Category Archives: Heart Health

HEART DISEASE IN WOMEN

Go Red for Women – Wear Red on February 7th

In 2003, the American Heart Association began National Wear Red Day®. With so many women dying each year from heart disease, this movement was formed to bring attention to the problem. Their goal was to educate women and reduce this statistic.

 For the past ten years, each February, the Go Red for Women events have raised awareness and helped women make strides against heart disease. Fewer women are dying from coronary artery disease now, but it still remains the number one threat.

 In support of women’s heart health, Lipstick Logic is providing free excerpts and a sale on our book for the month of February.

 This is a perfect gift for yourself and those you love.

Your Heart – Prevent and Reverse Heart Disease in Women, Men and Children

Kindle e-book $2.99   http://tinyurl.com/kindle-heart-sale          

Paperback $9.99  https://www.createspace.com/4330606

  Your Heart Book Cover- Final FINAL

 Chapter 5

Female Heart Disease

Women and Heart Disease

Many women do not realize they are at high risk for heart disease and early death. Under age 50, heart attacks in women are twice as likely to be fatal as in men. Each year more than 250,000 women die of heart attacks. Six times the number of women die from heart disease than from breast cancer. Many factors weigh into these statistics including hormones.

♥ Research reported in the National Institutes of Health bulletin, The Heart Truth for Women, states that by leading a healthy lifestyle, women can lower risks by 82%. You are in charge. This means: regular exercise, healthy weight and not smoking. Also take medications to control other risk factors such as high blood pressure and high cholesterol. What you choose to do and what you eat can improve health and prolong life.

Coronary Microvascular Disease

Early in life, male and female hearts look alike and act the same. With aging, gender differences in disease processes become apparent and contribute to misdiagnosis in women. Men typically develop arterial heart disease that narrows large coronary arteries on the heart surface. Women have the same type of large vessel disease as men, but are also prone to coronary microvascular disease — a problem involving the small vessels called arterioles.

Possibly triggered by inflammatory disorders, coronary arterioles in women become stiff and unable to supply adequate oxygen to the heart muscle. Chest discomfort and other symptoms more subtle are often associated with increased activity. Microvascular disease increases your risk for heart attack and sudden death.

A number of health problems cause inflammation including high blood glucose, smoking and chronic infection that also affect men. Additional factors in women are: poorly controlled premenopausal hypertension, anemia and autoimmune disorders*. All of these problems may contribute to developing coronary microvascular disease. However, the cause of this disease is unknown. The Women’s Ischemia Syndrome Evaluation study (the WISE study) provided extensive information for the disorder. Some researchers believe estrogen reduction is a related. Anyone can develop coronary microvascular disease, but inflammatory disorders appear to be a prominent factor and they are more common in women.

Special tests are required to diagnose coronary microvascular disease. Advanced disease may be present, placing the person at risk, yet a coronary angiogram — the best diagnostic evaluation for large coronary arteries — can be normal. If the clinical suspicion for heart disease is high and the angiogram is normal, a “Stress-Echo” is usually recommended to evaluate for microvascular disease.

Coronary microvascular disease cannot be treated with stents or a bypass, but medications and lifestyle changes are beneficial and life-prolonging. Treatment is similar to that used in large vessel coronary disease:

● Statins to lower cholesterol

● Low dose aspirin to inhibit platelets

● Nitroglycerine to relax and dilate arterioles to improve blood flow and treat chest discomfort

● ACE inhibitors to lower blood pressure

● Beta blockers to lower heart rate and reduce heart stress

● Heart healthy diet, daily exercise, no smoking, weight loss

Note: Autoimmune diseases occur when the body produces harmful antibodies against itself. Examples: Lupus, rheumatoid arthritis, psoriatic arthritis, multiple sclerosis, some thyroid diseases and many others.

More life-saving information like this can be found in Your Heart: Prevent & Reverse Heart Disease in Women, Men & Children

Thanks for stopping by.

Betty Kuffel, MD

Bev Erickson Co-author/Artist/Cover art

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Cardiovascular Disease – Leading Cause of Death related to Childbirth

Heart Disease in Young Women

 Statistics from the state of California confirmed the leading cause of death related to childbirth is cardiovascular disease:

                ♥1/4 of women who died had some form of cardiovascular disease

                ♥2/3 of the deaths were related to cardiomyopathy (heart muscle weakness)

Only 6% of these women had been diagnosed with a heart problem prior to pregnancy. (American Heart Association Scientific Session report)

We think of pregnant women as healthy vibrant individuals who do well and have healthy babies. But, pregnancy is a high risk condition for many reasons. Pregnancy places a large cardiovascular load on a woman’s body.

Young women without underlying heart disease are better prepared to tolerate the stress of pregnancy than older women. However many women are now delaying planned pregnancies until an older age when the potential for heart disease has increased.

Lifestyle, including food choices, alcohol consumption, and tobacco use all impact health during pregnancy. Obesity and Type 2 diabetes also increase risk to mother and infant. Cigarette smoking increases risk for sudden infant death and women who smoke are also more likely to suffer sudden death.

Two conditions often seen with pregnancy are: high blood pressure (pre-eclampsia) and diabetes (gestational diabetes). Both require careful monitoring and treatment Women with these problems during pregnancy are more likely to develop high blood pressure, diabetes and cardiovascular disease later in life.

Being overweight and pregnant places both mother and child at risk for cardiovascular disease and complications during delivery, including C-sections and anesthesia-related problems. Overweight pregnant women are more likely to have stillbirths, deliver prematurely and may have large infants making delivery difficult. Large babies are more likely to become obese in childhood.

Additional statistics: (From The American College of Obstetricians and Gynecologists)

  • Over one-third of women living in the US are obese
  • More than one-half of pregnant women are overweight or obese
  • 8% of reproductive-age women are extremely obese & at high risk for pregnancy complications

Guidelines for pregnancy weight gain are calculated based on the woman’s pre-pregnant BMI (Body Mass Index). Details are available on the American Congress of Obstetricians and Gynecologists website: www.acog.org  Search “Weight Gain During Pregnancy.”

 General guideline:

·         1.1 – 4.4 pounds in the first three months

·         1 pound/week during the last six months

·         The average total weight gain over all BMI ranges =  30 pounds

·         Low weight women: over 30 pounds may be acceptable

·         Obese women: gain only 11-20 pounds during the entire pregnancy

Nutrition counseling at all weights is very important to assure proper food choices and nutrition during pregnancy.

Before becoming pregnant, healthy choices, an active lifestyle (including daily exercise) and weight control are all important. Seek a full medical evaluation including laboratory studies before becoming pregnant. An exercise program and nutrition counseling will benefit mother and infant.

 

EXERCISE FOR LIFE

DSCF3133Fall is an invigorating time of year for many people. Even if you are not into fitness, it is a good time to start a plan. Walking in crisp fresh air, surrounded by evolving brilliant foliage colors, can help stimulate daily activity that will generate better health in years to come.

 A recently published medical study noted advanced planning can change the course of your life. Americans are living longer, but not always better. Our current life expectancy is seventy-eight, but with longer life more people are dealing with chronic diseases. So, the goal should be to begin modifying your risk base as soon as possible. Developing fitness in middle age, even if exercise was never a priority for you, reshapes your personal health landscape and can make later years more vibrant.

 In the longitudinal study of 18,000 people beginning in 1970, most of those who were the least fit at the time of their middle-aged checkup, had developed some of the following conditions early in the aging process: dementia, diabetes, heart disease and colon or lung cancer. Those who were most fit in their forties and fifties typically did not develop chronic illnesses until the final five years of their lives, instead of 10-20 years earlier like the less physically fit individuals.

 So if you look at the big picture, exercise is beneficial in delaying illness and living well in later years. Longevity without dementia is determined by genetics, fitness and staying involved mentally and socially. Even walking half an hour a day can improve your health.

 An article reviewing 45 studies, examining physical activity in people with cancer published in the Journal of the National Cancer Institute this year, emphasized the benefits of exercise. There was a decrease in all-cause mortality, including cancer-related death. Many of the studies examined involved women with breast cancer. With exercise, there are improved insulin levels, reduced inflammation and an increase in cells known to attack tumors.

 Muscle cells strengthen with exercise. Balance improves. But another important benefit is better blood flow to organs including the brain. In an animal study published in the journal Learning and Memory, fit animals not only showed improved memory, they generated new neurons in areas of the brain involved with learning.

 We all have many excuses for not being able to exercise. However, if you evaluate your interests and abilities, usually there is something to do to remain active, even if you have physical problems that interfere. Water exercises for individuals with joint and balance problems can increase muscle strength and be relaxing, too. If you have joint or back problems, consider riding a stationary bicycle for non-weight-bearing activity. Talk with your physician. Maybe a consultation with a physical therapist could set you on a course to improve muscle conditioning and your overall health.

If you say, “I’m too tired to exercise” consider this: studies have found exercise energized people, even those undergoing cancer treatments. Remember, exercise doesn’t have to be vigorous. Just taking a slow walk outdoors in the fall sunshine can brighten your day, increase bone-density to ward off osteoporosis, strengthen your muscles and help you live a longer healthier life.

Betty Kuffel, MD

POST-MENOPAUSAL HORMONE THERAPY IS BACK!

Low Dose Estradiol (bioidentical estrogen) and Dermal Patches Show Benefit

For those who have not experienced hot flashes or flushes, as they are sometimes called, they don’t sound like much of a problem. For most women, they aren’t. For me, someone who is often cold and wears wool socks to bed the year-round, it was a comfortable experience. I was warm enough for the first time in my life, except for experiencing the 108 degree temperatures on a Nevada desert.

The actual cause of vasomotor instability resulting from low estrogen is not fully understood and the problem is highly variable between women. Some are afflicted with numerous episodes each day associated with marked flushing, drenching sweats requiring clothing changes and faintness, while others barely notice the transition of waning hormones.

Women often seek medical care for hot flashes but it is the silent problems evolving without estrogen stimulation become important over time. Hot flashes tend to disappear while related heart disease and osteoporosis evolve causing problems in years to come.

Until about ten years ago, most women with menopausal symptoms were prescribed some form of hormone replacement. But results from the 2002 Women’s Health Initiative (WHI) and the Million Women Study (MWS) changed this practice. There was controversy and confusion among the experts, but in the end, the women lost when the consensus was that hormone replacement carried too much risk. The risks primarily included increased breast cancer, uterine cancer, strokes and blood clots.

Experts decided risks outweighed the benefits and recommended discontinuing hormone therapy. — Suddenly, hot flashes around the world contributed to global warming.

Breaking from the refusal to order hormone replacement for women, in June 2013 the British Menopause Society and Women’s Health Concern updated their guidelines. New recommendations are based on findings from a panel of experts that reanalyzed data from the WHI and MWS studies related to the specific hormones used. This time, when tracking the hormone options, they found low dose bioidentical estrogen, both oral and skin patch, carried less risk.

 Supporting Information

Another article just published in the Journal of the American Medical Association, JAMA, agrees with the use of bioidentical estrogen in hormonal replacement.  A joint University of Washington/Group Health study revealed women taking the generic estradiol had fewer vascular problems than those taking the equine estrogen preparation (Premarin). This difference may be related to clotting factors levels making blood clots more likely in women taking Premarin. Also the risk of having a heart attack was slightly higher in women using Premarin. No difference in stroke risk was seen.

Which Estrogen is Preferred?

There are many forms of estrogen and progesterone, both in oral, patch and cream forms. But estradiol is the same as that produced by the human ovaries. Premarin and other preparations are similar in effect but differ in chemical structure from estradiol. This new evaluation of the 2002 data showed the skin patch delivery of hormones appears most favorable.

 What About Other Risks?

Science evolves. Study outcomes change how we treat diseases. Hormone replacement surged from high utilization to stopping its use all together. Now the transition is back toward favorable aspects of low dose preparations. This is not to say, it is safe in all cases.

  • If you have had breast cancer, even the cell type without estrogen or progesterone receptors, you are probably not a candidate for hormones.
  • If you have had a stroke or venous blood clots in your legs or elsewhere, you would not likely be prescribed either estrogen or progesterone.

 The hormone progesterone is known to increase the risk of heart disease in women. Its use is to induce hormonal withdrawal bleeding and reduce the risk of uterine cancer in association with estrogen replacement in women who have a uterus. Estrogen can be used alone, without progesterone, following hysterectomy.

 If you are troubled with disabling hot flashes or marked bone loss (osteoporosis) you may be a candidate for estrogen replacement. You should discuss taking an FDA–approved bioidentical form of estrogen via skin patch with your physician.

 In my book, Your Heart – Prevent & Reverse Heart Disease, there is a chapter on women’s heart disease and the impact of menopause.  Additional favorable studies are noted reporting similar findings using low dose estrogen after menopause. One such study showed a significant reduction in heart disease with bone density improvements in women who took low dose estrogen.

 Note: “Bioidentical” is not the same as pharmacy-compounded estrogen products that are not standardized and may have variable potency.

 For more information on menopause check out: http://www.womenshealth.gov and my book at http://www.yourheartbook.com.

Betty Kuffel, MD

References:

SAGE Publications. Hormone replacement therapy: British Menopause Society and Women’s Health Concern release updated guidelines. ScienceDaily, 24 May 2013. Web. 2 Oct. 2013.

Nicholas L. Smith. Lower Risk of Cardiovascular Events in Postmenopausal Women Taking Oral Estradiol Compared With Oral Conjugated Equine Estrogens. JAMA Internal Medicine, 2013

CALCIUM SUPPLEMENTS INCREASE HEART RISK

 RETHINKING CALCIUM SUPPLEMENTS

The British Medical Journal published an important research study online in February 2013. Involving over 60,000 Swedish women, following their mammograms and health over 19 years, researchers found 32% of deaths were from cardiovascular disease with half being from coronary artery disease and the rest from strokes. When diet and supplemental calcium were assessed, they found increased calcium, above 1,400 milligrams per day, was associated with almost a doubling of death from coronary artery disease.

 Calcium supplements combined with high calcium in the diet increased the risk.

 This is not the first report regarding calcium supplements and increased risk of heart attacks. A recent report in JAMA Intern Med 2012, in a 12 year follow-up of nearly 400,000 men and women, showed increased risk of heart disease death in men (but not women) who took 1000 mg of calcium supplements. In the June 1012 issue of Heart; (98:920-925), researchers found dietary intake with calcium supplements increased overall cardiovascular mortality. In 2010, another BMJ article showed calcium supplements without vitamin D supplements increased the risk of heart attack.

The US Preventive Services Task Force consists of a group of experts in preventive healthcare. Their recommendations published February 2012 in the Annals of Internal Medicine stated the following:

  • In men and women without osteoporosis or vitamin D deficiency, it is unclear whether they should take vitamin D and calcium supplements to prevent fractures.
  • It is unclear whether postmenopausal women should take daily supplements of more than 1000 mg of calcium.
  • They also report, daily supplements of 400 IU of vitamin D and 1000 mg of calcium has no effect on the incidence of fractures in postmenopausal women

So, why are so many women taking vitamin D and calcium supplements if calcium supplements do not translate to better health and fewer fractures? -And, when many studies are actually showing evidence of adverse cardiovascular effects associated with increased calcium intake? The debate on the topic of calcium supplements is ongoing, but at this time, calcium supplements are no longer broadly encouraged, unless based on unique health decisions between patient and physician.

The safest approach to this conundrum is to consult your physician, site these articles and, unless you have osteoporosis, discuss stopping calcium supplements and obtaining your calcium from foods in your diet. Dietary calcium is found in broccoli, green leafy vegetables, fortified soy milk, tofu and baked beans. Tofu, bean cake made from soy, is high in calcium. One-half cup of tofu made with calcium sulfate = 434 milligrams.

Elements of strong bones include: calcium, protein, phosphorous, magnesium, vitamin D and potassium. For years we have consumed large amounts of milk, sometimes called “liquid meat.” Cow’s milk is nutritious containing proteins, vitamin D, phosphorous and calcium.  All are needed for strong bones.  Milk also contains undesirable saturated fat and calories. Drink less milk and eat more calcium rich foods to obtain your daily calcium dietary requirements.

Vitamin D and Heart Attack: New research from the University of Copenhagen shows increased risk of heart attack and death with low levels of vitamin D. And, Vitamin D deficiency may increase blood pressure. There is no proven cause between low D and heart risk, but this correlation requires more study. The study, published in the Arteriosclerosis, Thrombosis and Vascular Biology journal, evaluated 10,000 Danes in the Copenhagen City Heart Study..

Exercise and vitamins are very important for bone health. In fact, bone strength is primarily generated during the teenage years and maintained throughout life with weight bearing exercise such as walking and a healthy diet containing about 1000 mg of calcium. Eating a healthy diet rich in calcium and vitamin D is important to long-term bone and heart health.

Talk to your medical professional about the appropriate way to meet your calcium and vitamin D needs. Ask for a vitamin D level to see if you need to eat more D foods or take a supplement. Another way to get vitamin D is through limited sun exposure on your skin to allow your body to generate vitamin D. Those who live in northern climates are often vitamin D deficient because they lack sun exposure. Sunblock, important to protect against sun damage and melanoma, limits natural vitamin D conversion and contributes to vitamin D deficiency.

In the meantime, eat a diet containing the nutrients you need. Walk more to increase bone density. Exercise correlates with longer life and better health, too.

Just as recommendations related to hormone replacement after menopause changed in the past,  science-based recommendations in the area of calcium supplements are changing. What we thought was the solution to maintaining bone density may be adding serious health risks. Studies on bone health are ongoing, so watch the media for additional information. Because so many women have reduced bone density and are on calcium supplements, these studies are very important. Coronary artery disease is the leading cause of death in both men and women. Calcium supplements are so commonly consumed, this may be a factor contributing to the high incidence of heart disease.

This is one of the many topics covered in our book, available later this month: Your Heart: Preventing and Reversing Heart Disease in Women, Men and Children.

Betty Kuffel, MD

WOMEN’S HEALTH CONFERENCE IN WHITEFISH

SAVE THE DATE AND BRING YOUR FRIENDS

TO THE

SPRING INTO ACTION

WOMEN’S HEALTH CONFERENCE

Saturday May 4th 2013 10 am – 2 pm

Rocky Mountain Lodge in Whitefish

Additional information will be posted at the North Valley Hospital Website.

At the conference, I will be doing a presentation on heart disease with information especially for women.

The new Lipstick Logic Health Series book on  heart disease won’t be ready in time for the conference but will be available as both an e-book and in print later in May.

YOUR HEART: Preventing and Reversing Heart Disease

Coronary artery disease is the leading cause of death for both men and women-and it is preventable.  Your Heart is a comprehensive evidence-based guide to heart health.  Up-to-date heart information includes details on diagnosis, treatment and prevention, along with food and lifestyle recommendations.

Hope to see you at the conference!

Betty Kuffel, MD

LINKS TO LIVING LONGER

DON’T WAIT–DROP THE WEIGHT

Coronary artery disease (CAD) kills more men and women than any other disease including cancer. Being overweight increases your chance of heart attack. With 68% of adults in the US now being overweight or obese, weight loss is key in reducing heart disease and sudden death risks. Reduce your risk for dying from this silently progressive disease by taking control of your life. The most important step to reduce your risks for Type 2 diabetes and heart disease is to obtain a normal weight. Weight loss is difficult, possibly more difficult than quitting smoking, but if you do smoke, it is killing you. You need to stop. Smoking is the number one risk for heart disease. To reduce your weight, you can’t  just stop eating. Instead, you must make choices, change your eating habits and begin following a path to health.

This is the first LINK TO LIVING LONGER blog. Regular postings will follow. Many will be excerpts from our book Your Heart that will be available this month. Your Heart is a handbook for heart health and the road to longevity. All of the information is science-based. No gimmicks. All the facts are there, from normal heart function to what happens at the cellular level when cholesterol starts clogging your arteries.

We won’t try to turn you into doctors, but all the facts will be there to help you make informed decisions related to your health and the health of your family. You will be able to understand cholesterol, dietary fats, sugar, high fructose sugar and how obesity is killing us. The book is not a diet book but does provide factual information on food choices.

You may want to try the “5:2” diet popularized by Dr. Michael J. Mosley. See the link below. In the 5:2 diet, you eat normally for five days, then you eat only 500 calories for 2 days.  Many people are finding this “intermittent fasting” diet a way to jump-start their weight loss program. You might call it a gimmick, but it is a way for you to begin losing weight while  learning to change what you eat. If you are diabetic, you should do this only under the care of your physician. However, as a Type 2 diabetic, weight loss does reduce insulin resistance and may actually get you off your medications. Weight loss also lowers blood pressure and reduces your risk of cardiovascular disease, heart attacks and stroke.

On the days your calorie intake is down, your body will thank you. Soon, you will be patting yourself on the back. Feeling better and lowering heart risks is your present to yourself. http://en.wikipedia.org/wiki/5:2_diet

Betty Kuffel, MD

YOUR HEART: PREVENTING AND REVERSING HEART DISEASE

TAKE CONTROL OF YOUR HEALTH

Your Heart: Prevent and Reverse Heart Disease will be available this month. We are in the final editing process. To give you an early start on some of the book’s content, Lipstick Logic will be posting excerpts. Based on the latest evidence-based research, you will have the information and power to make changes to improve your heart health. 

Front Page - Kindle- 6x9Your Heart is a handbook on heart disease. Coronary artery disease is preventable. Caused by narrowed heart arteries it kills more men and women than any other disease including cancer. Because one-in-four women die of heart disease and two-thirds of them have no recognized symptoms, learning the information in this book may be life-saving.

The heart is the only muscle that never rests. You sleep, but your heart doesn’t. Its built-in nervous system electrically drives this biological engine every minute of your life. Your heart’s neurological pacemaker fires off an electrical impulse signaling the heart muscle to contract. As the muscle contracts, the chamber inside the heart becomes smaller. As the chamber reduces in size, it pushes blood through the aortic valve into the aorta and through the rest of the body.

The coronary arteries run on the surface of the heart and with each contraction, blood surges into them to supply the heart muscle with nutrients and oxygen. With each beat about 70 ml (2+ounces) of blood exit the heart. If your heart rate is 70 beats per minute, add it up—your heart circulates approximately 5 quarts of blood each minute. Without this mandatory oxygen distribution to the body life ends.

Along with transporting red blood cells that carry oxygen to all organs, the blood carries many other cells, proteins and factors needed to sustain life. This red super-highway carries wonderful nutrients to feed your cells. Swirling throughout the body are cells that fight infection, promote clotting and support life functions. The blood also carries factors, that in excess, cause heart disease and early death.

In developed countries throughout the world coronary artery disease (CAD) is the primary cause of death. It is a disease of affluence. We eat not only because we feel hungry, we eat for enjoyment, to pass time, and at social events we munch mindlessly. The fact is, we eat too much and it’s making us sick.

Coronary artery disease, the leading cause of death in both men and women, is tied to obesity. Your food choices, portion sizes and exercise interplay, but CAD is more complex than these factors alone.

Understanding the anatomy, physiology and dynamics of heart function in health and disease, and actions both men and women can take to reduce related risk factors are provided in the book. The latest research information makes this book a up-to-date valuable reference and includes diagnosis, treatment details and dietary recommendations.

Betty Kuffel, MD

WOMEN’S HEART DISEASE

Front Page - Kindle- 6x9The first volume in our women’s health book series is in the final editing process. After many iterations, our cover has evolved to the attached image. We aren’t sure this will be the final but it’s close.

As many newly published e-book authors know, the old adage You can’t tell a book by its cover doesn’t hold true anymore.  The first glimpse at a book cover should be readable in postage stamp size. Subtitles can tell it all and many sources suggest using a subtitle to further identify your book contents to those people skimming titles on the many Internet sites available to all of us.

With expanding knowledge in the e-book, media and marketing world, it is difficult to keep up with the many options.

Blue Heron Loft has done a great job in creating this cover and my Eyes of a Pedophile cover.  http://www.blueheronloft.com

Your Heart is a complete handbook of the anatomy, physiology and dynamics of heart health. It provides detailed explanations of many types of heart disease, some specific to women, and choices you can make to maintain a healthy heart. By learning about a disease that impacts so many lives and then taking steps to improve your own cardiovascular health and the health of your family, who knows? – You may save your life or the life of someone you love.

Below is an excerpt from Your Heart: Prevent and Reverse Heart Disease:

DIFFERENCES IN THE FEMALE HEART

Early in life, male and female hearts look and act the same. With aging, gender differences in disease processes become apparent and often contribute to misdiagnosis in women. Men develop the usual type of arterial heart disease which narrows the large coronary arteries on the heart surface. Women often have narrowing of large coronary arteries like men, but females are also prone to developing coronary microvascular dysfunction (CMD) – a problem involving the small vessels called arterioles. In the face of inflammatory disorders that often affect women more than men, these tiny arterioles become stiff and unable to supply adequate oxygen to the heart muscle.

A number of health problems cause inflammatory changes: high blood-sugar, smoking and chronic infection. Additional factors like poorly controlled premenopausal hypertension, anemia and rheumatologic disorders also affect women and are thought to contribute to the development of CMD. However, the specific cause of CMD is still unknown and anyone can develop these changes. Coronary microvascular dysfunction cannot be treated with stents or bypass, but medications are beneficial and life prolonging.

Special tests are required to diagnose CMD. Women may have advanced microvascular changes and be at risk for a heart attack, yet a coronary angiogram — the best diagnostic evaluation for large coronary arteries — may appear normal. When the angiogram is normal but clinical suspicion for heart disease is high, a “Stress-Echo” is recommended to evaluate for CMD. Diagnostic methods are discussed in SECTION 15.

 Heart risks increase in menopause

Menopause is the biological time period when ovary function ceases. Ovaries produce estrogen, progesterone and a small amount of the male hormone, testosterone. At menopause, ovarian production of these hormones stops and hastens the occurrence of changes in the female body.

Not only are there cardiac changes. Around age fifty, when ovarian function naturally fades, most women begin recognizing other bodily changes as well. Some of these are: mood disorder, reduced libido, and hot flushes. But unknown to them, many women also begin silent internal vascular changes leading to heart disease. When premenopausal women have their ovaries surgically removed, the changes of menopause begin abruptly. This is referred to as “surgical menopause.” Starting at a younger age, problems related to estrogen deficiency take a toll on bone health making osteoporosis more likely. In all women lacking estrogen, skin changes become evident with vaginal tissue dryness. Hair may become thinner and skin less resilient.

In the past, hormone replacement therapy (HRT) using estrogen, progesterone or a combination of the two, was recommended. However, based on information from the Women’s Health Initiative, as of May 2012, the U.S. Preventive Services Task Force recommended against HRT to prevent chronic diseases such as: heart disease and osteoporosis. This is based on longitudinal studies over many years, weighing risks and benefits of taking replacement hormones. Still, under some circumstances HRT may be appropriate. If you have concerns, discuss hormone replacement with your physician.

Coronary heart disease gradually increases in women after menopause but can affect younger women, too, including those who have functional ovaries and continue to menstruate. Women under age 55 may not recognize the symptoms of heart disease or don’t seek medical attention believing they are too young to have a heart attack. American Heart Association statistics show heart disease kills 16,000 young women between the ages of 30-55, each year.

Because heart disease in women is variable, women of all ages, not only post menopausal women, should pay attention to symptoms that could indicate heart trouble, such as: indigestion, unexplained dizziness or weakness, jaw aching, sweating and feeling short of breath.

Betty Kuffel MD

A HEART STOPS – A FRIEND DIES

 

Taking Control of Your Health

You know the feeling – the sinking, shocking feeling –  when you hear the news a good friend has just died of a heart attack. In disbelief, you think – it can’t be. She/he was so young – maybe even a year or two younger than you. Then you begin to consider all the issues that might have contributed: he did smoke; she had a stressful job; she was overweight. All of these are risk factors that lead to coronary heart disease and sudden cardiac deaths.

Do you have stress in your life? Is your blood pressure under control? Are you overweight? Do you exercise regularly? Do you know your numbers – your blood pressure, cholesterol and triglyceride numbers? You need to know them.

Don’t let a heart attack happen to you. Learn to recognize the symptoms. Learn what you can do to prevent and reverse heart disease. Take control of your life.

Many sudden death heart attacks are preventable; heart disease is preventable. With proper interventions, arterial narrowing in heart arteries can be reversed.

Lipstick Logic is about to publish an up-to-date book on the links to cardiovascular disease and what you can do, right now–today–to start changing your habits and improve your chances of living longer and healthier.

This book called, Your Heart, will provide you with a complete and thorough understanding of how your heart works and what it needs to work well —and what causes it to malfunction. If you take the time to learn this critical information now, you could make changes that will save your life.

Your heart is the only muscle in your body that never stops working, until it stops, dead.

You have the ability to make important choices in your diet, your lifestyle and exercise regimen right now to decrease your risk of progressive artery narrowing. The book details how your food choices can clog your arteries and cause a stroke or heart attack. Don’t wait until a heart attack to make changes – learn what you can do now to prolong your life.

Just as it is for men, heart attacks are the number one killer of women. More woman die annually of heart attacks than breast cancer.

With Your Heart, you’ll have an opportunity to read a comprehensive heart book written for women by Betty Kuffel, MD, a doctor of Internal Medicine. Dr. Kuffel has spent much of her professional life in emergency departments where she saw far too many women arrive by ambulance in cardiac arrest.  Many times these women had not recognized their heart symptoms and had not consulted a physician. Had they known what this book can teach you, they might be alive today.  Although the book was written with women in mind, except for some heart diseases specific to females, most of the information also pertains to men.

With years of medical education, experience treating both men and women, studying and staying current on heart research and interventions, Dr. Kuffel is the ideal, highly qualified person to share this information. And importantly, she has dedicated her professional life to helping women improve their health.

Your Heart will become your “go-to” book for everything you want to know about your what makes your heart work well and what you can do to improve heart function to extend your life. This book includes the unique aspects of heart disease in women. Goals for blood pressure, cholesterol levels, food choices, exercise, and what you need to discuss with your doctor are all specified in this book.

Watch for blog up-dates and publication date of YOUR HEART.

Bev Erickson, Lipstick Logic Co-founder