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Each Woman's Heart Health Is Unique
Heart disease is an inherited disease, and it is not gender specific. Women have been provided 'equal opportunity' for heart disease due to their genetic pool alone.
by Brenda Garrett
February 1, 2007
O n the day of conception, gene selection occurs for everything in our body—color of hair, our height, and yes, our predisposition to develop heart disease. Our genetic code that can determine our risks for heart disease is not gender selective, merely determined by our parents.
As a cardiovascular nurse, I have experienced this scientific lesson many times. Women who appear healthy find themselves in harms way when heart disease is diagnosed. Although it may be true that heart attack risk, being equal in males and females, may occur at an earlier age in a male than a female – nearly two thirds of American women die of a heart attack with no prior symptoms and no prior detection.
The good news is we can positively affect a woman's heart disease risk even when she is predisposed by her genetic makeup.
Choosing a healthy lifestyle plays a far greater role than one might think. Our lifestyle choices can actually ‘turn on’ or ‘turn off’ many of our genes that cause heart disease. For example, if someone inherits multiple high blood pressure genes but does not gain weight or eat foods high in salt, she might not develop high blood pressure. However, if she gains excess body fat, is sedentary and adds salt to every meal, the likelihood of her having high blood pressure is very great. So whether, male or female, young or not – our daily environmental choices interact with our genes.
Sometimes, it takes more than a healthy lifestyle. Sophisticated early detection and individualized treatment strategies are now available to specifically target why one individual develops heart disease as opposed to why another develops the disease. I'll use a charming female executive I worked with as an example.
While our 47-year-young executive took pride in the fact that she had led a healthy lifestyle and had managed to keep her weight at an average body mass index (BMI), she was a heart attack waiting to happen.
She was referred to the Fuqua Heart Center for Prevention because she was found to have an abnormal lab value called Lipoprotein (a) or Lp (a). This marker is most often discovered through an advanced lipid analysis, not a routine cholesterol screening. This sophisticated test was performed as part of her annual executive physical.
When we met her, she had already been prescribed a mild antihypertensive medication but was not treated for any cholesterol disorders. Her family history was what we refer to in medicine as “ remarkable” . Her father had suffered a heart attack in his early 40s and died from his second heart attack at age 49. At 50, her slightly older sister had already required one stent implanted to open a blockage in the blood flow to her heart but was reportedly doing well.
Our patient was rightfully concerned about her health. She had her only child at age 37 and was currently not only a busy executive but also an avid Girl Scout leader to a group of 10-year-olds! The year before her diagnosis, she had experienced episodic symptoms of left shoulder pain and visited an ER during the night for an evaluation. She was informed she should not worry – it was not heart-related.
This patient was ultimately diagnosed at Piedmont Hospital to, in fact, have heart disease. She had undoubtedly inherited some of her father's genes. Her metabolic profile revealed that she was positive for not only Lp(a) but also a combination of an impaired HDL (good cholesterol) and a ‘ small LDL’ (bad cholesterol) trait – better known as the Atherogenic Lipid Profile (ALP gene). Her prescribed drug therapy was a statin and niacin combination that would not only lower her bad cholesterol but also specifically target raising her good cholesterol. The niacin would also target lowering her inherited elevated Lp(a). Her interventional therapy was an elective procedure that consisted of a stent to prop open a narrowed artery that supplied blood to the bottom portion of her heart.
Women are not just small men – our symptoms often are different from those of men. We also are a bit more challenging to diagnose and should not rely on stress tests alone to rule out heart disease. Early detection of all risk factors (inherited as well as environmental) and intervention (sometimes as simple as a diet supplement) can prevent disease progression.
February is heart disease awareness month – let this be the month you seek proper screening if you have a positive family history of heart disease or have any concerns or symptoms. Learn today what can be prevented tomorrow.
Brenda Garrett is a Cardiovascular Nurse Specialist Fuqua Heart Center for Prevention at Piedmont Hospital. For more information call 404.605.2495
