Are You at Risk for Heart Disease?

You may feel healthy, but is your heart happy? In this exclusive interview, Harvard cardiologist Malissa J. Wood, M.D., explains how a can-do attitude helps prevent heart disease, plus more heart-healthy lifestyle changes…

Malissa J. Wood, M.D., treats lots of women – depressed, anxious women – at her Corrigan Women’s Heart Health Program within Massachusetts General Hospital.

“They get so caught up in day-to-day dramas that they can’t enjoy life,” she says.

Sound familiar? Rejection, curt words from the boss – we all get stressed out now and then. But the problem with depression and anxiety is that they “raise heart rate and blood pressure,” forcing the heart muscle to pump harder and often leading to heart disease and diabetes.

But there are some simple cures, Wood says: Laughter, for one. Dancing. And even a doughnut here and there.

An assistant professor at Harvard Medical School, Wood advocates a holistic approach to heart health that includes nutritional advice, exercising, managing stress and overcoming depression and anxiety.

She’s also a marathon runner, so she practices what she preaches.

In this exclusive Lifescript interview, she explains how women can turn their health around simply by eating better and laughing more – and why a “broken heart” hurts more than just your feelings.

Do you see a big difference between women who lead a healthy lifestyle and those who don’t?
It’s substantial. Heart disease is the No. 1 killer of women, and yet it’s often preventable.

In fact, the single most common cause of otherwise preventable death is cigarette smoking.

You talk about the need for a “happy heart.” How does that correspond to a physically healthy one?
The brain has control over the heart.

For example, “broken-heart syndrome” is a condition where something bad happens in a person’s life and the brain sends a message that something’s wrong. That leads to the heart ballooning out and not pumping well.

Information goes the other way too. When you’re more organized and happy, and your life is in control, your heart can improve.

How can women achieve a “happy heart”?
Quit smoking, exercise regularly, follow the American Heart Association’s nutrition guidelines, manage stress and have fun!

We want more women to laugh – it’s great for your blood pressure and your brain.

We know that when people experience depression, their risk for heart disease is much higher.

How does stress damage women’s hearts?
It raises heart rate and blood pressure. The heart muscle is pumping harder, so it needs more oxygen to pump the same amount of blood.

This isn’t bad in the short term, but over time it can weaken a heart.

If this condition becomes the norm, the high level of stress hormones, such as cortisol and glucagon – fight-or-flight hormones created to give us immediate energy surges – make your body store fat and carbohydrates around your middle, creating the apple body shape. This can lead to diabetes and high blood pressure.

What are the best methods for managing stress?
When things get out of control, set aside at least three minutes to sit quietly and do a mantra meditation, which gets you into that relaxed space. This involves deep breathing while thinking about a word or image.

(For instructions on mantra meditation, read 7 Moves to Lift Your Mood.)

How’s heart disease different in women than it is in men?
Some risk factors for men and women are the same, such as high blood pressure, diabetes, obesity and stress.

But younger women with heart disease are more likely to have a family history [of heart problems], and low HDL [“good” cholesterol] linked to that family history.

More men have heart attacks when they’re younger, and women have them when they’re older. Women who have heart attacks under the age of 55 tend to be more sedentary or obese, and are more likely to die during hospitalization than men.

And how are women’s heart-attack symptoms different?
They tend to experience tightness in throat, jaw, neck, ear or back, and they will feel extreme fatigue. We think the way the heart affects nerves makes women sense the discomfort differently.

(For more on heart attacks, read Women: How to Recognize a Heart Attack and What to Do.)

How do you help women make the right choices?
We encourage women to look at the whole picture: what they eat, their weight and stress levels, and how much exercise they’re getting. Then we help them work on the pieces that are broken.

For example, we tell a patient about exercise programs in her community – like the YWCA, Pilates classes or walking groups. We might also suggest steps to go off medications for high blood pressure.

How does exercise change the structure and function of the heart?
Exercise “trains” the heart, allowing it to become more efficient by making the blood vessels more flexible. It decreases stiffening of the valves and heart muscle.

It helps with high blood pressure, weight management and glucose [blood sugar] metabolism.

Are there other benefits?
It also helps your brain – by giving you time to yourself and the knowledge that you’re doing something good for your body.

Some women in our program have admitted that they come home after a difficult day, sit down and eat a loaf of white bread – and then they feel guilty and helpless. The opposite feeling happens when a woman goes out to walk with her group on a Saturday morning.

I’m a huge advocate of mind over matter. When I visited China, I saw people in their 90s doing tai chi, and they were spritely!

Here, we’ve found that when very sick patients started doing tai chi, their quality of life improved significantly.

How long do you need to exercise to keep your heart healthy?
The current guidelines suggest about 2-1/2 hours of moderate exercise or 75 minutes of brisk exercise per week. You can break this into chunks of time if necessary.

What dietary changes should women make for maximum heart benefits?
Eat small meals with lots of fresh fruit and vegetables, and fewer processed foods.

Moderation is key – what you eat 90% of the time matters. If you love Krispy Kreme doughnuts or steak, then have it once a month.

Any advice on how to make healthful substitutions?
When shopping for meals, instead of thinking, What’s quick, easy and cheap? Think: What’s cheap, nutritious and delicious?

We teach women to make recipes using yogurt instead of sour cream and olive oil instead of butter, and to broil food instead of frying.

You’re involved in a prevention program through your hospital. What does that include?
Yes, the HAPPY Heart (Heart Awareness and Primary Prevention in Your Neighborhood) study at Massachusetts General Hospital is a primary prevention study of 65 low-income women between 40 and 60 years old who have at least two risk factors for heart disease, but haven’t had a heart attack.

Each meets with a cardiologist, nurse, nutritionist and physical therapist, and also has access to tai chi, Zumba [dance fitness] and yoga classes. The goal is for these women to drop weight and lower their cholesterol.

What did you learn about stress from women in the study?
One thing we found is that 70% of the women entering the study were depressed.

We also found that 60% of them had metabolic syndrome [a cluster of conditions that can include obesity, high blood pressure, high triglyceride levels and insulin resistance], but only 2% had a doctor who recognized that.

Metabolic syndrome is very malignant. It consists of multiple factors that are begging to be managed by healthier lifestyle changes.

What techniques have been successful for overcoming depression and anxiety?
The women in our program deal with a lot of adversity in their lives, and yet they’re very resilient. They meet once a week and support one another.

One key success of our study is this social interaction – women share their challenges and solutions with each other. Their scores show that at the one-year mark, they’re less depressed.

Anything else about heart health women should know?
Many women don’t realize they’re at risk for heart disease, and they don’t pay a lot of attention to it when they’re young.

Women go to the doctor once a year to get a Pap smear and mammogram, and certainly these are great tests. But they should also talk to their doctors about their risks for heart disease.

And a woman should know her numbers: her cholesterol and triglyceride levels, blood pressure, body mass index and waist circumference.