Heart Disease in Women

 I'm very excited to be talking today in during Heart Month which is a very important heart awareness campaign and I want to talk to you guys today about the differences between heart disease and women and men and I'm gonna talk a lot about the differences in you know specifically and the diagnosis of heart disease the risk factors prevention and some interesting differences between the different ways that when men men and women respond to certain medications so  I look forward to hearing from you and thank you for joining us again so heart disease is one of the leading causes of death and women and it's mostly due to disease in the heart and also to stroke it's actually more common cause of death than cancer and this is often surprising I don't know that many of us are aware that heart disease is actually the number one killer actually outperforms cancer across the board and because of its high mortality it's also it's responsible for a huge costs in this country greater than 400 billion dollars a year treating heart disease in this country you know if you look at the the top nine causes of death in women across the United States heart disease is at least three to four times you know more prevalent  than stroke significantly more than breast cancer as you can see breast cancer is actually number six so even though we are all aware of the the off awful you know a problem with breast cancer in this country heart disease is actually extremely important and us being women are significantly at risk the good news is that since the 80s you know we've all recognized heart disease being a significant killer in the United States men have actually had a significant improvement over the years with the technology specifically newer medications.                                                                                                                    you know our emphasis on diet an exercise changing our patterns in this country our eating habits and of course in the technologies and now we have for treating heart disease this sort of more concerning aspect is that women although we've had significant improvement since the 80s the rate of improvement is much slower and lags behind that of men so we really have some work to do with respect to improving outcomes and women in the United States if you look at you look at the you know take a female over the age of 40 and you project her 10-year 20-year risk of having a heart attack or stroke and you look at two different women one woman who's a smoker who has high blood pressure and another who does not smoke and has normal blood pressure normal cholesterol there's a huge difference in their risk future event rates so that we're talking about at least a 10 fold change increase in risk if you are a smoker or if you have high blood pressure or high cholesterol yo can be the same female and not smoke and reduce that risk by a significant period amount so the good news is even though it's very prevalent it's actually something that we can control significantly with just our risk factors unfortunately there are there are also some other risk factors that may be more difficult to control there is diabetes which can sometimes we're born with diabetes but oftentimes that can also be exacerbated by being overweight lack of exercise and then having insulin resistance which is kind of a pre-diabetic State I don't know if how many of you heard about the metabolic syndrome but having metabolic syndrome is almost as significant of a risk factor as having diabetes itself in terms of your risk of having a heart attack or stroke in the future and I'll show you some of that in addition there are other risk factors like triglycerides and I'm not sure that we talked about triglycerides a lot we talked a lot about cholesterol and in the you know in the news there are a lot of medications like I'm sure many of you have heard of such as statins which are important in reducing cholesterol but they don't necessarily have as much of effect on the triglycerides which are a different type of cholesterol which also seems to be extremely harmful in women as opposed to men in addition there are certai dietary patterns that can be more harmful in women as well such as excess carbohydrates and we talked about the metabolic syndrome it's actually defined by just having a waist circumference greater than 40 inches in men 35 inches in women you you would have to have a high triglyceride level greater than 150 low HDL HDL is the good cholesterol so a high triglyceride a low HDL high blood pressure and a high fasting glucose you only need three of those following three of these factors to actually be diagnosed with the metabolic syndrome again this is a pre-diabetic syndrome if you look at patients who have metabolic syndrome and you compare women and men women are more likely and more at risk to die of heart disease if they have metabolic syndrome than men so it's extremely important that we recognize metabolic syndrome in women and we are aggressive in management so that we can improve our outcomes in addition.                                                                           we really need to start making changes at a much earlier age and this is something that I'm not sure we recognized several years ago so yes it's true that there are less women that have heart disease before menopause and post menopause but I think that the numbers are still probably under recognized and and you know and I think we probably need to do some more studies on that topic what is the link between heart disease and diabetes and women's so the the study I was discussing about metabolic risk  I want to try to go back of higher risk of heart disease than patients who don't have the metabolic syndrome and that this was more prominent in female patients this is very similar to the trends and diabetes but diabetes is an important risk factor again for both men and women so not to be overlooked is the risk of death from heart disease higher for black women so that's a good question so you know there certainly are differences in both racial and gender differences and heart disease I would say that that black women are at least as much at risk as the general population and that it probably is an area that needs further research as well but yes I think that that black women are particularly at at risk of heart disease and this is often a you know population that gets under treated under recognized and as something we need to focus on so what can women do after menopause to reduce their risk of heart disease so the things that we can do our basically lifestyle modifications so really seeing your doctor regularly checking your blood pressure you know blood pressure is something that is silent it's often something that we don't know we have high blood pressure until maybe your of being untreated so I would say seeing your doctor regularly checking your blood pressure making sure that you are up-to-date on all your blood work that you have a diabetic screen that your cholesterol profile is up-to-date and really that you really follow a healthy diet and exercise those would be the main things that I recommend obviously things like smoking you know highly highly highly encourage that by that time that you would that wes hould obviously not be doing but specifically after menopause I would say you know all the other risk factors that are preventable like blood pressure weight management of diabetes and smoking cessation will be the big ones so but it all right well.