Text for the Living with Heart Disease: A Woman's Guide 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.

[drawing of the heart

in the first column]

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. Overweight increases the likelihood of developing high blood cholesterol and high blood pressure, and physical inactivity increases the risk of heart attack. Regular exercise, good nutrition, and smoking cessation are key to controlling the risk factors for CHD.

Who Gets Heart Disease?

Heart disease is often thought of as a man's disease, but that is a mistake. One in ten American women 45 to 64 years of age has some form of heart disease, and this increases to one in five women over 65. Heart disease is the number one killer of American women. The good news is that many of the risk factors for coronary heart disease are controllable. This brochure tells you what kinds of habits and health conditions increase the chances of developing heart disease --and how you can help protect your heart.

[drawing of three blood

vessels at the bottom of

the second column]

(the following is the text designed to help you complete the brochure's inside)

 

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.

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 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.

Take Your 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, so follow the dose instructions carefully and report any troublesome 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.

Aspirin--helps prevent heart attacks when taken regularly in a low dose on your doctor's orders.

Digitalis--makes the heart contract harder and prescribed when the hearts 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)--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.

Blood cholesterol-lowering agents--HMG CoA reductase inhibitors (or "statins"), nicotinic acid, bile acid sequestrants, fibric acid derivatives, and probucol.