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Take Health to Heart


Did you know that heart disease is the leading cause of death among American women? Your doctor may not know either.


By Sheree Crute

One night six years ago, Evelyn Mallery was strolling out of a play, chatting with her daughter about the evening, when suddenly she was overcome with dizziness. “I thought I was just reacting to someone’s strong perfume,” Mallery says. “I got into the car, leaned against the door, and waited for it to pass.” Luckily for Mallery, her daughter had other ideas. She insisted her mom go to the emergency room. Doctors there told Mallery she’d had a mild heart attack.

“I’d been having mild chest pains for six or seven months at that point, but I thought it was just job-related stress,” explains Mallery, who was dealing with a difficult classroom environment at the Vacaville, California, high school where she teaches English. “Heart disease was the last thing on my mind. I didn’t have high blood pressure or high cholesterol. I was a few pounds overweight but nothing dramatic, and no one in my family had heart disease.”

After several tests, doctors discovered a small blockage in a tiny artery. Mallery, who was 53 at the time, had open heart surgery to remove the blockage, but there was still a question about the role stress might have played, given her lack of other risk factors.

Undiagnosed—and Dangerous

If Mallery’s story sounds unusual, it’s not. Women like her are the norm, not the exception, when it comes to heart disease. She didn’t recognize her symptoms, and she was under severe stress for at least a year before she got sick.

Heart-Healthy Recipe!

Mincemeat Chiffon Pie
  • 1 envelope Knox Unflavored Gelatin 2/3 c orange juice
  • 1 c skim milk 2 eggs, separated
  • 1/2 teaspoon grated orange peel 2 packets Splenda
  • 2/3 c mincemeat 1/4 c chopped pecans

Combine gelatin, orange juice, and milk until gelatin is dissolved. Add egg yolks; beaten with orange peel. Let chill in refrigerator about 2 hours or until mixture mounds when dropped from a spoon.
Whip egg whites with Splenda until peaks form. Gently stir mincemeat and pecans into gelatin mixture then fold in egg whites. Garnish with grated orange peel if desired. Spoon into individual serving dishes.
About 70 calories per serving. Mixture may be poured into a baked pie crust; which adds to the calorie count.
Makes 6-8 servings.

“Physicians often underestimate risk in women, even when their risk factors are the same as men,” says Lori Mosca, M.D., chair of the American Heart Association’s (AHA) expert panel on Guidelines for Women. A recent survey of physician awareness found that only one in five knew that heart disease and stroke (which is also a cardiovascular disease) are the first and third leading causes of death among American women—claiming more than 500,000 lives each year.

“There is an even higher risk in Black women, in part because of their higher rates of hypertension and diabetes,” explains Elizabeth Ofilli, M.D., chief of cardiology at the Morehouse School of Medicine in Atlanta. “And [there are] higher rates among Hispanic women because of the increasing number of women with diabetes or obesity.” Yet a national AHA poll found that only 13 percent of women surveyed identified heart disease as their leading health risk. A whopping 51 percent thought it was breast cancer.

Women are also different than men when it comes to diagnostic tests for cardiovascular disease. “Standard stress testing is less accurate in women,” says Sharonne N. Hayes, M.D., director of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minnesota. “Electrocardiograms are also more likely to read false positive or negative in women.”

Faced with these issues and attitudes, Mosca and a team of top cardiologists from around the country have been working with AHA, Women Heart (the only national support organization for women who have been diagnosed with heart disease), and other experts to make sure that women like Mallery can recognize and manage their risk in advance, which is the most powerful weapon against heart disease.

How much control do we have? Hereditary factors may increase your personal risk, but “lifestyle is huge,” says Mosca. “In some cases, it can account for 80 percent of your risk.”

Taking Control

Fortunately for women, scientists, physicians, and health care advocates are working hard to reveal the secrets of heart disease—how it develops, what triggers an attack, how we can protect ourselves—so that we have more hope for prevention than ever before. Everything from attitude to healthy eating and getting enough exercise can make a difference. People working in education have a little extra motivation, says Hayes. “Of course they can help themselves, but they also can have a tremendous positive influence on the next generation.” Here’s how you can begin to make heart health a priority:

  • Use the educator’s edge. “Teachers are experts at modeling,” says Hayes. Use that concept to help the kids and yourself by bringing healthy snacks and exercise into your classroom. And go one step further, she suggests, “Be an advocate for a healthy school environment. Fight for healthier school lunches for you and your students.”
  • Create your personal risk profile. In 2004, AHA teamed up with leading cardiologists and experts to develop specific guidelines to help women recognize their risk. Go to http://circ.ahajournals.org/cgi/content/full/109/5/672 to determine whether you’re at a low, moderate, or high level of risk.
  • Know your numbers. The AHA offers a simple, printable chart for keeping track of cholesterol, blood pressure, and weight. Log onto http://www.americanheart.org/ and click on “Go Red for Women,” then “Know Your Numbers.”
  • Work with your doctor. “Women can teach their physicians to do a better job of treating heart disease by asking the right questions,” Hayes advises. “Be proactive; make sure your doctor asks about your cholesterol and blood pressure.” If you’re at moderate or high risk, ask if you’re a candidate for cholesterol-lowering drugs or hypertension medication.
  • Learn the signs of a heart attack. Forget chest pain. Dizziness, fatigue, nausea, and weakness may come first. Your chest may not hurt at all! Check out “Heart Attack/Stroke Warning Signs” at http://www.nea.org/neatoday/0603/www.americanheart.org to learn more.
  • Understand the critical role of emotional well-being. Recent research shows that only 50 percent of heart attacks can be directly attributed to factors such as high cholesterol. Edward C. Suarez, a professor of psychiatry at Duke who conducts research on inflammation, heart disease, and stress, says that chronic states of distress—such as irritability, anger, and anxiety—trigger chemical reactions in the body that damage arteries.
  • Work your network. “Pull together your support,” says Suarez. “Teachers might pick a buddy who understands the job and trade off listening to each other.” Talking with a trusted colleague can help you calm down and gain perspective on the situation.
  • Make happiness a goal. “We’ve found that depression may precede heart disease,” explains Joyce Bromberger, a professor at the school of public health at the University of Pittsburgh. “And many studies have shown that women have rates of depression that are two-fold higher than men. If you feel down, tell your doctor and ask to be evaluated. If you’re depressed, get treatment.”
  • Work your body. Exercise is a necessary component of any prevention plan. “Your school is the perfect environment for a daily workout,” says Trevor Douglin, personal trainer and founder of Move It Intense Training in Brooklyn, New York. “If you have a track or gym, request permission to use the facilities on your break, lunchtime, or after school,” says Douglin. ”Start out walking one lap around the gym. Once you feel stronger, add three-pound dumbbells and more laps. Walk 10 minutes at a time, three times a day, or do 30 minutes all at once.”

Ultimately, protecting your heart health and reducing your risk of disease is in your hands. “Everyone is looking for the magic bullet, but the fact is, it lives within,” Mosca says. “Take 30 minutes a day to calm yourself, and try to feel gratitude for all you have. You can’t be depressed and thankful at the same time. Thankfulness heals the heart.”

Managing Heart Disease

NEA Member Tip

Marcia Boone, a special education teacher at Morrow High School in Morrow, Georgia, has lived her entire life knowing she was at very high risk for heart disease. By 33, even though she was only a size 10, Boone was diagnosed with blood pressure high enough to require medication. Then Boone lost a kidney—due, in part, to hypertension—and eventually developed diabetes and high cholesterol. Yet today, at 58, she’s still square dancing once a week. Her solution? Trump those risk factors one step at a time.

Boone’s tips for managing heart disease:

  • Exercise. I walk 8,000 steps a day, using my pedometer to keep track, and I do 4,000 of those steps at school.
  • Eat healthy. I don’t eat salt, and I stick with seven servings of fruits and vegetables each day.
  • Be a good patient. I take my hypertension and cholesterol medication and follow my health plan, faithfully.

 

Illustration: illustration works

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21-Mar-06