Women
Should Cut Heart Disease Risks Before Menopause
The
longer women wait, the greater the threat
The
ticking of a woman's biological clock signals the approaching end of
her reproductive years. But a new study suggests it should also serve
as an alarm about increasing risks for heart disease.
The
research says waiting until after menopause to take steps to reduce
the risk of a heart attack or stroke is waiting too long.
"What this
research tells us is that the time to begin reducing your risk of heart
disease is before you actually are at risk. And for women, that means
making the appropriate lifestyle and dietary changes prior to when menopause
begins," says Carol Derby, study author and an assistant professor
of neurology and epidemiology at the Albert Einstein College of Medicine
in New York City.
The findings were
presented at the American Heart Association's recent annual conference
on cardiovascular disease, epidemiology, and prevention in Miami.
The research involved
some 1,300 women between the ages of 42 and 52 who were evaluated for
future risk of heart disease. Based on their current status, by the
time they turned 55, more than half the women would need some type of
lifestyle change or drug therapy to avoid a heart attack or stroke,
the researchers projected.
Perimenopause
Key Time To Address Heart-Related Health Issues
The take-home message,
says Derby, is clear: "Women need to recognize that the perimenopausal
period is the key time in which to address the issues that increase
their
risk of heart disease later in life—and to do so before they reach
the point where their age becomes another significant risk factor."
For cardiologist
Dr. Dan Fisher of New York University Medical Center, the advice is
sound but can be a double-edged sword.
"While it's
a good idea to reduce risk factors for heart disease before problems
develop, at the same time women should not come away with the idea that
they can throw caution to the wind up to age 54 and then suddenly make
the appropriate changes, because that's not always going to help,"
he says.
Most
Risk Factors For Heart Disease Have Cumulative Effect
In reality, Fisher
says, most risk factors for heart disease have a cumulative effect.
So the earlier you begin to adopt healthy behaviors—such as quitting
smoking, losing weight, or keeping appropriate cholesterol levels—the
better off you will be.
The new study was
based, in part, on the National Cholesterol Education Program Adult
Treatment Panel Guidelines. They are part of a system that utilizes
a series of risk factors, including age, to determine at what point
cholesterol levels require medical intervention to protect against heart
disease. That intervention can include drug therapy or lifestyle changes,
such as losing weight, or both.
According to the
guidelines, the age at which intervention is usually first considered
is 55, so the researchers used this year as a criterion in their study
as well. Then they looked at the current heart disease risk profiles
of the women in the study, who came from five different racial or ethnic
groups. Those profiles included current cholesterol levels, blood pressure
and amount of body fat, as well as contributing lifestyle factors such
as smoking.
"If nothing
else about these women would change, we used their current risk profile
to project into the future and see how many would fall into the treatment
category by the time they turned 55," Derby says.
The end result:
The projections showed that if nothing else but age changed, 65 percent
of the women would require treatment to avoid serious heart disease.
Of that 65 percent, 19 percent were Hispanic; 18 percent were African-American;
15 percent, Caucasian, 8 percent, Japanese; and 5 percent, Chinese.
This information
will hopefully help women realize the need to look at themselves and
their health risks during the perimenopausal years, and make the changes
that can affect their heart disease risk later in life, Derby says.
Fisher agrees, but
also suggests that change is needed much earlier. "We need to make
reducing the risk for heart disease a lifetime lifestyle, beginning
as young as possible," he says.
Always consult your
physician for more information.
Heart
Disease Prevention
Living a healthier
lifestyle can help to prevent heart disease. This includes the following:
- Eliminating
all tobacco products. You should be aware that all tobacco products
are included as risk factors for chronic illness, not just cigarettes.
And, although there may be medical uses from derivatives of some social
drugs, such as alcohol, there is no therapeutic use for nicotine.
As soon as you stop smoking, your body begins to heal itself from
the devastating effects of tobacco.
Maintaining a
heart-healthy, balanced diet will help to: manage stroke and heart-attack
risk factors; prevent or manage other chronic diseases; assist in
losing weight and boosting energy; and promote overall good health.
Online
Resources
American
Academy of Pediatrics (AAP)
American
Heart Association
National
Cholesterol Education Program Adult Treatment Panel Guidelines
National
Heart, Lung, and Blood Institute (NHLBI)
National Institutes of Health (NIH)
National
Institutes of Health (NIH)
|
April
2003
In
This Issue:
The
Longer Women Wait, the Greater the Threat
Perimenopause
Key Time To Address Heart-Related Health Issues
Most
Risk Factors For Heart Disease Have Cumulative Effect
Heart
Disease Prevention
Heart
Disease Prevention Should Actually Start In Childhood
Online
Resources
Other
Resources :
Find
a St. John's Mercy Physician
Cardiac
Services at St. John's Mercy
Cardiac
Conditions and Diseases
St.
John's Mercy Classes and Programs
In
Other News About Your Heart Health:
Heart
Disease Prevention Should Actually Start In Childhood
New
guidelines recommend heart healthy behavior for kids
Armed
with increasing proof that heart disease begins in childhood, the
American Heart Association has issued the first set of heart disease
prevention guidelines aimed specifically at children.
"Many
studies have shown an association between atherosclerosis and high
cholesterol, high blood pressure, and obesity beginning in children
as young as 5 years old," says Dr. Rae-Ellen Kavey, chairman
of cardiology at the Children's Memorial Hospital in Chicago and
lead author of the guidelines.
Yet,
she adds, while guidelines exist for preventive care for adults
at risk for heart disease, there were no similar guidelines for
children despite the knowledge that early intervention can be enormously
effective in delaying the onset of disease.
"It's
a process that begins in childhood, so guidelines have to begin
in childhood," she says.
Kavey
presented the guidelines at the American Heart Association's recent
annual conference on cardiovascular disease, epidemiology, and prevention
in Miami.
A
year in the making, the guidelines present a comprehensive list
of the health risks associated with heart disease, including overweight,
high blood pressure and/or cholesterol, diabetes, and a family history
of heart disease. They are followed by recommendations to pediatricians
for reducing those risks.
"It's
all put together in one statement to emphasize that physicians need
to think of these things together. It's something to put on a bulletin
board in their offices," says Dr. Stephen Daniels, a pediatrics
professor at Cincinnati Children's Hospital Medical Center who also
collaborated on the guidelines.
The
guidelines offer a list of things physicians can do to promote cardiovascular
health in all children and directives for young people already at
risk for heart disease. Included as well is a large bibliography
of studies for physicians who want to read the research upon which
the recommendations are based.
For
otherwise healthy children and teens, suggestions are to regularly
assess children's heart health by checking weight, blood pressure,
and lipid levels if deemed necessary. The guidelines also ask physicians
to recommend healthy food choices, such as eating more fruits and
vegetables, to restrict the intake of saturated fats to less than
10 percent of a child's daily caloric intake, and to keep sugar
intake low.
Next,
the guidelines emphasize the importance of limiting sedentary activity—no
more than two hours of television and/or sitting at the computer,
for instance—and being physically active every day. The dangers
of smoking are also discussed. The authors hope this focus will
prompt healthier behaviors when children are young.
"It's
much easier to establish healthy eating and physical activity patterns
than to change unhealthy patterns later," Kavey says.
The
second part of the guidelines targets those children or teenagers
already at high risk of cardiovascular disease. These include children
with a body mass index (BMI) over the 85th percentile for age, height
and weight, a blood pressure reading in the 90th percentile for
age, sex, and height, and a cholesterol reading of 170 or higher.
Also putting children at higher risk is family history of heart
disease, particularly if male family relatives had heart disease
before age 55 and female relatives before the age of 65.
Information
here concerns specific monitoring of weight, diet and physical activity,
blood pressure, cholesterol, and recommendations for interventions
with medications.
"These
guidelines are excellent tools for educating pediatric providers,"
says Dr. Thomas Klitzner, chief of pediatric cardiology at the Mattel
Children's Hospital, University of California at Los Angeles.
"The
problems, particularly of obesity, are daunting, and steps like
this are essential if we are going to begin to approach a solution
to this problem," he adds.
Always
consult your child's physician for more information.
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