To celebrate February as American Heart Month, the News Blog is highlighting some of the latest heart-centric news and stories from all parts of Penn Medicine.
The flowers and cards have all been delivered. The chocolates were devoured and Cupid can now take his annual break. But just because Valentine’s Day has come and gone doesn’t mean the time for hearts is over. There’s still some days left of American Heart Month and while the public is bombarded with commercials and news stories about the topic, no one – especially women – should think they’ve heard all there is to know about heart disease.
Yet after scores of public education programs and public service campaigns the message still hasn’t sunk in. “For decades, heart disease was considered a man’s disease,” said Nazanin Moghbeli, MD, MPH, FACC, the director of the Women's Cardiovascular Center at Pennsylvania Hospital. 
“Previous heart disease research and public awareness efforts only focused on cardiovascular disease in men. But we know differently today. Today we’re faced with the sobering fact that a woman suffers a heart attack every minute in the United States. Not only do we need further research and continuing education, we must focus on teaching women the important differences in the symptoms and risk factors of heart disease.”
“It’s obvious that women should be aware of the risks of heart disease and recognize the signs of a heart attack. Yet women also need to realize they can take action. If they know the risks factors of heart disease and can minimize or eliminate them, they can greatly improve their chances of preventing cardiovascular disease,” Dr. Moghbeli says “When it comes to risk factors of heart disease for women, I like to break them down into two categories: the usual suspects and the not-so-usual suspects.”
The usual heart disease risk factors are the more commonly known ones: quit smoking; exercise; lose weight and maintain a healthy weight; eat a diet high in fiber, fruits and vegetables while limiting fat, sugar and alcohol intake; and control high blood pressure, cholesterol and sugar levels. While woman certainly cannot control their gender, ethnicity or family history, Dr. Moghbeli notes that they can successfully control the “usual suspects” risk factors.
In addition, women should be sure to see their primary care physician regularly to help them monitor and control existing health conditions. And, they should also visit the dentist regularly. It is especially important that women – particularly as they get older and reach menopause, avoid gum disease.”
According to the American Congress of Obstetricians and Gynecologists a woman’s risk of heart disease rises 70 percent if she doesn't brush her teeth at least twice a day. That’s because researcher theorize that the bacteria that drive gum disease ultimately contribute to inflammation throughout the body, including in the heart and circulatory system.
While the ‘usual suspects’ risk factors for heart disease are the same for women as they are for men, there are definitely “unusual” – or more uncommonly known risk factors for heart disease that uniquely affect women.
Estrogen — This naturally-occurring hormone provides protection to a woman’s cardiovascular system during her reproductive years, from approximately age 12 to 50. However, estrogen's protective effects seem to wane as women age. It may even actually increase the risk of heart attack or stroke if given as a hormone replacement therapy during menopause.
Birth Control Pills — Oral contraceptives may increase the risk of high blood pressure and blood clots in some women. This risk is compounded if a woman smokes or has additional, existing risk factors.
Pregnancy — During the nine months of gestation, women can develop pre-eclampsia (the development of high blood pressure and excess protein in the urine after 20 weeks of pregnancy and which is a leading cause of preterm births) and gestational diabetes that may put them at a significantly increased risk of heart disease, even after delivery.
Cholesterol – LDL, or the ‘bad cholesterol, can clog arteries increasing the risk of heart attack and stroke. And it only gets worse for women after menopause when more women will develop high cholesterol.
Triglycerides — High levels of triglycerides, the most common type of fat in the body, can compound health problems caused by high cholesterol. Together, this dynamic duo of arterial disaster and can increase a woman’s risk and heart disease.
Menopause — Due to the reduction of the hormones estrogen and progesterone being produced in the body, a woman’s overall risk of heart disease may increase. (Check out Dr. Moghbeli’s discussion on the News Blog next week for more on what women should know about heart disease, hormone replacement therapy and menopause.)
“While there definitely needs to be more clinical research focusing on women and preventing heart disease I want women everywhere to know that they are their own best preventative measure in fighting heart disease,” said Dr. Moghbeli. “They can make vital changes that directly tackle their risk factors and they don’t have to do it alone. They can team up with their physicians, family members, and good friends and gradually alter their diet, weight and behavior – all for the better. What women need to remember is to be aware. Aware of their bodies. Aware of their risk factors. And aware of symptoms that may signal trouble. Many women are often so busy taking care of others, they forget to take care of themselves. The steps they take today to improve their cardiovascular health could save their lives tomorrow.”
Check out this Go Red for Women video for a reality check on why it’s important for women to pay attention to what their body is telling them – and why it’s often so easy not to.