ICDs Not as Effective for Women

 

An implantable cardiac defibrillator (ICD) is a small device that is implanted in the chest to help correct irregular life threatening heart rhythms (ventricular tachycardia or ventricular fibrillation).  When the heart starts beating abnormally the ICD delivers an electrical impulse to the heart to shock it back into a normal heart rhythm.  Patients with a weakened heart muscle (congestive heart failure) due to irregular pathways of caused by a heart attack, cardiomyopathy or high blood pressure are at risk for irregular heart rhythms.  Research studies have shown that patients with irregular heart rhythms (ventricular tachycardia, ventricular fibrillation) are less likely to die suddenly after they receive an ICD.  Many of these studies have included mostly men.  So what is the impact of ICDs on a woman’s survival?

 A study published in the Archives of Internal Medicine (2009) found that women with heart failure were just as likely to die with an ICD as women who did not receive the device.  Men in the study had a 22% lower risk of dying if they had an ICD.  But no benefit was observed in women with the ICD.  The researchers suggest that because women are less likely to die from sudden irregular heart rhythms than men they are less likely to benefit from an ICD.  Women are more likely to die from other causes.  Since this study looked at the risk of death from any cause the results need to be reviewed with caution.  Women who are candidates for an ICD should not be alarmed by the findings of this one study, clearly more data is needed.  Women need to discuss their individual benefits and risks with their physicians to determine the most appropriate treatment.

For more heart healthy info visit www.heart-strong.com

Premature Heart Disease Common in Indians and South Asians

Heart disease is the number one killer of men and women in the United States.  The prevalence of heart disease varies among ethnic groups.  Immigrants from India (South Asia) have a four times greater risk of developing heart disease than other Americans.  Indians are also more likely to develop premature heart disease, have heart attacks at an earlier age and develop diffuse disease due to a genetic predisposition and a multitude of lifestyle risk factors.  This includes both vegetarians and non-vegetarians.

 Genetic risk factors include: high lipoprotein (a) levels, elevated triglyceride levels and lower levels of less protective HDL (healthy) cholesterol.  Indians are also more prone to have abdominal obesity, diabetes, sedentary lifestyles and diets high in fat and starches which can increase the risk of developing heart disease.  The traditional Indian diet includes deep-fried foods (re-use of vegetable oil when cooking), coconut milk, roti, naan and other white breads, white rice, paneer (cheese), whole milk and high fat yogurt.

 Even though Indians have a strong genetic risk for heart disease they can lower their risk by making healthy lifestyle changes. 

 Below are some tips that may help reduce the risk of heart disease:

• Avoid deep frying, try to broil, bake, steam instead
• Use low fat milk and dairy products
• Increase fruit and vegetable and fiber intake
• Use olive oil or canola oil, do not re-use cooking oil
• Avoid ghee (clarified butter)
• Increase intake of fish, nuts
• Decrease intake of starches like white rice, roti, white potatoes and naan
• Avoid eating all or majority of carbohydrates at one meal, do not skip meals
• Increase activity level (walking 30 minutes a day counts as exercise)
• Weight loss (lose abdominal fat, waist circumference goal men <36 inches, women <32 inches)

 Lipoprotein (a) is a sub-class of LDL (Bad) cholesterol, when levels are elevated in the blood the risk for heart disease and stroke are increased.  Elevated lipoprotein (a) levels are associated with premature heart disease and have little to do with diet or lifestyle, they are usually hereditary.  All Indians/South Asians should have a lipoprotein (a) level checked at least once in their lifetime, preferably when they are younger since it is a marker of premature heart disease.

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes. “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com

Support Women with Heart Disease with HeartScarves

 

Red Heart Yarns http://www.redheart.com/ and WomenHeart: The National Coalition for Women with Heart Disease http://www.womenheart.org/ have joined forces to create the HeartScarves Project Kit featuring everything you need to knit or crochet a red scarf. HeartScarves provides handmade red scarves to members of our WomenHeart Support Networks, and to women undergoing cardiac procedures. The red scarves offer comfort, support, and encouragement for a woman with heart disease and become a part of her healing journey.

For every kit purchased from http://www.shopredheart.com/, Red Heart will donate $3 to WomenHeart.  The kits are $12.99 each.  To order your HeartScarves kit and get started today visit www.womenheart.org  or http://www.redheart.com/.

Is Diabetes a Risk Factor for Atrial Fibrillation (AF)?

For the first time diabetes has been shown to be an independent risk factor for AF according to a study published in the October 2009 issue of Diabetes Care. While there is an increased risk of AF in men with diabetes, there is a stronger association between diabetes and AF in women.  Diabetes is an even stronger risk factor than obesity and high blood pressure in women.  Normally, AF occurs more in men than women.  This study showed that women with diabetes had the same incidence of AF as men without diabetes.

While the actual reason behind this relationship is not understood, there is a theory.  Diabetes is known to cause damage to nerves, called neuropathies, and it is possible that the diabetes causes a type of neuropathy in the heart, which can lead to irregular heart rhythms.

 The bottom line is that it is important for diabetic patients to see their healthcare provider regularly and to be evaluated for any type of palpitations.

 Learn how to control your risk factors:

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes. “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com

Women with Atrial Fibrillation have Higher Stroke Risk

 Approximately 2.2 million people in the U.S. have atrial fibrillation.  Atrial fibrillation (abbreviated afib) is a heart rhythm disorder, which causes the atria (top 2 chambers of the heart) to quiver and not empty completely.  This can lead to blood clot formation in the top chambers of the heart.  If these blood clots become dislodged they can travel to the brain and cause a stroke.

 Afib is more common in men but research studies have found that women have more complications than men and are not treated as aggressively.  In the September 2009 issue of Gender Medicine an article was published evaluating 20 years worth of data collected on gender differences and afib.  The summary found:

• Women are more likely than men to have a stroke when they develop afib
• Women are not prescribed blood thinning medications to prevent blood clots as often as men
• When women do receive blood thinners they are more likely to have bleeding problems
• When women are treated with antiarrhythmic medications (medications that try to control the irregular heart beat or slow a rapid heart beat) they are more likely to have adverse side effects than men
• Women are less likely to be referred for catheter ablation (a heart procedure that is used to try and block the abnormal electrical heart impulses and stop afib)

 Future studies need to be conducted specifically on women to determine the best treatment methods for afib in order to prevent a stroke.  Women with afib also need to be closely monitored by their health care providers and treatment options should be evaluated on a case-by-case basis.

 “Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes. “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com

Exercise 1 Hour a Week & Lower Your Cholesterol

Previous studies have found that exercise can improve good (HDL) cholesterol levels.  This is one of the first studies to find a link between exercise and significant lowering of bad (LDL) cholesterol in women.  This study did not find a benefit in men and this needs to be evaluated further.  Almost 9,000 sedentary middle-aged adults were followed in this 9 year study which was published in The Journal of Lipid Research (August 2009).  

 Women who did as little as one hour a week of moderate physical activity (like taking a brisk walk) or 30 minutes of vigorous activity a week had a decrease in their bad (LDL) cholesterol levels.

White women had a 4 mg/dl decrease in LDL cholesterol

African American women had a 10 mg/dl decrease in their LDL cholesterol

 Postmenopausal women had an even greater benefit.

Postmenopausal white women had a 5.9 mg/dl decrease in LDL cholesterol

Postmenopausal African American women had a 14.7 mg/dl decrease in LDL cholesterol

 Now we can all fit 1 hour a week of exercise into our busy schedule.  Your Heart with Thank You!!

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes.  “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009.  For more info visit www.heart-strong.com

Women are Different – Heart Attack Symptoms in Women

Walk or Bike to Work to Decrease Your Heart Attack Risk

Can walking to work or riding your bicycle really lower your risk for a heart attack?

The CARDIA (Coronary Artery Risk Development in Young Adults, published in July 2009 issue of Archive of Internal Medicine) study followed over 2,300 men and women and found that active commuting to and/or from work really did help lower heart disease risk factors.  Unfortunately only 16% of people in the study actually performed active commuting on a daily basis, more men than women.

Men who actively commuted had lower triglyceride (blood fat) levels, lower blood pressures, better insulin levels, lower weights, and higher HDL (good) cholesterol levels.

The number of women who participated in active commuting was too small to determine any significant health benefits but women who performed daily physical activity had healthier numbers.

Numerous factors may not make it feasible for you to walk or bike to your place of employment.  But we always like to say that even SMALL CHANGES can make a difference.  Try getting off the bus or subway one stop earlier and walking the rest of the way to work.  If you have to drive to work, try parking your car further away from the door, which would allow some extra steps.  Take a walk at lunch time.  All Activity Counts!

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their blood pressure and other risk factors to prevent a heart attack, stroke and heart failure.  “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009.  For more info visit www.heart-strong.com

Preventing Heart Disease in Women

Do Hot Flashes Lead to High Blood Pressure?

 Women who experience hot flashes have been found to have higher blood pressures than those who don’t.  Systolic blood pressures (top number) were found to be significantly higher in women who have hot flashes regardless of menopausal status.  The higher blood pressures were consistent even when differences in weight, ethnicity and age were evaluated.  This study was conducted on 154 women 18 to 65 years old with no history of heart disease and normal blood pressures (published in the Journal of the North American Menopause Society March 2007).

 Hot flashes are believed to be caused by an increase in the activation of the sympathetic nervous system (this is the “fight or flight” system which leads to an increase in heart rate and constricts blood vessels).  This logically can also then lead to an increase in blood pressure.

 Women experiencing hot flashes should make sure they closely monitor their blood pressure.  Remember a normal blood pressure should be less than 120/80.

For more information about menopause, high blood pressure and other risk factors for heart disease see our new book “Take Charge: A Woman’s Guide to a Healthier Heart” at www.heart-strong.com