Heart Disease: Battle of the Sexes

Intro: We're talking wellness at MemorialCare Health System. It's time for Weekly Dose of Wellness. Here's Deborah Howell.

Deborah Howell (Host): Well hello there and welcome to our show. I'm Deborah Howell, today's guest is Cindy Peters, RN, MSN, ACNP, and Nurse Practitioner Center for Women's Cardiac Health and Research, MemorialCare Heart and Vascular Institute, Long Beach Memorial. She's here to talk about heart disease and the battle of the sexes. I love it. Welcome, Cindy.

Cindy Peters, NP: Thank you, glad to be here.

Deborah Howell (Host): Yes, it's wonderful to have you. So when a woman is asked about her number one health concern, many will say breast cancer. The fact is - is that heart disease is the number one killer of women, not breast cancer. So too often thought of as a man's disease, heart disease in women is definitely on the rise and something we need to talk about. So how many people are actually affected by heart disease in the United States?

Cindy Peters, NP: Well, more than one in three females have some form of cardiovascular disease.

Deborah Howell (Host): One in three.

Cindy Peters, NP: So that's females.

Deborah Howell (Host): And what about men?

Cindy Peters, NP: 387,000 men.

Deborah Howell (Host): Okay.

Cindy Peters, NP: And that was in 2010.

Deborah Howell (Host): Okay, well, that's... You know, the statistics are... are not good in any case, so. Why do you think breast cancer is their number one concern and not heart disease when, you know, when you're talking about women?

Cindy Peters, NP: Well, I think part of it is that we have done all of our studies, our research for heart disease on men.

Deborah Howell (Host): Mm-hmm.

Cindy Peters, NP: And so that was a big focus, whereas women all we heard about was breast cancer. But as we've come into the workforce and we have all the stressors in our life and we drink and smoke, all those have all added and increased the chance of having heart disease in women.

Deborah Howell (Host): So in a way, you're saying, "We kind of did it to ourselves."

Cindy Peters, NP: Yeah, we caught up with the men.

Deborah Howell (Host): Yeah, yeah, yeah, yeah. So let me ask you this. Do women experience different symptoms from heart disease than men? And if so, what are those different symptoms?

Cindy Peters, NP: Yes, they do. One of the reasons is because we have smaller arteries and so our symptoms are a little different because of that. So chest pain or discomfort is common in men as well as women, but women get it more in their arms and back or neck or jaw compared to men.

Deborah Howell (Host): Wait a minute, in their jaw?

Cindy Peters, NP: In their jaw, mm-hmm.

Deborah Howell (Host): Can you elaborate on that?

Cindy Peters, NP: Sure, it comes from the chest area and then it comes up into the neck and the jaw, specifically on the left side, it can be on the right side. So if you're having jaw pain you might think it's a toothache but it's your heart.

Deborah Howell (Host): I have never heard that.

Cindy Peters, NP: Yes.

Deborah Howell (Host): You know, a lot of people would also think it might be TMJ and not even remotely related to their heart.

Cindy Peters, NP: Right, exactly. So if this is a new TMJ diagnosis, I would definitely get it explored.

Deborah Howell (Host): Wow. That's absolutely incredible information. See why we have these programs?

Cindy Peters, NP: That's right.

Deborah Howell (Host): Everybody learns something.

Cindy Peters, NP: That's right.

Deborah Howell (Host): So what are some of the risk factors specific to women?

Cindy Peters, NP: Risk factors specific to women, of course, are around our child reproducing.

Deborah Howell (Host): Mm-hmm.

Cindy Peters, NP: So what we found now is that when women have high-risk pregnancies, including pre-eclampsia, high blood pressure during the pregnancy, or they have diabetes during the pregnancy, then they have a greater chance of having heart disease later in life.

Deborah Howell (Host): Okay.

Cindy Peters, NP: It's almost like a precursor to having issues later.

Deborah Howell (Host): Mm-hmm.

Cindy Peters, NP: As well as our risk goes up when we reach menopause because estrogen is very protective for us while we're younger, but once we reach menopause and our estrogen is dissipated, we... our risk goes up quite a bit. And replacing with estrogen does not help.

Deborah Howell (Host): It does not help?

Cindy Peters, NP: No.

Deborah Howell (Host): Alright. Can you elaborate on that?

Cindy Peters, NP: Sure, there's been several studies that are looking at estrogen and progesterone combinations, or just estrogen, and none of them do the same thing as just our natural estrogen. It seems like once our natural estrogen is gone that replacing that estrogen actually can cause more problems like blood clots and high cholesterol and those kind of things.

Deborah Howell (Host): But I suppose we're not supposed to worry about cholesterol anymore. Since that new study was released. Can you talk about that or is that off the page?

Cindy Peters, NP: Well, um, that's probably out of my bailiwick, but I can tell you that as risk factors for heart disease, uh, that is one of the risk factors for heart disease is high cholesterol.

Deborah Howell (Host): Okay.

Cindy Peters, NP: So it just depends. When people talk about cholesterol, they're talking about different types of cholesterol, the good cholesterol, the bad cholesterol, the total cholesterol, and so you have to be careful about what you're exactly talking about. Because if someone tells me I have a high total cholesterol, that may not we may not be able to see the whole picture and really be, if we should be concerned or not.

Deborah Howell (Host): Okay. You did a marvelous job of answering that question out of your bailiwick.

Cindy Peters, NP: Sure.

Deborah Howell (Host): Alright. What are some of the lifestyle changes women can do to lower their risk factors?

Cindy Peters, NP: Well, uh, if you're smoking, quit smoking.

Deborah Howell (Host): Mm-hmm.

Cindy Peters, NP: Uh, high blood pressure, um, can, if it can be, uh, managed, go to your physician and have your, uh, blood pressure managed with medication. If you, uh, lose weight, that can also help lower your blood pressure.

Deborah Howell (Host): Okay.

Cindy Peters, NP: Um, and of course being overweight is a risk factor. So along with that goes physical inactivity. So exercising, uh, at least moderate strenuous, uh, about 150 minutes a week is the recommendation right now.

Deborah Howell (Host): Okay. And that even includes just walking.

Cindy Peters, NP: Yes, moderate exercise, so that's not running, that would be vigorous.

Deborah Howell (Host): Mm-hmm.

Cindy Peters, NP: Um, and yeah, and you do 150 minutes a week, so if you have the weekend where you can do 60 both days, then you only have the 30 to do during the week.

Deborah Howell (Host): Wow.

Cindy Peters, NP: Yeah.

Deborah Howell (Host): That's not so bad.

Cindy Peters, NP: Get it done. Yeah.

Deborah Howell (Host): Or you can do 15 minutes every day. Something like that.

Cindy Peters, NP: That's right. Mm-hmm.

Deborah Howell (Host): Okay. Alright. What type of tests do women need to learn their heart health risk factors?

Cindy Peters, NP: So what, the one we were talking about is the cholesterol, and that means a complete lipid panel, which includes the good and the bad cholesterol and the blood sugar. And also an electrocardiogram, which most women are not even offered before the age of 55.

Deborah Howell (Host): Mm-hmm.

Cindy Peters, NP: Um, and I think that those are important tests to have baseline so you can manage from there. And then have your blood pressure monitored because you feel fine with a high blood pressure so you need to have it checked.

Deborah Howell (Host): Okay. I have one final question for you Cindy. Where can women go to get tested for heart disease?

Cindy Peters, NP: Well, we have a clinic here at Long Beach Memorial, it's called the Women's Cardiac Health Screening Clinic and we do invite men to come as well. It just was developed for women.

Deborah Howell (Host): Okay.

Cindy Peters, NP: Um, it is a $55 charge, and that includes a complete lipid panel, cholesterol breakout, a 12-lead electrocardiogram, and a blood pressure and weight, and then I go over all those results with the person talking about their risk factors, how we can change some of the numbers if they're not in the right place, and how we can improve things going forward.

Deborah Howell (Host): Great. Knowledge is power and knowledge is health.

Cindy Peters, NP: That's right, and I think from the age of 18 on, no one is too young to come and get a baseline and find out where their factors are. Because we can't do anything about genetics, but we can do something about all those other things.

Deborah Howell (Host): Okay. So if you're over 18, you're a man or a woman, go get tested. It, you know, it really can't hurt you and it takes just a few minutes and boy can it give you some information that can be life-changing.

Cindy Peters, NP: That's right.

Deborah Howell (Host): Thanks so much for taking time out of your day to be on the show, Cindy, we really appreciate it.

Cindy Peters, NP: Thank you.

Deborah Howell (Host): For more information or to listen to a podcast of this show, please visit memorialcare.org. That's memorialcare.org. That's all for this time. I'm Deborah Howell, we'll see you soon for another Weekly Dose of Wellness brought to you by MemorialCare Health Systems. Have yourself a wonderful day.