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Women’s Health and Fitness Series Part II: Heart Health

Last week we discussed the role of fitness in women’s overall health, and this week, we will address cardiovascular disease, which kills about 17 million people a year, and is the leading cause of death for women in the United States according to the CDC’s most recent estimates. A wide range of factors are associated with increased risk of heart disease, including high cholesterol, high blood pressure, diabetes, cigarette smoking, obesity, poor diet, lack of physical activity, and alcohol use, and since many  of these factors are behavior-related, they can be modified to reduce risk.

For example, stress can contribute significantly to poor cardiovascular health. To investigate this relationship, researchers from Harvard University observed 22,086 women working as medical professionals over a 10 year span. They found that this population, interpreted as having high-stress jobs, had a 38% increased likelihood of experiencing a cardiovascular disease (CVD) event compared to women who held low-stress positions. While this risk should never deter anyone from a career in medicine,  it is worth noting the importance of making efforts to stay active and lead a balanced lifestyle when evaluating any career choice.

However, there are other cardiovascular disease risk factors, such as age, family history, and, most recently observed, geographic variation, that are harder for individual women to control. A PLOS ONE study published last November examined data for 26,029 women from across the United States averaging 53 years of age who did not show signs of cardiovascular disease. The researchers, from Harvard Medical School, looked at the blood levels for certain compounds, or biomarkers, that are associated with and are known to increase the risk for heart disease in women, and compared the variation across the country. They found that those living in Southern and Appalachian states had high levels of specific biomarkers, indicating higher risk for cardiovascular disease. Even after implementing controls to account for environmental or behavior-related risks, the variation remained. The authors note, however, that more research is necessary to understand exactly why this variation exists.

There are a multitude of variables that affect heart disease, some controllable and others not, but research continues to show that there are steps we can take to actively improve individual and general heart health. And, as the scope of this research continues to expand, we are able to explore the finer details of the disease and how it affects different populations like women. For example, while the “elephant on the chest” metaphor works well enough to describe the symptoms associated with heart attacks in men, women tend to experience more subtle symptoms when having heart failure, which leads to a high rate of delayed and misdiagnosed cases. Specifically, women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease or microvascular disease ( – which makes their symptoms different from those that men experience.  There is a misconception that heart failure affects men more than women, but as medical professionals and the public have a clearer understanding of these anatomical particulars, they will be better equipped to target prevention and treatment for women.

Remember to check out next week’s post on the Women’s Health and Fitness Series where we will discuss anorexia.

Citation: Slopen N, Glynn RJ, Buring JE, Lewis TT, Williams DR, et al. (2012) Job Strain, Job Insecurity, and Incident Cardiovascular Disease in the Women’s Health Study: Results from a 10-Year Prospective Study. PLoS ONE 7(7): e40512. doi:10.1371/journal.pone.0040512

Citation: Clark CR, Coull B, Berkman LF, Buring JE, Ridker PM (2011) Geographic Variation in Cardiovascular Inflammation among Healthy Women in the Women’s Health Study. PLoS ONE 6(11): e27468. doi:10.1371/journal.pone.0027468

Image Credit: Nattu from Flickr

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