Heart disease is leading cause of death for women. Doctor shares health factors to watch

It's American Heart Month and women have specific factors they should consider in staying heart healthy, University of Missouri Health Care cardiologist Mary Fisher said in a Tuesday interview on Zoom.

"I would strongly emphasize that women recognize that adult women almost 50% of them will have some form of cardiovascular disease," Fisher said. "And so it affects far, far too many of us and it is the leading cause of death for all women. And the big thing is 85% of heart disease is preventable. And the earlier we know about it, the earlier we can make changes and influence how that disease progresses over time."

Pregnancy is nature's first stress test for women, Fisher said.

"So women that had issues going through pregnancy, those are things that have now been shown to be independent risk factors for future cardiovascular disease," Fisher said. "I think that any women who had any hypertensive disorders of pregnancy or gestational diabetes, that they recognize that something that's important to talk to their doctors about."

Women who have adverse pregnancy outcomes including preeclampsia and gestational hypertension are at increased risk of heart disease and should be monitored each year, Fisher said.

Menopause history also is important, she said.

"A lot of women will go through early menopause because of the surgical reason and go for periods of time where they're not on hormones that under typical situations, we would have the influence of those hormones," Fisher said. "I think those are things that kind of change what your risk looks like in your 50s if you've been without estrogen for the last 20 years because of a surgery."

Hormone replacement therapy can increase a woman's risk of heart disease if it continues too long after menopause, Fisher said.

"Women should generally not be on hormone replacement therapy eight years past their menopausal time period," Fisher said.

There are non-hormonal options for controlling menopause symptoms, she said.

Heart attacks are different in women and men, she said.

"It's true that most women don't have the substernal chest pain that we classically see on TV," Fisher said. "It can be more nausea, vomiting, sweating, fatigue, doing things that they used to be able to tolerate well, and those are signs that would certainly need to be red flags that they bring to the attention of their doctors."

Aerobic exercise is good for all hearts, she said.

"We'd like for patients to get 150 minutes of aerobic activity in a week," Fisher said. "There's some stress and strain we put on ourselves that if it's not 30 minutes of uninterrupted time somehow that doesn't count. I disagree with that. I think any bit of activity is better than no activity. And if you have to split it up with 10 minutes, three times a day, or 15 minutes twice a day to hit that goal, your body is benefiting from that."

Eating fruit, vegetables, grains and beans that aren't processed and don't have added salt is a win, she said.

"We get salt in our diet through processed meals or canned veggies as opposed to our whole veggies," Fisher said. "And certainly the nutritional value changes significantly when we when we look at whole foods versus the already processed foods."

The patient's family health history plays a huge role in preventing cardiovascular disease, Fisher said.

"If your family member has had a heart attack in their 40s or early 50s, this is relevant," Fisher said. "This tells me about your genetic makeup and it changes my timeline and aggression of when I'm thinking about things for you. If you have a mother or a sister that have had an adverse pregnancy outcome this means that we need to monitor you very, very closely. I think there's a lot of new and exciting data that we know about genetics and how that influences heart disease. There's a lot of screening tools that are available to us with genetic screening, but all of those start with a detailed family history."

Roger McKinney is the Tribune's education reporter. You can reach him at rmckinney@columbiatribune.com or 573-815-1719. He's on X at @rmckinney9.

This article originally appeared on Columbia Daily Tribune: MU doctor shares health factors with role in women's heart disease