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Women's Heart Care fights cardio disease by Heather Woolwine Public Relations Despite a decline in the number of women dying from cardiovascular disease, MUSC Women’s Heart Care (WHC) is determined to see an even greater drop as it continues its collaboration with the American Heart Association’s Go Red for Women campaign.   The Go Red For Women campaign complements the mission of WHC, which opened a year ago. As reflected in booked schedules, WHC and its three female cardiologists, Pamela Morris, M.D., Marian Taylor, M.D., and Amy Rawl-Epps, M.D., continue to connect with Lowcountry women   “The idea behind the American Heart Association’s Go Red campaign and our belief here at Women’s Heart Care is that sometimes the only way to get the message out is to shout it,” Morris said. “We want to capture women’s interest and enthusiasm in fighting this disease.”   Heart disease remains the  No. 1 killer of women in the United States despite the declining death rate, according to the National Heart, Blood and Lung Institute (NHBLI). Heart disease death rates remain well above all types of cancer and accidental deaths combined. Growing awareness of heart disease is helping to reduce death rates, as well as an increased emphasis on lifestyle changes and prevention. According to Elizabeth Nabel, M.D., NHLBI director, and the WHC staff,  people can reduce the risk of heart disease by as much as 82 percent by maintaining a normal weight, increasing physical activity, following a heart-healthy diet, and quitting (or not starting) smoking. Women underestimated, underserved, undertreated In addition to supporting the AHA’s Go Red For Women campaign and awareness movement, the founders of the MUSC Women’s Heart Care program seek to bring information and care to a population not often thought of when it comes to heart disease.   “People just don’t think about women having heart disease,” said Marian Taylor, M.D., Women’s Heart Care. “The research has been focused primarily on men, and we know more about how heart disease affects men in the clinical setting.”   For all the conspiracy theorists out there, no one is “out to get” women at risk for heart disease. Women have just been left out of the loop until recent years. Much of this can be attributed to a difference in symptoms for women having a heart attack and the complexities involved in studying women of age for heart disease. Because women tend to live longer than men, the onset of heart disease in women begins a little later in life, around age 60. By nature, people seem to pay more attention to diseases that affect them at an earlier age. Women also present complexities due to hormonal changes that can send mixed signals and, in some cases, require drug therapies that could exacerbate conditions leading to heart disease.   “The numbers might be looking a little better, but many physicians are still underestimating and undercalculating the risk for heart disease in women,” Morris said. “And with non-classical symptoms, women also underestimate their risk and/or deny symptoms as they occur. This is especially true for underserved women with limited access to health care and who are on the outside of the awareness movement.”   Epps echoed Morris’ comments, saying, “At a recent community screening, I was amazed to see the amount of people who did in fact have numerous risk factors as well as the number of people having actual problems and in need of a referral. Comparing the number of people we saw to the  ones who needed additional help, the numbers were staggering.”   Morris categorized the types of patients she and her colleagues see via the rule of thirds. One-third, she said, have a family history of heart disease or other risk factors, but because they have chosen to lead a healthy lifestyle, those women are often reassured that their chance of developing heart disease is low. “With this group, we’re able to give some peace of mind, maybe let them know they are dealing with indigestion, not heart disease,” Morris said. The next third arrive suspicious of their family history and realize that they may not have managed their health well or who have some symptoms that are cause for concern. The last third have many risk factors, are often unaware, and are usually the ones arriving at the WHC on the brink of medical disaster or who are enduring symptoms of a heart attack.   To make the last third a smaller portion of their patient mix, Morris and her colleagues strive to provide a comprehensive, multi-disciplinary, gender-specific approach to prevention, early detection and management of heart disease in women. They work closely in a clinical setting with a multidisciplinary team, including specialists in endocrinology, gynecology, psychology, nutrition and exercise physiology. Their goal is to address all aspects of women’s heart health and heart disease management in a clinical setting, as well as within a research construct. A head start One message that Morris, Taylor and Epps want to emphasize is early prevention of heart disease based on discoveries made from risk factor screening. “It’s important to try and establish good habits early, so you’re not faced with trying to change them later in life,” Morris said.   Many have heard that moderation is the key in many things, and protecting oneself and family from heart disease is no different. The more vigilant a person is at a young age about diet, exercise, risk factors (especially family history and smoking) and personal health care, the more likely that person will live a life free from heart disease. And the message doesn’t stop with men and women, but includes children and adolescents. “With climbing rates of obesity, diabetes and other risk factors not only for adults but for our children, it’s very important to pass along the message that in order to prevent disease, people need to be taking care of heart health from childhood and adolescence throughout adulthood,” Morris said. Upcoming Women’s Heart Care event On April 28, approximately 400 community members can attend a special heart education day for women at the Gaillard auditorium.   Speakers and presenters will discuss topics including ethnic differences in heart disease, how to recognize symptoms, how to understand a heart disease diagnosis, question and answer sessions, understanding the impact of anxiety and stress on the heart with tips for stress reduction, taking hormones, sleep disorders and cardiovascular disease, and exercise and nutrition break-out sessions.   In addition, the Charleston Ballet will perform special choreography for participants and an all-red fashion show will highlight heart disease patients and their providers as everyday women.   Look for updates and more specific registration information in coming issues of The Catalyst. Heart disease risk factors Age and sex: Woman more than 50 years old. Begin scheduling regular check-ups in your 20s with your family physician to monitor cholesterol levels, blood pressure, and devise a healthy diet and exercise plan to lower unhealthy levels. Begin medication if necessary. Family history: Father or brother had heart attack before age 55, or mother or sister had one before 65, or mother, father, brother, sister or grandparent had a stroke. Know your family history. Heart disease medical history: Had a heart attack, heart disease, or other heart conditions. Stroke history: Had a stroke, have carotid artery disease, leg artery disease, high red blood cell count or sickle cell anemia. Blood Pressure: Around 140/90 mm Hg or higher. Tobacco smoke: You smoke or live with people who smoke. Begin a smoking cessation program. Call 792-9192 or visit http://hcc.musc.edu/patient/support_services/QuitToWin.cfm. Total cholesterol: Is 200 mg/dL or higher. HDL cholesterol: less than 40 mg/dL for men, less than 50 mg/dL for women. Physical activity: Less than total of 30 minutes of physical activity on most days. Overweight: You’re 20 pounds overweight for height and build. Diabetes: Have diabetes, or take medicine to control blood sugar. Steps to a healthy heart Move more, eat less. Experts call for at least 30 minutes of physical activity per day. This can be 15 minutes on a walk during a lunch break, a brisk walk with the dog when you get home, and then maybe vacuum the whole house at a brisk pace. Invest in a pedometer. Morris suggests walking 10,000 steps per day. Use the pedometer to track your progress. Don’t smoke or live with a smoker. Implement a healthy diet. Arguably the hardest part of staying healthy, especially in today’s world, a proper diet requires discipline and can be frustrating with the barrage of current nutrition information available today. Work with your physician to devise something that makes sense for you.     Friday, Feb. 16, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.