Transcription:
Women’s Cardiac Health, Overall Advancements in Women’s Healthcare

Melanie Cole (Host):  You may not realize this but heart disease, not cancer, is the number one cause of death for women in America. Nearly every minute of every day each year, a woman dies of heart disease. My Guest today is Dr. Patricia Guerrero. She’s a cardiologist and the director of women and heart disease for Florida Hospital. Welcome to the show, Dr. Guerrero. Please start by telling us about what’s a little bit different for women and our heart disease than it has been, typically, for men.

Dr. Patricia Guerrero (Guest):  Good morning, Melanie. Thank you. Women have different symptoms when they present with heart disease. I think most people would think of heart disease as heart attacks or that disease or symptoms that relate to an inadequate blood supply to the heart muscle. Men, customarily, would more typically, have chest pain. Women can have chest pain, if they are presenting with a heart attack but they, also, from a percentage point of view, are more likely to have symptoms that are not considered typical, meaning it is not chest pain, not the elephant sitting on the chest. It may be nausea, it might be shortness of breath, it could be jaw pain, shoulder pain or pain radiating down the arm. The presentation can be different and also the type of disease and how it affects the arteries can be different in women when compared to men, meaning that men will more typically have a focal disease, meaning that the blockage in the artery is in a discreet area versus in women it can encompass more of the entirety of the vessel. The other difference is age of presentation. Men, customarily and statistically, would have heart disease at an earlier age when they present at a later age. The outcome after a heart attack is worse for women than in men. So, it behooves women to really focus on prevention because we do fair less well after a heart attack. We have a greater percent of, in the first year, of dying and we have a greater percent in the first five years, compared to men, of having complications related to heart attacks.

Melanie:  Women, we are the caregivers of society, Dr. Guerrero, and we, typically, are always treating everybody else before we take care of ourselves. So, give women your best advice about risk factors, things we should be aware of, so that we can concentrate on ourselves and then we can help the rest of society.

Dr. Guerrero:  I agree with you. Women are the caregivers and so their focus is on others first before themselves. I would say, remember that you can’t care for others unless you care for yourself. The best example that you can give to your children, particularly your daughters, is showing that caring for yourself is not being selfish. It’s actually in taking care of yourself so that you can help others. The main thing that I would recommend all women to do, and this is part of the American Heart Association and the American College of Cardiology guidelines, is that as of age 18 when you reach adulthood, that you systematically have a review of what are your cardiovascular risk factors. This is a tool that is available online, even through the American Heart Association’s website but also through the Florida Hospital Women’s Heart website. It is a questionnaire, up to 50 questions and you feel uncomfortable going through those questions, you should seek help from your primary care provider. What the things that are addressed as risk factors are things like:  high blood pressure, is your blood sugar high, do you not exercise routinely, is your weight above what would be considered normal, do you smoke, are you a diabetic, do you have a family history of heart attack or strokes under the age of 65?  Then, there are some additional risk factors that are unique to women that also include that during pregnancy they develop diabetes or develop high blood pressure, something called eclampsia. Those are early warning signs, those are the things that should be taken as a clue that that young women will subsequently have a higher risk of developing heart disease. Routinely, reevaluating at least yearly what are your risk factor and either using the questionnaire that will help estimate what your risk factor category is or even better, seeing your primary care doctor yearly and addressing all those risk factors and what can be done to prevent disease.

Melanie:  What do you like to tell people about preventing?  You’ve mentioned these risk factors, some of them controllable, some of them not, but what do you tell them where diet and exercise are concerned and that’s relation to heart disease?

Dr. Guerrero:  Well, in reference to that, what has been repeatedly proven is that the more you move, the healthier you will remain. So, I encourage women and men to perform at least 200 minutes of aerobic exercise per week. That boils down to about 30 minutes every day. It can be in blocks as small as ten minutes and it does not have to be formal exercise but it should involve increasing your heart rate to a point where you are slightly short of breath but can still sustain a conversation. I encourage everyone to exercise as many days of the week as possible instead of trying to just accumulate all 200 minutes in one or two days as it provides a beneficial effect on maintaining a normal blood sugar level, a normal cholesterol value, normal blood pressure and it helps with weight management. I also advise women, in particular, to do some resistance training. It doesn’t necessarily have to be with machines or weights but that at least three times a week, they do some sort of resistance training to maintain muscle mass and good posture. So, maintaining muscle mass also assists in maintaining a metabolic rate that assists you in maintaining a healthy weight as well as one ages, maintaining good posture because you have the muscle mass that may help prevent something that also occurs frequently in women which involves fractures secondary to osteoporosis. Weight training, resistance training whether it be with your own body weight or using accessory weights is beneficial.

Melanie:  What about diet?  Women wonder if omega-3s will help them to prevent some heart disease. They wonder about their cholesterol levels. Speak about knowing your numbers and where your diet comes in.

Dr. Guerrero:  Well, knowing your numbers is critical, particularly if you have a family history of premature cardiovascular disease, these numbers should already be evaluated even when you’re still a child under a care of your pediatrician to help decrease the risk early on. At a minimum, even if your values are normal, your values should be checked at the age of 18 and at least every five years. Once you approach middle age, so you’re approaching menopause, it should probably should be checked yearly unless there are illnesses that are diagnosed early on like diabetes which would also incur a risk of elevated cholesterol values. So, the main impact of diet onto healthy lipids is that your diet should be preferably produce based. Two-thirds of what you consume should be fruits and vegetables and then a third should be a lean protein. I think when you approach the plate and you divide it in thirds, then you make sure that 2/3 of that plate is either produce and the one remaining 1/3 is a protein and all of these things should be prepared in a lean fashion and as fresh as possible in order to use food as medicine, which is the best sort of medicine there is. I also encourage my patients to be mindful of hydration. So, oftentimes, we consume more food because we are really thirsty because we aren’t attentive to enough fluid intake. By making sure that you drink adequate fluid in the form of water or non-alcoholic beverages, then you’re less likely to eat food because you’re really thirsty.

Melanie:  That is great, great advice. In just the last few minutes, please continue along that line. Wrap it up with your best women and heart disease advice and why women should come to Florida Women’s Hospital for their care.

Dr. Guerrero:  Well, the best advice I can give is that you should know your risk factors. Don’t be ignorant. Be involved and take charge of your health. Florida Hospital has wonderful avenues through their new women’s program but also Florida Hospital is dedicated to taking care of women and heart disease and all its manifestations. So, they can visit our website, they can also call our nurse online for directions if they need assistance, whether it be to see a cardiologist or to see a heart rhythm specialist or to help find a local primary care provider that then can help them with assessing their risk factors. The risk factor assessment tool is online and anyone is welcome to take it. We also have a bus. It is a women’s coach that is dedicated to breast cancer screening as well as screening for cardiovascular disease. You can inquire as to where the coach might be located on any given week and attend any one of its functions. So, we welcome all women to call, inquire, and seek assistance. We are there to assist and to promote good health in the community.

Melanie:  Thank you so much, Dr. Guerrero. It is great information and you’re so well spoken. Thank you for being with us today.  For more information on Florida Hospital for Women, you can go to FHforwomen.com. That’s FHforwomen.com. You’re listening to Health Chat by Florida Hospital. This is Melanie Cole. Thanks so much for listening.