Text for the African American Women & Heart Disease: Are You at Risk? Brochure

(the first part of this file is the text designed to support the medical art in the first two columns of the brochure's "outside")

What is Coronary Heart Disease?

The heart is your body's hardest-working muscle, pumping blood throughout your body, day after day. Like any muscle, the heart needs a constant supply of oxygen and nutrients. These reach the heart muscle via the coronary arteries. When the coronary arteries become narrowed or clogged and cannot supply enough blood to the heart, the result is Coronary Heart Disease (CHD). If not enough oxygen-carrying blood reaches the heart, the heart may respond with pain called angina.

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When the blood supply is cut off completely, the result is a heart attack. The part of the heart that does not receive oxygen begins to die, and some of the heart muscle may be permanently damaged.

What Causes Heart Disease?

CHD is caused by a thickening of the inside walls of the coronary arteries. This thickening, called atherosclerosis (ath a row skle row sis), narrows the space through which blood can flow, decreasing and sometimes completely cutting off the supply of oxygen and nutrients to the heart.

Atherosclerosis usually occurs when a person has high levels of cholesterol, a fat-like substance, in the blood. Cholesterol and fat, circulating in the blood, build up on the walls of the arteries. The buildup narrows the arteries and can slow or block the flow of blood. When the level of cholesterol in the blood is high, there is a greater chance that it will be deposited onto the artery walls. This process begins in most people during childhood and the teenage years, and worsens as they get older.

In addition to high blood cholesterol, high blood pressure and smoking also contribute to CHD. On the average, each of these doubles your chance of developing heart disease. Therefore, a person who has all three risk factors is eight times more likely to develop heart disease than someone who has none. Being overweight and physically inactive are other factors that can lead to CHD. Regular exercise, good nutrition, and smoking cessation are key to controlling the risk factors for CHD.

Who Gets Heart Disease?

Anyone can develop high blood pressure and heart disease, but African Americans are at higher risk than any other race or ethnic group. High blood pressure tends to be more common, happens at an earlier age, and is more serious for many African Americans. And it is not just a man's disease. Most American women over age 60 have high blood pressure-and nearly 80% of African American women over age 60 have it.

The good news is that high blood pressure can be controlled - and better yet, it can be prevented. This brochure tells you what kinds of habits and health conditions increase the chances of developing thi disease--and how you can help keep your heart healthy.

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Stop Smoking:

Smoking by women in this country causes almost as many deaths from heart disease as from lung cancer. If you smoke, you are two to six times more likely to suffer a heart attack than a nonsmoking woman, and the risk increases with the number of cigarettes you smoke each day. Smoking also boosts the risk of stroke.

There is simply no safe way to smoke. Although low-tar and low-nicotine cigarettes may reduce the lung cancer risk somewhat, they do not lessen the risks of heart diseases or other smoking related diseases. The only safe and healthful course is not to smoke at all. There is nothing easy about giving up cigarettes.

Studies have shown that African American smokers have higher levels of cigarette chemicals in their bodies than white and Mexican American smokers, even when each group smokes the same number of cigarettes. This may explain why African Americans find it harder to quit smoking than other groups.

But as hard as quitting may be, the results are well worth it. In the first year after stopping smoking, the risk of coronary heart disease drops sharply. It then gradually returns to "normal"--that is, the same risk as someone who never smoked. So no matter what your age, quitting will lessen your chances of developing heart disease.

Eat Healthy Foods:

Among the lifestyle steps that prevent and control high blood pressure are: losing excess weight, choosing foods low in salt and sodium, monitoring cholesterol, and limiting alcohol intake.

Excess body weight in women is linked with coronary heart disease, stroke, congestive heart failure, and death from heart-related causes. The more overweight you are, the higher your risk for heart disease.

Salt and sodium both affect blood pressure, and must be watched. You should consume no more than 6 grams (about 1 teaspoon) of salt a day. This includes ALL salt--that in processed foods or added in cooking or at the table

If you drink alcohol, you should have no more than one drink a day

Extra cholesterol and fat in the diet cause 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.

Stay Active:

Various studies show that physical inactivity is a risk factor for heart disease. Heart disease is almost twice as likely to develop in inactive people as in those more active.

Even low- to moderate-intensity activity can help lower the risk of heart disease. Examples of such activity are pleasure walking, stair climbing, gardening, yardwork, 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.

Start slow, and look for opportunities to become more physically active throughout your day:

  • 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.

  • Mow your own lawn.

Medication Decisions:

Birth Control Pills - Women who use high-dose birth control pills are more likely to have a heart attack or a stroke. These risks are lessened once the birth control pill is stopped. The risks of using low-dose birth control pills are not fully known. Therefore, if you are now taking any kind of birth control pill or are considering using one, keep these guidelines in mind:

  • If you smoke cigarettes, stop smoking or choose a different form of birth control. Smoking boosts the risks of serious cardiovascular problems from birth control pill use, especially the risk of blood clots. For women over 35, the risk is particularly high.

  • Use of birth control pills may increase blood pressure, and the risks appear to increase with age and length of use. If you take oral contraceptives, you should get your blood pressure checked regularly.

Hormone Replacement Therapy -- HRT has been on the front page of the news recently. A major government study of the risks and benefits of combined estrogen and progestin therapy was stopped, since the increased risk of heart attacks, strokes and breast cancer outweighed the reduced risks of colorectal cancer and hip fractures.

Hormone Replacement Therapy is not finished. The government is still hosting a major estrogen-without-progestin study, and the benefits of estrogen may outweigh the risks. Complicating matters: the results of these studies may not apply to you, based on your age and health. Talk to your doctor - it's a complicated issue, and your personal circumstances will help decide if HRT is appropriate for you.