How about a little humor with your heart attack? I just finished watching the “Little Heart Attack” video (www.goredforwomen.org/?popup=little-heart-attack) and I’m still laughing. Any woman should look as good as Elizabeth Banks while having a real heart attack.
But all joking aside, how often have we heard the story? All the signs and symptoms are there—shortness of breath, cold sweat, jaw pain, shoulder and/or back pain, chest pressure, nausea or vomiting, a sense of indigestion, sweating, light-headedness, weakness—and denial.
It’s February again—heart-disease awareness month. This year, February also kicks off the “SpeakUp ™” campaign, developed by the Joint Commission in collaboration with the American Academy of Neurology, American Association of Neuroscience Nurses, American Heart Association (AHA)/American Stroke Association, National Stroke Association, and National Institute of Neurologic Disorders. (Visit www.jointcommission.org/assets/1/6/Speakup_Stroke.pdf.) This campaign aims to get consumers more involved in their care and educate them to prevent the devastating effects of silent killer diseases.
You already know the numbers: Heart disease is still the #1 killer of women and men in this country; each year, one in three women die from heart disease. More women die from cardiovascular disease than from all forms of cancer combined. Stroke is the third leading cause of death in the United States, and also can cause severe long-term debilitating disability. Stroke symptoms are less vague—possible unilateral weakness and numbness of the face, arms, and legs; confusion and difficulty forming or understanding words; visual disturbances; difficulty walking or maintaining balance and coordination; and severe headache.
While a myocardial infarction (MI) reportedly occurs every 34 seconds, we’ve made great strides in treating MIs and strokes. Survival rates continue to climb as hospitals shorten the time from diagnosis to intervention. The United Kingdom recently reported a 50% decrease in mortality from heart disease over the last decade—most likely from healthier lifestyles and better treatment and drugs. For 15 years, the Centers for Disease Control and Prevention has helped states bring together public and private partners to raise awareness and improve preventive measures through its National Heart Disease and Stroke Prevention Program (www.cdc.gov/dhdsp/programs/nhdsp_program/index.htm).
So, what about bringing the message home? From time to time, nearly all of us feel overwhelmed by all the things we’re “supposed to do” to stay healthy. For example, the AHA recommends the following physiologic parameters and lifestyle habits for a healthy heart:
- total cholesterol level of 200 mg/dL
- low-density lipoprotein (“bad” cholesterol) level below 160 mg/dL for those at low risk for heart disease, and possibly below 70 mg/dL for those at high risk
- high-density lipoprotein (“good” cholesterol) level of 50 mg/dL or higher in women and 40 mg/dL or higher in men
- triglyceride level below 150 mg/dL
- blood pressure below 120/80 mm Hg
- fasting glucose level below 100 mg/dL
- body mass index below 25 kg/m2
- waist circumference less than 35″ for women and less than 40″ for men
- 30 minutes of moderate-intensity aerobic exercise fives days/week, or 25 minutes of vigorous exercise three days per week, or a combination; plus muscle strengthening activity 2+ days/week
- a healthy low-fat diet of whole grains, vegetables, and lean meats, poultry, or fish
- no tobacco products
- one alcoholic drink or less daily for women and two or fewer drinks for men (one drink is defined as 4 oz wine, 1 oz liquor, or 12 oz beer).
Got all that? We know the seriousness of the numbers and what can happen when ours don’t match up. It means we need to commit to being fit. That’s no easy task for busy professionals, no matter their age. Competing demands in our personal lives take precedence. When the fatigue factor kicks in, we’re tempted to sacrifice healthful foods that require preparation and dedicated time to exercise for easier choices.
We’re reminded of our need to stay healthy by campaigns such as the Wear Red Day® challenge—part of AHA’s Go Red For Women™ campaign, now in its ninth year. During this month of red hearts, media outlets across the country cover the activities that galvanize women and men to think about saving lives. As we think about the challenges we may face personally to stay healthy, we become aware of the challenges many of our patients face. And we need to be aware of the racial and ethnic disparities related to heart disease:
- higher rates of cardiovascular diseases in African-Americans, some American Indian and Alaskan natives, and Asian populations
- higher dyslipidemia rates in Mexican-American women and men
- BMIs more commonly above 25 in African-American women and Mexican-American men
- higher diabetes mellitus rates in American Indian and Alaskan natives, African-American men and women, Mexican-American women, and native Hawaiians and other Asian Pacific Islanders.
Getting fit is still the best way to reduce the risk of heart disease and stroke. To get fit, get more physical activity, eat a heart-healthy diet, and avoid tobacco. Remember that approaches to getting fit should be tailored to meet cultural needs. What works in one community may not work in another.
There’s no better time than today to take stock of your own heart health risks. Flex your muscles to get fit, and flex your brain to spread the word about cardiovascular health.
Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN