STEPS THAT WOMEN CAN TAKE TO PROTECT THEIR HEARTS

Thursday, April 2nd, 2009 | General health

It is true that women who develop heart attacks tend to be older than their male counterparts; and they are at more risk from heart attacks if they have high blood pressure and diabetes. So if you have one or the other, or both, of these conditions (they often go together), you must be particularly careful to keep it under good control.

For high blood pressure, that means

• Taking the correct antihypertensive drugs

• Having monthly blood pressure checks For diabetes, it means

• Strict control of weight—the BMI (Body Mass Index) should be strictly between 20 and 25, and preferably closer to the lower figure

• Frequent small meals containing large amounts of fiber

• Multiple injections of small amounts of insulin each day

• A daily diary of your blood glucose (booklets for keeping records of blood glucose, insulin doses, and food intake are available from your doctor)

• A monthly visit to your diabetic clinic

Hypertension among women has not been studied nearly as much as it has been among men. Some researchers question whether the findings about men apply directly to women. Several hypertension medications affect blood lipid levels and these effects may be different and perhaps counterproductive for women, possibly affecting their sex life. Potential changes in sexual response for women on certain blood pressure medications have been ignored by researchers and unquestioned by family doctors. These holes in research are rapidly being filled by current studies, so keep your eyes open for new information as it is released.

The female hormone estrogen appears to protect women against heart attacks—a protection that falls away after menopause. So why not try hormone replacement therapy (HRT) after your menopause to keep your heart attack risk low? In a large study of American nurses, HRT halved the risk of coronary disease in postmenopausal women. Worries that HRT might cause breast cancer appear to be unfounded, but there is very definite evidence that it greatly reduces the risk of ovarian cancer—and also, surprisingly, of rheumatoid arthritis. Nevertheless, women who have many close relatives with breast cancer should probably avoid HRT; there may be a very small risk that it can accelerate the development of an already existing growth.

The good news for women about heart disease is that the very strong risk in men with high cholesterol levels probably does not apply to women. Younger women naturally have higher blood cholesterol levels than men of the same age, but most of it is of the beneficial HDL type. Only if there is obvious hyperlipidemia, or a history of early deaths from heart attacks in women in the immediate family, should a high cholesterol level in a woman be taken as something to worry about, and needing a special diet or drugs.