The Silent Killer

by Tondalaya Dix MS, CRNA, ARNP

As a modern day woman, we wear many hats.  We have excelled and navigated to become professional career women.   We are mothers, nurturers, wives, and companions. We often wear more than one of these hats at any time.  We have perfected the art of multitasking and find ourselves saying, it’s all in a day of work.

While we successfully balance the activities of daily living, we must also stay informed and take charge of our health.  We must be mindful that an ounce of prevention is worth a pound of cure.   It is important to incorporate annual wellness exams with your healthcare provider. These preventative exams may help to detect the “silent killers” that affect thousands of women every year.  In this 3 part series over the next few months ahead, we will explore how heart disease, hepatitis, and cervical cancer are just a few of the many devastating illnesses women face.  Part I begins with heart disease.

Heart disease can affect women of all ages.  It is acquired through stress, diet, smoking, lifestyle habits, genetics and other illnesses that stress the heart.   The statistics are staggering with more than 267,000 deaths occurring in women as a result of myocardial infarction or more commonly known as a heart attack.  Of the 267,000, 9,000 of those deaths occur in women less than 45 years of age (Zblerajewski-Eischeld, Loeb 2010).  Women who experience myocardial infarctions have “atypical symptoms” meaning the symptoms are not always what one would expect and one may attribute the symptoms to some other common ailment.  Most people identify the signs of a heart attack as chest pain, difficulty breathing, pain that radiates to your left arm, sweating etc… for women it may not be that cut and dry.

Symptoms of an impending heart attack can be back pain, jaw pain, nausea, vomiting and heartburn.  The first step in prevention is education, recognizing what is abnormal and taking charge of your health.  Remember you are your best advocate!    The strongest predictor of having a myocardial infarction is having a history of a previous attack ( Miller, Oparil 2003).  Other risk factors for heart disease include but are not limited to:   hypertension, diabetes, smoking, obesity.

First Risk Factor
The first risk factor noted is hypertension more commonly known as high blood pressure.  Optimal blood pressure is less than or equal to 120/80.  Hypertension occurs when blood pressure is elevated to 140/90 on one or more occasions at least two weeks apart  (Dierdorf, Stoelting 2002).    There are two types of hypertension:  Essential hypertension, the etiology of the hypertension cannot be identified and Secondary hypertension, the cause of the hypertension is associated with an identifiable cause such as kidney disease (Dierdorf, Stoelting 2002).  The risk of hypertension increases with age and is more prevalent in African Americans.

Second Risk Factor
The second risk factor for heart disease mentioned is diabetes. Diabetes occurs when blood glucose (blood sugar) is abnormally elevated on routine lab work or a fasting glucose test.  Diabetes that occurs in adulthood is most commonly considered Diabetes type II.  This occurs when the body has developed a resistance to insulin, the hormone that lowers blood glucose.  The normal value for blood glucose is 70-100. Common symptoms of diabetes in women are recurrent yeast infections, increased thirst, frequent urination, and weight loss.

Third Risk Factor
The third  risk factor is smoking. Smoking  increases heart disease because it contributes to atherosclerosis or hardening of the arteries over a period of time.   This increases the work of the heart muscle and increases blood pressure.  The final risk factor mentioned is obesity. Obesity is classified when body weight is 20% above ideal body weight.   A measure of obesity is the Body Mass Index or BMI (Dierdorf, Stoelting 2002).  A normal BMI is 18.9-24.9.  Obesity is classified as a BMI of 30.  BMI is determined by a simple formula of weight in lbs/height in inches squared multiplied times 703.  For example a woman that is 140 lbs  5’5” (65”) would have the following BMI:  140/65”x65” (703),  BMI=23.

Heart disease does not have to be a silent killer.  Educate yourself and family members, make simple life style changes such as diet modification. A diet low in fat, high in fiber infused with fruits and vegetables are heart healthy choices.  Opt to bake meat as opposed to frying, reduce sodium intake, hydrate your body with water and skip on the juices and carbonated beverages high in calories and sugar.  It’s ok to indulge at times, but in moderation.  It is difficult to implement exercise after a long day of work.

Exercise is a lifestyle change and you have do what works for you; perhaps exercise during your lunch hour for half an hour or early in the morning for an half hour before heading out to work. Consistency is  key!  If you have a history of heart disease or other illnesses, check with your healthcare provider before implementing any type of strenuous exercise.   Don’t skip annual or routine check- ups with your health care provider.  Ask questions during your visit, write them down prior to your visit, and lastly, be forth coming and honest about your health.  The tests that are ordered by your healthcare provider are based on observation and the symptoms the patient (you!) report.  Take care of yourself, take care of your heart!

References

Miller, A., & Oparil, S. (2003).  Secondary prevention of coronary heart disease in women:  A call to action.  Annals of Internal Medicine, 138(2), 150-151.

Stoelting, R., & Dierdorf, S. (2002).   Anesthesia and Co-Existing Disease (4^th ed.).  Pennsylvania:  Churchill-Livingstone

Zblerajewski-Eischeld, S. & Loeb S.  (2010).   Recognizing myocardial infarction in women.

Cardiac Insider, 40, 1-7.