By: Dr. Melissa Grimm, General Internal Medicine
Cardiovascular disease is the leading cause of death among U.S. women. In fact, for women the average lifetime risk for some type of cardiovascular disease is high, approaching 1 in 2 women. But what can we do to prevent cardiovascular disease and how do we know if we are at high risk?
The presence of any one or more of these risk factors constitutes a high risk of future cardiovascular events such as a heart attack or a stroke:
- History of coronary heart disease, such as a previous heart attack or stent placement or history of coronary bypass surgery
- History of cerebrovascular disease, such as a previous stroke or TIA (mini-stroke)
- Peripheral artery disease, which may cause pain in the legs with walking due to lack of blood flow through the arteries
- Abdominal aortic aneurysm
- Diabetes mellitus, type 1 or type 2
- End stage kidney disease
- 10-year risk of cardiovascular disease ≥ 7.5%, based on other risk factors such as blood pressure, cholesterol, and smoking status
If you have any of the above, controlling other risk factors is known to decrease future risk. Therefore, keeping blood pressure and cholesterol under control using medication and lifestyle modifications is very important. Smoking cessation is extremely beneficial. Also, daily aspirin therapy (either a baby aspirin or full dose aspirin) should be used unless it is not tolerated due to a history of gastrointestinal bleeding.
If you do not have any of the above, you still may have a high lifetime risk of cardiovascular disease. This is dependent on the number of other risk factors that are present and they tend to have a cumulative effect. These include:
- High blood pressure: Defined as BP ≥120/80, or if being treated for blood pressure with medication. Even a slightly high level doubles the risk of heart disease.
- High cholesterol, or being treated for cholesterol. About one-third of American women have high enough cholesterol to pose a serious heart disease risk.
- Cigarette smoking: Almost as many women smokers die from heart disease as from lung disease.
- Sedentary lifestyle
- Poor diet
- Poor exercise capacity on treadmill testing
- Obesity: At 20% or more over ideal weight, particularly in abdomen, the risk of heart disease increases.
- Family history: if you have a blood relative with heart disease (men < 55 years old or women <65 years old), your risk significantly increases. The more you know about your family health history, the more you can do to protect yourself.
- Metabolic syndrom
- Inflammatory arthritis: Such as lupus or rheumatoid arthritis
- History of pregnancy complications of preeclampsia, gestational diabetes or pregnancy-induced hypertension
How these risk factors are approached can make a difference in the success of improving your health. Knowing which of these risk factors can be modified by lifestyle changes and to what extent is important. Work with your provider and health care team to guide you as lifestyle modifications are always important, but may not always be enough.
In regards to lifestyle changes, it is often problematic when people try to make “all-or-nothing” changes searching for a “perfect” solution to eliminate their risk of disease. This can become overwhelming and can be a set-up for failure.
It can be more helpful to think of making changes as a lifelong process, setting small reasonable goals that are easily accomplished and can be maintained. These changes become habits and can be motivating to make further changes.
Meriter offers many different wellness options to guide individuals in making healthy lifestyle changes. This includes our Women’s HeartCare Program which provides the multidisciplinary guidance of a nutritionist, exercise physiologist, health psychologist and physician to support women to better heart health. Meriter also offers a very successful Smoking Cessation Program and interdisciplinary Diabetes Care Team among many other resources. For more information, visit meriter.com/wellness.