10 Things Women Should Know About Heart Health

Regular readers of this blog know that I am very into self-care; and that as much as I love a facial or pedicure, it’s the totally not sexy self-care acts such as daily preventative care and routine checkups that are crucial. For example, as mopey as I was after my recent well-visit, the checkup (and, er, weigh in) ended up being just the catalyst I needed to jump start my fitness efforts. I am here for the self-care, friends, and I want you to join me!

Which leads me to today’s post. February is American Heart Month and despite efforts to build awareness on this topic, it’s one that doesn’t tend to be top of mind as a health priority for women. This is strange given that heart disease is the number 1 killer of women – 1 in 4 deaths among women is due to cardiovascular disease whereas 1 in 38 deaths are due to breast cancer. So I’m really thrilled to have Dr. Ayan Patel, Director of the Women’s Heart Center at Tufts Medical Center to share some wisdom about women and heart health.

1. Why is heart disease such an under-recognized health issue in women?

One major issue is perception around symptoms. First, sometimes women do not attribute their symptoms to heart disease because they assume that it’s predominantly a disease of men. And second, because symptoms of heart disease can be more variable in women, women may not realize that their symptoms are related to heart disease and attribute them to some other cause. So, it’s crucial that we educate women about the risk factors and warning signs of heart disease in women, and to help women understand that heart disease is an important health concern.

2. What risk factors are unique to women?

Common risk factors include: smoking, high blood pressure, diabetes, high cholesterol levels, or being overweight/obese. Having a family history of a first-degree relative with heart disease at an early age can be a risk factor for some women. Some pregnancy-related conditions that increase risk for heart disease include gestational diabetes, pregnancy-induced hypertension, and pre-eclampsia. And in women who have been treated for breast cancer, a history of radiation therapy is also associated with increased risk of heart disease.

3. What can I do to lower my risk?

Here is the remarkable thing: It’s estimated that approximately 80% of cardiovascular disease events can be prevented by healthy diet, regular physical activity, maintaining a healthy body weight, not smoking, controlling blood pressure, controlling diabetes, and maintaining recommended cholesterol levels.

4. Wow, 80%! OK, let’s start with key nutritional tweaks. What do you recommend as top actions for a healthy diet?

In a nutshell, the simpler and less processed the better, but examples of foods for a healthy balanced diet include: fruits and vegetables, unrefined fiber-rich whole grain foods, nuts and legumes, low-fat or fat-free dairy products, skinless poultry, and eating fish twice a week (“oily” fish such as salmon, mackerel, albacore tuna, lake trout, herring, and sardines are high in “good” polyunsaturated fats, including beneficial omega-3 fatty acids). Women who are pregnant or breast feeding should avoid certain types of fish that may contain high mercury levels (such as shark, swordfish, king mackerel, or tilefish). Moderate intake of monounsaturated fats can also be beneficial; these include foods such as avocado, olives, walnuts, and non-tropical oils. And it’s important to avoid foods with added sugars, saturated fats (fat from animal sources of food), or trans fats.

5. And how about exercise? What are the current recommendations?

I think a lot of people get stuck in the thinking that exercise needs to be something intense or that they need to get to a gym, but it doesn’t need to be complicated. The key is regular exercise: At least 150 minutes per week of moderate intensity aerobic exercise (such as brisk walking), or at least 75 minutes per week of vigorous aerobic exercise (such as race walking, jogging, swimming laps, or bicycling at ≥10 mph), or an equivalent combination of both moderate and vigorous exercise. In addition, at least 2 days per week of moderate to high intensity muscle strengthening activity involving all major muscle groups can provide further health benefits.


6. How can I tell if I’m actually making progress lowering my risk?

Women should talk to their doctor regarding individual recommendations for lowering their risk. General recommendations include aiming for healthy body mass index (BMI) between 18.5 kg/m2 and 24.9 kg/m2, and a waist circumference ≤ 35 inches. It should be noted that in individuals who have very high or low muscle mass, BMI may not accurately reflect body fat; in these individuals, waist circumference may be a better indicator of body fat. For example, women who have a normal BMI but an increased waist circumference may still have an increased risk of heart disease. Recent national guidelines recommend that optimal blood pressure is <120/80 mmHg. Ideally, LDL cholesterol (“bad cholesterol”) levels should be less than 100 mg/dL.

7. Given that varied body shapes are a thing, why does excess fat at the waist in particular increase risk of heart disease?

Fat around the abdomen and waist is associated with deep fat that is deposited around internal organs (visceral fat), which is the most dangerous type of fat. Visceral fat produces hormones and other substances that alter regulation of blood pressure, cholesterol levels, and blood sugar. These changes increase the risk of high blood pressure, abnormal cholesterol levels, diabetes, and heart disease, and stroke.

8. Following my last question, what are the top ways that women can burn fat?

First, in order to burn body fat it is essential to take in fewer calories than you expend. For women who are trying to lose weight, the recommended exercise goal is to achieve a minimum of 60-90 minutes of at least moderate intensity physical activity on most days of the week, and preferably every day. Participating in moderate to high intensity muscle strengthening exercises is also recommended; by strengthening muscles, you will increase your body’s rate of burning off calories, which will help to burn off fat.

9. Can you share about your recommendations related to sodium and heart health?

Excess sodium intake can increase risk of high blood pressure and may cause the body to retain excess fluid. The majority of sodium that is consumed in the U.S. diet comes from foods that are processed or commercially prepared, and most Americans consume more than the recommended daily amounts. Foods such as canned soups and processed meats are high in sodium, but be aware that some foods that are not obviously salty, like breads, can also contribute quite a bit to your daily sodium intake. Condiments such as salad dressing and sauces can also substantially increase the sodium content of a meal. The current national recommendations are to limit sodium intake to no more than 2300 mg/day (approximately 1 teaspoon of salt), and no more than 1500 mg/day in individuals with high blood pressure.

10. OK, so heart disease takes different forms, and some heart conditions can lead to a heart attack, which is something everyone seems to know about. How do the warning signs of a heart attack differ for women vs. men?

One of the tricky things about heart disease is that the symptoms of heart attack may be more subtle in women than in men. While chest pain is a common symptom of a heart attack, women may sometimes experience other symptoms such as jaw, neck, or back pain, shortness of breath, cold sweats, unexplained nausea, unusual dizziness, or unusual fatigue. If you’re experiencing these symptoms it’s important to listen to your body and your instincts; if you’re feeling unwell, don’t just write it off as related to stress or something else. Call your doctor or, if you think you might be having a heart attack or stroke, call 9-1-1! Women are far less likely to call 9-1-1 for themselves than for others, but it can be dangerous to minimize your own symptoms.

This is all great advice! Anything else that you recommend women do for their hearts?

Encourage a friend or family member to join you in making heart health a priority by taking steps to improve heart health! For example, swap favorite heart healthy recipes with friends. Buddy up for neighborhood walks or other fitness activities. Share heart health information with some women you care about and ask if they have heard of the heart disease risk factors and what to do about them. The actions that women can take to help one another prioritize heart health can be so simple, but can have an important impact.

About Tufts Medical Center

The CardioVascular Center (CVC) at Tufts Medical Center in Boston, MA regularly treats cardiac patients from across the country and around the globe. We were named one of the nation’s top 50 cardiovascular hospitals and recognized as a “Blue Distinction Center for Cardiac Care.” The CVC has performed more heart transplants than any other hospital in Boston over the last 5 years, and has the largest advanced heart failure program in New England.

Our collaborative approach and commitment to bringing together the perfect combination of specialists to treat any heart condition provides patients with access to leading doctors in Cardiology, Cardiac Surgery, Vascular Surgery, interventional Radiology and Anesthesiology.

Interested in learning more about why doctors and patients prefer the CardioVascular Center at Tufts Medical Center? Visit our website.

Disclaimer: The content provided in this post is intended solely for the information of the reader. This information is not medical advice and should not replace a consultation with a medical professional.

Disclosure: This post reflects a compensated editorial partnership with Tufts Medical Center. All personal commentary is, of course, my own! Featured photo by Jamie Street on Unsplash