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Feature Story


Ladies, it's time to get to the heart of the matter.

by Javelyn Ramos

MAY 2012

Many would consider women lucky, since their bodies have better immune systems and have a higher tolerance for pain. However, this edge does not necessarily apply when it comes to the issue of heart disease.

Market intelligence firm Euromonitor charted a steady—albeit small—rise in deaths in the Philippines due to heart diseases from 2006 to 2010. Although the growth rate of deaths due to heart diseases have slowed down—attributed to the health and wellness trend being practiced by all economic classes in the country, it cannot be denied that the Philippines is following in the overall upward trend making Filipinos more prone to hypertension and stroke.

The 2008 National Nutrition and Health Survey (NNHeS II), a separate study by the government, revealed an increase in the number of hypertensive Filipinos from 22.5 percent in 2003 to 25.3 percent in 2008. Even with the health and wellness trends in the country, taking care of the heart seems like a challenging ordeal for Filipinos.

Benjamin Co, M.D., a specialist at Asian Hospital, defines hypertension as “when your blood pressure [reaches] beyond 140/90 ...” He adds that once an individual’s blood pressure reaches 130/80, “…you already are [pre-]disposed for hypertension.”

Hypertension is a known cause for stroke. Dr. Co explains that it happens “… if there is a blood clot somewhere in the heart of the person. Elevated blood pressure can push these blood clots to the brain or the lungs.” The former results in stroke, the latter, in pulmonary embolism—both of which can cause debilitation and possibly death.

The fairer sex

Everyone is aware that hypertension and stroke are consequences of modern day health concerns such as obesity, diet and stress. However, the factors specific to women are not as commonly discussed.

Lynda Rosenfeld, M.D., co-author of the Yale School of Medicine Heart Book states, “[Heart disease] is more prevalent in women than what was previously thought.” She says that in both men and women, heredity, age, race, blood pressure, blood cholesterol and smoking are risk factors for heart disease. “However, women appear to be more affected by certain factors, such as smoking and diabetes, than are men.” Other factors such as a woman’s naturally smaller body size and arteries are also factors to consider when checking their susceptibility to heart disease.

Dr. Rosenfeld also considers uniquely female life experiences as factors in their susceptibility to hypertension and heart disease: “Only women become pregnant, experience menopause, and are prescribed contraceptive pills and postmenopausal estrogens.” These can cause changes in a woman’s body that may leave her more prone to cardiovascular problems.

Menopause and effect

As we age, bodily functions tend to slow down as organs begin to deteriorate. However, for women, age also entails menopause, which gradually causes the depletion of estrogen, which editorial writers Narkiewicz, Kjeldsen and Hedner call the “protective effect” of the female gender, both for cardiovascular disease and for hypertension.

Dr. Rosenfeld says that estrogen, which regulates menstruation and starts to dwindle at ages 45 to 65, protects women against heart attack by increasing a high-density lipoprotein, a type of cholesterol which prevents blockages in the arteries. “When menopause occurs naturally, the risk of a heart attack rises gradually; when it is caused by surgical removal of the ovaries, heart attack risk rises more abruptly,” she elaborates.

Hormone replacement therapy (HRT) with estrogen is a possible solution, known to relieve the discomfort of menopause and confer possible protection against heart disease at this stage of life. However, it also carries an increased risk of endometrial cancer and other estrogen-dependent tumors. It is best to consult an OB-GYN to weigh the pros and cons of HRT.

Birth control, smoking and stress

Oral contraceptives are also a consideration. High-dose birth control pills of the past were found to contribute to heart attack risk. However, modern formulations have lower doses and different forms of estrogen, and no longer increase cardiovascular risk unless a woman smokes or has other risk factors, according to some studies. Dr. Rosenfeld qualifies that “a woman taking oral contraceptives is more likely to develop high blood pressure if she is overweight, has a family history of high blood pressure, or has mild kidney disease.”

Smoking, besides being the popular reason for lung cancer, can also affect a woman’s resistance to heart diseases. Dr. Rosenfeld explains, “Smoking is … probably the most significant risk factor in women, because it reduces a woman’s two best protectors, estrogen and HDL.” She mentions some researchers speculate that if there were more women smokers than men smokers, heart attack will become a woman’s disease—which may happen sooner than we think, if current trends progress.

Working women in today’s modern times also increases the gender’s susceptibility to hypertension and stroke. The increasing female force in the workplace has led researchers to wonder about the impact of job-related stress on women’s hearts. Research from the Framingham Heart Study has revealed that women maintain a low heart disease risk as they move up the corporate ladder to positions that accord them more autonomy. However, this eventually reverses once these jobs produce unhealthy habits, such as eating high-calorie, high-cholesterol business dinners, or smoking to relieve stress.

For tips on preventing the onslaught of heart problems for women, grab a copy of the May issue of HealthToday magazine, out now in bookstores and major newsstands.

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