Spotlight on Women's Health

Dr. Rachel Dreyer

An Interview About Heart Health

March 02, 2018

Did you know that heart disease is the number one killer of American women, and stroke is fourth? The good news is there are steps you can take to lower your risk of heart disease and stroke at any age. We spoke to Dr. Rachel Dreyer, an Assistant Professor at the Yale School of Medicine who specializes in cardiovascular outcomes research with a focus on women’s health. Dr. Dreyer shares the basics you need to know about heart disease and how to keep your heart healthy.

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What steps can women take for good heart health?

There are several ways that women can help control their risk of heart disease, or, in other words, there are steps women can follow for good heart health. The American Heart Association calls them “Life’s Simple 7.” These seven steps include staying physically active, controlling levels of cholesterol, following a heart-healthy eating plan, managing blood pressure, maintaining a healthy weight, reducing blood sugar, and quitting smoking.

Are there risk factors for heart disease that are out of women’s control?

Yes, there are some risk factors for heart disease that women can’t change, such as age, sex, heredity (family health history), and race or ethnicity.

How can women work with their doctors to figure out their risk for heart disease?

Schedule a visit with your doctor to discuss your risk factors and learn more about your heart disease numbers to assess your risk of heart disease and stroke.

What are the heart disease numbers women need to know for good heart health?

There are several key numbers to know, including:

  • Total blood cholesterol, which is a waxy, fatty substance in the blood. When too much cholesterol builds up on the walls of the blood vessels, it makes it very difficult for the heart to pump blood.
  • LDL cholesterol or low-density lipoprotein, often called “bad” cholesterol. Bad cholesterol can cause plaque to build up, which can lead to heart disease and stroke.
  • HDL cholesterol or high-density lipoprotein, often called “good” cholesterol. It can help eliminate bad cholesterol from your blood.
  • Blood pressure, which is essentially the pressure the blood puts on the arteries as the heart beats and relaxes. Blood pressure varies depending on exercise, stress, and sleep levels.
  • Blood sugar or the amount of sugar present in the bloodstream.
  • Body mass index, which is a measure of body fat based on height and weight. This varies depending on age, gender, and build.

To know what your numbers should be, you need to talk with your doctor.

Why are these numbers important, and what steps can women take to improve them?

Knowing these numbers and the risk factors associated with heart disease can help you to take control of your health and seek advice from your doctor.

You can control or treat some risk factors with lifestyle changes (Remember: “Life’s Simple 7.”). Your doctor may also recommend certain medicines, if necessary.

One of the best things women can do for good heart health is quit smoking. Nicotine addiction is very powerful. Women should talk to their doctors about coming up with a quit plan. They can also call the smoking quitline at 1-800-QUIT-NOW.

What are some small heart-healthy eating changes women can make?

I have eight tips!

  • Eat more fruit and vegetables, and aim for variety.
  • Eat more whole-grain foods, including whole-wheat bread, rye bread, and brown rice.
  • Use olive, canola, or corn oil when cooking, and limit your saturated fats. You find saturated fat in foods like pizza, ice cream, and fried chicken.
  • Eat more lean proteins, such as skinless poultry, fish, and vegetable protein like legumes and lentils.
  • Read food labels to make healthy food choices.
  • Limit sodium intake.
  • Cut down on sugar-sweetened drinks.
  • Eat plenty of calcium-rich foods, such as dairy products and dark leafy greens.

When it comes to exercise and heart health, what should women know?

Staying physically active can increase your length and quality of life and help reduce the risk of heart disease. It also leads to an overall reduction in blood pressure and can boost levels of good cholesterol. You should try to get at least 30 minutes of moderate physical activity each day, such as brisk walking.

What about stress?

Stress, particularly chronic stress, can negatively affect your health. It not only causes issues related to heart health, but it can also lead to uncomfortable physical symptoms like headaches and stomach problems. A stressful event causes the body to react and release a hormone, adrenaline, which speeds up your heart rate and breathing and briefly raises your blood pressure. It’s often called the “fight or flight” response. Chronic stress means that your body is in this state for days and even weeks on end, leading to an increase in heart rate and blood pressure. This may damage artery walls.

Stress may be particularly relevant to women who previously had a heart attack. A heart attack is a life-threatening and unpredictable event, which causes serious amounts of stress during and after the event. Women who have experienced a heart attack often report feeling a lack of control, uncertainty, and helplessness. This resulting psychological stress may not only affect women’s emotional well-being, but it also negatively affects their cardiac health and recovery after the heart attack. 

There are ways to manage stress. You can try exercising, maintaining a positive attitude, quitting smoking, and eating well. You also can try relaxation or stress management techniques.

If you could tell women one thing about heart health, what would it be?

Know your numbers and use your numbers. Discuss your risk factors with your doctor, and take action around the risk factors that can be controlled.

Is there anything else you’d like to share?

You should know that the heart attack symptoms women experience may be different than classic chest pain. For example, women may experience nausea, vomiting, and pain in the back, neck, jaw, or throat, among other symptoms. Learn the symptoms of a heart attack so that you can get help right away.

Learn more about heart disease and women.

The statements and opinions in this blog post are those of the author and do not necessarily represent the views of the U.S. Department of Health and Human Services Office on Women's Health.