 point) 8. I am taking birth control pills (nonsmokers add 1 point, smokers add 2 points) 9. My blood CRP (C-Reactive Protein) level is elevated (1 point) 10. I have metabolic syndrome. (2 points) (Metabolic syndrome is any three of the following: high blood sugar, high triglycerides, low HDL cholesterol, hypertension, and central obesity ("fat belly.")) Results Add up your points. If your score is 5 or higher, your risk of developing heart disease is high. If your score is 2 - 4, your risk is moderate. If your score is 0 - 1, your risk is low. If your risk is high, you need see a doctor soon for a cardiac evaluation, and for help with aggressive risk modification. If your risk is moderate, you should see a doctor for a complete risk assessment and for guidance in risk modification. Even if your risk is low, you need to deal with any modifiable risk factors you have (those mentioned in statements 3 - 11.)

Should women drink wine for their health?


	The answer is yes and no. While properties in red wine do help prevent heart disease and some cancers, and reduce inflammation caused by arthritis, these benefits aren't unique to red wine. "Red wine in small amounts has been shown to have beneficial effects," says Christine Gerbstadt, MD, RD, spokesperson for the American Dietetic Association. "However, there's nothing special in red wine that you couldn't obtain in other foods that are antioxidant rich." For example, red grapes, grape juice, grape seed oil, deep green vegetables, melon, pumpkin, squash, blueberries, and peppers are just some of the other sources of antioxidants similar to the ones found in red wine.

Sometimes my heart beats really fast and other times it feels like my heart skips a beat. Am I having a heart attack?


	Most people have changes in their heartbeat from time to time. These changes in heartbeat are, for most people, harmless. As you get older, you're more likely to have heartbeats that feel different. Don't panic if you have a few flutters or if your heart races once in a while. If you have flutters AND other symptoms such as dizziness or shortness of breath (feeling like you can't get enough air), call 911.

10.

Can estrogen replacement therapy reduce my risk for heart disease?


	No. Estrogen replacement therapy, also called hormone replacement therapy, can help minimize the symptoms of menopause (such as hot flashes) and to reduce the risk of osteoporosis (weakening of the bones). It was once thought that HRT could also help protect against heart disease. New studies have shown that when it comes to heart health, HRT actually does more harm than good. If you’re taking HRT to help prevent heart disease, talk to your doctor about whether you should stop. (Information provided by familydoctor.org)

11.

What is ischemic heart disease?


	Ischemic heart disease occurs when patients have blockages in the arteries supplying their heart (coronary arteries). These blockages are virtually always due to atherosclerosis (build-up of fats in the walls of the arteries). If these blockages get too severe, your heart will not receive enough blood when you ask it to do more work (like when you walk briskly up a hill). Sometimes, blood clots form over the blockages, and the vessel becomes completely closed. Then blood flow to part of the heart may cease completely, and that part of the heart muscle dies. This is a heart attack. Ischemic heart disease is the leading killer of American adults. You can reduce your chances of getting it by controlling your risk factors, including high blood pressure, cholesterol, diabetes, and cigarette smoking.

12.

Is there a link between Gum Disease and Heart Attacks?


	Some studies have suggested that periodontal disease may cause heart disease. So far, however, the research is inconclusive, but there is some evidence that gum disease is a sign of heart risk. Studies are under way now to try to determine whether there is a cause-and-effect relationship between periodontal disease and an increased risk of heart attack or stroke. Until the results are in, it makes sense to practice good oral hygiene to prevent periodontal disease.

13.

Does coffee decrease my risk of Heart Disease?


	According to a recent study at Autonoma University of Madrid, Spain, researchers analyzed data from 84,214 women. Study participants were ask to complete questions pertaining to their coffee consumption as well as their dietary habits and other health concerns. Coffee consumption was asssessed from the years 1980-1986 and then followed up in 2004. While this recent study did find that women who consumed 2-3 cups of coffee per day were less likely to suffer from heart disease, Events of the Heart wants to remind everyone that this study is not definite and is still under investigation. Events of the Heart will keep you informed on all the "buzz" surrounding coffee and heart disease.

14.

How does Broken Heart Syndrome (stress cardiomyopathy) differ from a heart attack?


	As you know we are not physicians however, according to Johns Hopkins Medicine: Stress cardiomyopathy can easily be mistaken for heart attack. Patients with this syndrome can have many of the same symptoms that heart attack patients have including chest pain, shortness of breath, congestive heart failure, and low blood pressure. With a closer look, however, there are some major differences between the two conditions. First, most heart attacks occur due to blockages and blood clots forming in the coronary arteries, the arteries that supply the heart with blood. If these clots cut off the blood supply to the heart for a long enough period of time, heart muscle cells can die, leaving the heart with permanent and irreversible damage. This is completely different from what is seen with stress cardiomyopathy. First, most of the patients with stress cardiomyopathy that both we and others have seen appear to have fairly normal coronary arteries and do not have severe blockages or clots. Secondly, the heart cells of patients with stress cardiomyopathy are “stunned” by the adrenaline and other stress hormones but not killed as they are in heart attack. Fortunately, this stunning gets better very quickly, often within just a few days. So even though a person with stress cardiomyopathy can have severe heart muscle weakness at the time of admission to the hospital, the heart completely recovers within a couple of weeks in most cases and there is no permanent damage. For more information about Broken Heart Syndrome and other heart-health answers visit, HopkinsMedicine.org

15.

What are the 8 warning signs of heart disease for women?


	First let us tell you that 1/3 of all women do not experience the "hollywood chest pain" that we all seem to associate with heart diease. Most women actually experience flu like symptoms when they are having a heart attack. Keep that in mind when you think something is just not right. If you experience any of these signs get help immediately! Pain, pressure, fullness, discomfort in the center of your chest Stabbing chest pain that radiates to your shoulders, back, arms, jaw Shortness of breath or pounding heart beats Nausea or vomiting Sweating, dizziness, or weakness Panic with the feeling of impending doom Upper abdominal pain or gas-like pain Unexplained pain between your shoulder blades

16.

What 4 tests should I get for my heart?


	The four tests that every women should get to better understand her heart numbers are the following: 1. Cholesterol Test Cholesterol is different from most tests in that it is not used to diagnose or monitor a disease but is used to estimate risk of developing a disease� specifically heart disease. Because high blood cholesterol has been associated with hardening of the arteries heart disease and a raised risk of death from heart attack cholesterol testing is considered a routine part of preventive health care. 2. Blood Pressure Blood pressure is measured by a quick painless test using a medical instrument called a sphygmomanometer (SFIG'mo-mah-NOM'eh-ter). As the cuff which is placed around the upper portion of your arm inflates with arm the cuff compresses a large artery in the arm\| momentarily stopping the blood flow. As the pressure from the cuff is released your health care professional listens and watches the sphygmomanometer gauge and records two measurements. Systolic pressure is the pressure of the blood flow when the heart beats (the pressure when the first sound is heard). Diastolic pressure is the pressure between heartbeats (the pressure when the last sound is heard). Blood pressure is measured in millimeters of mercury which is abbreviated mm Hg. 3. Electrocardiogram (better known as an EKG Test) The electrocardiogram is one of the most basic tests cardiologists use to gauge the health of your heart. This painless noninvasive test analyzes your heart's electrical activity with the placement of electrode leads on your arms egs and chest. The EKG yields a graphic record that looks like a series of waves representing each beat of your heart which can help your physician detect whether you are having or have had a heart attack whether there are disturbances in your heart's rhythm or a thickening of your heart wall. 4. Stress Test During a stress test you exercise either on a treadmill or stationary bicycle while attached to the EKG machine via electrode leads. The test shows your physician how well your heart performs as more demands are made on it.

17.

What are my risk factors for Heart Disease?

Age:

Any woman over the age of 55 is at risk

Family History:

Must be a parent or sibling with heart disease over the age of 55, if it’s a male relative and 65, if it’s a female relative. Your grandmother who died of a heart attack at age 80 doesn’t count.

High Blood Pressure:

Effects 2.5 million women

Occurs in 50% of ALL women over the age of 55.

Is 2.5 times more likely to effect African American women

Since it is the “silent killer”, most women walk around with high blood pressure without ever knowing it

Cigarette Smoking:

Heart attack risk is 2-6 times greater in smokers

Second hand smoke increases your risk of heart disease by 30%

Women who smoke and take birth control pills have a 21% increase in heart attacks

Diabetes:

Women with diabetes have a higher risk of for heart disease than men with diabetes. Overall, 18.2 million people are effected by diabetes which represents 6.3% of the population.

High Cholesterol:

58% of women have an unacceptable cholesterol of greater than 200

28% of women have a dangerous level of cholesterol of greater that 240

Normally, we want to see a cholesterol level of 100 plus your age

18.

What if I have more than one risk factor?


	Risk factors have a “multiplier effect.” Many women don’t realize that their risk for heart disease significantly increases based on the number of risk factors they have. Having just one risk factor can increase a woman’s chance of developing heart disease twofold. Having two risk factors increases the chance fourfold and having three or more risk factors increases a woman’s chance of developing heart disease more than tenfold.

19.

How do I know if I have high blood pressure?


	Only your doctor can tell you if you have high blood pressure. During the day your blood pressure will change so most doctors will conduct several different readings over a period of time before deciding. A diagnosis of high blood pressure is a repeated reading of 140/90 mmHG or higher. If you have diabetes or chronic kidney disease 130/80 is considered high. Nearly 1 in 3 American adults have high blood pressure and once it develops, it usually lasts a lifetime. The good news is that it can be treated and controlled.

20.

I've been a smoker for 10 years, but Ive recently cut down. Am I still at risk for heart disease?


	Smoking is a major risk not just for heart disease, but for all of your health. Stop now! There is no safe amount.. Smoking causes a buildup of fatty substances in the arteries called atherosclerosis. When this occurs the walls of the arteries thicken and deposits of fat and plaque block the flow of blood through the arteries. In coronary artery disease, the arteries that supply blood to the heart become severely narrowed, decreasing the supply of oxygen-rich blood to the heart. This causes extra strain on the heart and doubles your risk of cardiovascular disease.

21.

How can obesity lead to heart disease?


	Obesity is a complex condition that is on the rise in adult women – in 2005, 35% of American women were obese. Obesity is increasing in children too. Many studies have found that obesity persists from childhood through adolescence and into adulthood. Obese adolescents are likely to become overweight adults and, as such, they are at risk for the complications of obesity—diabetes, cardiovascular disease, high blood pressure and stroke.

22.

I survived my first heart attack. What are my risks?


	Each year, since in 1991, more women than men have died of heart disease. Women are 21 percent more likely than men to die within a year of a first heart attack. African American women are 70 percent more likely than white women to die within the year of a first heart attack.

23.

I workout three times a week and I eat healthy. Why should I be concerned about heart disease?


	About one-third of women still underestimate their own personal risk of heart disease based on their medical history and risk factors (AHA, Circulation 2006). Yet millions of women have one or more risk factors that place them at seriously increased risk of developing heart disease. As women we tend to be the caretakers of our friends and families. Listen to your heart and take action when your heart speaks to you.

24.

My father had a heart attack when he was 50. Am I at a greater risk?


	Yes, even if you are a middle-aged woman, your family history plays a role in your risk of heart disease. Researched released just this year finds a person with either a first degree relative (your parents or siblings) or a second degree relative (an aunt, uncle or grandparent), is nearly ten times as likely to suffer from heart disease than someone whose family history includes no heart disease. Your doctor may wish to consider testing to help determine how low to target your cholesterol and blood pressure and whether to start aspirin therapy.

25.

Why do more women than men die of heart disease?


	The two main reasons are that: 1. Women are just not aware that heart disease is the number one killer of women. Thus, they fail to recognize the symptoms of heart disease and they fail to seek treatment. Women are so busy taking care of everyone around them, that they forget to take care of themselves. We have done such a great job with breast cancer awareness that women are now recognizing the symptoms of breast cancer, performing monthly self-exams and routinely getting mammograms. This has lead to women being diagnosed early with breast cancer when the disease may be more effectively treated. We MUST do the same awareness campaign for heart disease so that we can detect heart disease earlier when it is most treatable. 2. Women with heart disease present differently than men. Men with heart disease experience crushing chest pain beneath the breastbone (sternum) known as angina. Most women don’t experience ANY angina. The most common symptom of women with heart disease is fatigue. They also have more subtle symptoms such as jaw pain, arm pain, indigestion/heart burn. These symptoms often lead to the wrong diagnosis. For example: a women who is having jaw pain may mistake it for a toothache and see a dentist, a woman with indigestion may get diagnosed with gallbladder disease when, in fact, she has heart disease.

26.

What is the most invasive test for heart disease?


	There are various tests to detect heart disease which do not involve cutting the skin. When this happens doctors label it as an invasive test. Cardiac catheterization is the most common invasive test. A very very thin flexible tube called a catheter is inserted into your forearm or groin. A thin wire is then used to guide the catheter into the different arteries of your heart. The purpose of this test is to find out if there are any blockages in your arteries. Please speak to your doctor before you decide that this is the best option. Almost half of all women who are instructed to have a cardiac catheterization do not have significant blockages in their arteries.

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