Monday, February 2, 2004
Black women are at greater risk of heart disease than other women.
By TRACEY D'ASTOLFO
VINDICATOR CORRESPONDENT
Lily M. Wagner, 72, is black and diabetic, two factors that increase her risk of heart disease.
In January 2003, after suffering some mild chest pain, Wagner was told she had 70 percent blockage in the arteries of her heart. She underwent triple bypass surgery to remove the blockage.
Diagnosed with diabetes in 1985, she has followed an exercise regimen and stuck to her diabetic diet.
"Following your diet and exercise are key issues, especially with diabetics," she said.
She is also aware that black women are at a higher risk.
According to the American Heart Association, it is crucial for women to educate themselves about the risk factors for heart disease. Being aware of these factors, some of which can be controlled and some which cannot, is key to possibly preventing a heart attack.
Heredity and age
One risk factor that can't be controlled is heredity, including race. The AHA reports that black women face a greater threat of death from heart disease than women of other races.
Studies show that between the ages of 35 and 74, the 1995 death rate of black women from coronary heart disease was more than 71 percent higher than that of white women.
Children of parents with heart disease are also at a higher risk, reports the AHA, especially if their parents suffered a heart attack when younger than 60.
Another risk factor women can't control is increasing age. Women over age 65 are at more risk of heart disease than younger women, according to the AHA.
However, there are many factors women can control.
The single biggest controllable risk factor for heart attack is smoking, according to the AHA. Studies show that a smoker's risk of heart attack is more than twice that of a nonsmoker, and that smokers who have a heart attack are more likely to die suddenly (within an hour) than nonsmokers.
Evidence also indicates that chronic exposure to secondhand smoke may increase the risk of heart disease.
Other controllable factors include high cholesterol levels, high blood pressure, physical inactivity, obesity, diabetes and stress.
Testing for disease
Dr. Joseph A. Graziano, a cardiologist at the Heart Center of Northeastern Ohio and president-elect of the Youngstown branch of the American Heart Association, said women younger than 50 aren't routinely tested for heart disease unless they are at a high risk for it.
Dr. Graziano said one test that is recommended, even for women with low heart-disease risk, is a lipid profile to check cholesterol levels. If your cholesterol is high, your doctor can recommend measures to reduce it, such as diet changes or medication.
Studies show that some screening tests, including the exercise, or treadmill, stress test, are not as accurate for women as they are for men.
For example, in young women with a low likelihood of coronary heart disease, an exercise stress test may give a false positive result. In contrast, single-vessel heart disease, which is more common in women than in men, may not be picked up on a routine treadmill test.
In one study comparing the accuracy of treadmill tests in women and men, misleading treadmill results occurred in 35 percent of the women studied. This may result in a heart attack or stroke not being detected until later, which leads to more serious consequences.
Dr. Graziano said stress tests are usually not routinely given to people under age 50 unless somebody has an increased risk or symptoms of heart disease, such as trouble with exertion or chest pressure.
"Generally there aren't really any recommendations out there to routinely do stress tests on anybody, male or female. The only time we try to do them routinely would be if somebody wants to pursue an exercise regimen, and they're pretty sedentary," he said. "Most people, when they start exercising, are going to be short of breath because they're out of shape."
Other methods
The noninvasive and less invasive diagnostic tests that are more precise, including thallium, sestamibi or echocardiographic stress tests, also tend to be more expensive, according to the AHA, because they involve costly drugs and expensive machinery. However, such stress tests may be preferable in elderly women who cannot endure the physical demands of treadmill testing.
Although keeping on top of heart health may seem overwhelming, the AHA recommends simple ways to take control. Educating yourself about the risks and warning signs of heart disease, quitting smoking, keeping your cholesterol levels in check, letting your doctor know if heart disease runs in your family, eating less fat and participating in regular, moderate-to-vigorous exercise can all play a significant role in preventing heart and blood vessel disease.
If you have diabetes, it's critically important to monitor and control any other risk factors and keep glucose levels under control. More than 80 percent of people with diabetes die of some form of heart or blood vessel disease, according to the AHA.