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SM A H A S P E C I A L R E P O R T women & heart disease

knowing your risk what are your chances? Taking a risk assessment quiz is a good start toward understanding heart health. Check all the boxes in this risk assessment quiz that apply to you. If you check any of these boxes, see your doctor for a complete risk assessment. Age and sex. I am a woman over 50 years of age. Family history. My father or brother had a heart attack before age 55, OR my mother or sister had one before age 65, OR my mother, father, sister, brother or grandparent had a stroke. Heart disease medical history. I have coronary heart disease, atrial fibrillation or other heart condition(s), OR I ve had a heart attack. Stroke medical history. I ve been told that I have carotid artery disease, OR I ve had a stroke or TIA (transient ischemic attack), OR I have a disease of the leg arteries, a high red blood cell count or sickle cell anemia. Blood pressure. My blood pressure is 140/90 mm Hg or higher (high blood pressure), OR a healthcare professional has said my blood pressure is high, OR I don t know what my blood pressure is, OR my blood pressure is 120/80-139/89 mm Hg (prehypertension). Tobacco smoke. I smoke, OR I live or work with people who smoke tobacco regularly. Total cholesterol. My total cholesterol is 200 mg/dl or higher, OR I don t know my level. HDL cholesterol. My HDL ( good ) cholesterol is less than 40 mg/dl, OR I don t know my HDL cholesterol level. Physical activity. I get less than a total of 30 minutes of physical activity on most days. Overweight. I am 20 pounds or more overweight for my height and build. Diabetes. I have diabetes (a fasting blood sugar reading of 126 mg/dl or higher), OR I need medicine to control my blood sugar, OR I have been told I have an impaired ability to control my blood sugar (a fasting blood sugar reading greater than 100 mg/dl). You can reduce your risk of heart disease by first becoming aware of your personal risk factors. Some of them you can change, some you cannot. But knowledge gives you the power to alter your lifestyle to put yourself on the path to better heart health. Call 1-888-MY-HEART to receive a free red dress pin, Go Red For Women brochure and wallet card. 2

reading the signs warning signs of heart attack Afew heart attacks are sudden and intense, but most heart attacks start slowly, with mild pain or discomfort. Often people aren t sure what s wrong and wait too long before getting help. This is especially true for women. Here are some of the signs that can mean a heart attack is happening to you or someone you know. Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath. This feeling often comes along with chest discomfort. But it can occur before the chest discomfort. Other signs.these may include breaking out in a cold sweat, nausea or lightheadedness. If you or someone you re with has chest discomfort, especially with one or more of the other signs, don t wait longer than a few minutes (no more than five) before calling for help. Call 9-1-1 Get to a hospital right away. Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive often sooner than if someone gets to the hospital by car. The staff is also trained to revive someone whose heart has stopped. You ll also get treated faster in the hospital if you come by ambulance. If you can t access the EMS, have someone drive you to the hospital right away. If you re the one having symptoms, don t drive yourself, unless you have absolutely no other option. To learn more about heart disease, talk to your doctor, use this guide and visit www.americanheart.org or call 1-888-MY-HEART. controlling your risk page 4 managing your lifestyle page 6 discovering the facts page 7 asking for help page 8 This special report is made possible by funding from Pfizer. 3

controlling your risk take action to be healthier Once you know your risk factors, you can take steps to reduce your chances of developing heart disease. Six modifiable health conditions, or risk factors, have been identified as increasing your risk of heart disease. Controlling them, instead of letting them control you, can greatly reduce your overall risk for heart disease. They are: High blood cholesterol High blood pressure Tobacco smoke Physical inactivity Obesity or overweight Diabetes high blood cholesterol Cholesterol is a fat-like substance found in the body s blood and cells. A high blood cholesterol level can cause a buildup of cholesterol, along with other substances in the blood, on the inner walls of the arteries. This buildup, called plaque, can narrow the arteries and reduce blood flow. If plaques rupture, blood clots can form and block blood flow. If a clot totally blocks an artery that feeds the heart, it causes a heart attack. What to do: High cholesterol has no symptoms, so have your levels checked. There are two main types of cholesterol: good and bad cholesterol. Triglycerides, a third blood fat, are also important. They can be checked in the same blood test. In addition to recommending healthy nutrition, regular physical activity and weight loss, your doctor may prescribe medication to control your cholesterol. It is important to take medications as prescribed. Even if your doctor prescribes medication, healthy nutrition and physical activity are still important. high blood pressure Normal blood pressure moves blood smoothly throughout your body. High blood pressure, or hypertension, indicates that the heart is working harder than normal, pushing the blood with too much pressure against the artery walls. That makes the heart and arteries more prone to damage and increases the risk of heart attack, stroke and other cardiovascular diseases. blood cholesterol & blood pressure guidelines 4 Risk Total Cholesterol HDL LDL Blood Pressure High 240 and higher Below 40 Above 160 140/90 and higher Borderline High 200-239 130-159 120/80 to 139/89 Low (optimal) Below 200 60 and higher Below 100 Below 120/80

What to do: Simple activities such as walking, gardening, housework and dancing, as well as moderate to vigorous activity, can improve cardiovascular fitness. The American Heart Association recommends a minimum of 30 minutes of moderate physical activity on most if not all days of the week. The time can be broken up into shorter periods, too, as long as they add up to a minimum of 30 minutes. What to do: As a woman, if you are 20 pounds or more overweight, your chances of developing high blood pressure increase. So losing weight can make a significant difference. Also, pregnancy particularly the third trimester increases a woman s risk of developing high blood pressure. tobacco smoke Smoking is the most preventable cause of death in the United States. Even constantly breathing someone else s cigarette or cigar smoke increases your risk of developing heart and other diseases: stroke, peripheral artery disease, and lung, throat and mouth cancer. What to do: Quitting smoking, and avoiding other people s smoke, will lower your risk of developing all these diseases. physical inactivity Inactivity increases your likelihood of developing heart disease. obesity or overweight Too much body fat especially around your waist puts you at higher risk for heart disease, even if you have no other risk factors. Obesity raises the risk of other conditions, as well: high blood pressure, high blood cholesterol, stroke and diabetes. What to do: Try to reach and maintain a healthy weight. To lose weight, most women should eat 1,200 to 1,500 calories a day, depending on your goal weight and your activity level. Losing one to two pounds or less a week is a healthy weight loss (one pound equals 3,500 calories). Work with your doctor or a registered dietitian to set up a sensible program of eating and physical activity. diabetes Diabetes is a disease in which the body doesn t produce or properly use insulin. This causes sugars to build up too high in your blood. Left untreated, it damages blood vessels, increasing the risk of heart attack and stroke. Overweight, sedentary middle-aged people are at higher risk to develop diabetes, and more women than men get it after age 60. Women with diabetes are two to four times more likely to have cardiovascular disease than non-diabetic women. What to do: Regular checkups by your doctor are critical if you suffer from diabetes. If you are not diabetic but have a family history of diabetes, or are overweight, your doctor can screen you for diabetes. 5

managing your lifestyle get fit, eat healthy More movement, better nutrition help strengthen the heart. be physically active You don t need to be an athlete to exercise. In fact, just think about action and movement instead of exercise. Increase your physical activity to at least 30 minutes a day on most days of the week, even if you do it 10 minutes at a time. Try to include some of these activities in your daily life: Stairs. Use the stairs instead of the elevator. Start with one flight of stairs and gradually build up to more. Housework. Sweep the floor, wash windows or vacuum the carpet at a brisk pace. Plan. Make physical activity appointments with yourself and write them in your daily planner or computer schedule. 6 Walk. Take a walk after dinner. If the weather is bad, march or jog in place while watching television. Walk more. Park a few blocks from the office or store and walk the rest of the way. Move. When you sit for long periods, take an activity break. Get up, stretch and walk around. eat healthy Choosing healthier food can help you reduce three risk factors for heart attack and stroke high blood cholesterol, high blood pressure, and obesity or overweight. Consider these nutritional tips: Keep balanced. Eat fruits, vegetables, cereal and grain products, fat-free and lowfat dairy products, legumes, nuts, fish, poultry and lean meats. Low fat. Eat foods low in saturated fat and cholesterol. Less salt. Eat foods low in sodium to maintain a healthy blood pressure. Don t eat alone. Eat with other people. You will eat less than if you eat alone. Snack attacks. Know your snack triggers and plan ahead. Be ready with healthy snacks to fight the urge for high-calorie and high-fat foods. If improved nutrition and increased physical activity are not enough to help you reach your goals, your doctor may prescribe medication. Be sure to take all medications as prescribed and don t stop taking them, even if you feel fine. Review your medications with your doctor at each visit.

discovering the public enemy no. 1 facts Heart disease is not a man s disease anymore. Heart disease is the No. 1 killer of women over 25. Cardiovascular diseases kill nearly 500,000 women each year more than the next seven causes of death combined. About one in every 2.5 women will die of heart disease and stroke, compared to one in every 30 women from breast cancer. Although one-in-five women in the United States have cardiovascular disease, more than half of those who die suddenly of coronary heart disease have no previous symptoms. Men are generally considered the main sufferers of heart disease, but in 2001, women made up 53.6 percent of all deaths in the United States from heart disease and stroke. Heart disease is serious business for women. 7

asking for help you have the power to go red Visit our Web site and sign up for these free Go Red For Women programs. Choose To Move is a 12-week program that helps women take a first step by increasing their physical activity and improving their dietary habits. Simple Solutions provides tips about healthy nutrition, physical activity and other ways to live a heart-healthy life. Call 1-888-MY-HEART to receive a free red dress pin, Go Red For Women brochure and wallet card. I will make my health a priority. how do you Go Red For go red? Women is the American Heart Association s national campaign to raise awareness about women s No. 1 killer, heart disease. Join the movement, and commit today to take action to reduce your risk of heart disease and stroke. I will schedule and keep a doctor s appointment. I will be here for my child s wedding. I will take time for myself. I will celebrate my successes. a division of 2004 The StayWell Company 407 Norwalk St., Greensboro, NC 27407 www.staywell.com All rights reserved.