Women are different from men. Case in point:

Man says to male colleague: “Saw Bob the other day.”
Colleague responds: “Huh.”

Man says to female colleague: “Saw Bob the other day.”
Colleague responds: “Bob? Bob Jones or Bob Johnson? Is his ankle better? How’s their new baby? Is he sticking with McCain? Does he like the new job? How does his beard look?”
Man responds: “Beard?... Huh.”

So, when women want answers about heart health, words like “Eat right, keep fit” are not enough. We are women. We want details. We want dirt.

In the quest for details, HealthLeader queried pediatricians to periodontists; cardiologists to pathologists; chronobiologists to gynecologists; nurse practitioners to general practitioners. And we asked one question:

What two things can women start doing TODAY to protect their hearts?

Here’s the dirt.

 

Francisco Fuentes, MD, cardiologist
Specializing in cardiac rehabilitation
UT Medical School

 

“Two simple things: First, follow a Mediterranean diet as often as you can. This dietary choice consists of vegetables, whole grains, fish, legumes and fiber-rich fruits, not to mention healthy monounsaturated fats from nuts, olive oil and avocado.

“Then, include 30 minutes of daily exercise. The exercise time should be increased to 1-1.5 hours for overweight women. This also includes a yearly walk to your physician’s office for a preventive/wellness exam!”

 

Richard Smalling, MD, cardiologist
Specializing in interventional cardiology
UT Medical School

 

“First, find out your family history. Who had a heart attack, a stroke in your family? Who has diabetes? How old were they when it happened? This is important to know so that you can mitigate the influence of your personal history.

“Second, keep in mind that high blood pressure guidelines have been redefined. We now classify hypertension as anything above 115/70—not 140/90. So, if you check yourself at the drugstore and it’s high, make yourself recheck it once a week, three times in a row.  If you’re running high, make a doctor’s appointment.

“Third, work out aerobically at least 30 minutes a day, at least four times a week. More is better. Just like your diet, exercise helps keep your bad cholesterol (LDL) down. Aim for under 130, but under 100 is ideal.

“Finally, if you like meat in your diet, remember that small portions of beef or pork tenderloin—two naturally lean meats—contain about the same amount of saturated fat as skinless chicken and tend to be much better for you than most other cuts. Like all things, moderation is key.”

 

Nancy Schwab, PhD, RN, adult nurse practitioner
UT School of Nursing

 

“I would tell women that they should start learning how to read food labels. Learn about the types of fats in foods. Look at the carbohydrate grams. Pay attention to the amount of refined sugar you take in, which affects your triglycerides.

“Knowing what you are putting into your body and how it affects your overall health is an ongoing education, but it helps us take charge of our lives early on.

“I also would tell young women that they should check their blood pressure every three to six months and once women reach their 40s, monitor it every three months, unless their health providers suggest a closer eye.”

 

Deepa Vasudevan, MD, Family Medicine practitioner
Specializing in obesity
UT Medical School

 

“We women should be following a heart healthy diet. Then, we should be exercising at least 45 minutes a day, five to seven days a week. These are two things we can start right now!”

 

Michael Smolensky, PhD, chronobiologist
(the study of biological activity in relation to time, cycles and rhythms)
UT School of Public Health

 

“Women are unique. There are several issues to consider.

“Young women: eat the right things. Don’t get hooked on fad diets for sex appeal and be at risk for malnutrition and secondary unintended negative effects on your heart health.

“Young women: Keep a menstrual diary if you experience infrequent, yet periodic, pain or atypical heart rate rhythm – they might be indicative of underlying heart problems but only readily diagnosable at certain times or days of the month.

“If you take birth control pills, understand how your other lifestyle habits (smoking, the use of certain prescription and over-the counter medications) might be unhealthy for your heart.

“Mature women: Have your blood pressure checked as often as your doctor recommends. If you have a blood pressure cuff at home, find your baseline (or monitor your blood pressure medications) by taking it several times in a 24–hour period:  morning, afternoon, evening and at bedtime. High blood pressure is a significant risk factor for heart disease and stroke, especially if you have a family history of these or if you have diabetes or kidney disease.

“Young and more mature women: Get as close to eight hours of sleep per night as possible, or more if you require it. Women, especially working women with children, are found more and more to be sleep-deprived. It is normal for blood pressure to decline during sleep by 10-20 percent from one’s daytime level, thereby reducing the amount of work the heart must do each 24 hours. However, when we cheat ourselves out of needed nighttime sleep, blood pressure stays elevated for longer stretches each 24 hours, making the heart do extra work and, as thought by some, causing the premature aging of the heart and vascular system.

“Also, if you are experiencing sleep problems – problems falling asleep, frequent nighttime awakenings or if you snore, tell your doctor. You might have a sleep disorder that can result in additional undue strain on your heart during the night when your heart should be working less hard than during the day.“

 

Shahla Nader, MD, endocrinologist
Specializing in Polycystic Ovary Syndrome
UT Medical School

 

“Young women must take control of their health. Many of my young female patients have polycystic ovary syndrome, a spectrum of symptoms that includes insulin resistance, menstrual irregularities, infertility, hormonal imbalances and obesity. If left untreated, it can lead to heart disease and diabetes.

“As far as the overweight PCOS patient is concerned I tell them that the two most important things to do are to CONTROL WEIGHT (lose weight) and EXERCISE. I tell them that it is their destiny to be aware of what and how much they are eating at all times and that their body is too efficient when it comes to food storage.

“Research does show that the results of bariatric surgery in this group are positive. Their menses normalize, their fertility is restored, their BP improves and in the early stages, with enough weight loss, glucose intolerance can return to normal.”

 

Maximilian Buja, MD, pathologist
UT Medical School

 

“Get tested and treated if you have symptoms for the four major risk factors for cardiovascular disease: hypertension (high blood pressure), hyperlipidemia (high cholesterol), diabetes mellitus and cigarette smoking. Then, adopt a heart-healthy lifestyle incorporating a balanced diet and regular exercise.

“Menopause: Consult a physician regarding the risks and benefits of hormonal therapy for menopausal symptoms including start and stop points of short term (a few years at most) therapy and appropriate monitoring while on the therapy.”

 

Sheila Coogan, MD, vascular surgeon
UT Medical School

 

“Metabolic Syndrome is the name for a collection of risk factors: large waistline, high triglyceride levels, low good cholesterol levels, high blood pressure, higher than normal glucose levels. When three or more of these are present and linked with obesity, it correlates with women's heart disease and stroke. Body Mass Index (BMI) is one component of Metabolic Syndrome.

“Body Mass index can be calculated if you know your height and weight. Most women might think that they are not at significant risk if they are just a few pounds overweight. I think many would be surprised to know that even though they are not significantly overweight, they may still be at risk for heart disease based on their BMI. Ideally BMI should be less than 25.”

 

Jennifer Feldmann, MD, pediatrician
specializing in adolescent medicine
UT Medical School

 

“I tell my young patients to exercise regularly. People who exercise regularly as teens are much more likely to maintain healthy exercise patterns than those who do not exercise as children or teens. The benefits are lifelong.

“Eat healthfully. Again, it is about establishing healthy norms and learning to make good choices independently. These habits stick with you for a lifetime.”

 

Pamela Berens, MD, obstetrician/gynecologist
UT Medical School

 

“For exercise, I think the party line is ‘moderate’ physical activity on ‘most days of the week’ (I think that means six to seven days a week!) The research done on weight maintenance after lifestyle modification suggests 150–200 minutes of ‘moderate’ exercise per week with most recommending at least greater than 175. That ends up being at least 30 minutes a day six times a week.

“Aerobic exercise is used in most studies of weight maintenance, reduction of diabetes and cardiovascular disease (CVD). Often they recommend ‘brisk walking’. (I personally think swimming is excellent as well and often recommend that to patients who have access to water. Swimming puts less stress on the joints for people with joint pain.)

“Weight bearing exercise is important for maintaining bone health.  So, ideally I would recommend both aerobic exercise for CV health and weight bearing for bone health. A study (unfortunately for us women, it was done in men), found that unfit (based on exercise stress tests) lean men had twice the mortality of fit, lean men. So, for even those of normal body weight, exercise seems to reduce your CVD risk.

“My diet recommendation is for the typically recommended low calorie, low-fat, high-fiber diet. (Avoid saturated fats, trans fats and eat a low cholesterol diet). I believe the recommendation is for total fat to comprise 25-35 percent of calories with 20-30grams per day of fiber. For people who are obese, weight loss of 7–10 percent can significantly decrease complications related to obesity including diabetes and CVD. Often, if we set more realistic, moderate goals such as 7-10 percent, we can help people achieve a healthier life even if they don't necessarily look like the girl in Cosmo (a completely unrealistic goal for most ‘real’ women).

“For women battling their weight, strategies that have led to success include ‘self monitoring’. So, keep a food diary, keep an activity log and record your weight, body fat, body mass index (BMI) or whatever measure you wish to follow.

“I do recommend dietary supplementation for some women, though there’s not much science here to support us. Few rigorous scientific studies have confirmed the benefit of vitamins in those without deficiencies. I do stress vitamins for those at risk (women who have had a gastric bypass or are strict vegans). We also recommend vitamins with folate for women who could become pregnant to reduce the risk of neural tube defects in their children. I agree that iron supplementation is important in some women. I still see many pregnant and menstruating women who have iron-deficiency anemia.

“I also recommend calcium for women of all ages depending on their diet. Young women can still build bone, so if their diets are low in calcium, I suggest they take a supplement. (The old adage ‘drink your milk’ works, too if you don't have lactose intolerance). For women near menopause, I recommend calcium (depending on specifics,1000-1500mg per day) and Vitamin D. It appears that as we age we don't absorb Vitamin D as well and if we stay out of the sun it only compounds the issue.

“There are now commercially available vitamin products targeted for ‘peri-menopausal’ and menopausal women that contain calcium, Vitamin D and omega-3 fatty acids, among other things. Food sources are preferred, but if your diet is lacking, supplementation may be necessary.”

 

S. Ward Casscells, MD, cardiologist
UT Medical School

 

"Chronic stress, helplessness and hopelessness place you at high cardiac risk. When the body is under extreme stress, it releases adrenaline and cortisol, which have negative effects. Suddenly, the arteries constrict, the blood gets thicker and is prone to clotting. The heartbeat accelerates which can outstrip the blood supply and the irritability of the heart is increased, giving way to arrhythmia, the threshold for defibrillation. These hormones eat away at the body like acid.

“Take it easy in the mornings. If the wife of a couple is my patient, then I tell the husband he is expected to make the morning coffee. I want her to be relaxed and not jump out of bed because early morning is the most stressful time of day for the heart.”

 

Rachel Weltman, DDS, periodontist
UT Dental Branch

 

“Floss, floss, floss. There is a correlation between the health of your mouth and the health of your whole body.  Women who have gum disease need to pay particular attention. The fact that you have infection in your mouth, which is what gum disease is, may trigger other parts of your body to respond improperly. Researchers have discovered that gum disease-causing bacteria or the chemical by-products from bacteria and inflammation are carried throughout the body by the blood stream. Those by-products may exacerbate or contribute to health problems in the far reaches of your body. The bacterial plaque found in the rest of the body’s vasculature contain those species associated with periodontal disease.  So, take care of your mouth—it’s intimately linked to your heart.”

 

Visit:

• UT Physicians
• UT Dentists
• UT Health Services
• Memorial Hermann Hospital - Texas Medical Center

Last Updated: 2-08-2008

 

 

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