Tag Archives: Women’s Health Updates

RECOVERY & RESILIENCE

 

Color Your Life

Few people reach adulthood without experiencing devastation. What happens in the aftermath of a negative life-changing event? Some have the resilience to recover over time while others are stuck in a victim mode and never find the path to happiness and peace. Life goes on after something terrible happens. It is up to each of us to find a way to cope and recover.

Rising from the ashes of a relationship, a death, ill health or other deep personal losses takes effort and time. Disintegration and suffering begins a process that may take years to resolve. Grief is an initial response, but prolonged grief becomes pathological and prevents recovery. Hopelessness may be oppressive in dark moments and, like grief, must be fought.

Resilience is the ability to adapt to adversity and stress, ultimately returning to a stable functioning life. During initial stages, counseling can be beneficial, but once identified, the skills must be employed with each day’s dawn. Your personal task is to make positive decisions leading to recovery.

We all have messages spinning in our minds limiting achievements. Negative self-talk can be overcome. A great example is my shy friend whose third-grade teacher told her she couldn’t read. Today, she is a brilliant writer with a Masters in linguistics, but she still hears that negative voice in her head. We must replace negative thoughts with a positive plan. If you have self-sabotaging thoughts telling you “you can’t do it,” replace them with a positive empowering theme.

Create and solidify positive thoughts. Practice them. Add a positive picture, an image to visualize coupled with the positive affirmation that you can succeed.

Silence, sleep and knowledge are key components to empowerment in the transformation from turmoil to personal confidence. If you are constantly connected to the internet and television, your thoughts are being sidetracked and replaced by voices that may be as destructive as the negative thoughts spinning in your brains.

Fighting self-defeat takes a conscious effort to avoid negative influences. Without silence allowing thought and development of personal plans, you are avoiding the work required to make a full recovery

Education is an essential component of empowerment. Find reliable resources to read. Take a class. Base your life on knowledge, not fear. Your attitude can set you free, or it can destroy you.  It is your choice.  Taking the first step in making a positive change is up to you.

Your attitude is like a box of crayons that color your world. Constantly color your picture gray, and your picture will always be bleak. Try adding some bright colors to the picture by including humor, and your picture begins to lighten up. Allen Klein

Betty & Bev

 

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The Benefits of Daily Exercise after Menopause

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Women experience menopause with lost ovarian function due to aging or surgical removal. Loss of estrogen in the postmenopausal state affects the body in both obvious and subtle ways. Obvious effects are hot flushes, thinning hair and skin wrinkling, but there are many more silent harmful effects.

Early menopause contributes to osteoporosis. Gradual weakening of bones occurs without the estrogen stimulus to calcium metabolism and bone strength. Further bone loss may evolve to fractures and disability.

We also know the effectiveness of high-density-lipoprotein (HDL), the “good” blood fat, is reduced without estrogen effect. This transporter molecule is responsible for removing cholesterol buildup in arteries. HDL particles without the effect of estrogen are less efficient and the risk for heart attacks increases in women following menopause. Postmenopausal women can offset some of this effect by eating healthy and staying active. Statin medication to modify abnormal blood lipids may also be needed.

A study reported at the North American Menopause Society stated women after menopausal tend to weigh more, have larger waist lines, and a higher percentage of body fat than younger more active premenopausal women. Sedentary behavior correlated with a larger waist size – no surprise. But their findings showed regular exercise brought benefit to both pre- and post-menopausal women. When women increased their daily exercise – energy, mobility, and bone density all improved, along with reduction in waist size. Increased activity and weight control can also reduce the risk of developing Type 2 diabetes.

Last year, a journal of the American Association for Cancer Research reported a four year study examining women who walked the equivalent of thirty minutes per day had a lower risk of invasive breast cancer. The exact mechanism is unknown, but we do know exercise carries many positive benefits. Researchers stressed the benefit of lowered risk of invasive breast cancer was lost when exercise stopped — so daily exercise is key.

Walking daily can become a positive routine and is as important to overall health as brushing your teeth. Dogs love to walk. Our dogs provide encouragement to take a hike even in the rain. If you don’t have a dog, find a friend to join you. Exercise and social relationships correlate with happiness and longer life. Find a route that makes you smile and take a daily walk.

Some good advice from Dr. Seuss:
You have brains in your head.
You have feet in your shoes.
You can steer yourself in any direction you choose.

20151018_142608Betty and Bev

Broken Heart Syndrome

Takotsubo Cardiomyopathy

Losing a loved one, the sudden stress of receiving bad news, intense fear or domestic violence can break your heart. But this isn’t in the emotional sense we usually think about. There is an acute heart problem seen primarily in women of menopausal age in which the heart weakens in the face of sudden stress. The main pumping chamber of the heart balloons instead of contracts. Resulting chest pain and shortness of breath are symptoms indistinguishable from a heart attack.

The electrocardiogram shows classic ST segment elevation found in heart attacks. In addition, there is often a small sharp rise in troponin, a heart injury blood marker. In a typical heart attack caused by a blocked coronary artery, the damaged heart muscle cells leak troponin, but usually in larger amounts.

If an angiogram determines there is a blocked artery the cardiologist will likely place a stent. But in the broken heart syndrome known as Takotsubo Cardiomyopathy, instead of finding blockage, the coronary arteries are clear — the results indicate a failing heart with an odd shape. It looks like an octopus trap (a tako-tsubo).

 

The actual cause of this disorder is not known but is likely related to a surge of stress hormones that stun the heart and prevent normal muscle contraction. Takotsubo is usually seen in older estrogen-deficient menopausal women. However, younger women who lack estrogen because of surgical menopause from ovary removal are also at risk. Animal studies show estrogen appears to protect the heart in stress states.

There are no treatments shown to reverse Takotsubo. Doctors usually order common heart failure medications including beta blockers (to reduce heart rate and blood pressure), ACE inhibitors (to dilate arteries making it easier for the heart to pump) and diuretics (to remove excess fluid). It isn’t known if continuing the drugs can prevent a recurrence, but within two months, most patients fully recover. A few women are left with reduced heart function, and occasionally abnormal heart rhythms occur.

Women in this age group may also have underlying heart disease requiring medical management unrelated to the sudden stress state. Like men, women develop blockage of the major coronary arteries.

Another heart problem most often seen in women involves only small heart arteries. The large coronary arteries are clear but tiny arteriolar vessels are diseased. Microvascular disease is serious. It can lead to heart attacks and heart failure. A treadmill in combination with continuous monitoring, followed by echocardiogram to check heart function will show abnormalities. Microvascular disease is also treated medically.

Techniques used to help reduce stress hormone surges include: progressive muscle relaxation, exercise, yoga, avoiding alcohol and caffeine. Controlling anxiety is not easy and counseling may be necessary.

 

Lipstick Logic
Betty Kuffel, MD

LOVE YOUR HEART

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

For the entire month of February, Your Heart is offered at sale rates.

American Heart Month is a perfect time to raise awareness and explore reversible risk factors for cardiovascular disease. Know your health history and address factors that can be modified to improve heart health:

♥ Tobacco use and cessation

♥ High blood pressure identification and treatment

♥ Cholesterol abnormalities paired with dietary modification and statin use when needed

♥ Obesity and diabetes with recommendations for normalizing weight and glucose

♥ Low activity levels counteracted with exercise prescriptions

♥ Alcohol consumption history and limitation of use

♥ Heredity factors and recommended interventions

Heart risk factors are within your ability to control. Make this the month you evaluate your personal risks and take action to reduce them. With the right knowledge and actions, the number one cause of death in women and men is preventable.

Book Excerpt:

Why is coronary artery disease the leading cause of death?

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

Coronary artery disease is tied to obesity. Food choices, portion sizes and exercise interplay, but the disease is more complex than any of these factors.

Statistics are boring to read and don’t mean much when they are without a face. But consider the fact that 50% of all people have high blood pressure, high cholesterol or smoke; all three factors cause heart disease. Many of us personally know someone with these problems. Is it you? A loved one? You have the ability to make healthy choices and improve your health by treating these factors.

Part of the high death rate from heart disease is due to a lack of education about the cause and what can be done to fight it. But even knowing sound health practices, many people do not follow them. In recent years, there has been a reduction in heart deaths through improved treatment, education and reduction of risk factors, but coronary artery disease still remains the leading cause of death.

Two programs to address education, diagnosis and treatment are: the Million Hearts initiative, developed by the Department of Health and Human Services, with a goal to prevent a million heart attacks and strokes by 2017; and the WISEWOMAN program, administered through the Centers for Disease Control and Prevention.

Heart disease is a huge problem in developed countries around the world, including the United States. The Million Hearts program joined with the US Centers for Disease Control and Prevention, the American Heart Association and other organizations. Together they share strategies to reduce heart risk factors and save lives. Information from these organizations is available for education programs to implement change.

At 21 US sites, the WISEWOMAN project provides a screening and evaluation program to help women obtain healthcare when they have little or no insurance. Examinations, laboratory tests and education to lower risks are included.

Diabetes, overweight, poor diet choices, low physical activity and excess alcohol are all issues placing people at risk. If any of these affect you, take control, read more, learn more and make heart healthy changes. Don’t become a statistic. Take action. Choose to reduce your personal risk factors.

According to the US Centers for Disease Control and Prevention, 50% of men and 64% of women who die suddenly of coronary heart disease have no previous symptoms. Even if you have no symptoms, you may still be at risk for heart disease.

Katie, a registered nurse who believed she was healthy, working full time in a hospital but having difficulty with an arthritic knee finally decided to see an orthopedist. He recommended a total knee replacement procedure. As part of her preoperative evaluation, her primary physician evaluated her and performed an electrocardiogram. The electrical tracing of her heart conduction and rhythm was abnormal, indicating ischemia. A special nuclear medicine test of her heart showed marked reduction of circulation in the heart muscle. Katie went directly to the heart cath lab where two main coronary arteries were found to be more than 90% blocked by cholesterol plaques. The cardiologist dilated and stented both arteries. The orthopedic surgery had to be placed on hold. — Katie denies ever having any symptoms related to her heart.

Many people are aware that high cholesterol is associated with heart attacks, yet have never had a cholesterol blood test done. Because they have no symptoms, they can’t believe they might be a candidate for a heart attack. The more you know how lifestyle, food choices and heredity factors impact heart health, the more equipped you will be to make healthy choices and obtain proper healthcare. This section provides more information on risk factors.

 Thanks for stopping by. We hope 2014 will be a healthy and happy year for you.

Betty and Bev

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

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.

 

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

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