Why am I “Telling A Friend”?
• It is important for women to talk to their nurse or
doctor about their heart health
• It is important for women to talk to their nurse or
doctor about symptoms of heart problems
• Women need to tell other women about heart health
and important risk factors
Key Messages for Women
• Heart disease is the #1 cause of death in women
• Stroke is the #3 cause of death in women
• Know the symptoms of heart attack and stroke,
and seek medical attention promptly
• Prevention is important for everyone!
CVD & Other Causes of Death
More than 1 in 4 women will die of heart disease
1 in 30 women will die of breast cancer
Women are getting the message
What is the leading cause of death in women?
We know the answer: Heart Disease!
In 1997, only 30% (less than 1 out of 3) women
knew the right answer.
In 2010, 57% of women knew the right answer.
Death After a Heart Attack
• Women are more likely to die in the first year
following a heart attack than men the same age
– 1 of 4 men will die in the first year
– More than 1 of 3 women will die in the first year
• We don’t know all the reasons for this difference
• The government requires that heart disease
researchers:
– Include women as research subjects
– Report how men and women respond to treatments
Always Know Your Numbers!
• Cholesterol profile numbers
• Blood pressure reading
• Blood sugar: blood test for diabetes
Risk Factors for Heart Disease
• Guidelines put women in 1 of 3 classes:
– Low Risk
– Moderate Risk
– High Risk
• The same things that increase risk for a heart attack
can increase the risk for a stroke
• Ask your nurse or doctor to help you make a plan to
lower your risk level
What are the Risk Factors?
What You CAN Change
What You CAN’T Change
•
Physical Activity
• Age
•
Life Stress
• Gender
•
High Blood Pressure
• Family History
•
Obesity
•
Diabetes
•
High Cholesterol & Triglycerides
•
Smoking
•
Unhealthy Diet
(HIGH in saturated fat & calories; LOW in
fresh fruit, veggies, whole grains & fish)
Signs You’re at High Risk
for Heart Disease
• Previous heart attack or stroke
• Angina
• Circulation problems
• Diabetes
• Chronic kidney disease
Signs You’re at Moderate Risk
for Heart Disease
• One or more of the following risk factors:
–
–
–
–
–
High cholesterol
Diabetes
Smoking
High blood pressure
Family history of heart disease or stroke at a young age
(<50 for men; <60 for women)
• Metabolic Syndrome – more about this later!
• Can only exercise for a short time during a treadmill
test performed by your nurse or doctor
Signs You’re at Low Risk
for Heart Disease
• “Optimal Risk”
• No major risk factors
• Healthy Diet
• Daily Exercise
Tackling a Risk Factor:
HIGH BLOOD PRESSURE
Recognizing High Blood
Pressure
• High blood pressure is very common as women get
older
• Even women who had good blood pressure all their
lives are at risk for high blood pressure as they age
• High blood pressure is called the “silent killer”
because it doesn’t have any symptoms
Know Your Numbers:
Classification of Blood Pressure
Optimal:
<120 systolic and <80 diastolic
Pre-Hypertension:
120-139 systolic or 80-89 diastolic
Stage 1 Hypertension:
140-159 systolic or 90-99 diastolic
Stage 2 Hypertension:
>160 systolic or >100 diastolic
Lowering Your Blood Pressure:
Good Things Can Happen!
• When you lower your blood pressure, you lower
your risk of:
– Stroke by 40%
– Heart Attack by 25%
– Heart Failure by 50%
Lowering Your Blood Pressure:
What Can You Do?
• Make healthy habits
– Take a 30 minute walk everyday
– Avoid being overweight
– Lower salt in your diet
– Follow a heart-healthy diet (low fat, lots of fruits/veggies
and 2-3 servings of low fat dairy products every day)
• Take the right medicines
– There are many good and safe medicines
– Most people will need more than one
Tackling a Risk Factor:
HIGH CHOLESTEROL
Know Your Numbers:
The Cholesterol (Lipid) Profile
Total Cholesterol Goal:
<200 mg/dL
“Bad Cholesterol” LDL Goal:
<100 mg/dL
(Low Density Lipoprotein Cholesterol)
“Good Cholesterol” HDL Goal:
(High Density Lipoprotein Cholesterol)
Triglycerides Goal:
>50 mg/dL
<150 mg/dL
Lowering Your Cholesterol:
What Can You Do?
• Main Target of Treatment = LDL Cholesterol
• Healthy behaviors are important!
• If you already have heart disease or diabetes, or if
your cholesterol level or risk is high, you might need
medicine to lower your cholesterol
Note: Women who are pregnant, nursing, or who may become
pregnant should not be prescribed cholesterol-lowering medications
Tackling a Risk Factor:
DIABETES
Women and Diabetes
Type 2 diabetes increased 50% in the last 10 years
• A woman with diabetes has 5x the risk of heart
disease than a woman without diabetes
• Women with diabetes get heart disease at a
younger age
• If you have diabetes, it is important to have ALL of
your risk factors treated:
– Blood Pressure
– Cholesterol
– No Smoking!
Know Your Numbers:
Diabetes Guidelines*
Optimal fasting blood sugar level:
<100 mg/dL
Impaired fasting glucose:
Prediabetes
100-125 mg/dL
You have diabetes if:
Your fasting blood sugar is 126 or more (and tests at that
level or higher on a second reading on a different day)
*American Diabetes Association Guidelines
Lowering Your Risk for Diabetes:
What can you do?
• Research shows that diabetes can be prevented,
or at least postponed by improving diet, losing
weight, and increasing physical activity
• People at risk for diabetes who follow a diet and
exercise can decrease their risk of developing
diabetes by more than 50%
– This has been proven in a trial where the people lost an
average of less than 10 pounds.
• Small steps make a BIG difference!
OTHER RISK FACTORS
Smoking:
The #1 Preventable Risk
• Women who smoke have 2-6 times the risk of
sudden cardiac death than non-smokers
• That risk is even higher for heavy smokers
• Second-hand smoke increases health risks, too
• Health benefits begin as soon as you quit!
• Talk to your nurse or doctor about how to stop:
– Quitting is difficult
– Nicotine replacement or medications may be helpful
Overweight and Obesity
• A growing problem in the United States
• Being overweight increases risk of:
– High blood pressure
– Cholesterol abnormalities
– Diabetes
• Exercise recommendations to lose weight:
– 60-90 minutes of moderate-intensity activity every day
• All women should reduce saturated fat intake to less
than 7% of calories
Easy Ways to “Cut”
and “Spend” Calories
• Choose fat free milk instead of whole milk
• Park far away, so you can walk
• When eating out, share an entrée or save half for
the next day
• Wear a pedometer to count your steps – then
increase your steps gradually (2,000 steps = 1 mile)
• Walk to a co-worker’s desk instead of emailing
The Metabolic Syndrome
• Certain risk factors tend to “go together” and
increase your risk for getting diabetes or heart
disease:
–
–
–
–
Overweight, especially when carried around the waist
High blood pressure
Cholesterol abnormalities (low HDL or high triglycerides)
Elevated blood glucose
• People with these risk factors need to be treated
very aggressively for heart disease prevention
• Heart healthy habits are key!
Risk Factors Add Up!
Exercise is Key!
Exercise helps:
• Lower blood pressure
• Prevent diabetes
• Lower LDL (bad cholesterol) and raise HDL (good
cholesterol)
• Weight management
• Manage stress
• Bone health
What About Postmenopausal
Hormone Therapy?
Postmenopausal Hormone Therapy (HT) is NOT
recommended to prevent heart disease.
• Research trials have failed to demonstrate that HT
lowers risk.
• It may increase stroke
• Women should focus on the things we know really
work to improve heart health
• Hormone therapy may still be used to treat
menopause symptoms – talk to your nurse or doctor
When Prevention Fails:
HAVING A HEART ATTACK
How Do You Know:
Symptoms of a Heart Attack
• Uncomfortable pressure, fullness, burning or
squeezing sensation in the chest
• Pain in your chest, neck, arms, or back
• Unusual shortness of breath
• Nausea, vomiting, dizziness, sweating
• Unusual fatigue
• Feeling of doom – a sense that something really bad
is happening, or about to happen
How Do You Know:
Symptoms of a Heart Attack
• You may not have all symptoms
• Symptoms are different for everyone
• It may not be as dramatic as on TV or movies
• You know your body – trust your instincts!
• Immediate treatment that can limit the amount of
heart muscle damage is crucial
SYMPTOMS REQUIRE IMMEDIATE ACTION!
CALL 9-1-1
When Prevention Fails:
HAVING A STROKE
How Do You Know:
Symptoms of a Stroke
• Sudden numbness or weakness in your face, arm,
or leg – especially on one side of your body
• Sudden confusion, trouble speaking or
understanding
• Sudden trouble seeing in one eye, or both
• Sudden trouble walking, dizziness, loss of balance
or coordination
• Sudden, severe headache with no known cause
How Do You Know:
Symptoms of a Stroke
• A stroke is a brain attack
• Emergency treatment that can limit the amount of
brain damage must be started quickly
• It is usually not the person experiencing the stroke
that calls 9-1-1
• Make your family aware of the symptoms
SYMPTOMS REQUIRE IMMEDIATE ACTION!
CALL 9-1-1
KEY TAKE-AWAYS
Key Take-Aways
• Know the symptoms of heart attack and stroke
• Know your risk factors for heart disease
• Work with your nurse or doctor to reduce your risk:
– Avoid tobacco products and second-hand smoke
– Have your blood pressure and cholesterol profiles
measured (and blood sugar if at risk for diabetes)
– Follow their advice to manage risks with healthy behavior
changes and medicine, if needed
– Eat a heart healthy diet – low in fat and salt
– Exercise – walking for 30 minutes each day is perfect
Key Take-Aways
Spread the Word: TELL A FRIEND,
neighbor, sister or co-worker
Online Resources