Women's Health Issues with H. Barry Raff, M.D., Cardiologist, Delaware County Memorial Hospital
When it comes to women’s health issues, stories about breast cancer and pelvic malignancies seem to dominate the headlines. However, throughout the last few decades, heart disease has become the No. 1 killer of women in the United States, causing more than half a million deaths among females every year.
“Heart disease is not just a disease of males; in fact, it is prevalent in women, and it much more common than cancer in affecting women in terms of both morbidity and mortality,” says H. Barry Raff, M.D., a cardiologist at Delaware County Memorial Hospital (DCMH). “One out of every three women in this country will die from cardiovascular disease. That is six times the amount of women that die every year of breast cancer. Twice as many women will die from heart disease than all forms of cancer combined.”
Dr. Raff spoke about the prevalence of heart disease among females during DCMH’s “Women’s Health Issues,” a half-day seminar covering important topics in women’s health.
According to Dr. Raff, while men often develop heart disease at an earlier age, the sexes eventually catch up to each other.
“When we take a patient’s family history, we ask him or her whether he or she has a family history of heart disease,” he says. “We are referring specifically to males who had heart attacks or death at an age less than 55, but to females who had the same history at an age less than 65. By the time the persons are 75 years old, however, the incidence of heart disease is equal between men and women, and it continues to be equal from that time forward.”
Dr. Raff explains that the 10-year “lag period” between the genders can be blamed on female physiology.
“Menstruation and hormones are clearly felt to play a role,” he says. “The combination of a relatively lowered blood pressure during a woman’s menstrual cycle, the loss of iron through bleeding, and the favorable effects of estrogen on lipids and cholesterol seem to protect a woman during her pre-menopausal years. There is clear data that shows that this protection is lost after menopause.”
Dr. Raff also explained the signs and symptoms of heart attack to those in attendance.
“The most common symptom that we think of is chest discomfort – often it is pressure or pain, but it might be shoulder discomfort, neck discomfort, arm discomfort or shortness of breath,” he says. “Other symptoms include nausea, vomiting, sweating, dizziness, weakness or fatigue. These atypical symptoms can make heart attack very difficult to diagnose.”
Fortunately, physicians and researchers have developed several methods for treating heart attacks.
“There are basically two major ways that we treat heart attack today,” Dr. Raff says. “The first is called ‘thrombolytic therapy,’ which involves what are commonly referred to as ‘clot-busting drugs.’ Heart attacks are felt to be caused by clots that develop in the blood vessels within the heart and cut off the oxygen supply to the heart, causing that area of the heart to die. If you can administer these drugs and get the clots to dissolve, more heart muscle can be saved.
“The other way that heart attack is treated is angioplasty,” he says. “Balloon catheters and stents are used to open the arteries and keep them open. In women, it often can lead to an increased risk of complications, due to the fact that women’s blood vessels are smaller than men’s, and because women tend to be older than men when they suffer heart attacks.”
However, Dr. Raff noted, the best way to treat a heart attack is to never have one in the first place.
“We are all pretty well familiar with the major heart risk factors,” Dr. Raff says. “High blood pressure, smoking, family history, cholesterol, obesity. One of the more important factors in women is diabetes. In fact, the American Heart Association counts diabetes essentially as having two risk factors, so if you have diabetes, you should count it twice as much, because the condition is so potent and so deadly in women.”
By carefully watching your risk factors, Dr. Raff says, you can help keep heart disease from negatively affecting your life.
“Heart disease is extremely common and prevalent in women, and you have to watch out for atypical symptoms,” he says. “Don’t be afraid to discuss those symptoms with your physician. We would rather hear from you and find out that what you are concerned about is nothing or not related to the heart than to have you ignore it and deny it and then find out there is a problem.”
To find a DCMH cardiologist who’s right for you and make an appointment, call 1-800-CK-HEALTH (1-800-254-3258).
Women and Stress, with Susan K. Ball, M.D., Psychiatrist, Crozer-Chester Medical Center
It seems a woman’s job is never done – after getting the kids up and off to school and completing an 8- or 9-hour work day, it’s back home to cook dinner, help with homework, bathe the kids and clean the house. It is no wonder that today’s generation of women is more stressed than any that’s come before it.
Fortunately, there are some things you can do to relieve stress in your life. Susan K. Ball, M.D., a Crozer-Chester Medical Center psychiatrist, recently offered advice to women attending Delaware County Memorial Hospital’s “Women’s Health Issues” conference.
“Most people have a hard time understanding exactly what stress is – we know what things cause stress in our lives, but we don’t know why,” Dr. Ball said. “Stress is actually a very normal response of the body to unusual circumstances. The most famous interpretation of this is ‘fight or flight.’ This occurs in both men and women, but women have a slightly different response to stress.”
Dr. Ball explained that men in stressful situations produce hormones, adrenaline, cortisol and the male hormone testosterone. Women, on the other hand, produce cortisol, epinephrine and adrenaline, but also a hormone called oxytocin, which is also produced during childbirth and during social interactions.
“Instead of ‘fight or flight,’ women have a tendency to ‘friend and befriend,’” she says. “Women under stress will phone a friend or relative, hug a child, talk to a stranger in the supermarket line – basically reach out to others.”
Men and women alike typically experience two types of stress: positive stress and negative stress. Common negative stressors include the death of a loved one, divorce, separation, the disruption of a relationship, the loss of a job, conflicts at home and work, and financial problems. Positive stressors, on the other hand, are occasions that seem beneficial but can cause just has much stress, such as coming into an inheritance, the birth of a child, marriage, a new job and vacation.
“The normal response to all of these things boils down to one emotion: fear,” Dr. Ball said. “Your body mounts a response to the stressor. Your heart rate goes up, your blood pressure rises, your muscles get shaky and tense. If you have stress for a long time, your immune system may be affected. And you will manifest that stress in ways that are individual to you. Some people may become angry or irritable; some may not sleep well; some have crying spells; some lose their appetite.”
If stress is not controlled, it can lead to such conditions as depression and anxiety, as well as frequent illnesses.
“So what are the basics in stress reduction? Diet, exercise, relaxation and sleep,” Dr. Ball said. “In terms of diet, sugar, caffeine, alcohol and smoking are all very bad for someone who is already stressed out, by affecting sleep, increasing the heart rate, stimulating kidney function and raising blood pressure. Exercising releases hormones called endorphins, which are responsible for pain relief, so you feel better after having exercised. Relaxation and sleep can also help you deal with stress by helping to restore your sense of well-being and recharging your batteries.”
Among the other tips offered by Dr. Ball are:
- Stretching. “Our bodies were originally designed to be walking around, to be doing things, and because we live such sedentary lifestyles now, we need to stretch the muscles in our bodies.”
- Laughter. “When we get very stressed, we forget how to laugh. But it’s important to laugh. Laughter makes you take deeper breaths and releases good hormones.
- Music. “Music can be extremely soothing. You can sit and calm yourself by listening to soothing music.”
- Massage. “Massage is a wonderful way to relax. You can either go to a massage therapist or teach a relative or friend how to do it.”
To find a Crozer-Keystone mental health professional who’s right for you, call 1-800-CK-HEALTH (1-800-254-3258).