Galveston County Daily News February 18, 2014
By Dr. Rafic Berbarie
“I’m worried about my risk of having a heart attack.”
Whenever I start my office notes in seeing patients, the first line I fill out is the patient’s chief complaint. The above statement is a common complaint in my general cardiology practice. But often the patients have no symptoms; rather, a friend or loved one just had a heart attack and so they are worried and want a heart “checkup.”
February is heart disease awareness in women month, and as a physician, I want you to know what can be done to help prevent heart attacks.
While awareness is growing, people are often shocked to hear that heart disease is the No. 1 killer of women in the United States. In fact, if you added up how many women died of cancer, the number still would not equal the number of women dying from heart disease.
And while there are established screening guidelines for several cancers, there are no unifying screening guidelines for heart disease in women.
My first recommendation is to have a good primary care doctor who is reviewing your risk factors for heart disease.
The most important risk factors are whether you have diabetes, high blood pressure and high cholesterol. Much can be done to modify and control these risk factors, including making dietary changes, increasing regular exercise time and losing weight. If that does not work, then there are many medications to help control these medical problems.
A risk factor unique to women that is under-recognized is if you have had high blood pressure during pregnancy. We are now seeing this as a risk factor for developing high blood pressure later in life and then also as a risk factor for early onset heart disease.
In addition, and this is again important for women, you should recognize symptoms of a potential problem with your heart. We are taught that a clear warning sign of a heart attack is chest pain. However, when talking to patients who are actually having a heart attack, the symptom is not chest pain but “discomfort.”
Pay attention to symptoms such as pressure, tightness or squeezing in the chest, especially if these symptoms come on with exertion or stress. Almost two-thirds of women who die suddenly of a heart attack had no previous symptoms or warning signs. In addition, women are more likely than men to present without chest discomfort symptoms but rather shortness of breath, nausea, jaw or back pain. Report these symptoms to your doctor who can then decide your next best test.
While there are many risk factors for heart disease, I believe the most important (and at the same time easiest to treat) is high cholesterol.
New guidelines recommend using certain cholesterol medications (“statins”) at moderate to high doses to help decrease risk. Statins are very safe and they work at certain doses to reduce your cholesterol by greater than 50 percent.
If we are going to make a dent in the overall numbers of heart disease related deaths in women, then I think a great starting point is using statin medications in the right patients.
By Dr. Rafic Berbarie is an assistant professor in the Division of Cardiology at the University of Texas Medical Branch at Galveston.