Woman: Look After Your Heart, Here’s Why

Woman: Look After Your Heart, Here’s Why

What does someone with heart disease look like? A stressed out CEO? A smoker over 50? Whatever image came to your mind, chances are it was of a male. We think of heart disease as a male problem, but did you know that more women die of heart disease than men? It's now the leading cause of female deaths worldwide. Yet up until recently, two-thirds of all heart health research has focussed exclusively on men. What’s wrong with this picture?

If you’re a woman at risk of cardiovascular disease (CVD) there is good news - researchers are now stepping up to close the gender gap and prioritize female-based cardiac research. Let’s see what the latest research is saying about female-specific heart disease factors and how you can reduce your risk.

What the Gender Gap Means for Women’s Heart Health

Women’s Bodies Are Different

We may think of women’s ‘hearts’ as different than men when it comes to relationships, but what about literally? It turns out that women’s hearts and arteries tend to be physically smaller than men’s. Plaque build-up in our arteries is a key factor in all heart disease, and smaller arteries mean they can get clogged faster in women. 

Different Plaque Deposits

It's not just anatomical differences - the way that arterial plaques and injuries show up in women can be very different from men, delaying a heart disease diagnosis, or even misdiagnosing it. This may be why more women die from heart attacks than men, and why women are more likely to have second heart attacks. 

Dismissive Diagnosis

Heart attack symptoms often look different in women. For example, the sharp chest pains of angina precede a heart attack in everyone, but women may have additional symptoms such as extreme fatigue, trouble breathing, and pain across the stomach and upper back. Not recognizing these red flags can also lead to a dangerously delayed or incorrect diagnosis

The research tells a troubling story. When female patients report stress alongside recognized heart disease symptoms, they are significantly more likely than men to be given an anxiety diagnosis. Even when the same heart-related symptoms were reported. 

Less Risk Factor Screening

But it doesn’t end there. After receiving a heart disease diagnosis, women are not screened as often as men for depression. Research shows that depression is a key heart disease risk factor, and strikes almost twice as many female heart disease sufferers than men. This crucial gap can increase womens’ risk for subsequent fatal heart attacks, and slow down recovery.

Different Hearts, Different Diseases

The term ‘heart disease’ or ‘cardiovascular disease’ goes way beyond heart attacks, and includes a host of different issues affecting the heart, blood vessels and arteries. Not surprisingly, some heart conditions affect more women than men. For example, 90% of all 

Spontaneous Coronary Artery Dissection (SCAD) patients are women, and it accounts for 25% of all heart attacks in women under the age of 60. 

What happens when your health care practitioner is only looking for the heart diseases that mainly affect men? You guessed it - potential late or incorrect diagnosis for female patients. 

What Special Risk Factors Do Women Have? 

Many heart disease risk factors are the same for men and women - it's the strength of the risk that matters. 

Obesity & Smoking

Of the many shared factors, obesity and smoking are the ones that most often impact women more than men. In one study, obesity increased the risk of heart disease by 64% in women, compared to 46% in men. In another study, female smokers had a 25% higher risk of heart disease when compared with men.

Breast Cancer Treatment

Women receiving radiation for breast cancer are particularly vulnerable, with studies showing higher rates of fatal heart disease. 

Inflammation

Chronic inflammation is a factor too. Recent research shows that women who have inflammation-related health conditions are a higher risk of heart disease.

Hormones, in Particular Estrogen

Hormones also come into play. We think of estrogen as the quintessential ‘female’ hormone that affects our periods, pregnancy, and menopause. But did you know that there is a key link between estrogen and female heart disease risk?

Pregnancy 

In pregnancy there are big changes in heart rate and blood pressure, which can increase heart attack risk. Diabetes is also a key risk factor, and if Gestational Diabetes appears during pregnancy, the heart attack risk is increased further. 

Menopause

Research shows that heart disease risk for women increases significantly after menopause. It is thought that higher estrogen levels pre-menopause provide a protective heart effect. Studies show that cholesterol levels tend to increase after menopause. Remember those small female arteries that can clog faster than men? More cholesterol means more heart disease risk.

BHRT

Many women undergo Bioidentical Hormone Replacement Therapy during or after menopause to mitigate risks and reduce symptoms, however research shows that for some women, these changing hormone levels can increase heart disease risk. This underlines the importance of working with a professional who is able to properly follow you and test for risk factors.

How You can Reduce Your Heart Disease Risk

In addition to quitting smoking and reducing stress, weight management is the most effective way for women to reduce heart disease risk. Excess weight is hard on the heart, and is a stronger heart disease risk factor for women than men. Let’s look at a few easy ways to get on the path to heart health:

Get Moving

Current medical guidelines suggest that women should engage in a minimum of 2.5 to 3 hours per week of vigorous physical exercise. If that sounds like a lot, try breaking it up into exercise bites of 10 - 15 minutes each.  Take a walk during work breaks, take the stairs instead of the elevator, or have a personal dance party!

Eat More Plants

You don’t have to become a vegetarian or vegan to welcome more plant foods into your life. The key is to make it enjoyable by choosing fruits and veggies that you like, and get lots of variety. Think of veggies as the main course instead of the side dish - aim to have at least 60% of your lunch and dinner plates covered with veggies.  Summer is a great time to get gorgeous local produce. See what’s in season and don’t be afraid to try something new!

Eat Good Fats

When your body craves fat, it's not asking for more chips. It really wants ‘good fats’ like those found in salmon, eggs and walnuts. But if you don’t have these foods often, they’re not on your body’s radar. Try adding these foods to your diet, and see if you notice a change in your fat cravings. Once your body gets to know these nutrient-dense foods it will request them more often!

Nutrients to Support Good Heart Health 

Essential Fatty Acids

These ‘good fats’ are called Essential Fatty Acids (EFAs), and have been shown to significantly reduce the risk of developing heart disease. This supplement is especially important for women, as EFAs also balance hormones. 

Since estrogen levels are a key factor in womens’ heart health, EFA supplementation can play double duty! Ever wonder what’s so  ‘essential’ about them? Our bodies can’t make them on our own, so we need to eat EFA-rich foods, or supplement with high-quality oils.

Selenium

Studies show that low selenium levels are strongly linked to heart disease risk. Selenium is one of the most effective antioxidant supplements, protecting your heart, blood vessels and arteries from damaging free radicals. Brazil nuts are by far the best food source of selenium, with a handful providing a thousand percent of the recommended daily minimum!

It's time to prioritize your heart health.

As a functional health care practitioner, I treat the patient, not the disease. Get in touch and let’s discuss your health history and risk factors, run some targeted labs for a clear picture of what’s happening inside your body and design a personalized treatment plan. Women lead with the heart, make sure yours stays healthy.

Best,

Dr. P

Dan Purser MD

Resources & references

Canadian Women’s Heart Health Centre: http://cwhhc.ottawaheart.ca/

Barish R, Lynce F, Unger K, Barac A. Management of Cardiovascular Disease in Women With Breast Cancer. Circulation. 2019;139(8):1110-1120. doi:10.1161/CIRCULATIONAHA.118.039371

Garcia M, Mulvagh SL, Merz CN, Buring JE, Manson JE. Cardiovascular Disease in Women: Clinical Perspectives. Circ Res. 2016;118(8):1273-1293. doi:10.1161/CIRCRESAHA.116.307547

Kane AE, Howlett SE. Differences in Cardiovascular Aging in Men and Women. Adv Exp Med Biol. 2018;1065:389-411. doi:10.1007/978-3-319-77932-4_25

Karvinen, S. et al. (2019) Menopausal Status and Physical Activity Are Independently Associated With Cardiovascular Risk Factors of Healthy Middle-Aged Women: Cross-Sectional and Longitudinal Evidence. Front. Endocrinol. doi.org/10.3389/fendo.2019.00589.

Leonard EA, Marshall RJ. Cardiovascular Disease in Women. Prim Care. 2018;45(1):131-141. doi:10.1016/j.pop.2017.10.004

Mattina GF, Van Lieshout RJ, Steiner M. Inflammation, depression and cardiovascular disease in women: the role of the immune system across critical reproductive events. Ther Adv Cardiovasc Dis. 2019;13:1753944719851950. doi:10.1177/1753944719851950

Patel H, Chandra S, Alexander S, Soble J, Williams KA Sr. Plant-Based Nutrition: An Essential Component of Cardiovascular Disease Prevention and Management. Curr Cardiol Rep. 2017;19(10):104. Published 2017 Sep 8. doi:10.1007/s11886-017-0909-z

Rosano GM, Spoletini I, Vitale C. Cardiovascular disease in women, is it different to men? The role of sex hormones [published correction appears in Climacteric. 2018 Feb;21(1):92]. Climacteric. 2017;20(2):125-128. doi:10.1080/13697137.2017.1291780

Saeed A, Kampangkaew J, Nambi V. Prevention of Cardiovascular Disease in Women. Methodist Debakey Cardiovasc J. 2017;13(4):185-192. doi:10.14797/mdcj-13-4-185

Heart and Stroke Foundation of Canada: https://www.heartandstroke.ca/

World Health Organization: https://www.who.int/gho/women_and_health/mortality/situation_trends_causes_death/en/

A Natural Approach to Lowering High Blood Pressure

A Natural Approach to Lowering High Blood Pressure

Did you know your blood pressure could be out of control without you even knowing? High blood pressure is a major contributor to heart disease, and the months of stress, uncertainty, poor diet and immobility we have all been going through are not helping matters.

When the way your blood flows through your body is affected by your habits, vital nutrients and oxygen can’t get to where they are needed in the body. And as the pressure continues to mount, we start to see physical damage in the arteries and organs that can lead to heart disease and stroke. 

Heart Disease is Killing Women

Heart disease is the biggest contributor to deaths worldwide, and in spite of what many believe, it’s not only men who are affected. In fact, men represent 49% of deaths from heart disease, whereas women represent 51%. Here are some more jaw dropping facts on women and heart disease:

• A woman dies of heart disease in Canada every 20 minutes.

• Early signs of an impending heart attack were missed in 78% of women, according to a retrospective study published in Circulation.

• Two-thirds of heart disease clinical research still focuses on men.

• Women are five times more likely to die from heart disease than breast cancer.

• Among women, the risk of having a heart attack greatly increases during the 10 years after menopause

1 in every 5 female deaths in the US is attributed to heart disease. Approximately 1 in every 16 women age 20 and older has coronary heart disease, the most common type of heart disease. 

The good news is that there is a lot you can do to bring down your blood pressure and reduce your risk of developing more serious issues in the future.

The 2 Types of High Blood Pressure

Primary hypertension

Primary hypertension is the most common type. It is a long term, chronic condition that develops over time due to factors such as a lack of exercise, poor diet, or a genetic predisposition to high blood pressure. A 2020 study showed that variations in the CYP24A1 gene can have a strong impact on a person’s risk of developing chronic high blood pressure. 

Secondary hypertension

Secondary hypertension is acute, and not as common. It is the direct result of other conditions such as thyroid or adrenal gland issues, kidney disease or alcohol dependence. 

What are the Symptoms of High Blood Pressure?

High blood pressure can develop slowly, with no symptoms. Meanwhile, it may be quietly damaging your arteries, contributing to heart disease and a range of chronic diseases. 

If it goes undiagnosed and untreated for too long, it may start to cause serious issues such as:

• Trouble breathing

• Vision disturbances

• Dizziness

• Headaches

• Nosebleeds

High Blood Pressure Leads to Other Health Conditions

The effects high blood pressure has are determined by which major arteries are affected.

1. Heart Disease and Heart Attacks

High blood pressure affects the body in many ways that increase the risk of developing heart disease or having a heart attack.

• Atherosclerosis

High blood pressure damages blood vessel walls. They respond by putting down fatty deposits (plaques), which act like band-aids over damaged areas but over time make the artery walls hard and inflexible. Arteries become narrower due to the plaque build-up, preventing them from delivering vital oxygen and nutrients throughout the body. And if the plaque breaks apart it can result in a blood clot that could block arteries entirely. 

If the heart arteries are affected, Atherosclerosis can lead to coronary heart disease, chest pain and increased heart attack risk.

• Enlarged Heart

High blood pressure means that the heart needs to work overtime to pump out a higher volume of blood. This increases risk of heart thickening (hypertrophy) especially of the main pumping chamber of the heart, which makes the heart enlarged and less efficient. As the size of the heart increases, so does the risk of a heart attack. 

2 - Cognitive Impairment and Stroke

When atherosclerosis affects the neck instead of the heart arteries, the brain doesn’t receive enough oxygen and nutrients which can cause an entirely different set of symptoms. 

• Vascular Cognitive Impairment

Over time, reduced oxygen flow to the brain can impact our cognitive and problem-solving ability. The most severe form of Vascular Cognitive Impairment is called Vascular Dementia, but milder symptoms can happen much earlier and heart issues should be considered and investigated if problems with multitasking and memory arise. 

• Stroke

If a blood clot or severely narrowed arteries prevent blood flow to the brain for even a short time, it can result in a stroke. The impact of a stroke depends on which part of the brain has been deprived of blood flow. 

An Ischemic Stroke happens when the artery is fully blocked, and is the most common type of stroke. Mini strokes happen when an artery is temporarily blocked, then clears up causing what is sometimes called a ‘warning stroke’. 

Because high blood pressure weakens artery walls over time, the weakened wall may finally give way leading to a hemorrhagic stroke – when a brain artery bursts entirely.  

Any stroke is a dangerous medical emergency.

Lifestyle Factors to Help Lower High Blood Pressure

If you have been diagnosed with high blood pressure, you should continue to take the medication prescribed and have regular check-ups. The following factors are important part of a heart healthy lifestyle:

1 - Diet

Fat, sugar and salt are classic comfort foods, but they can wreak havoc on blood pressure and heart health. When do you crave these foods? Is it when you’re sad? Lonely? Anxious? One way to stop negative dietary habits in their tracks is by recognizing when you’re triggered into emotional eating. 

Reduce Saturated and Trans Fats

Fats play a vital role in the body, such as helping us absorb fat-soluble vitamins like A, E, D and K, and providing energy but not all fats are healthy fats. Here’s how to reduce saturated and trans fats and increase intake of healthy mono- and poly-unsaturated fats. 

Eat Less of These Fats

• Fried foods (chips, French fries)

• Processed meats (deli meats, burgers, hot dogs)

• Fatty meats 

• Grain-based desserts (cakes, cookies, donuts)

• Plant oils (palm and palm kernel)

• Dairy

Replace With These Fats

• Nuts (walnuts, peanut butter)

• Seeds (sunflower, flax)

• Tofu

• Fish (salmon, mackerel, sardines)

• Avocados

• Plant oils (olive, safflower, sesame)

• Beans and Legumes 

Reduce Your Sugar Consumption

Although sugar provides the body with valuable energy, too much can raise blood pressure. Even ‘healthy’ sugars such as coconut sugar and honey should be reduced. 

• Read Product Labels

Sugar goes by several names, making it hard to recognize on product labels. The worst offender is high fructose corn syrup, but anything that ends with ‘ose’ is a sugar. The surprising biggest culprit? Sugar-sweetened beverages. 

Consume less

• Alcohol

• Soft drinks

• Sports drinks

• Canned fruit in syrup

• Processed desserts (candy, chocolate bars)

Replace With

• Water

• Green tea

• Pure fruit juices without added sugar

• Low sugar fruits: berries, kiwis, citrus and melons

• fresh herbs to boost flavor

Reduce Your Sodium Intake

We need salt to maintain electrolyte and fluid balance, but in moderation only. Salt is frequently added to processed foods to extend shelf life and enhance taste. Here’s how to cut back:

Reduce Intake

• Less processed, pre-packaged and fast foods

• Rinse canned goods before eating

• Remove the salt shaker from your table

• Taste food before adding salt

• Crackers, chips and salted nuts

Replace With

• Herbs, spices or lemon to enhance flavour

• Cooking more at home, where you can control salt levels

• Raw nuts, homemade crackers, homemade sweet potato chips or kale chips

• cut-up veggie sticks

2 - Exercise

Exercise can effectively reduce high blood pressure by improving artery health and managing weight. The Heart and Stroke Foundation recommends a minimum of 150 minutes per week of moderate to vigorous aerobic exercise for adults, and one hour per day for children and youth. 

Tips to Increase How Much You Exercise

1. Mix it up: do weight-bearing exercise two days per week and cardio 3 days per week

2. Set daily hour limits on sedentary activities like watching TV 

3. Use active transportation like walking or biking for short trips

4. Plan active family outings like hiking or going for a swim

5. Do active household tasks as a family like shovelling snow and dog-walking

6. Embrace outdoor winter activities like ice skating, tobogganing and skiing 

7. Try indoor cardio like an online aerobic class or put on your fave tunes and dance like nobody's watching 

3 - Reduce Your Stress Levels

Stress has a strong blood pressure-raising effect. Here’s how to lower your stress response, and improve stress resilience:

Mindfulness and Meditation

A 2020 review examining behavioural strategies found that mindfulness training had the greatest blood pressure-lowering effect. How does it work? Participants in a 2020 study reported that increased self-awareness, attention control, and emotion regulation helped them make better health choices, and improved their ability to handle stress.

Another 2020 study found that after 12 months of using a breathing meditation app, participants' blood pressure was significantly reduced. 

Simple Activities That Help Increase Mindfulness

• Meditation. The key is to focus on one thing to the exclusion of all else. Try one of the many free meditation apps (like Headspace). Try fixing your mind on a single candle, or close your eyes and visualize a peaceful spot. 

• Deep Breathing. Breathwork can quickly bring you back to a calm state, and can be done anywhere, anytime. Try the simple but effective box breathing technique: breathe in for four counts; hold for four; breathe out for four, hold for four.

• Yoga. Combining breathing, focus and exercise, yoga is one-stop shopping for stress relief. Include forward bends but avoid poses that compress the diaphragm. Try these 5 blood pressure-reducing poses from Yoga International.

4 - Blood Pressure-Friendly Food Based Supplements

While supplements are not a substitute for maintaining close contact with your physician and following their advice, certain everyday nutrients have shown positive results in research studies. 

Vitamin C

Vitamin C does more than support our immune systems. A 2020 review concluded that Vitamin C supplementation resulted in significant reduction of blood pressure in patients with essential hypertension. Another 2020 review found that low vitamin C levels were strongly associated with high blood pressure. 

Garlic

What kitchen staple can reduce blood pressure? The allicin in garlic supplements have been shown to lower blood pressure by widening blood vessels, increasing nitric oxide production and relaxing the smooth muscles found in blood vessels. 

CoQ10

Brain Support Micro PQQ MicroActive CoQ10 is one of the best sources of all natural CoQ10. It has one of the highest doses for any supplement CoQ10 on the market. 220mg per dose provides massive anti-inflammatory cardiovascular support. Not to mention all the brain health benefits as well.

Are you at risk of high blood pressure? It's never too early to talk about prevention. Integrative Medicine can help put you on a path to a healthy lifestyle designed to work for you. Prevention and management requires changing lifestyle habits but going at it along can be challenging. Let’s work together to ensure your heart health and overall health is maximized!

Give us a call today 801-796-7667 or info@danpursermd.com

Best,

Dr. P

Dan Purser MD

References

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Ran L, Zhao W, Tan X, Wang H, Mizuno K, Takagi K, Zhao Y, Bu H. Association between Serum Vitamin C and the Blood Pressure: A Systematic Review and Meta-Analysis of Observational Studies. Cardiovasc Ther. 2020 Apr 29;2020:4940673. doi: 10.1155/2020/4940673. PMID: 32426036; PMCID: PMC7211237.

Tabassum N, Ahmad F. Role of natural herbs in the treatment of hypertension. Pharmacogn Rev. 2011 Jan;5(9):30-40. doi: 10.4103/0973-7847.79097. PMID: 22096316; PMCID: PMC3210006.

Benjamin, E.J., Muntner, P., Alonso, A. Bittencourt, M.S., Callaway, C.W., Carson, A.P., … & Virani, S.S. (2019). Heart disease and stroke statistics – 2019 update: A report from the American Heart Association. Circulation,139, 56-528.

Heron, M. (2018). Death: Leading Causes for 2016. National Vital Statistics Report, 67(6), 1-76.