The document discusses heart disease as the leading cause of death in women and provides information about risks, symptoms, and prevention strategies. It notes that heart disease symptoms can be more subtle in women and they are more likely to die from their first heart attack than men. The summary concludes by emphasizing lifestyle changes like diet, exercise, and not smoking to prevent heart disease.

1. Women of Summa: It’s Time for a Heart to Heart Vivian von Gruenigen, BSN, MD Chair Obstetrics and Gynecology Women’s Service Line Director Summa Akron City Hospital

2. 5 Leading Cause of Death in All Females, All ages Heart Disease 27% Cancer 22% Stroke 8% Respiratory Disease 5% Alzheimers 4%

3. Differences in gender Women get heart disease later in life Symptoms more subtle Women are much more likely to die from their first heart attack than men Women hesitate to call 911, and get to the hospital ~60 minutes later than men In the past, CV research was done in men Women experience a unique increase in lipids after menopause Matthews KA et al. J Am Col Cardio 2009

4. Differences in Gender The signs and symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks This may be because women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease.

5. What Is Heart Disease? Coronary Heart Disease High Blood Pressure Heart Failure Valve Disease Diseases of Pulmonary Circulation

6. What Have We Learned? Risk Factors Factors leading to heart disease can start in young women and develop over time The Disease Heart disease can strike women at any age Prevention and Treatment Healthy lifestyle changes can prevent or postpone heart disease

7. Why Is It Important? Cardiovascular disease kills 1 in 3 women Tens of millions 64% of women who die suddenly from coronary heart disease have no previous symptoms 80% of cardiovascular disease is preventable

8. What is a heart attack? A heart attack occurs when the blood flow to a part of the heart muscle is blocked Most heart attacks start slowly , with mild pain or discomfort Interrupted blood flow to your heart can damage or destroy a part of the heart muscle .

9. What Is A Heart Attack? Warning Signs Chest discomfort Discomfort in upper body Shortness of breath Cold sweat Nausea Lightheadedness

10. Signs Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue Women also have more symptoms compared to men (2.6 on average vs 1.8 symptoms in men) Approximately one quarter of all myocardial infarctions are silent , without chest pain or other symptoms. The onset of symptoms in myocardial infarction (MI) is usually gradual , over several minutes, and rarely instantaneous. Emergency

11. Stroke Warning Signs Sudden numbness or weakness of the face, arm or leg, especially on one side of the body Sudden confusion , trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking , dizziness, loss of balance or coordination Sudden, severe headach e with no known cause

12. Am I at risk? Vascular injury accumulates from adolescence , making primary prevention efforts necessary from childhood. Risk factors can be modified, treated or controlled and some can’t The more risk factors you have, the greater your chance of developing coronary heart disease “ Deadly quartet” of chronic conditions that includes Diabetes, Obesity, Blood pressure Cholesterol

13. Am I At Risk? If you have any of these risk factors, you are at risk for heart disease.

14. Your Risk: High Blood Cholesterol Cholesterol is a soft, fat-like substance found in the bloodstream and in all your body’s cells The saturated fats, trans fats and cholesterol you eat may raise your blood cholesterol Cholesterol can build up in the walls of arteries, narrowing the flow If a narrowed artery gets blocked by a clot or other particle , the heart or brain loses its blood supply, resulting in a heart attack or stroke www.3dchem.com

15. Your Risk: High Cholesterol- Lipid Profile Includes: Total Cholesterol LDL [low-density lipoprotein] (bad) HDL Cholesterol (good) Triglycerides

16. Your Risk: High Blood Cholesterol Total Cholesterol Level Desirable = Less than 200 Borderline high = 200 to 239 High = 240 and above ~ 50% of women have a total cholesterol of 200 mg/dL and above, which puts them at risk for heart disease. www.nhlbi.nih.gov

17. Your Risk: High Blood Cholesterol HDL – the higher your HDL, the better HDL Cholesterol Risk Levels Less than 50 mg/dL for women Therefore, want > 50 LDL – is the main carrier of harmful cholesterol LDL Cholesterol Risk Levels > 130 mg/dL Borderline, >160 high, > 190 very high Therefore, want between 100-130

18. Your Risk: High Blood Pressure High blood pressure = hypertension (HTN) Blood pressure, is simply the pressure of the blood as it circulates No one knows exactly what causes most cases of HTN HTN is called the “silent killer,” because it increases the risk for heart attack, angina, stroke, kidney failure , heart failure and peripheral artery disease (PAD) 1 in 3 adults has HTN, tens of millions

19. Your Risk: High Blood Pressure Risk Factors Genetics African Americans Over age 35 Overweight Physical inactivity Nutrition Salt, alcohol Diabetes, kidney disease Pregancy

20. Your Risk: High Blood Pressure Normal Blood Pressure Around 120/80 Hypertension Above 140/90

21. Classification of Blood Pressure in Adults OPTIMAL: <120 systolic and <80 diastolic PREHYPERTENSION 120-139 systolic or 80-89 diastolic STAGE 1 HYPERTENSION 140-159 systolic or 90-99 diastolic STAGE 2 HYPERTENSION >160 systolic or >100 diastolic

22. Your Risk: Diabetes Incidence is increasing Type I Diabetes – also called juvenile The body fails to make insulin Type II The most common 95% of Americans Middle-aged. Linked with obesity and physical inactivity. The body doesn’t make enough.

23. Your Risk: Diabetes Complications of Diabetes Stroke, TIA Blindness Heart attack, angina Kidney disease High blood pressure Erectile dysfunction Loss of legs or feet Nerve disease People with diabetes are two to four times more likely to develop cardiovascular disease.

24. Your Risk: Diabetes Prevention and Control Control your weight and cholesterol (low-saturated fat and low-cholesterol diet) If you take medicine, take it exactly as directed Discuss exercise with your physician Nutritionist consult/team

25. Your Risk: Obesity & Overweight The majority of Americans are overweight Excess Weight : Strains your heart Raises blood pressure and cholesterol Can lead to diabetes

27. Your Risk: Obesity & Overweight Set goals, potential roadblocks Lifestyle change, not a diet You may need help or support Team approach Keeping weight off can be as challenging as losing it

28. Your risk: Physical inactivity Regular, moderate-intensity physical activity can lower your risk of Heart disease and heart attack HTN High cholesterol Overweight or obesity Diabetes Stoke Cancer

29. Your risk: Physical inactivity Inactive women: White females – 38% Black females – 52% Hispanic females – 54% All healthy adults ages should be getting at least 30 minutes of moderate intensity activity 5 days a week

30. Your risk: physical inactivity Most Americans favor walking as their favorite physical activity Many places - at home, local parks, YMCAs, travel… Many types – swim, resistance, ski, golf… Find your sole-mate or mates Family, friends, colleagues Stay motivated

32. Your Risk: Smoking Benefits of Quitting Within 1 to 2 years of quitting, the risk of coronary heart disease is substantially reduced A smoker’s cough will go away It is easier to be physically active Second hand smoke is real

33. Your risk: Nutrition Quality Be aware of calories Low fat Lean meats Fiber, whole grains Low fat dairy Fruits and veggies Diversify your colors Whole foods versus processed White food…sugar Limit fast foods Super size me

34. Decreasing your sodium intake: where is salt found in our diets?

35. Your risk: Depression Depression is twice as common in women as in men, and it increases the risk of heart disease by 2-3 times Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment Talk to your doctor if you're having symptoms of depression

36. Your risk: HRT Can estrogen replacement therapy reduce my risk for heart disease? No. Estrogen replacement therapy, also called hormone replacement therapy (HRT New studies have shown that when it comes to heart health, HRT may do more harm than good. If you’re taking HRT to help prevent heart disease, talk to your doctor about whether you should stop.

37. First aid Call for help Aspirin Oxygen Nitroglycerin Automated external defibrillator (AED) Opiod painkillers Air travel kits

38. Women in Recovery and Rehabilitation after a Heart Attack The first year following a heart attack, women tend to have a higher rate of disability and death , and show poorer psychological adaptation than men. Social support and mood were the best predictors of overall quality of life at one year for women Those with more social support tended to have a higher rate of persistency, while a belief in the positive health benefits of exercise increased the amount of exercise undertaken by the participant. Moore SM et al J Cardio Rehab 2003

39. What Can I Do To Prevent Heart Disease? Eat a healthy diet low in saturated fat, trans fat, cholesterol and sodium. Keep your weight under control. Be physically active at least 30 minutes on most or all days of the week. Control your blood pressure and cholesterol levels. Manage your blood sugar if you have diabetes . Don’t smoke , and avoid tobacco smoke. Taking your medicines as directed by your physician

40. What Can I Do To Prevent Heart Disease? You are here You are an advocate You are educated Teach those who are not as fortunate Lead by example Grass roots

41. “ Women, whether subtly or vociferously, have always been a tremendous power in the destiny of the world.” Eleanor Roosevelt

42. Be the kind of woman that when your feet hit the floor each morning the devil says~~ &quot;Oh crap , She's up!“ Email from Aunt Jeanette

43. Questions? YOU are beautiful, smart and have the power to make a difference