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	James L. Holly, M.D.

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Your Life Your Health - Women and Heart Disease: Fitness

James L. Holly,M.D.

April 26, 2001

Your Life Your Health - The Examiner

All woman need to know the following facts about heart disease and the risk it poses for them:

After menopause and as they age women are at greater risk for heart disease than men.
More women die from heart disease each year than men.
Heart disease in women is probably under treated and under diagnosed in the United States.
The presentation of heart disease in men and woman is different. (For a discussion of these issues see related artilce(s) below.)

Once these facts are known, what should be done? First, women must know that the same risk factors affect them as affect men. Risk factors are habits or traits that make a person more likely to develop a disease. Many of those for heart disease can be controlled. These include:

Cigarette smoking
High blood pressure
High blood cholesterol
Overweight
Physical inactivity
Diabetes

In addition, for women, elevated trigylcerides are an independent risk factor in and of themselves. And, in women, a low High Density Cholesterol (HDL) seems to be worse than in men. Low estrogen levels after menopause and/or hysterectomy also contributes to the risk of heart disease in women.

The more risk factors a woman has, the greater her risk of developing heart disease. Don't ever forget, coronary heart disease is a woman's concern; it is every woman's concern. One in ten American women 45 to 64 years of age has some form of heart disease, and this increases to one in four women over 65. Another 1.6 million women have had a stroke. Both heart disease and stroke are known as cardiovascular diseases, which are serious disorders of the heart and blood vessel system.

Regular physical activity can help women reduce their risk of coronary heart disease. Being active helps women:

Take off extra pounds,
Control blood pressure,
Lessens a diabetics need for insulin, and
Boosts the level of good HDL-cholesterol.
Some studies also show that being inactive increases the risk of heart attack.

What kind of activity promotes heart health? Even low to moderate-intensity activity can help lower the risk of heart disease. Examples of such activity are pleasure walking, stair climbing, gardening, yard work, moderate-to-heavy housework, dancing, and home exercise. To get heart benefits from these activities, do one or more of them every day. More vigorous exercise improves the fitness of the heart, which can lower heart disease risk still more. This kind of activity is called "aerobic" and includes jogging, swimming, and jumping rope. Walking, bicycling, and dancing can also strengthen your heart, if you do them briskly for at least 30 minutes, three or four times a week.

Most people do not need to see a doctor before they start a gradual, sensible program of physical activity. But do consult your doctor before you start or increase physical activity if you:

Have heart trouble or have had a heart attack
Are taking medicine for high blood pressure or a heart condition
Are over 50 years old and are not used to energetic activity
Have a family history of developing heart disease at a young age

The keys to success in improving the condition of your heart are:

Go slow. Build up your activity level gradually. For example, if you are inactive now and want to begin walking regularly, you might begin slowly with a 10-15 minute walk, three times a week. As you become more fit, you can increase the sessions to every day, and if you wish, you can make each session longer. If you choose a fairly vigorous activity, begin each session slowly. Allow a 5-minute period of stretching and slow movement to give your body a chance to "warm up." At the end of your workout, take another 5 minutes to "cool down" with a slower exercise pace.
Listen to your body. A certain amount of stiffness is normal at first. But if you hurt a joint or pull a muscle or tendon, stop the activity for several days to avoid more serious injury. Most minor muscle and joint problems can be relieved by rest and over-the-counter pain-killers.
Pay attention to warning signals. While regular physical activity can strengthen your heart, some types of activity may worsen existing heart problems. Warning signals include sudden dizziness, cold sweat, paleness, fainting, or pain or pressure in your upper body just after exercising. If you notice any of these signs, stop the activity and call your doctor immediately.
Check the weather report. On hot, humid days, do outdoor activity during the cooler and less humid parts of the day. Wear light, loose-fitting clothing and drink lots of water before, during, and after the activity. On cold days, wear one layer less of clothing than you would wear if you were outside but not exercising. Also wear gloves and a hat.
Keep at it. Unless you have to stop your regular physical activity for a health reason, stay with it. Set small, short-term goals for yourself. If you find yourself becoming bored, try doing the activity with a friend or family member. Or, switch to another activity. The health rewards of regular physical activity are well worth the effort.

Making Opportunities

To become more physically active throughout your day, take advantage of any opportunity to get up and move around. For example:

Use the stairs up and down instead of the elevator.
Start with one flight of stairs and gradually build up to more.
Park a few blocks from the office or store and walk the rest of the way. Or if you ride on public transportation, get off a stop or two early and walk a few blocks.
Instead of eating that extra snack, take a brisk stroll around the neighborhood.
Do housework, such as vacuuming, at a brisker pace.
Mow your own lawn.
Carry your own groceries.
Take an exercise break get up and stretch, walk around and give your muscles and mind a chance to relax.

The motto for exercise is that if you "Move It," you will "Lose It." (This is speaking of weight.) Activity burns calories per hour as follows:

Sitting Quietly 80
Standing Quietly 95
Light Activity 240

Office Work
Cleaning house
Playing golf

Moderate Activity 370

Walking briskly (3.5 mph)
Gardening
Bicycling (5.5 mph)
Dancing

Strenuous Activity 580

Jogging (9 min. per mile)
Swimming

Very Strenuous Activity 740

Running (7 min. per mile)
Racquetball
Skiing

The above figures are for a healthy 140-pound woman. If you weigh more than 140 pounds, you will probably burn more calories per hour. If you weigh less, you will probably burn fewer calories per hour.

Depending upon your age, the following are the target heart rate zones which you should achieve in order to condition and maintain a healthy heart:

20 years 100-150 beats per minute
25 years 98-146 beats per minute
30 years 95-142 beats per minute
35 years 93-138 beats per minute
40 years 90-135 beats per minute
45 years 88-131 beats per minute
50 years 85-127 beats per minute
55 years 83-123 beats per minute
60 years 80-120 beats per minute
65 years 78-116 beats per minute
70 years 75-113 beats per minute

Regular activity can help you feel better because it:

Boosts energy
Helps you cope with stress
Improves self-image
Increases resistance to fatigue
Helps counter anxiety and depression
Helps you relax and feel less tense
Improves your ability to fall asleep and sleep well
Provides an easy way to share time with friends or family and an opportunity to meet new friends

Regular activity can help you look better because it:

Tones muscles
Burns off calories to help lose extra pounds or to help you stay at your desirable weight. Each pound requires you to burn off 3,500 more calories than you take in
Helps control your appetite

Making a decision to improve your physical conditioning is easy once you realize the risk of not doing so. Remember, a quick, fast start is not as important as "keeping at it." Consistency over ten years will make a big difference in your life and health; a short burst of effort for a few days will possibly only result in a sports injury.

Next week, Dr. Robin Merket, the new Sports Medicine Specialist with Southeast Texas Medical Associates will discuss training and injuries in this column.

As you make decisions about your weight, your heart, or your condition, remember, it is your life and it is your health.

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	Women and Heart Disease

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