High blood pressure at mid age may raise risk for heart attacks and stroke
Posted by on June 16, 2012 - 6:58am

A hike in your blood pressure during middle age significantly raises the risk of having a heart attack or a stroke during your lifetime, according to new Northwestern Medicine research. The study offers a new understanding on the importance of maintaining low blood pressure early in middle age to prevent heart disease later in life.

Men and women who developed high blood pressure in middle age or who started out with high blood pressure had an estimated 30 percent increased risk of having a heart attack or stroke compared to those who kept their blood pressure low.

Previous estimates of a person’s risk of cardiovascular disease were based on a single blood pressure measurement. The higher the blood pressure reading, the greater the risk. The new Northwestern Medicine study expands on that by showing a more accurate predictor is a change in blood pressure from age 41 to 55.

The study is published in Circulation: Journal of the American Heart Association.

“We found the longer we can prevent hypertension or postpone it, the lower the risk for cardiovascular disease,” said lead author Norrina Allen, assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine. “Even for people with normal blood pressure, we want to make sure they keep it at that level, and it doesn’t start increasing over time.”

“There hasn’t been as much of a focus on keeping it low when people are in their 40’s and 50’s,” Allen added. “That’s before a lot of people start focusing on cardiovascular disease risk factors. We’ve shown it’s vital to start early.”    People that maintain or reduce their blood pressure to normal levels by age 55 have the lowest lifetime risk for a heart attack or a stroke.

Men who developed high blood pressure in middle age or who started out with high blood pressure had a 70 percent risk of having a heart attack or stroke compared to a 41 percent risk for men who maintained low blood pressure or whose blood pressure decreased during the time period. Women who developed high blood pressure had almost a 50 percent risk of a heart attack or stroke compared to a 22 percent risk for those who kept their blood pressure low or saw a decrease.

Men generally have a 55 percent risk of cardiovascular disease in their lifetimes; women have a 40 percent risk.

The research was supported by the National Heart, Lung and Blood Institute.

By Marla Paul -- NU health sciences editor

Sex differences in heart disease
Posted by on November 5, 2011 - 7:07am

Heart disease affects men and women in different ways. In women, symptoms of burgeoning heart disease are often more insidious, but when a heart attack strikes, it is more lethal than it is in men. Roughly 25 percent of men will die within a year of their first heart attack, but among women, 38 percent will die. Women are twice as likely as men to have a second heart attack within 6 years of their first one, and women are twice as likely as men to die after bypass surgery.

Yet after a heart attack, women’s hearts are more likely to maintain their systolic function—their ability to contract and pump blood from the chambers into the arteries. According to C. Noel Bairey Merz, MD, Director of the Women’s Heart Center at Cedars-Sinai Heart Institute in Los Angeles, this suggests that heart disease manifests differently in women, affecting the microvasculature (small blood vessels) instead of the macrovasculature (major blood vessels) as it does in men.

The heart is a muscle, and as with other muscles, depriving it of oxygen causes damage that diminishes its ability to function. Conventional wisdom notes that the most prevalent form of heart disease is coronary artery disease, in which atherosclerotic plaque narrows and eventually blocks the major arteries leading into the heart, thus cutting off the heart’s supply of oxygen. The damage to the heart tends to be permanent, and after a heart attack, the heart never quite regains its former power.

But when reviewing the medical literature, Dr. Bairey Merz and her colleagues found that women’s hearts were less likely than men’s to lose their ability to pump blood after a heart attack, and that female heart patients were less likely to present with obstructive coronary artery disease. Instead, the oxygen deprivation and subsequent damage to the heart is more likely to occur when small blood vessels, not major arteries, become dysfunctional.

“That is the reason women are often misdiagnosed and suffer adverse events,” said Dr. Bairey Merz. “Physicians have been looking for male pattern disease, when we need to start looking at female patterns.” Likewise, more research is needed to develop appropriate treatments and reduce risk in women, she added.

According to Dr. Bairey Merz, the good news is that it is possible to measure damage to small blood vessels objectively. “The gold standard is reactivity testing, angiograms, and other physiologic measures, rather than anatomic study.”

Dr. Bairey Merz is looking at data that  can be applied to help clinicians understand gender differences in the pathophysiology of heart disease.

 

Women and Heart Attacks---Make the Call!
Posted by on March 28, 2011 - 8:37am

A woman suffers a heart attack every 90 seconds in the United States. Yet according to a 2009 American Heart Association survey only half of women indicated they would call 9-1-1 if they thought they were having a heart attack and few were aware of the most common heart attack symptoms.

The Make the Call. Don't Miss a Beat. campaign is a national public education campaign that aims to educate, engage, and empower women and their families to learn the seven most common symptoms of a heart attack and encourage them to call 9-1-1 as soon as those symptoms arise.

The first step toward surviving a heart attack is learning to recognize the symptoms. The campaign, developed by the U.S. Department of Health and Human Services' Office on Women's Health, encourages woman to make the call to 9-1-1 immediately if they experience one or more of the heart attack symptoms listed below. The most common signs of heart attack in both women and men are:

Unusually heavy pressure on the chest, like there's a ton of weight on you
Most heart attacks involve chest pain or discomfort in the center or left side of the chest. It usually lasts for more than a few minutes or goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. It may even feel like heartburn or indigestion.

Sharp upper body pain in the neck, back, and jaw
This symptom can include pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of stomach (not below the belly button). Pain in the back, neck, or jaw is a more common heart attack symptom for women than it is for men.

Severe shortness of breath
This symptom can come on suddenly. It may occur while you are at rest or with minimal physical activity. You may struggle to breathe or try taking deep breaths. Shortness of breath may start before or at the same time as chest pain or discomfort, and can even be your only symptom.

Cold sweats, and you know it's not menopause
Unexplained or excessive sweating, or breaking out into a "cold sweat," can be a sign of heart attack.

Unusual or unexplained fatigue (tiredness)
Sudden and unusual tiredness or lack of energy is one of the most common symptoms of heart attack in women, and one of the easiest to ignore. It can come on suddenly or be present for days. More than half of women having a heart attack experience muscle tiredness or weakness that is not related to exercise.

Unfamiliar dizziness or light-headedness
Unlike in the movies, most heart attacks do not make you pass out right away. Instead, you may suddenly feel dizzy or light-headed.

Unexplained nausea (feeling sick to the stomach) or vomiting
Women are twice as likely as men to experience nausea, vomiting, or indigestion during their heart attack. These feelings are often written off as having a less serious cause. Remember, nausea and vomiting may be signs that something is seriously wrong, especially if you have other symptoms.

If you have any one of these symptoms and it lasts for more than five minutes, call 9-1-1 for emergency medical care. Even if your symptoms go away in less than five minutes, call your doctor right away—it could be a sign that a heart attack is coming soon. Don't waste time trying home remedies or waiting for the feelings to pass on their own. Remember, quick treatment can save your life.

 

February is American Heart Month!
Posted by on February 1, 2010 - 10:21am

What is Heart Disease?

Heart Disease is a general term used to describe various diseases and syndromes of the heart and blood vessels.  Included in the definition are diseases such as coronary artery disease, heart arrhythmia, heart valve disease, heart failure, and congenital heart defects, among others.

Heart disease is the number one killer of both men and women worldwide, but may be prevented or treated with healthy lifestyle choices.  The symptoms of heart disease vary dependent on the specific condition but include chest pain, shortness of breath, fluttering in the chest, swelling in the lower limbs, and fatigue.  Symptoms of a myocardial infarction (or heart attack) tend to be different between men and women, with women experiencing more subtle symptoms such as fatigue, shortness of breath and nausea.  Consequently, it may be more difficult for health professionals to diagnose and respond to a heart attack in a woman.  In addition, recent research has shown that women suffer disproportionately than men from coronary artery disease in the small vessels (arterioles) as opposed to the larger arteries.  This may further complicate diagnosis and treatment of heart disease in women.

Causes of heart and cardiovascular disease include poor diet, little exercise, obesity, smoking, and high blood pressure, but may also be caused by congenital defects.  A healthy diet and exercise along with maintenance of blood pressure, cholesterol, and stress may help reduce the risk of heart disease.  Treatments for heart disease include lifestyle changes, medication, and in some cases surgery, and it is best treated when diagnosed early.

Resources at Northwestern for Heart Disease:

The Bluhm Cardiovascular Institute at Northwestern Memorial Hospital offers state-of-the-art treatment in all areas of cardiovascular care.  Patients receive a comprehensive, multidisciplinary approach to treatment and prevention from physicians, nurses and other healthcare providers specializing in cardiology, cardiac surgery, vascular medicine and surgery, cardiovascular anesthesiology, cardiac behavioral medicine and radiology, among others.  The Institute is comprised of six heart health centers for atrial fibrulation, coronary disease, heart failure, heart valve disease, vascular disease, and women’s cardiovascular health.  The Women’s Cardiovascular Health Center offers treatment specifically designed for women, tailoring treatment plans to optimize their specific cardiovascular needs.  The Center is also committed to promoting women’s awareness of cardiovascular health, highlighting the differences in symptoms and risk factors for women.

For more information call: (866) 662-8467 (toll free)

Northwestern Physicians/Researchers specializing in Heart Disease:

Researchers at the Feinberg Cardiovascular Research Institute are committed to exploring complex problems in cardiovascular research including molecular, cellular, stem cell and imaging technology research.   Investigators at the Institute work in areas of basic science and clinical research.  The innovative program in Cardiovascular Regenerative Medicine seeks out new ways of growing new cardiac tissue as opposed to improving function of damaged tissues.  The program provides researchers with the means to bring basic science research into use in clinical trials.  Led by Dr. Douglas Losordo, MD, clinical trials are being conducted for treatment in the areas of coronary artery disease, heart failure, and vascular disease.

For more information visit: http://www.fcvri.northwestern.edu/index.html

IWHR Highlighted Researcher

Dr. Mercedes Carnethon is an Assistant Professor of Preventative Medicine at Northwestern University’s Feinberg School of Medicine.  She earned her PhD in Epidemiology from the University of North Carolina in 2000 and joined the faculty of Northwestern in 2002.  Her research interests include the role of the nervous system on cardiovascular disease (CVD), the relationship between fitness and cardiovascular health and the effects of sleep on the risk for CVD.  She is a member of several professional societies including the American College of Epidemiology and the American Heart Association.  Most recently, Dr. Carnethon has initiated a study to evaluate how sleep duration might affect a patient’s risk for cardiovascular disease.  Previous studies have evaluated patients with major sleep disturbances, such as sleep apnea, or have used sleep deprivation to evaluate the relationship.   Dr. Carnethon’s study will more closely mirror how women and men sleep during a normal week, and compare their sleep duration to indicators of their cardiovascular health.  The study hopes to justify the recommendations for total amount of sleep that an adult might need to maintain his or her heart health.

Photo: The Heart Truth Campaign

Photo: The Heart Truth Campaign

Upcoming Public Events:

NMH Annual Cardiovascular Symposium:  Heart Health – What Smart Women Need to Know, February 24, 2010, Prentice Women’s Hospital

Don't Forget - National Wear Red Day® is February 5th!