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Health & Fitness

Top Killer

Sheree Crute

Not Son of Sam, car accidents, or cancer. For American women, it’s in your heart.

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

One night six years ago, Evelyn McMillan was strolling out of a play with her daughter when suddenly she was overcome with dizziness.

 “I thought I was just reacting to someone's strong perfume,” McMillan says. “I got into the car, leaned against the door and waited for it to pass.” Luckily, her daughter insisted she go to the emergency room, where doctors found she'd had a mild heart attack.

She needed open-heart surgery to remove a small blockage in a tiny artery.

“I'd been having mild chest pains for six or seven months, but thought it was just job-related stress,” says McMillan, 53 at the time, who had been dealing with a difficult classroom environment at the Vacaville, California high school where she teaches.

“Heart disease was the last thing on my mind. I didn't have high blood pressure or cholesterol. I was a few pounds overweight, but nothing dramatic and no one in my family had heart disease.”

Undiagnosed—and Dangerous

McMillan's story is not unusual when it comes to women and heart disease: She didn't recognize her symptoms and she was under severe stress for a year before she got sick.

“Physicians often underestimate risk in women,” says Lori Mosca, chair of the American Heart Association's (AHA) panel on Guidelines for Women. A recent survey found only one in five doctors knew that heart disease and stroke are the first and third leading causes of death among American women—claiming more than 500,000 lives each year.

What’s more, electrocardiograms are less accurate in women than in men, says Sharonne Hayes, director of the Women's Heart Clinic at the Mayo Clinic in Rochester, Minnesota.

Mosca and other top cardiologists are working with AHA and Women Heart (the national support organization for women diagnosed with heart disease) to help women like McMillan recognize and reduce their risk. How much control do we have? Heredity can increase your risk, but “lifestyle is huge,” says Mosca. “It can account for 80 percent of your risk.”

Take Control

  •  Create your personal risk profile.    Determine whether you're at low, moderate, or high risk.
  •  Know your numbers.    The AHA offers a simple chart for keeping track of cholesterol, blood pressure, and weight. 
  •  Work with your doctor. “Be proactive,” Hayes advises.  Make sure your doctor asks about your cholesterol and blood pressure.” If you are at moderate or high risk, ask if you are a candidate for cholesterol-lowering drugs or hypertension medication.
  •  Learn the signs of a heart attack.   Not just chest pain—dizziness, fatigue, nausea, and weakness may come first. Your chest may not hurt at all! Check out “Heart Attack/Stroke Warning Signs."
  •  Understand the role of emotional wellbeing. Duke University psychiatry Professor Edward Suarez says chronic distress triggers chemical reactions that damage arteries. “Depression may precede heart disease,” adds Joyce Bromberger of the University of Pittsburgh School of Public Health. “If you feel down, tell your doctor and ask to be evaluated.”
  •  Work your body. Exercise is a necessary component of any prevention plan.


Short Takes

Don’t Kill Yourself, Exercising To Live Longer

The No Sweat Exercise Book,  by Harvey Simon, MD, 304 pp.

We’ve reviewed a lot of exercise books recently, but exercise is important, and it’s something that nobody will do very consistently until they find a form that’s fun and comfortable for them.

Here’s one for the rather reflective, fairly intellectual person who doesn’t really like huffing and puffing. If you’re a passionate squash player, or you love to dance the night away, you may not need this book.

But if you still haven’t made exercise a serious habit, give it a try—especially if you like understanding how your body works and why some activities are a very good idea and others aren’t.

Jocks, actually, can get a lot out of it, too.

Harvey Simon teaches at the Harvard Medical School, and this book is much better than most at explaining how exercise works and the current state of knowledge about how to do yourself the most good without, well, destroying yourself in the process.

Among the many interesting pieces of information you’ll pick up: Why shoveling snow is a really bad idea, especially if you’re a man; how sex is like raking leaves; and of course, how to get fit without breaking a sweat.

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