Heart disease and women: so you have heart disease.IF YOU'RE A WOMAN WHO HAS or thinks she has coronary heart disease coronary heart disease: see coronary artery disease. coronary heart disease or ischemic heart disease Progressive reduction of blood supply to the heart muscle due to narrowing or blocking of a coronary artery (see atherosclerosis). , this fact sheet is for you. It explains the causes, symptoms, detection, and treatments of coronary heart disease. Coronary heart disease is a chronic condition--it will not disappear--and you may need to make some changes. But caring for your heart is worth the effort--your heart will thank you every day. A Long Process Coronary heart disease, the most common form of heart disease, develops over many years. It can begin as far back as childhood. In a process known as atherosclerosis, fatty substances build up inside the walls of blood vessels Blood vessels Tubular channels for blood transport, of which there are three principal types: arteries, capillaries, and veins. Only the larger arteries and veins in the body bear distinct names. . Blood components also stick on the surface inside vessel walls. The vessels narrow and "harden," becoming less flexible. The buildup and narrowing proceed gradually and result in decreasing blood flow and, eventually, the development of symptoms. But the buildup, or "plaque," may break open and suddenly produce a blood clot blood clot n. A semisolid, gelatinous mass of coagulated blood that consists of red blood cells, white blood cells, and platelets in a fibrin network. , limited blood flow, and symptoms. When blood flow to the heart is reduced, chest pain, or"angina," can result. If blood flow is nearly or completely blocked, a heart attack can occur and cause muscle cells in the heart to die. Because the cells cannot be replaced, the result is permanent heart damage. Who Gets Coronary Heart Disease? Coronary heart disease rarely affects young women. Instead, it usually develops after menopause. Before menopause, the ovaries Ovaries The female sex organs that make eggs and female hormones. Mentioned in: Choriocarcinoma ovaries (ō´v make estrogen, which helps protect the heart. Being over age 55 is a "risk factor" that affects the development of coronary heart disease. There are other risk factors (see Box A). They are: family history of early heart disease, cigarette smoking, high blood pressure, high blood cholesterol, being overweight, physical inactivity physical inactivity A sedentary state. Cf Physical activity. , and diabetes. The risk factors do not add their effects in a simple way. Rather, they multiply each other's effects. For example, if you smoke and have high blood pressure and high blood cholesterol, you're eight times more likely to develop coronary heart disease than a woman with no risk factors. You can have coronary heart disease without being aware of it. The best way to protect your heart is to know whether you have coronary heart disease and treat it as early as possible. You need to talk to your doctor about your coronary heart disease and any symptoms you may be experiencing (see Box B). Do You Have Angina? The first symptom of coronary heart disease may be chest pain, or"angina." The chest pain, which is caused by reduced blood flow to the heart, typically occurs behind the breastbone breast·bone n. See sternum. and may travel down your left arm or up your neck, or be a squeezing, pressing sensation that does not change with breathing. It is usually caused and made worse by exercise and eased by rest. The pain usually lasts 2 to 5 minutes. If you have this kind of chest pain, you should contact your doctor. A reduced blood flow to the heart can cause symptoms other than chest pain. For example, some women get a less typical angina. The chest pain may linger, occur in a different location than behind the breastbone, or not be worsened by exertion and eased by rest. Some women have shortness of breath Shortness of Breath Definition Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. or indigestion. If you have such symptoms, you should talk with your doctor. If treated, the outlook is good. Without treatment, however, the symptoms may recur and worsen and can become unstable and even lead to a heart attack. Women who have coronary heart disease need to talk to their doctor about the symptoms of a heart attack and the appropriate steps to take to get emergency care. It is important to know the telephone number to call to get emergency transportation to the hospital. In most areas, this will be 9-1-1 or a 7-digit emergency number. Getting to the hospital fast allows use of thrombolytic thrombolytic /throm·bo·lyt·ic/ (throm?bo-lit´ik) dissolving or splitting up a thrombus, or an agent that so acts. thrombolytic 1. dissolving or splitting up a thrombus. 2. an agent that dissolves or splits up a thrombus. therapy--a clot-dissolving agent is injected to restore blood flow through an artery. This therapy saves lives and reduces damage to the heart muscle. But it must be done as soon as possible. Doctors also have a new fast test for a heart attack. It detects changed levels of an enzyme (creatine kinase creatine kinase /cre·a·tine ki·nase/ (ki´nas) an enzyme that catalyzes the phosphorylation of creatine by ATP to form phosphocreatine. MB) produced by the heart. It once took up to a day to test the levels and tell if someone has had a heart attack--but now it can be done within 6 hours. So doctors can give fast care to those who need it and send the others home. What Are the Tests For Coronary Heart Disease? Diagnostic tests are usually needed to confirm the presence and assess the severity of coronary hears disease. Your doctor will know whether you need any of them. Often more than one test is needed because different tests supply different information. Also, patients vary in their symptoms and so may need more than one test to find out the heart's condition. The main tests used to diagnose coronary heart disease are described below. Many are not "invasive" procedures--they are done outside the body--and are painless. The tests are: * Electrocardiogram electrocardiogram /elec·tro·car·dio·gram/ (-kahr´de-o-gram?) a graphic tracing of the variations in electrical potential caused by the excitation of the heart muscle and detected at the body surface. (ECG or EKG ECG or EKG A record of the waves that relates to the electrical impulses produced at each beat of the heart. Mentioned in: Electrocardiography ) makes a graphic record of the heart's electrical activity as it beats. This can show abnormal heartbeats, muscle damage, blood flow problems, and heart enlargement. * Stress test (or treadmill test treadmill test Exercise stress test, see there or exercise ECG ECG electrocardiogram. ECG abbr. 1. electrocardiogram 2. electrocardiograph ECG Also called an electrocardiogram, it records the electrical activity of the heart. ) records the ECG during exercise, usually on a treadmill or exercise bicycle. Some heart problems show up only when more effort is asked of the heart, as happens during increased activity. So the exercise ECG may be done even if the resting ECG is normal. Other exercise tests may be done with an ECG or a nuclear scan (see below) to assess heart muscle contraction or blood flow in the heart. Older women may not be able to exercise due to arthritis or another condition. For them, a stress test can be done without exercise by using a drug that increases blood flow. Echocardiography Echocardiography Definition Echocardiography is a diagnostic test that uses ultrasound waves to create an image of the heart muscle. Ultrasound waves that rebound or echo off the heart can show the size, shape, and movement of the heart's valves and converts sound waves, bounced off the heart, into images that show heart size, shape, and movement. The sound waves also can be used to see how much blood is pumped out by the heart when it contracts. * Nuclear scan assesses heart muscle contraction as blood flows through the heart. A small amount of radioactive material radioactive material Radiation A substance that contains unstable–radioactive–atoms that give off radiation as they decay. See Radioactive decay. is injected into a vein, usually in the arm, and a scanning camera then records how much is taken up by the heart muscle. * Coronary angiography coronary angiography Interventional cardiology A diagnostic technique in which a radiocontrast is injected directly into the coronary arteries, allowing visualization and quantification of stenosis and/or obstruction. (or arteriography arteriography /ar·te·ri·og·ra·phy/ (ahr-ter?e-og´rah-fe) angiography of an artery or arterial system. catheter arteriography ) displays blood flow problems and blockages. A fine, flexible tube (or "catheter") is threaded through an artery of an arm or leg up into the heart. A fluid that shows up on x ray is then injected, and the heart and blood vessels are filmed as the heart pumps. The picture is called an angiogram an·gi·o·gram n. An angiographic x-ray of blood vessels used in diagnosing pathological conditions of the cardiovascular system.//An x-ray of one or more blood vessels produced by angiography and used in diagnosing pathology in the cardiovascular or arteriogram Arteriogram A diagnostic test that involves viewing the arteries and/or attached organs by injecting a contrast medium, or dye, into the artery and taking an x ray. Mentioned in: Kidney Transplantation arteriogram a radiograph of an artery. . Treating Your Heart Right You can reduce your risk of complications of coronary heart disease. But you must do your part. There are three main types of treatment: lifestyle, medication, and special procedures for advanced atherosclerosis. A discussion of each of these follows. Lifestyle Since you have coronary heart disease, you will need to take five key steps to keep your heart as healthy as possible: stop smoking, lower high blood pressure, lower high blood cholesterol, lose any extra weight, and become physically active. In fact, these steps are so crucial for good health that they should be adopted by all people, even the young. So as a plus, do them with your family and friends. Studies show that such support makes lifestyle changes easier. You'll improve more if others join you in your new behavior. And teaching your children or grandchildren heart-healthy habits is a gift that will last them a lifetime. Here's more on the five steps: Stop smoking cigarettes. There is no safe way to smoke. Smoking accelerates atherosclerosis. If you smoke, you are two to six times more likely to have a heart attack than a nonsmoker, and your risk increases with the number of cigarettes you smoke each day. But if you quit, then the risk to your heart drops sharply, even in the first year, no matter what your age. Even if you've had a heart attack, you'll benefit from quitting--some women's risk of having a second heart attack is cut by 50 percent or more after they stop smoking. The National Heart, Lung, and Blood Institute National Heart, Lung, and Blood Institute, n.pr established in 1948, this division of the National Institutes of Health is responsible for research and education on cardiovascular, pulmonary, systemic diseases, and sleep disorders. (NHLBI NHLBI, n.pr See National Heart, Lung, and Blood Institute. ) has information to help you kick the habit (see For More Information at the end) or ask your doctor for advice. Lower high blood pressure. Also called hypertension, high blood pressure usually has no symptoms. It has no cure but can and must be controlled. High blood pressure makes the heart work harder and, uncontrolled, can lead to heart disease, stroke, heart failure, kidney problems, and other conditions. Blood pressure is given as two numbers--the systolic pressure systolic pressure n. The highest arterial blood pressure reached during any given ventricular cycle. over the diastolic pressure diastolic pressure n. The lowest arterial blood pressure reached during any given ventricular cycle. , and both are important. A measurement of 140/90 mm Hg or above means you have high blood pressure. But even pressures slightly under that can put your heart at greater risk. Most American women over age 60 have high blood pressure--nearly 80 percent of black women over age 60 have it. However, blood pressure does not have to increase with age-hypertension can be prevented. And controlling your blood pressure will reduce your chance of suffering a first or repeat heart attack. Discuss your blood pressure with your doctor. A normal blood pressure level is around 120/80. Often, this can be reached through lifestyle changes. If necessary, a medication will be used. If a drug is prescribed, you must take it as instructed, even if you feel fine because, if you stop, your blood pressure probably will rise again. (See the medication section for drugs that treat high blood pressure.) If you make lifestyle changes, however, your doctor may be able to decrease your medication. The lifestyle steps that prevent and control high blood pressure are: losing excess weight, becoming physically active, choosing foods low in salt and sodium, and limiting alcohol intake. (The first two are described separately.) Salt and sodium both affect blood pressure and must be watched. Salt (sodium chloride sodium chloride, NaCl, common salt. Properties Sodium chloride is readily soluble in water and insoluble or only slightly soluble in most other liquids. It forms small, transparent, colorless to white cubic crystals. ) is only one source of sodium, and there are others. You should consume no more than 6 grams (about 1 teaspoon) of salt a day, which equals 2.4 grams of sodium. This includes ALL salt-that in processed foods or added in cooking or at the table. A good way to keep track of sodium is by reading food labels. If you drink alcohol, you should have no more than one drink a day. One drink equals 1.5 ounces of 80-proof whiskey, or 5 ounces of wine, or 12 ounces of beer (regular or light). Recently, news stories have said that alcohol may lower the risk of having a heart attack. But this has yet to be proved. And too much alcohol has dangers. So if you don't drink, it's best not to start. Lower high blood cholesterol. Why is cholesterol so important? The body makes all the cholesterol it needs. Extra cholesterol and fat in the diet cause the atherosclerotic buildup inside blood vessels. So, a high blood cholesterol leads to coronary heart disease. And, once you have coronary heart disease, an elevated blood cholesterol increases your risk of a future heart attack. But you can take steps to keep your blood cholesterol from rising. Cholesterol travels through the blood in protein-fat packages called lipoproteins Lipoproteins The packages in which cholesterol and triglycerides travel throughout the body. Mentioned in: Lipoproteins Test lipoproteins (lip´ōprō´tēns), n. . The two main types are: low-density lipoprotein low-density lipoprotein n. Abbr. LDL A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of atherosclerosis and coronary artery disease. , or LDL LDL - ["LDL: A Logic-Based Data-Language", S. Tsur et al, Proc VLDB 1986, Kyoto Japan, Aug 1986, pp.33-41]. , which causes deposits and is termed the "bad" cholesterol; and high-density lipoprotein high-density lipoprotein n. Abbr. HDL A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a decreased risk of atherosclerosis and coronary artery disease. , or HDL (Hardware Description Language) A language used to describe the functions of an electronic circuit for documentation, simulation or logic synthesis (or all three). Although many proprietary HDLs have been developed, Verilog and VHDL are the major standards. , which helps remove cholesterol from the blood and is referred to as the "good" cholesterol. Women who have coronary heart disease should have an LDL level of 100 mg/dL or less. A low level of HDL (less than 35 mg/dL) is a major risk factor for coronary heart disease. Physical activity, weight loss if you're overweight, and stopping smoking help raise the level of HDL. Foods high in total fat and in saturated fat saturated fat, any solid fat that is an ester of glycerol and a saturated fatty acid. The molecules of a saturated fat have only single bonds between carbon atoms; if double bonds are present in the fatty acid portion of the molecule, the fat is said to be are also high in calories and often in cholesterol. Saturated fat, which raises blood cholesterol more than anything else in the diet, is found mainly in foods that come from animals--dairy products, meat, and poultry skin. Some vegetable fats--coconut oil, cocoa butter, palm kernel oil, and palm oil--also are high in saturated fat. Cholesterol is found only in foods that come from animals egg yolks, liver, and kidney, for example. A few pointers: To cut down on saturated fat, total fat, and cholesterol, choose fish, poultry, and lean cuts of meat; choose low-fat foods; choose low-fat or no-fat milk and other dairy products; and eat plenty of fruits and vegetables. Breads, rice, and pasta made from enriched or whole grains also are good choices. Broil, bake, roast, or poach poach damage caused to sodden pasture by the hooves of cattle and sheep. In clay soils and when the ground is sufficiently wet the damage caused by a heavy stocking rate of sheep may be very high. Said also of the take-off in front of a jump in an equitation course or a race. , instead of frying, and be sure any sauce is also low in fat. Lose excess weight. America is becoming heftier--and older women are among those gaining weight. More than half of American women ages 50 to 59 are overweight--30 years ago, only 35 percent of them were. This is a dangerous trend, because being overweight increases the risk of coronary heart disease, even if there are no other risk factors. But being overweight also increases the chance of developing several other risk factors, which would compound the danger. Losing excess weight is critical for good health. But weight loss must be viewed as a change of lifestyle, not as a temporary effort to drop pounds quickly. Such quick fixes are just that--temporary. The weight soon returns. To lose weight, follow a heart-healthy eating plan and become physically active. Eat a variety of low-calorie, nutritious foods in moderate amounts. Keep to the eating pattern outlined for high blood cholesterol. Do not try to lose more than one-half to one pound a week. Remember: When it comes to weight loss, take it slow and steady--learn a new way of eating to get to and stay at a healthy weight. Become physically active. Physical activity is one of the best ways to control coronary heart disease. It is vital for good health and well-being. It helps lower LDL and raise HDL. Even if you're overweight, you'll have a lower blood pressure if you're active You may worry that "becoming physically active" requires a lot of time and effort. Not so. Research shows that even a little exercise can improve your heart's health. And "exercise" can mean going up a flight of stairs Noun 1. flight of stairs - a stairway (set of steps) between one floor or landing and the next flight of steps, flight staircase, stairway - a way of access (upward and downward) consisting of a set of steps (instead of taking the elevator) or gardening or walking at the mall. Walk with a friend or your husband, or get your whole family moving together. Try to do some type of activity for at least 30 minutes on most days. But, if 30 minutes is too long a period, break up the time into shorter sessions done throughout the day. Incorporate exercise into your other daily activities too. Since you have coronary heart disease, you should consult with your doctor before starting a physical activity program. This is especially important if you're over age 55, have been inactive, or have diabetes or another medical problem. Your doctor can help you prevent problems from overexertion overexertion horses appear to be able to race beyond their real capacity when they are not properly fit and develop pulmonary edema as a result. . It also is important to exercise in a way that will help you without hurting you. If you've been inactive, start slowly. Walking 10-15 minutes, three times a week, makes a good start. If you've had a heart attack, you'll benefit greatly from exercise. Many hospitals have a"cardiac" (heart) rehabilitation program. Ask your doctor about your ability to exercise and about a suitable program for you. If you have arthritis or another limiting condition, you may benefit from exercises that help keep you as flexible and healthy as possible. Again, ask your doctor about a suitable exercise. Medications A healthy lifestyle will improve your heart's condition. But you may need medication too, especially if you have chest pain, or if you have high blood pressure or high blood cholesterol that was not lowered enough with lifestyle changes. Drugs can have side effects Side effects Effects of a proposed project on other parts of the firm. , so none should be taken without first seeing your doctor. If you take a drug, follow the dose instructions carefully and report any trouble-some side effects to your doctor. Often a change in dose or type of drug can stop the side effect. Your doctor may even prescribe a combination of drugs to treat your coronary heart disease. The following list will briefly introduce you to some medications used to treat coronary heart disease and its risk factors. If you need a medication, discuss it with your doctor and be sure you understand how and why it should be taken. * Aspirin--helps prevent heart attacks when taken regularly in a low dose on a doctor's orders. * Digitalis--makes the heart contract harder and is used when the heart's pumping function has been weakened; it also slows some fast heart rhythms. * ACE inhibitor--stops production of a chemical that makes blood vessels narrow and is used for high blood pressure and heart muscle that has been damaged. * Beta-blocker--reduces how hard the heart must work and is used for high blood pressure, chest pain, and to prevent a repeat heart attack. * Nitrate (including nitroglycerine ni·tro·glyc·er·in also ni·tro·glyc·er·ine n. A thick, pale yellow liquid, C3H5N3O9, that is explosive on concussion or exposure to sudden heat. )--relaxes blood vessels and alleviates chest pain. * Calcium-channel blocker--relaxes blood vessels; used for high blood pressure and chest pain. * Diuretic--decreases fluid in the body and is used for high blood pressure. Blood cholesterol-lowering agents--HMG CoA reductase reductase /re·duc·tase/ (-tas) a term used in the names of some of the oxidoreductases, usually specifically those catalyzing reactions important solely for reduction of a metabolite. inhibitors (or "stating"), nicotinic acid nicotinic acid: see coenzyme; vitamin. , bile acid sequestrants, fibric acid fibric acid /fi·bric ac·id/ (fi´brik) any of a group of compounds structurally related to clofibrate that can reduce plasma levels of triglycerides and cholesterol; used to treat hypertriglyceridemia and hypercholesterolemia. derivatives, and probucol. Special Procedures If you have advanced atherosclerosis, you may need a special procedure to open an artery and improve blood flow. This is usually done to ease severe chest pain or clear major or multiple blockages in blood vessels. The two main procedures are: * Coronary angioplasty--also called "balloon" angioplasty. A fine tube is threaded through an artery to the narrowed heart vessel, where a tiny balloon at its tip is inflated. The balloon flattens the buildup and stretches the artery, improving blood flow. It is then deflated de·flate v. de·flat·ed, de·flat·ing, de·flates v.tr. 1. a. To release contained air or gas from. b. To collapse by releasing contained air or gas. 2. and removed, along with the tube. * Coronary artery bypass graft coronary artery bypass graft n. Abbr. CABG A surgical procedure in which a section of vein or other conduit is grafted between the aorta and a coronary artery below the region of an obstruction in that artery. surgery--also known as "bypass surgery Bypass surgery A surgical procedure that grafts blood vessels onto arteries to reroute the blood flow around blockages in the arteries (arteriosclerosis). ." A piece of blood vessel blood vessel n. An elastic tubular channel, such as an artery, a vein, a sinus, or a capillary, through which the blood circulates. blood vessel(s), n the network of muscular tubes that carry blood. is taken from the leg or chest and is stitched onto the narrowed heart artery, making a bypass around the blockage. Sometimes, more than one bypass is needed. Bypass surgery is used when blockages in an artery can't be reached by, or are too long or hard for, angioplasty. A bypass requires about 1 week in the hospital and several weeks of recuperation recuperation /re·cu·per·a·tion/ (-koo?per-a´shun) recovery of health and strength. recuperation, n the process of recovering health, strength, and mental and emotional vigor. at home. For More Information The NHLBI has more information that can help you improve your heart health. Materials cover such topics as: how to stop smoking, high blood cholesterol, high Cholesterol, High Definition Cholesterol is a fatty substance found in animal tissue and is an important component to the human body. It is manufactured in the liver and carried throughout the body in the bloodstream. blood pressure, physical activity, heart-healthy recipes, hormone replacement therapy Hormone Replacement Therapy Definition Hormone replacement therapy (HRT) is the use of synthetic or natural female hormones to make up for the decline or lack of natural hormones produced in a woman's body. , coronary heart disease, heart failure, and heart arrhythmias. Contact: NHLBI Information Center P.O. Box 30105 Bethesda, MD 20824-0105 (301) 251-1222 The NHLBI also has a toll-free telephone line with recorded messages about the treatment and prevention of high blood pressure and high blood cholesterol. Call: 1-800-575-WELL. Remember: Take action and take charge! RELATED ARTICLE: Box A: Factors That Put Your Heart At Risk One in ten American women ages 45 to 64 has some form of heart disease. That increases to one in five for women over age 65. Some of the factors that increase the risk to your heart cannot be controlled-but most can. You'll protect your heart by controlling those that can be changed. Here's a rundown of both types of risk factors: Unchangeable un·change·a·ble adj. Not to be altered; immutable: the unchangeable seasons. un·change risk factors-- * Being age 55 or older * Having a family history of early heart disease (this means having a mother or sister who has been diagnosed with heart disease before age 65, or a father or brother diagnosed before age 55) Changeable risk factors-- * Cigarette smoking * High blood pressure * High blood cholesterol * Overweight * Physical inactivity * Diabetes RELATED ARTICLE: Box B: Talking With Your Doctor Caring for a chronic condition like coronary heart disease is a partnership--you and your doctor should work as team. That means good communication. Here are some pointers to help you talk with your doctor: Before your office visit-- * Write down your concerns. * Keep a diary of your symptoms, so you can describe them accurately. * Note any past treatments. * Gather any drugs you are taking and bring them or a list of them to the office visit. During your office visit-- * Be open. You will only hurt yourself if you're not. For instance, if you have trouble breathing or have pain, tell your doctor. * Briefly describe all symptoms. Tell when each started, how often it happens, and if it has been getting worse. * Note any causes of stress in your life. For instance, say if you are the caregiver for a sick parent or husband, or have other stressful responsibilities. * Ask questions. Be sure you understand what the doctor says. Ask for an explanation of any term you do not understand. Be sure you know the instructions for any medication--when to take it; what to do if you forget and skip a dose; what other drug, food, or activity to avoid while taking it; and what side effects may occur with it. * Write notes. This will help you remember what the doctor says. * Bring a friend or relative with you if necessary. If you are worried about understanding what the doctor says or have trouble hearing, have someone with you during the discussion. * Share your views. If something bothers you, say so. The doctor needs to know if something is working or not, or if you're having trouble following a treatment. For instance, if you're having trouble fixing low-saturated fat meals, say so. You may be referred to a dietitian dietitian /di·e·ti·tian/ (di?e-tish´in) one skilled in the use of diet in health and disease. di·e·ti·tian or di·e·ti·cian n. A person specializing in dietetics. for help. Dietitians are health care professionals who can help design an eating plan for you. If a diagnostic test is ordered-- * Ask the reason and find out what will be learned from the test. * Ask when results will be ready. * Know what the test involves and how to get ready for it. * Ask who will do the test. * Find out if you will need help getting home after the test. * Find out if the test poses any dangers or side effects. If you need a special procedure-- * Find out the benefits and risks of the procedure. * Ask what kind of doctor you need for it and get a referral. * Ask if you will need to be hospitalized and for how long. * Ask what kind of pain or discomfort you may feel. * Ask about the recovery period, how long it will last, and what it will involve. RELATED ARTICLE: Box C: Diabetes-The Self-Help Disease Diabetes mellitus diabetes mellitus Disorder of insufficient production of or reduced sensitivity to insulin. Insulin, synthesized in the islets of Langerhans (see Langerhans, islets of), is necessary to metabolize glucose. In diabetes, blood sugar levels increase (hyperglycemia). increases the risk to your heart. It also is the single most common cause of kidney disease Kidney Disease Definition Kidney disease is a general term for any damage that reduces the functioning of the kidney. Kidney disease is also called renal disease. . If you have diabetes, you will need to control it. Because those with it must manage their condition day-by-day, diabetes is sometimes called the "self-help disease." In diabetes, the body cannot properly convert foods into energy. This causes a buildup in the blood of a form of sugar called glucose. The buildup produces symptoms and damages organs. Women should have a routine test for diabetes. The doctor will test for too much sugar in the urine or blood. Symptoms of diabetes include: a vague sick feeling, being "run down," increased thirst, frequent urination urination Process of excreting urine from the bladder (see urinary system). Nerve centres in the spinal cord, brain stem, and cerebral cortex control it through involuntary and voluntary muscles. The need to void is felt when the bladder holds 3. , unexplained weight loss, blurred vision, skin infections or itching, and slow healing of cuts, bruises, and gum and urinary tract infections. Controlling diabetes can help keep your heart healthy. For more information on diabetes, contact: National Diabetes Information Clearinghouse The National Diabetes Information Clearinghouse(NDIC) is an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health, which is part of the U.S. Box NDIC NDIC National Drug Intelligence Center NDIC National Diabetes Information Clearinghouse NDIC Nigeria Deposit Insurance Corporation NDIC National Defence Industries Council (UK defense) 9000 Rockville Pike Bethesda, MD 20892 (301) 654-3327 RELATED ARTICLE: BOX D: Tips For Having Your Blood Pressure Taken A blood pressure test is painless. Here are some tips to assure that you get a good reading: * Before the test, sit for 5 minutes with your feet flat on the ground, arm resting on a table at the level of your heart * Wear short sleeves so your arm is exposed * If you know your arm requires a large adult cuff, say so * Get two readings, taken at least 2 minutes apart, and average the results Women with coronary heart disease need to have a "lipoprotein lipoprotein (lĭp'əprō`tēn), any organic compound that is composed of both protein and the various fatty substances classed as lipids, including fatty acids and steroids such as cholesterol. analysis" done to check their levels of total cholesterol, HDL, and LDL, as well as triglycerides Triglycerides Fatty compounds synthesized from carbohydrates during the process of digestion and stored in the body's adipose (fat) tissues. High levels of triglycerides in the blood are associated with insulin resistance. , which is another type of fat in the bloodstream. Lipoprotein tests should be taken on two occasions and the results averaged. The level of LDL is usually the main target of treatment. Many women with coronary heart disease can lower their high blood cholesterol enough through lifestyle changes. However, cholesterol-lowering drugs may be needed as well. Hormone replacement therapy (see Box E) also may improve blood cholesterol. The lifestyle changes call for adopting a healthy eating plan, becoming physically active, and losing excess weight (the latter two described belong). For healthy eating, have: * Less than 7 percent of your day's total calories from saturated fat * 30 percent or less of your day's total calories from fat * Less than 200 milligrams of dietary cholesterol a day * Just enough calories a day to achieve and maintain a healthy weight RELATED ARTICLE: BOX E: Hormone Replacement Therapy-New Findings At menopause, the ovaries essentially stop all production of the hormone estrogen. Menopause can occur naturally or surgically. Hormone replacement therapy (HRT HRT abbr. hormone replacement therapy Hormone replacement therapy (HRT) Also called estrogen replacement therapy, this controversial treatment is used to relieve the discomforts of menopause. ) supplies the estrogen the body no longer makes. It has been used to relieve the symptoms of menopause, such as hot flashes hot flashes Hot flush Gynecology A symptom afflicting 80-85% of middle-aged ♀, first occurring during the perimenopause, continuing with ↓ intensity for yrs, manifesting itself as transient waves of erythema and uncomfortable warmth beginning in the and flushes, sweats, disturbed sleep, and an increased rate of bone loss. New information from the Postmenopausal post·men·o·paus·al adj. Of or occurring in the time following menopause. postmenopausal Change of life Gynecology adjective Referring to the time in ♀ when menstrual periods stop for ≥ 1 yr Estrogen/Progestin Intervention Trial (PEPI PEPI Cardiology A trial–Postmenopausal Estrogen/Progestin Interventions Trial evaluating the effect of combined hormonal–♀–therapy on cholesterol levels and major CAD. ) suggests that HRT may also improve coronary heart disease risk factors after menopause. The research found that estrogen given alone or with a natural or synthetic progesterone progesterone (prōjĕs`tərōn'), female sex hormone that induces secretory changes in the lining of the uterus essential for successful implantation of a fertilized egg. increased HDL and decreased LDL. Progesterone is also a hormone made by the ovaries until menopause; it helps control the growth of cells that line the uterus. None of the HRT therapies tested significantly affected blood pressure or weight. But estrogen taken alone caused abnormal cell growth of the lining of the uterus. PEPI's findings offer these guidelines: * If you have a uterus, you may want to consider a combination therapy that uses both estrogen and a progesterone. If you have a uterus and take estrogen alone, you need to have a yearly endometrial biopsy. * If you don't have a uterus, you may want to consider taking estrogen without a progesterone. However, uncertainties remain, including the effects of HRT on breast cancer risk. So far, studies have had conflicting findings and more research is ongoing. Current evidence suggests that there is a small increased risk of breast cancer from HRT but that, for most women, the benefits of HRT probably outweigh the risk. You should discuss these questions with your doctor. |
|
||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion