Coping with heart disease.

If you've had a heart attack, a stroke, or even just been diagnosed with some form of cardiovascular disease, you're probably reeling with shock and filled with questions. How will this change my life? What does this mean for my family? Am I going to die?

First, take a deep breath. The major reason the death rate from heart disease is dropping these days is because of a wide range of new and improved drugs and other treatments, as well as a greater understanding of the kind of lifestyle accommodations you need to make to reduce your risk of death. It may sound strange, but there's no better time in history to have heart disease.

Having said that, let me also say that I hope your doctor or another health professional has had "The Conversation" with you. You know, the one about modifying your diet, physical activity level and stress level.

I say "hope," but I'm not too optimistic. Doctors get so little time with patients these days that it's difficult for us to provide the kind of intensive education you need after a heart attack or heart disease diagnosis. So I urge you to check with your local hospital. Most offer special courses on managing heart disease risk that are focused on nutrition, physical activity and stress management.

Also talk to your health care professional about a prescription for cardiac rehabilitation, a specialized exercise program designed to strengthen your heart and improve your physical fitness. In one survey of women with heart disease, half of those referred to such a program rated it very positive, with several saying they "loved it." (28)

One of the biggest changes you'll likely make will be in your diet. The survey I mentioned above, which included 204 women with heart disease, found that only a few women felt they'd had sufficiently healthy diets before their diagnosis.

What kind of changes should you make? Well, the biggest one I recommend is cutting out red meat altogether or at least cutting back. It's one of the biggest sources of saturated fat in our diet and saturated fat--the kind that stays solid at room temperature--is only going to clog up those arteries again.

Instead, go out and buy a cookbook that gives you 100 ways to cook fish. While you're at it, pick up a good vegetarian cookbook and commit to making two meals a week completely vegetarian. The other major nutritional change: switch over all your dairy products (don't forget sour cream, yogurt and ice cream) to low- or non-fat. Poof! Another source of saturated fat gone.

Now, when it comes to exercise, don't be like the women in the survey discussed above. Twenty-two percent said they had decreased or ceased all physical activity because of their heart disease, and 68 percent said they either hadn't increased their exercise levels at all or increased the amount only a small bit.

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Regular exercise will do wonders for helping you control your weight, raising levels of "good" cholesterol, preventing depression and minimizing stress. Just make sure you talk to your doctor before beginning any exercise program.

That brings me to the next change you're going to have to make. You have to slow down and focus on yourself for a change. If you continue to take care of everyone else first, you're doing as much damage to your heart as if you ate a 15-ounce porterhouse steak every night. In fact, I know one leading cardiologist who is so convinced of this that she writes as many prescriptions for bubble baths for her female patients as she does for medications.

It doesn't take much; just commit to at least 30 minutes a day for you. You can read magazines, take a bath, lie down and nap, take up knitting. If you feel you don't have time for this plus exercising, turn your "alone" time into exercise time and take a walk in a peaceful neighborhood or go for a bike ride.

I promise you: if you start with these lifestyle changes--along with any medical therapy your doctor has prescribed--you will not only be back to your old self, but will feel better than you have in years.

References

(28) Monroe MC. Semays PW, Sousa JF, et. al RAVEL Study Group. Randomized Study with the Sirolimus Coated Bx Velocity Balloon-Expandable Stent in the Treatment of Patients with de Novo Native Coronary Artery Lesions. Related Articles. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002 Jun 6:346(23);1773-80.

By Pamela Peeke, MD, MPH

NWHRC Medical Advisor

Dr. Peeke is a Pew Foundation Scholar in Nutrition and Metabolism, and Assistant Clinical Professor of Medicine at the University of Maryland in Baltimore. She writes about health and lifestyle issues important to all women.