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Understanding a woman's heart

When it comes to the heart, women are different from men. A rundown on major preventive factors and tips for the rest of the family by Dr. GEORGE THOMAS.


Adopt a healthy lifestyle...a diet that is low in fat is Ideal.

Ay me, how weak a thing

The heart of woman is!

"Julius Caesar" by

William Shakespeare

A WOMAN'S heart may be `literally'. But medically her heart is stronger than a man's. This is nature's way preserving the human race.

Nature has various tricks up its sleeve to protect a woman's heart. The most important shield is the female hormone. But, the woman is protected only during the childbearing and rearing period. Once that is over, all protection conferred on her is withdrawn.

Nature gives a woman immunity from ischaemic heart disease. An uninterrupted supply of blood, which contains oxygen and nutrients, is essential for the proper functioning of the heart. Although the heart is a reservoir of blood, it cannot utilise the blood in its chambers — like a chef who is not permitted to eat in the hotel kitchen. So the heart receives blood through the "coronary arteries". Ischaemic heart disease occurs due to a decrease in this supply. This is usually due to obstructions in the coronary arteries or coronary artery disease. Small obstructions usually do not cause symptoms. However, symptoms occur when the blockage is 70 per cent or more. This will critically impede the flow of blood and hence the delivery of vital oxygen to the heart muscles. The cry of a choking heart manifests as chest pain (angina) or experiencing shortness of breath.

When it comes to the heart, women are indeed different from men. Ischaemic heart disease is a leading cause of death and disability. Fortunately it is less common in women of childbearing age. This does not mean that women cannot get ischaemic heart disease. Nature's protection has its limits. If you pay scant heed to health by adopting a reckless lifestyle then nature also will desert you.

Smoking may not be the cardinal risk factor in women in India. But for those who smoke there is no alternative but to quit. Actively discourage everyone in the family from smoking. Passive smoking is as dangerous as active smoking. Some experts condone moderate alcohol consumption. But it is better to abstain because the dividing line between benefits and harm is too blurred.

Fat content or "cholesterol" is another risk factor. These are made up of HDL (good cholesterol), LDL (bad cholesterol) and triglycerides. Low levels of HDL appear to be a stronger risk factor for women over 65 than for men over 65 years of age. Triglyceride levels may also be a significant risk factor for women, especially older women. Many heart experts now suggest an optimum goal for women for LDL under 130 mg, HDL over 45 mg and triglycerides under 150 mg.

High blood pressure (hypertension) is a treatable risk factor. Treating and controlling hypertension can reduce heart disease risk significantly. For details see the article "Did you check your BP" in the Sunday Magazine dated October 14, 2001.

Obesity is strongly linked to heart disease. Preventing obesity in childhood may reduce the number of adults with heart disease three to seven times, compared to a two-to three-fold risk increase in men. To prevent and control diabetes, maintain a healthy weight, stay active and reduce fat intake in the diet.


Heart disease...race makes a difference.

The risk of ischaemic heart disease increases after age 40 in men. In women, the risk rises when they're about 55. Women well past menopause, especially over 60, are at four times the risk as younger women. A family history of heart disease is more common in women with coronary disease than men. Race makes a difference, too. There is a malignant form of coronary disease among people of Asian origin. If there is a history of coronary disease in the family, this is good enough reason to take preventive measures.

For looking after your family's health, you have to look after yourself. A healthy lifestyle means developing a taste for wholesome food. A well-balanced diet should be low in fat, high in fibre and include raw vegetables and fruit.

Lack of exercise is a major risk factor at any age. With modern conveniences, we do not get enough exercise. Make exercise a habit. Start by doing household chores. Make exercise a partnership. Find something which you and your husband enjoy doing together. Like walking or gardening. Be a supportive partner. Married people who have supportive families — especially their spouse — have better heart and blood pressure responses to stress.

Consult your doctor about your weight, cholesterol and blood pressure and what to do if the figures are awry. Take time to relax. Have a siesta. Meditation has a positive effect. A working woman needs to organise her life to balance her professional and family life. Here the family members can help by sharing domestic chores and understanding her professional woes.

Prevention of heart disease should start early in life. And there can be no better person than you for this onerous job. Parents need to teach children a healthy lifestyle at an early age or it will never happen. Tastes are developed. Encourage children to eat food low in fat and salt. Ban junk food and aerated drinks in your family. Encourage children to help you in the kitchen. Talking about good foods while cooking together will leave a lasting impression. Make physical activity a routine too. Today's children are less fit and are more likely to develop heart disease. Encourage children to play outdoors. Cut down on TV and video games. Walking and playing together can make physical activity fun. Give your children household tasks that involve activity. This can improve their performance at school too.

Some special problems related to women need to be mentioned. Angina in young women could be due to a disease in the small blood vessels of the heart. This is usually not a grave problem. If you are on the pill inform your doctor. It could be a cause for hypertension. Some women develop high blood pressure during pregnancy.

If you are suffering from angina, excessive periods could worsen the problem. For women past menopause the question of hormone replacement therapy (HRT) is controversial. This is good for the treatment of menopausal symptoms. But for the prevention of heart disease the issue is unsettled. The current recommendation is that HRT should not be begun solely for this purpose.

With a strong heart, the woman plays a pivotal role in protecting her family. It is important for a woman to be aware of health issues and put such knowledge into practice. This can improve the <243>cardiovascular health of society at large.

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