Greg Alexander

Go Red for Women

Mason-Dixon Arrive, February 2009

Heart disease is the No. 1 killer of American women. It’s an indisputable fact, proven by the American Heart Association (AHA); however, many women are at great risk for some form of heart disease – or are already showing symptoms of heart disease – and are not aware of their condition.

To help better educate women, the AHA launched the “Go Red for Women” campaign in 2004 to promote the fact that almost a half million American women die each year due to cardiovascular disease, a fact that many women still don’t take to heart.

Who’s at Risk?

While all women should be cognizant of heart disease and aim to live a healthy lifestyle, there are certain risk factors that increase your risk of developing heart disease. Hypertension (high blood pressure), diabetes, elevated cholesterol levels, moderate obesity and tobacco use are some of the leading risk factors, says Dr. George D. Bittar, MD, FACC, an interventional cardiologist, a specialty that deals with catheter based treatment of structural heart disease, at Union Memorial Hospital in Baltimore.

Dr. Bittar adds that if you have a blood relative with heart disease, your odds of developing heart disease significantly increase. That’s why the AHA recommends that all women map out a family tree and indicate whether any of them have or had diabetes, stroke, high blood pressure, heart attack or any other heart disease. The AHA points out that while heart disease can be passed on to younger generations, so can healthy eating habits and physical fitness habits.

“People who have had previous heart conditions or a stroke are also at a higher risk of developing future heart conditions,” says Dr. Bittar. “Also in a higher risk category are certain demographics. For example, Asian-Americans, due to their smaller body size, tend to have smaller arteries, increasing their risk for blockage, and Indian and Pakistani women are at risk due to a diet that may contain a high number of saturated fats. Also, African-Americans have a predisposition for higher blood pressure.” In fact, according to the AHA, nearly half of all non-Hispanic African- American females have some form of heart disease, stroke or other cardiovascular disease. Additionally, blacks are 1.5 times more likely to die from heart disease than whites, have almost twice the risk of first-ever stroke compared to whites, and blacks 35-54 years old have four times the relative risk for stroke.

Another factor once associated with heart disease is pregnancy. “There has always been a debate on whether pregnancy increases women’s risk of heart disease. In the past, hormone supplements were given to pregnant women to combat heart disease; however, studies showed that this increased women’s risk for breast cancer. In the end, most studies concluded that pregnancy did not contribute to heart disease,” says Dr. Bittar. “A woman’s smaller body frame, like Asian-Americans, does increase the risk of heart disease due to the smaller arteries, and treatments and equipmentlike stents can be more challenging in women.”

What Can You Do?

“Knowing your critical numbers is very important,” says Dr. Bittar. “Every year, we decide that optimal cholesterol numbers could be lower. In the past, any number below 200 was considered positive; however, I tell patients to focus less on the total cholesterol number and instead focus on good cholesterol, HDL, vs. bad cholesterol, LDL. If you have no history of heart disease, strive for LDL numbers less than 100. If you are at high risk of heart disease, especially if you have a history of heart disease, strive for less than 70. For HDL, or good cholesterol, a number in the mid- to high-40s is great; however, it is difficult to raise HDL numbers,” says Dr. Bittar. “Also important is your number of triglycerides, which should be less than 150.” The AHA also recommends a blood pressure level less than 120/80 and a blood sugar level less than 100.

Diet plays a major role in decreasing your risk of heart disease. The AHA recommends steaming, broiling, baking, grilling or roasting foods, considering that fried, sautéed and au gratin foods are high in fat and calories. Even when eating out, especially in Mexican, Indian and family-style restaurants, there are steps you can take to ensure a healthier meal; visit for more details. The AHA also touts 30 minutes of exercise a day, 60 minutes for those aiming to lose weight. “If you’re a smoker, try quitting or at least cutting back,” adds Dr. Bittar.

What Are the Symptoms?

“Of course, the No. 1 symptom most women are familiar with is chest pain. For years, when women were experiencing chest pain, many times it was assumed that it was gastrointestinal related; however, now when a woman has chest pain, especially those over 50 years of age, heart disease is now the first concern. Chest pain located at the sternum or left of the sternum is an obvious warning sign of a potential heart attack, as is left arm pain, numbness in the jaw or teeth and nausea. One of the problems with heart disease is that most people assume that chest pain would be the first sign, but many times other symptoms may occur first,” says Dr. Bittar, who adds that diabetics, for some reason, usually don’t experience chest pain but may be, in fact, having a heart attack.

“For any symptom that you experience for a long period of time or after exertion, assume that it’s a heart attack,” says Dr. Bittar. “Call 911. Go the hospital. Don’t wait until tomorrow. It’s not worth the risk.”

For more information on heart disease, tips to decrease your risk and heart-smart recipes, visit

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