Women warned obesity can kill

Women warned obesity can kill

By VIRGINIA ANDERSON
The Atlanta Journal-Constitution
Published on: 02/05/04

Losing weight through a healthy diet and exercise is the best way for women
to prevent heart disease, the American Heart Association says in its
first-ever guidelines aimed specifically at women.

RECOMMENDATIONS OF THE AMERICAN HEART ASSOCIATION

. Stop smoking, exercise regularly, and eat a
heart-healthy diet.

. ACE inhibitors and beta-blockers are recommended for all
high-risk women or those who have a family history of heart disease, high
blood pressure, diabetes, high levels of triglycerides or of LDL, or "bad,"
cholesterol.

. High-risk women should be prescribed statin therapy even
if their LDL cholesterol levels are below 100 mg/dL. Statins are drugs like
Lipitor and Zocor that lower bad cholesterol.

. Aspirin is recommended for prevention in all high-risk
women but is not recommended for low-risk women. For intermediate-risk
women, aspirin can be considered as long as blood pressure is controlled and
the benefit is likely to outweigh the risk of side effects, such as
gastrointestinal bleeding or hemorrhagic stroke.

. Blood pressure-lowering drugs are recommended when blood
pressure is greater than or equal to 140/90.

. Women with diabetes must have their blood sugar
carefully controlled.

. Hormone therapy and antioxidant vitamin supplements are
not recommended to prevent heart disease for women at any level of risk.

. Women with cardiovascular disease should be evaluated
for depression and treated or referred for treatment when indicated.

. In addition to a heart-healthy diet, supplementation
with omega-3 fatty acids and folic acid may be considered in some high-risk
women.

Related links:
. americanheart.org
. Heart Disease Facts: What Every Woman Should Know

"Management of weight got our highest classification [for
recommendations
for change]," said Dr. Nanette K. Wenger, professor of medicine in the
division of cardiology at Emory University School of Medicine and a
co-author of the new guidelines.

"These lifestyle behaviors can lead to risk factors later on. A lot of these
obese women really do have risk factors because of their obesity, and they
don't know it. This is an epidemic in today's society."

The recommendations published Wednesday in Circulation: Journal of the
American Heart Association, are part of a new push to remind women that
heart disease is the No. 1 killer of women as well as men. Heart disease
claims the lives of more than 500,000 women each year.

In years past, the group has not focused as intensely on women's heart
health. That happened in part because studies did not indicate that certain
interventions that helped men, such as the prescribing of
cholesterol-lowering drugs, also helped women.

To remedy that, the association is targeting women through an aggressive
public awareness effort called the Red Dress campaign, distributing
thousands of lapel pins through regional offices across the country of an
enameled red dress.

Also, the group enlisted and received the support of first lady Laura Bush,
who Wednesday appeared on "The Today Show" and at a heart center in Savannah
to promote heart health.

On "Today," the president's wife said she takes long walks and lifts weights
to keep her heart healthy.

Obese and overweight women are more likely to have higher blood pressure and
higher overall cholesterol levels than their slimmer sisters - factors that
increase the risk of heart disease. Many may not even know they are at risk,
because the numbers can change within a few months during the years before
menopause, the researchers said.

All women should have a doctor assess risk factors, which also include a
family history of heart disease, diabetes, metabolic syndrome and elevated
levels of bad cholesterol.

The association's guidelines also advise that women should avoid hormone
replacement therapy to prevent heart disease and that those at low risk of
heart disease should not take aspirin as a preventive measure. The group
also nixes antioxidant supplements to prevent heart disease, at least until
further study proves supplements work.

After years of research into women's heart health, researchers also wanted
to know more about women's attitudes and knowledge about heart disease.

Harris Interactive polled women in late June and early July to determine
their knowledge of cardiovascular disease. While a similar survey in 2000
indicated that 34 percent of women listed heart disease as women's leading
cause of death, the more recent survey showed that 46 percent of the
respondents knew heart disease is the chief killer of American women.

As with many diseases across both genders and all age groups, women often do
not take the dangers personally, however. While nearly half know the danger
of heart disease, 70 percent do not know all their relevant heart numbers,
such as levels of high- and low-density lipo-proteins; triglycerides; blood
sugar; and blood pressure.

Women and their physicians should recognize that all women are at some level
of risk for heart disease, said Wenger and co-chair Dr. Lori Mosca, director
of preventive cardiology at New York-Presbyterian Hospital/Columbia
University Medical Center.

Dr. Jay Kulkin, an Atlanta gynecologist who is a board member of the
district American Heart Association, said he began incorporating heart
screening and measures into his patients' yearly gynecological checkups
about three years ago.

"I started retooling, doing a risk assessment, risk reduction, taking a
comprehensive family history," said Kulkin. He has identified at least 20
patients at high risk for heart disease who may not otherwise have known.

--
Ken

"I want to tell you about a school in Houston. It's a school for 'at risk'
children.
In other words, folks, these are children who can't learn."

- G.W. Bush, presidential debates