The Heller School for Social Policy and Management, Brandeis University

National Program on Women & Aging
 

Women & Aging Letter
Excerpt - February 1999

Healthy Hearts
Volume 3, Number 5

This Women & Aging Letter focuses on an important health issue for women  as they grow older--keeping their hearts healthy. Heart disease kills more American women than does any other disease. One in nine American women age 45 to 64 years has some degree or type of heart disease. By the time a woman has passed her 65th birthday, the incidence of heart disease increases to one in four. Yet much of it is preventable.

The Letter interviewed four specialists at Brigham and Women's Hospital, a teaching affiliate of Harvard Medical School, who are experts in the area of women and heart disease: Paula Johnson, MD, MPH, Division of Cardiovascular Medicine; Linda Arslanian, MS, PT, Director of Rehabilitation Services; Elizabeth Eagan-Bengston, MS, RN, Nurse Manager, Cardiac Rehabilitation Center; and Connie Roberts, MS, RD, Manager, Nutrition Consultation Service and Wellness Programs. Here are some excerpts from those interviews.

How are women treated differently in the diagnosis and treatment of heart disease?

Paula Johnson: Some data suggest that women are less often diagnosed with coronary heart disease than they should be, that symptoms are attributed to other causes such as gall bladder disease. But this is changing. There's been a lot of time spent by the American Heart Association and other groups to educate healthcare providers and women about the importance of heart disease. It's also true that women receive some interventions -- bypass surgery, angioplasty -- less often than men do. These findings need to be explored further.
 

Because of mortality risks, elderly women need more aggressive care than they've been getting. Do you agree?

Paula Johnson: Heart disease is hitting women in their 60s, 70s, and 80s. We know that even at a later age, alteration in risk factors and aggressive treatment can be beneficial. We need to overcome age bias and treat women aggressively. Even at older ages, if women alter their lifestyles they can reduce their risks.

Can hormone replacement therapy stop heart disease?

Paula Johnson:  There's been a push to make sure that hormone replacement therapy is discussed with all women. But we can't really tell women we have the absolute answer about its effectiveness because we don't. We should not be giving it to every patient indiscriminately without data from randomized controlled trials that follow women over a longer period of time to determine the extended benefit or detriment from its use. When you're using hormone replacement therapy for osteoporosis and for symptoms of menopause, we have proof of its effectiveness. But when you're talking about heart disease we don't really have the final answer.
 

For prevention of heart disease, what is your key advice as physical therapists?

Linda Arslanian: The most important message is that it's never too late to increase your awareness of activities and the importance of exercise. There are many examples of women who start exercising for the first time in their 50s, 60s, and beyond. The good news about exercise is that it has so many other positive benefits besides the cardiovascular benefits -- weight control, increased energy, a better ability to withstand stress, and improved mental health. The key element with exercise is that you start gradually, trying to build it into every day life activities by looking for opportunities like walking a little farther, walking a little faster, or walking more frequently.

There are some cautions. A woman who has  never really exercised shouldn't embark suddenly on a program of formal exercise or increased activity without first having a good discussion with her physician.

Also, we're now finding some very compelling evidence of the benefits to women of not only aerobic exercise (e.g., walking, bicycling, swimming) but also strength training. When our muscles can metabolize energy more efficiently it's also good for our hearts.

Ten Questions to Ask Your Doctor
Ask your doctor these important questions about heart disease and stroke.  Take them with you to your next check-up!

1. What are my risk factors for heart disease?
2. Am I at risk for stroke?
3. What are the warning signs or symptoms of heart disease and stroke?
4. What should I know about the effects of menopause on my health?
5. Do I need to lose or gain weight for my health?
6. What is a healthful eating plan for me?
7. What kind of physical activity is right for me?
8. What is my blood pressure? Is it healthy for my age?
9. What is my cholesterol level and is it too high?
10. Based on my personal history and risk factors, what can I do to lower my risk of heart disease and stroke? (Women who smoke should ask for assistance in quitting.)

Adapted from American Heart Association, Inc. Visit their site for more information.

This is an excerpt only

Back to Women & Aging Letter page

Back to Home Page