Tuesday, February 14, 2012
The Heart of the Matter
February is heart month! Yah- I think Valentine is bullshit. One day a year to tell someone you love them? I DON"T THINK SO. That being said- in the spirit of heart month I thought I'd devote a Tuesday to empowering my cybersisters on good heart health....
A few weeks ago I found myself at a cocktail party (yes doctors are people too) and inevitably the question of “what do you do?” came up from a woman at the party.
“I’m a physician”, I responded innocently enough, between sips of my Riesling.
“Family doc?” she asked almost eagerly. Given the shortage of female family doctors I was not surprised that she was hoping to be one of my newest patients.
“No, I’m a specialist in Cardiac Risk Management. You know, Diabetes, High Blood Pressure, Cholesterol.” I answered.
“Oh”, she said disappointed, “I’ll never need you. No family history and I am a Yoga freak”.
We shared a laugh, and the conversation went on without me about her latest hot yoga instructor. In the end, it was not the place or the time for me to give my infomercial speech about the importance of risk factor screening in women. But here I sit in a local Vancouver café, the wine has been replaced with a non-fat late and I’m feeling the need to inform. Don’t get me wrong, I hope that lovely woman at the party NEVER needs my help, but there is a very good chance she will.
When it comes to risk factors for heart attacks and strokes, as women we have a ways to go. One in three women in Canada will die of heart attacks and strokes, compared to one in twelve women who will die of breast cancer. It sounds bleak but the best thing we can do for ourselves is what women have always done when faced with a challenge… inform and reform. So I thought I would spend my first five inaugural entries on the five greatest risk factors for heart attacks and strokes that affect women and what we can do about them:
First up this week is High Blood Pressure: (also called Hypertension)
Sixty percent of Canadian women over the age of 60 have high blood pressure and only about half of them are aware of it. The average person will need at least 3 medications to control their blood pressure to target.
The optimal numbers for blood pressure are less than 120/80 mmHg. Prehypertension is defined as blood pressure between 120-139/80-89. Hypertension is a blood pressure 140/90 or higher.
The top number is called the systolic (systole is Latin for “pump”) and the bottom number is called the diastolic (diastole is Latin for “relax”). Both numbers are equally important and home blood pressure readings are far more accurate than the readings at a doctor’s office. (Hell the book is always better than the movie) Your optimal numbers at home should be 5 mmHg lower than in the office. (So high blood pressure at home are numbers greater than 135/85)
So Ladies…. You know your shoe size, you hair colour and your dress size in Europe and North America….time to know your blood pressure. Next time you are at the drug store (You know who you are…I see you casually pacing the cosmetics isle wondering if today is the day to spend $40 on the lip plumping serum) Make your way over to the pharmacy and sit down at the blood pressure machine and follow these simple steps:
1. Put down the basket, purse and cell phone you are holding.
2. Turn off your iPod- 3 minutes with your own thoughts will not kill you.
3. Think good thoughts
4. Sit down at the machine, comfortably, feet on the floor
5. Wait 3-5 minutes quietly.
6. Longest 5 minutes ever isn’t it?
7. Arm in the machine, elbow resting, make sure the machine’s “sleeve” is covering your bicep. (Best to have a bare arm)
8. Push the button on the machine marked “start” (I’m really not a jerk)
9. The cuff does the rest for you…..
10. Take two readings about 2-3 minutes apart and keep track over a period of a few weeks.
I know, not rocket science. Anyone who can put lipstick on in a moving vehicle should find this frighteningly simple. The thing is it is probably one of the best screening tests a woman can do in terms of cardiovascular health.
So now you know your numbers… what to do about them? Well if you have high blood pressure…. See your family doctor. It is likely (almost certain) you will need blood work monitored and medications to control your blood pressure. The biggest thing to remember is that there are a variety of classes of medications to choose from so don’t be discouraged. Your doctor will find the right one for you to take. Most agents have very little side effects for the majority of patients. Lifestyle modification is also key and I will get to that in a minute.
What do you if your blood pressure is “kissing” high?
Studies show that women with mild elevations in blood pressure (pre-hypertension) can dramatically reduce their blood pressure and their risk of developing high blood pressure through diet and exercise. I know, a doctor who preaches lifestyle modification? Where the hell did I go to school?
It’s something to think about the next time you find yourself alone at a restaurant waiting for your girlfriends to arrive and your Blackberry has run out of batteries My bottom line? Check your blood pressure, know your numbers and get moving a little more each day. Know a little bit about what you are eating and don’t just “live green” – eat it. Finally, don’t rush towards the next big change. All in all, change is good but it is best when it is done in steps. We tend to stick to things if they come on gradually rather than if they are severe. Think of it like running in heels…. You really need to walk first.