Salt Sensitivity Greater Risk for High Blood Pressure in Women


Adults following a “typical American diet” are estimated to consume about 4,000 to 5,000 milligrams (mg) of sodium a day.  The majority of this sodium comes from the processed foods we eat everyday.  The current recommendations state that adults should only be eating 2,400 mg of sodium a day (that’s about a teaspoon of salt per day) and people with high blood pressure should have less than 2,000 mg of sodium a day.  Too much salt/sodium in our diet can lead to high blood pressure.

Some people are more “salt sensitive” meaning that salt/sodium in their diets is more likely to cause high blood pressure.  Studies have shown that African Americans and postmenopausal women are more prone to salt sensitivity.  A new study performed by Dr Pollock just published in the journal Hypertension suggests that female hormones may actually be related to the increased risk of high blood pressure with high salt intake in postmenopausal women.  This is an area that needs further investigation.

We recommend that both men and women (of all ages) examine the amount of salt/sodium they are consuming.  Women should not wait until they reach menopause to start cutting back on salt because we know salt is an “acquired” taste and it takes time to cut back on your salt intake.  If you were to stop adding salt and eating salty foods suddenly everything is going to taste bland. Gradual changes are best – start by removing the salt shaker from the table, stop adding salt to foods when cooking, try experimenting with other spices to add flavor to your foods, use salt substitutes that have potassium instead of sodium listed in the ingredients (potassium has been shown to help lower blood pressure), and start reading food labels.  If you want to follow a diet that has only 2,400 mg of sodium per day try to have 800 mg of sodium per meal.  It takes time for your taste buds to adjust.  I was a salt fanatic for years and recently had to cut back on my sodium intake – and I did it gradually.  Now if I eat something with alot of salt in it I don’t enjoy it – so my tastebuds have adjusted.  Remember make small gradual changes….

Menopause Transition Affects Heart Disease Progression


It’s a well known fact that when women go through menopause their risk for heart disease increases.  The loss of estrogen postmenopause increases a woman’s risk for high blood pressure, increases LDL (“Lousy” or bad) cholesterol levels, decreases HDL (“Healthy” or good) cholesterol levels, and increases the risk for weight gain (especially around the abdominal area).  This clustering of heart disease risk factors makes the incidence of heart attacks more common in post menopausal women.

A new study called the Los Angeles Atherosclerosis Study (LAAS) headed by Dr. C. Noel Baiery Merz suggests that if women transition through menopause quickly (within three years go from premenopausal to postmenopausal) their risk for developing premature heart disease is even greater.  This was a small observational study but these results further support the need for a comprehensive heart disease risk factor evaluation in younger premenopausal women.  We know that 80% of heart attacks are preventable by optimizing risk factors.  In order to prevent the development of heart disease women need to learn their individual risk factors and try to optimize their numbers when they are young – before they start to experience menopausal symptoms.

Women’s Heart Disease Prevention Guidelines


            Heart disease remains the number one killer of women in the United States.   In February of 2004 the American Heart Association (AHA) published for the first time specific guidelines for cardiovascular disease prevention in women.  Women were oftentimes under-represented in earlier cardiovascular disease studies making it difficult to extrapolate treatment recommendations to women.  Over the past several years more gender specific trials (WISE Study: Women’s Ischemia Syndrome Evaluation, Nurse’s Health Study, Women’s Health Study) have been conducted and have provided valuable information about diagnostic strategies and treatment outcomes in women.  Approximately one out of three women in the United States will develop heart disease at some point during their lifetime placing the majority of adult women in a very high risk category.   In March 2007 updated prevention guidelines were released by the AHA which focus on lowering the lifetime risk of heart disease in women and more aggressive strategies for higher risk women. The latest guidelines were developed by a panel of AHA experts and incorporate findings from 246 heart disease clinical studies. 

            A recent survey performed by the AHA found that 81% of women stated they had heard or read information about heart disease within the past year but many reported being confused by media reports about prevention strategies, including hormone replacement therapy and vitamin supplements which are addressed in the  2007 guidelines.  In order to effectively prevent cardiovascular disease women need to know their individual risk factors and must be cognizant of the impact of positive lifestyle changes.  Women can substantially reduce their risk of developing heart disease by following a heart healthy lifestyle, identifying their risks as soon as possible and then implementing an aggressive risk reduction and treatment program. 

Overview of General Heart Disease Prevention Guidelines for Women:


1)      Smoking cessation, avoid second hand smoke. Counseling, nicotine replacement therapy, adjunctive medications or formal smoking cessation programs should be provided for women currently smoking.

2)      Thirty minutes of moderate-intensity activity all or most days of the week, 60 to 90 minutes of daily activity in women trying to lose weight/sustain weight loss.

3)      Diet rich in fruits/vegetables, whole-grain, high-fiber foods, fish (especially oily fish) twice a week, limit alcohol intake to no more than one drink a day, limit sodium intake to less then 2.3 grams/day (1 teaspoon salt/day), limit cholesterol to less than 300 mg/dl per day, and very low consumption of trans-fatty acids.

4)      Maintain BMI less than 25 kg/m2, and waist circumference less than 35 inches.

5)      Supplemental omega-3 fatty acids for women with heart disease or high triglyceride levels.

6)      Depression screening and treatment.


Optimal Values for Women:


Total Cholesterol                      less than 200 mg/dl                                                     

HDL (good) Cholesterol           over 50 mg/dl

LDL (bad) Cholesterol less than 100 mg/dl (less than 70 mg/dl if high risk)       

Triglycerides                             less than 150 mg/dl

Fasting Blood Sugar                 less than 100 mg/dl

Hemoglobin A1C                     less than 7%

Blood pressure                         Optimal                less than 120/80mmHg

                                                Normal                 120/80-129/84mmHg


Medications for Primary/Secondary Prevention:


1)      Aspirin (81 to 325 mg) daily for high risk women (s/p CABG, s/p PTCA/Stent, or with known vascular disease), in women over 65 y.o. as long as the risk of bleeding is low, and in women under 65 y.o. only when the benefits for ischemic stroke prevention outweighs the potential bleeding risk.

2)      Beta blockers are indicated indefinitely for all women after an acute coronary syndrome, or with left ventricular dysfunction.

3)      ACE inhibitors/ARBs are indicated for women after an MI, women with heart failure, or diabetes mellitus.



Unproven Therapies (Not Recommended for Prevention of Heart Disease in Women – May Be Harmful):


1)      Hormone replacement therapy should not be used for the prevention of heart disease.

2)      Antioxidant vitamins (Vitamin E, C, beta carotene)

3)      Folic acid

4)      Routine daily aspirin for healthy women less than 65 years of age





1)      Mosca, L., Appel, A., Benjamin, E., et.al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women. Circulation. 2004, 109: 672-693.

2)      Mosca, L., Banka, C., Benjamin, E., et.al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation. 2007,115.

3)      Mosca, L, Mochari, H., Christian, A., et.al. National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006, 113: 525-534.

We are cardiac nurse practitioners who want to help women live a longer healthier life. Brand New Book “Take Charge: A Woman’s Guide to a Healthier Heart” available Feb 2009. Visit www.heart-strong.com for more info.

Some Funny Health Advice Found on the Internet


(Not to be Taken Seriously)

Q:  I’ve heard that cardiovascular exercise can prolong life; is this true?

A: Your heart is only good for so many beats, and that’s it.  Don’t waste them on exercise. Everything wears out eventually. Speeding up your heart will not make you live longer; that’s like saying you can extend the life of your car by driving it faster. Want to live longer? Take a nap.

Q:  Should I cut down on meat and eat more fruits and vegetables?

A: You must grasp logistical efficiencies. What does a cow eat? Hay and corn. And what are these? Vegetables. So a steak is nothing more than an efficient mechanism of delivering vegetables to your system. Need grain? Eat chicken. Beef is also a good source of field grass (green leafy vegetable). And a pork chop can give you 100% of your re commended daily allowance of vegetable products.

Q:  Should I reduce my alcohol intake?

A: No, not at all. Wine is made from fruit. Brandy is distilled wine.  That means they take the water out of the fruity bit so you get even more of the goodness that way. Beer is also made out of grain. Bottoms up!

Q:  How can I calculate my body/fat ratio?

A: Well, if you have a body and you have fat, your ratio is one to one. If you have two bodies, your ratio is two to one, etc.

Q:  What are some of the advantages of participating in a regular exercise program?

A: Can’t think of a single one, sorry. My philosophy is: No Pain … good!

Q:  Aren’t fried foods bad for you?

A: You’re not listening!!!  Foods are fried these days in vegetable oil. In fact, they’re permeated in it. How could getting more vegetables be bad for you?

Q:  Will sit-ups help prevent me from getting a little soft around the middle?

A: Definitely not! When you exercise a muscle, it gets bigger. You should only be doing sit-ups if you want a bigger stomach.

Q:  Is chocolate bad for me?

A: Are you crazy? Hello … cocoa beans! Another vegetable! It’s the best feel-good food around!

Q:  Is swimming good for your figure?

A: If swimming is good for your figure, explain whales to me.

Q:  Is getting in shape important for my lifestyle?

A: Hey! ‘Round’ is a shape!

Well, I hope this has cleared up any misconceptions you may have had about food and diets.

Be a Healthy Role Model


Children learn by watching their parents – so be a positive role model


Set Good Examples for Your Kids to Develop Heart Healthy Habits:


1.   Don’t smoke.

2.   Avoid fried foods and “liquid sugar” (soda or sweetened beverages).

3.   Limit fast food and watch portion sizes (avoid extra large portions).

4.   Cut back on salt. (Limit to no more than 2,400 mg of sodium a day)

5.   Strive to eat at least 2 fruits and 3 vegetables every day.

6.   Maintain a healthy weight.

7.   Limit television, videos and computer games to less than 2 hours per day.

8.   Plan family outings that involve physical activity.

9.   Encourage your kids to get involved in sports.

10.Walk or bike (rather than drive) whenever possible.


Did you know?


According to a recent survey more than

50% of 6 year old boys and girls, and about 70% of teenagers spend more than 2 hours a day in sedentary entertainment (watching TV, playing on the computer)


For more heart healthy tips for adults and fun stuff for kids visit http://www.heart-strong.com

Vote and Campbell’s will Donate to AHA Go Red Campaign


Campbells is teaming up with the American Heart Association’s Go Red For Women movement and The Heart Truth campaign to help women learn about their risk factors for heart disease.

Jane Krakowski is one of the stars of TV’s hottest Emmy Award-winning comedy, “30 Rock.” Yet when it comes to women and heart disease, Jane definitely believes the issue is no laughing matter.

Help pick a Nicole Miller-designed red dress for Jane Krakowski to wear at a celebration for American Heart Month in February and Campbell’s will donate to the AHA Go Red campaign.

“I hope my involvement will help educate women of all ages about the importance of knowing their risk factors and living a healthful lifestyle.”
— Jane Krakowski

Please go to this site to vote and help the movement http://www.campbellsaddressyourheart.com/


Remember Feb 6, 2009 is National Go Red Day – wear red to help increase awareness of women and heart disease