Women and heart disease

Ask any woman which disease she's most afraid of, and the reply you will usually get is breast cancer. The reality however is very different; heart disease kills more women than any other disease. This comes as a surprise to most, as heart disease was always thought to be a 'man's disease'. In reality, women are as much at risk for heart disease as men are, but are protected by their hormones till they reach menopause.

The hormone estrogen is responsible for the strengthening of arteries but risks posed by lifestyle changes are overpowering the protection given by estrogen. Risk factors such as smoking, erratic working hours, obesity and stress are no longer associated only with men. In India, within the next 10 years, it is expected that one out of every three women will die of heart disease.

Another sad statistic is that a much larger percentage of women die within one year after having a heart attack, as compared to men. The reasons for this are not well understood yet. One possible explanation is that women tend to get heart disease later in life and are therefore more likely to have co-existing chronic conditions. Women also tend to get less treatment than men, because they are typically not the main earning member of the family. This is seen all over the world and in our country as well.

Dr Panda is vice chairman and managing director, Asian Heart Institute

• Women who smoke are at risk of having a heart attack 19 years earlier than non-smoking women.
• Women with diabetes are three to seven times more likely to have heart attacks.
• Women are almost twice as likely as men to die after by-pass surgery.
• Women often do not have the typical symptoms of angina (chest pain radiating to the arms) or other symptoms. associated with a heart attack. Therefore they are often not diagnosed correctly and in appropriate time.
• Women are 20 per cent more likely than men to die in the hospital following a heart attack.
• Women receive less aggressive treatment than men for their heart disease.

• 5-a-day: Eat at least five servings of fresh fruits and vegetables for a healthier heart.

• Banish that salt shaker from the dinner table. Never add extra salt to your food. Excess sodium intake causes hypertension.

• If you must drink, ensure that it's no more than two drinks a day for men and a drink a day for women.

• Walk for your heart. It's the best heart-healthy exercise and will not cost you a rupee. Every step you take during the day builds up your heart balance and helps prevent disease.

• When you go up, your blood pressure goes down. Take the stairs for a healthier heart.

• Thousands of Indians quit smoking everyday -- by dying. Save your heart and lungs. Smoking also speeds up the development of plaque in the arteries. Quit today.

• Start slowly. Build up to at least 30 minutes of exercise, five times per week. Try two 15-minute sessions or three 10-minute sessions to meet your goal. However, don't exercise right after meals, or when it's very hot and humid. Always warm-up before you exercise and cool down after you are done.

• Substitute lower-fat foods for higher-fat ones. Some examples include skim or 1 per cent milk instead of whole milk. Saturated fats are typically solid at room temperature. Try the squeeze test: the firmer the fat, the more it's saturated. AVOID AT ALL COSTS!

• Reduce your sodium intake to no more than 2,400 mg of sodium or 1 1/4 teaspoons of salt per day.

• Know your numbers. The first step towards better heart health is to know where you stand currently. For that it is very important for you to know your health numbers. Get your lipid profile, blood sugar levels and BP regularly checked. Have regular physical exams that include tests to see if, your are at risk for cardiovascular disease.

• Don't let the weighing scale rule you. It is important to maintain a healthy weight, according to your height, but it is more important to eat a healthful diet and exercise regularly.

• Follow your grandparents. Every day fad diets spring up, and foods tend to go in and out of fashion, as fast as clothes. The 'sensible diet' preached and followed by our forefathers is the best for health. Eat healthy and don't crash diet.

• Get yourself checked. Keep a tab on your last visit to your doctor. Don't miss your follow-ups. It is always advisable to go in for a complete health check-up at least once a year.

• Sugar is not so sweet. If you have diabetes, keep the blood sugar under 'tight control'. Remember, physical activity is the best way to burn off excess sugar in the blood. Those with diabetes are more prone to heart disease, especially women.