Day 289 of 365 - Will My Heart Fail Me?
There has been some public awareness campaigning by the Heart and Stroke Foundation in very recent years, about how heart disease presents in women. It's a topic of interest to me, because of my family history and my own risk factors.
Some of the risk factors are different for women, due to our hormonal make up. There is a protective factor from estrogen before menopause. After that, our risk increases. There can also be increased risk earlier, related to how we experience pregnancy. For example, I experienced pre-eclampsia, very high blood pressure, in the third trimester of my first pregnancy, requiring premature delivery of the baby. Apparently, this event puts me at higher risk of heart disease throughout life.
Most research on heart disease and treatment has been done on men. However, women's hearts and arteries are smaller and more prone to blockages from clots. There is also a cardiac event called SCAD (spontaneous coronary artery dissection) which happens mainly in women aged 30 - 60. It is a form of heart attack, but the symptoms can be different from the classic signs seen in men.
Although women may have chest pain during a cardiac event, we also could present with pain in arms, shoulders, back or stomach; unusual exhaustion; a fluttery rapid heart sensation; nausea or vomiting; and dizziness/light headedness. Women are often initially misdiagnosed with anxiety or indigestion. Even when diagnosed, treatment and follow up in the past has been more conservative than with men. Hopefully, improved education of doctors is changing this now.
Something I've been interested in for years as a risk factor is insulin resistance. This term comes up over and over in relation to topics of Type 2 Diabetes, heart disease and even dementia and Alzheimer's Disease. Signs that you are insulin resistant included things like increased abdominal fat, elevated cholesterol and elevated blood glucose. Since I started having signs of elevated cholesterol and increasing abdominal fat in my peri-menopausal and then menopausal years, it seemed clear that there was a hormonal connection.
The causes are not completely understood, but it is known to worsen when we are overweight, eat a high carb/ high sugar diet and are sedentary. As my age progressed, it was harder to shed abdominal fat, despite being quite active and eating pretty healthy.
But, what is insulin resistance anyway? The resistance refers to receptors on cells not opening to receive the insulin that is circulating in the blood. The role of insulin is to allow cells to take in glucose to use as fuel or to store it as body fat for later fuel. The body tries to cope with the resistance by producing more insulin. We end up with both too much insulin and too much glucose circulating in our blood. This causes inflammation throughout the body, which we now know puts us at greater risk for various diseases.
Despite the differences being described in heart disease presentation in women, the lifestyle recommendations to reduce or reverse insulin resistance and resulting inflammation are not really different. They still come down to weight loss, healthy diet and exercise. As I've described in other posts, after years of tinkering with dietary approaches, I feel like I'm closer to the right strategy for me. I've been able to lose most of the extra abdominal fat and though my cholesterol levels are still elevated they are coming down with diet, supplements and exercise.
So, will my heart fail me? I don't know the answer to that for sure, but I certainly hope that the odds are now stacked more in my favor.
Some of the risk factors are different for women, due to our hormonal make up. There is a protective factor from estrogen before menopause. After that, our risk increases. There can also be increased risk earlier, related to how we experience pregnancy. For example, I experienced pre-eclampsia, very high blood pressure, in the third trimester of my first pregnancy, requiring premature delivery of the baby. Apparently, this event puts me at higher risk of heart disease throughout life.
Most research on heart disease and treatment has been done on men. However, women's hearts and arteries are smaller and more prone to blockages from clots. There is also a cardiac event called SCAD (spontaneous coronary artery dissection) which happens mainly in women aged 30 - 60. It is a form of heart attack, but the symptoms can be different from the classic signs seen in men.
Although women may have chest pain during a cardiac event, we also could present with pain in arms, shoulders, back or stomach; unusual exhaustion; a fluttery rapid heart sensation; nausea or vomiting; and dizziness/light headedness. Women are often initially misdiagnosed with anxiety or indigestion. Even when diagnosed, treatment and follow up in the past has been more conservative than with men. Hopefully, improved education of doctors is changing this now.
Something I've been interested in for years as a risk factor is insulin resistance. This term comes up over and over in relation to topics of Type 2 Diabetes, heart disease and even dementia and Alzheimer's Disease. Signs that you are insulin resistant included things like increased abdominal fat, elevated cholesterol and elevated blood glucose. Since I started having signs of elevated cholesterol and increasing abdominal fat in my peri-menopausal and then menopausal years, it seemed clear that there was a hormonal connection.
The causes are not completely understood, but it is known to worsen when we are overweight, eat a high carb/ high sugar diet and are sedentary. As my age progressed, it was harder to shed abdominal fat, despite being quite active and eating pretty healthy.
But, what is insulin resistance anyway? The resistance refers to receptors on cells not opening to receive the insulin that is circulating in the blood. The role of insulin is to allow cells to take in glucose to use as fuel or to store it as body fat for later fuel. The body tries to cope with the resistance by producing more insulin. We end up with both too much insulin and too much glucose circulating in our blood. This causes inflammation throughout the body, which we now know puts us at greater risk for various diseases.
Despite the differences being described in heart disease presentation in women, the lifestyle recommendations to reduce or reverse insulin resistance and resulting inflammation are not really different. They still come down to weight loss, healthy diet and exercise. As I've described in other posts, after years of tinkering with dietary approaches, I feel like I'm closer to the right strategy for me. I've been able to lose most of the extra abdominal fat and though my cholesterol levels are still elevated they are coming down with diet, supplements and exercise.
So, will my heart fail me? I don't know the answer to that for sure, but I certainly hope that the odds are now stacked more in my favor.
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