Lifestyle changes can reduce risks

Mildred Rodriguez bicycles with her husband, Hector. At 52, Mildred had open heart surgery following a heart attack. She now works with WomenHeart of Miami Espanol. WomenHeart is a national coalition for women with heart disease. (Photo courtesy of Mildred Rodriguez)
Like many women, Mildred Rodriguez, 65, did not recognize the symptoms of a heart attack. Nor did she know she was at risk.

She did not know that her mother’s heart attack at the age of 62 or her fluctuating blood pressure put her directly in the line of fire.

She attributed the pain in her chest and bloating “gas pains” to a soda she drank at dinner. As for the ache in her left shoulder, she blamed that on a home improvement project she and her husband had recently completed.

She could not account for the excessive fatigue; as a full-time grandmother of eight, she knew life could be exhausting at times. She thought all she needed was a day of rest. That didn’t help either. Though she felt better, she still didn’t feel well.

“Better” was not good enough for Rodriguez’s husband. He insisted she see her doctor. She was glad he did. An EKG indicated that Rodriguez had had a heart attack.

“I walked around for three days with a heart attack,” she exclaimed.

This revelation was only the beginning. She required surgery to bypass six significant blockages in arteries of her heart. When a stress test some time later was abnormal, Rodriguez wound up with four stents to open additional clogged blood vessels.

That was the turning point for Rodriguez. She realized after this second bout of treatment for her heart disease that she needed to take control of her health. She admitted that prior to her attack, she did not know her cholesterol level, nor did she have an inkling where her triglycerides ranked.

“I looked more on the outside,” she said. “I looked healthy; that’s all that mattered.”

She doesn’t believe that anymore. She knew she had to turn her life around. “When you have open heart surgery, you have to have a new way of life,” she said. “If not, you will not live much longer.”

Symptoms of a heart attack can differ in women. Typical symptoms, such as chest pain, neck and jaw pain can be present in everyone. Women may experience shortness of breath, nausea, fatigue and tightness or squeezing in the chest.

Malissa J. Wood, M.D.
Co-Director, Corrigan Women’s Heart Health Program
Massachusetts General Hospital
Heart Center
What’s also different is the length of time to seek treatment. “Women tend to report to the emergency room an average one hour later than men,” said Dr. Malissa Wood, co-director of the Corrigan Women’s Heart Health Program at the Massachusetts General Hospital Heart Center. “They think ‘I know this isn’t cardiac’ or ‘it’s not severe enough to go to the hospital.’ ”

The differences between men and women and heart disease don’t stop at the emergency room. Take plaque, for instance. Plaque is an accumulation of fat, calcium and other waste that clings to the walls of arteries, including those of the heart. If the plaque builds up too much or breaks off and forms a clot, it can rob the heart of much needed oxygenated blood. This accumulation of plaque is the culprit behind angina, or chest pain, or heart attacks. The causes of plaque are many — smoking, high blood pressure, diabetes and inflammation, to name a few.

But plaque can build up differently in women, according to Wood. Instead of rupturing and causing a clot that typically happens in men, the plaque sloughs off bit by bit in women. That partly explains the differences in a heart attack in women. While men’s attacks can be sudden, in women they are more gradual.

Another problem is that plaque can build up in smaller arteries of the heart resulting in what’s called microvascular disease, or cardiac syndrome X. This makes diagnosis — and treatment — difficult. “Some of the diagnostic and treatment procedures are designed for the larger arteries of the heart,” explained Wood.

The good news is that heart disease is highly treatable with good success. Treatment ranges from medication to open heart surgery.

It is also highly preventable. And that is Woods’ mission. She developed HAPPY Heart to reduce the incidence of cardiovascular disease in low-income women. The program combines screening and prevention techniques, such as exercise, smoking cessation and stress reduction to reduce their risk of heart disease.

“Many of the traditional cardiovascular risk factors, including obesity, hypertension, smoking and diabetes tend to be more prevalent among low-income women,” said Wood. “Risk factors are cumulative. The more you have the greater your risk.”

Rodriguez doesn’t have to be reminded anymore about reducing her risk factors. She took part in a cardiac rehabilitation program. She consulted a nutritionist to teach her to eat right. She reached out to WomenHeart, the only national organization dedicated to promoting women’s heart health through advocacy, education and patient support.

Rodriguez made a plan and stuck to it. One by one her numbers began to change. “The numbers that needed to go up have gone up, those that needed to go down are down,” she said.

She’s got her exercising down pat, and even bought a treadmill to take away excuses. “We have time for everything but exercise,” she said. If she can’t get in one 30-minute walk a day, she breaks it up into three 10-minute walks. House work adds to her regular exercise routine.

Healthy eating is a challenge. That chicharrón — fried pork skin — is oh so good she admitted, but oh so unhealthy if eaten in volume. She might have a little bit from time to time, but has stopped frying as a regular means of preparing food.

She learned to read food labels. She’s traded her white rice and bread for brown rice and whole wheat bread. She cut down on fatty meats and relies more on fresh vegetables and fruit. Salads are now a staple.

All these changes have paid off. Her BMI is now normal and she has dropped three dress sizes. Her blood pressure is under control, and her diabetes is maintained by oral medications.

Her A1C, a test that shows how well glucose is maintained, hovers around 6 — well within the range expected for people with type 2 diabetes. The doctor told her, “I’m so proud of you.”

Rodriguez gives herself a pat on the back as well. She, too, is pretty proud of herself.

Soledad O'Brien speaks about WomenHeart

Courtesy of WomenHeart


For more on healthy eating and exercise see links below

Healthy eating key to living well

Exercise: The secret weapon for healthy living