You could have a greater risk of heart disease than you think. Recent studies have uncovered a variety of surprising factors in cardiovascular problems, from calcium to cancer treatments to a common virus. To mark American Heart Month, read on for the latest research, along with steps you can take to reduce your risk...
Many women underestimate the dangers of heart disease, believing it’s mostly an issue for men, the middle-aged or elderly.
But even younger women are at risk, experts caution.
“Heart disease is the No. 1 killer of women, and women under age 50 are twice as likely as men to die from a heart attack,” says Shalizeh Shokooh, M.D., a cardiac surgeon at the Orange County Heart Institute in Orange, Calif., and co-author of Women and Heart Disease: An Epidemic (OC Heart Health Books).
A woman's susceptibility to heart attacks rises with certain risk factors, new research has found.
Scientists are uncovering new clues about a variety of contributing issues – including genetic mutations, an HPV infection or even too many calcium supplements.
Read on to find out what they are and how to lower your risk.
Heart disease risk #1: Genes related to breast and ovarian cancer
The BRCA1 or 2 genes associated with hereditary breast and ovarian cancer also increase your odds of dying from a heart attack, says cardiac surgeon Subodh Verma, M.D., Ph.D., associate professor at the University of Toronto.
“You may be at a higher risk for developing heart disease [and] cancer,” he says.
Those mutated genes also hinder recovery from a heart attack by preventing “DNA repair in muscle cells,” says Verma, co-author of a 2011 study on the subject.
As a result, heart attacks in women with the mutations may be twice as severe, and 3-5 times more likely to be fatal, than for those without the
mutations, he says.
Reduce your risk: If you have breast or ovarian cancers in your family, or another known gene mutation, tell your doctor and get screenings. That means it’s even more important to follow good heart-health guidelines, including eating a nutritious diet and exercising regularly, Shokooh adds.
And see your doctor or call 911 if you experience any signs of heart disease, such as pain, pressure or discomfort in the chest.
Heart disease risk #2: Human papillomavirus (HPV)
If you have HPV – the group of viruses associated with genital warts and cervical cancer – you could be courting heart disease.
“You may be twice as likely to develop heart disease if you have HPV, even if you have no other risk factors,” says Ken Fujise, M.D., director of cardiology at the University of Texas Medical Branch in Galveston and co-author of a 2006 study on HPV and heart disease that involved 2,500 women.
“That’s because HPVs inactivate genes that regulate atherosclerosis [hardening of the arteries] and [harmful] cell proliferation,” Fujise says.
A subset of cancer-causing HPVs, which are responsible for 70% of cervical cancers, is also the most dangerous to your heart, he says.
Reduce your risk: “If you have chest pain or a cancer-causing HPV, get a routine medical evaluation to rule out heart disease, and incorporate healthy eating habits and exercise to help reduce your risk,” Fujise advises.
To prevent infection, consider getting an HPV vaccine, he adds.
It's most effective if you're vaccinated between the ages 13-26 and before you’re sexually active.
If you’re older than 26 or already sexually active, it may not offer as much
protection, he says.
Heart disease risk #3: Excess calcium
Watch out if you pop calcium supplements like candy.
Women who took 1,000 milligrams of calcium supplements daily increased their risk of heart disease by 31%, according to a 2011 study at the University of Auckland in New Zealand.
“Too much calcium in your diet can cause calcification of the arteries, which can cause a heart attack,” Shokooh warns.
Reduce your risk: “If you’re already getting enough calcium from your diet, you don’t need to take calcium supplements,” says Felicia Cosman, M.D., professor of clinical medicine at Columbia University College of Physicians and Surgeons in New York and clinical director of the National Osteoporosis Foundation.
What's the right amount for women?
“You need 1,000 milligrams if you’re 50 or younger, and 1,200 milligrams if you’re older than 50,” Cosman says. “That’s from a combination of foods and supplements, not 1,000-1,200 milligrams of calcium from supplements alone.”
For example, a serving of milk, enriched soy milk or yogurt all have about
300 milligrams of calcium.
Heart disease risk #4: Age-related stiff arteries
Our arteries naturally stiffen as we age, a known factor in heart disease.
But until recently, scientists didn't know what caused the condition. Now, research conducted at the University of Missouri in 2011 has isolated the culprit.
“Decreasing levels of elastin and other proteins like collagen cause stiffening, which increases cardiovascular disease and impacts blood flow to tiny blood vessels,” says Gerald Meininger, M.D., professor of medical pharmacology and director of the university’s Dalton Cardiovascular Research Center, who co-authored the study.
“The stiffening appears to begin around age 50 in healthy women and accelerates after menopause,” he adds.
Reduce your risk: Good health habits are the way to go.
“We’re still a ways from being able to regulate the production and degradation processes governing elastin within the blood vessel wall,” Meininger says.
“However, it’s clear that good nutrition and regular exercise lead to improved vascular health and delay or slow the stiffening process,” he says.
Avoiding risk factors such as diabetes, hypertension, metabolic syndrome, blood lipid problems (high cholesterol and high triglycerides) can also
delay problems, Meininger adds.
Heart disease risk #5: Insufficient screening
For years, doctors have relied on angiograms – X-rays that look at arteries in the heart – to detect heart disease. Now new research shows that angiograms don’t always reveal a problem.
“Up to a third of young women who have heart attacks don’t have the classic culprit of a blocked artery on their angiogram,” says Sohah Nauveed Iqbal, M.D., a cardiologist with NYU Langone Medical Center in New York and co-author of a 2011 study on the topic.
“Some women suffer heart attacks because of plaque or plaque ruptures in arteries [which cause blood clots],” she says.
When found, those problems need to be treated aggressively with medication, she says.
Reduce your risk: Plaque or plaque ruptures can be detected by ultrasound tests. If you’re at high risk for cardiovascular disease, ask your doctor if you’re a good candidate for a heart ultrasound.
Heart disease risk #6: Chemotherapy
“Chemotherapy could save your life, but it could also increase your risk of developing heart disease down the line,” Shokooh says.
Up to 32% of women who received chemotherapy with the drug anthracycline developed heart disease within 10 years, according to a 2011 study on nearly 20,000 women conducted at the University of Texas Anderson Cancer Center.
And 10%-50% of women who received anthracycline suffered heart weakening, which increases the risk for heart disease risk factors such as high cholesterol and blood pressure, according to study co-author Dennis Slamom, M.D., Ph.D., director of the Revlon/UCLA Women's Cancer
Research Program in Los Angeles.
Reduce your risk: Ask your doctor if you’re a good candidate for newer chemotherapy medications.
“With newer chemo drugs, it’s possible to minimize and, in some cases, eliminate exposure to drugs like anthracycline,” says David Rosi, M.D., medical director of the Marjorie G. Weinberg Cancer Center at Loyola University Health System outside Chicago.
But women who have had chemotherapy must still be vigilant. Newer chemo drugs are less dangerous, but they may still cause heart problems, Shokooh says.
So ask your doctor to check your heart before and during chemotherapy to make sure there are no major problems, according to the American Heart Association (AHA).
Also, tell your doctor immediately if you notice changes in your heart rhythm, shortness of breath, weight gain or fluid retention, Shokooh advises.
Heart disease risk #7: Radiation therapy
Radiation to treat breast cancer, especially in your left breast, may harden arteries and cause blood clots, according to a 2004 study of about 200 women conducted at Uppsala University in Sweden.
Reduce your risk: The good news is that radiation is much safer today than it was in 2004, Rosi says.
During breast cancer treatment, “much more … effort is being made to reduce radiation to the heart,” he says.
If you’re undergoing radiation, talk to your medical oncologist and radiation technician to ensure that they’re doing everything necessary to
protect your heart, Rosi adds.
Heart disease risk #8: Metabolic syndrome
Have excess belly fat, an enlarged waist (more than 35 inches), and high blood pressure, cholesterol and triglycerides?
Those factors, a condition called metabolic syndrome, double your risk of heart disease, according to a 2010 study conducted at Texas Tech University Health Science Center in Odessa.
Reduce your risk: Go on a diet.
(Find the right diet plan for you.)
“Losing just seven to 10% of your weight over six months can dramatically reduce your risk of metabolic syndrome,” says Michael Jenson, M.D., an endocrinologist with the Mayo Clinic in Rochester, Minn.
How to lose the weight? Eat a low-fat, low-cholesterol and low-sodium food plan like the Mediterranean Diet or DASH Diet. Include lots of fruits, vegetables and whole grains to help control your weight and reduce cholesterol, he says.
Heart disease risk #9: Being a couch potato
Researchers have long known that vigorous exercise is good for your heart and increases longevity, but they weren’t sure why – until recently.
Now scientists are giving some credit to endorphins, the feel-good chemicals released by strenuous exercise and responsible for “runner’s
high,” according to a 2007 conducted at the University of Iowa.
“Getting a runner’s high increases the release of several opioid systems in heart muscles and changes the expression of genes involved inflammation and cell death,” says Eric Dickson, M.D., associate professor of emergency medicine at the University of Iowa and co-author of the study.
Reduce your risk: Exercise daily, but “you don’t have to run to get a runner’s high," Dickson says.
"Any kind of aerobic exercise that works up a sweat – cycling, rowing, aerobic dance, working out on machines – is fine,” he advises. “Aim for at least 30 minutes four times a week. Even better, exercise every day.”
For maximum heart benefits, do interval training by incorporating a series of short bursts of intense exercise into your workout and alternating low-intensity exercise or rest, a 2011 study at the University of the West of Scotland found.
Women who sprinted saw more improvements in blood pressure and heart health than women who ran steadily for 20 minutes.
It also helps lose belly fat. Women who engaged in 20 minutes of interval training daily lost more belly fat than women who did cardio workouts that were twice as long, according to a 2010 study conducted at the
University of New South Wales in Australia.
To learn more, visit our Heart Health Center.
Are You on the Road to a Heart Attack?
Every 20 seconds, a heart attack occurs somewhere in the United States. Coronary heart disease, the leading cause of death in this country, contributes to the 1.5 million heart attacks that occur each year. Will you become a part of this statistic?
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