The heart of the matter: M & F HERS speaks with cardiologist Cliff Morris, MD, about America's leading killer—cardiovascular disease

Muscle & Fitness/Hers, Sept-Oct, 2003 by Adam D. Retsky

if you need get motivated for your next workout, here's a scary fact: Cardiovascular disease is the leading killer in America today. Though often thought of as a man's affliction, approximately 45% of all female deaths occur from some form of cardiovascular disease, according to the American Heart Association. Moreover, compared with 27% of men, 44% of women will die within one year after a heart attack. Your workout routine is an important first step toward prevention, but you also need to educate yourself about what cardiovascular disease is and how it affects your body.

Modern medicine can successfully diagnose, treat and cure many different forms of this disease. Yet it's up to you to take the initial step in reducing your risk by being responsible for your diet, medical care and personal habits. Cliff Morris, MD, cardiologist and medical director of cardiac rehabilitation at John Randolph Medical Center in Virginia, spoke with M & F HERS about some of the most prevalent cardiac issues facing American women today.

What is Cardiovascular Disease?

Cardiovascular disease is an umbrella term used to identify a range of diseases that affect the heart and circulatory system. The most common are:

[love] Coronary heart disease, which affects the coronary arteries of the heart and is the most frequently occurring form of heart disease;

[love] Atherosclerosis, which is a buildup of plaque on the inner walls of the arteries;

[love] Angina, which is a pain or discomfort in the chest;

[love] Stroke, which is a lack of blood flow to the brain;

[love] High blood pressure (hypertension), often called the "silent killer," which is the excessive force of blood pumped by the heart against the walls of the blood vessels; and

[love] Heart failure, which develops slowly.

What Can Lead to Cardiovascular Disease?

Some factors are beyond our control, such as advanced age, family health history and race. However, controllable factors such as smoking, obesity and stress play a major role in the development of these diseases.

"Smoking truly is the No. 1 risk factor for men and women," says Morris. "When you smoke, you accelerate the oxidation of the cholesterol in the bloodstream so that it can be deposited into the walls of the blood vessels at a much faster rate. Under normal circumstances, it's as if you have a brick mason on the inside of your blood vessels that's grabbing the cholesterol and sticking it on the walls of your arteries. But when you smoke, all of a sudden that becomes a super brick mason that's really packing those cholesterol particles into the blood vessels. Women who smoke are more likely to suffer some of the more severe consequences of coronary artery disease and stroke, even by being in contact with secondhand smoke."

Another risk factor for cardiovascular disease is obesity, which may facilitate the onset of type II diabetes in adults. "A woman with diabetes is at a much greater risk for developing complications from cardiovascular disease, such as congestive heart failure, other cardiovascular problems, stroke and peripheral vascular disease," says Morris. "Compared to men, women with diabetes are at increased risk of having heart attacks. Following a heart attack, they're also at risk for doing poorly during procedures such as angioplasty and bypass surgery."

Hypertension (high blood pressure) is also a contributory factor to cardiovascular disease. "High blood pressure is part of the metabolic syndrome (abdominal obesity, raised blood pressure, insulin resistance)," explains Morris. "Once again, women need to be aware of the importance of monitoring their blood pressure and keeping in close contact with their doctors to be sure they're taking the proper medications and that they're doing all the risk-reduction strategies to keep their blood pressure under control."

Your state of mind is another key piece of the cardiovascular puzzle. Morris states: "Even though they're not independent risk factors for coronary disease--such as cholesterol and tobacco--depression and stress are significant contributors to developing coronary artery disease. People who are depressed are at an increased risk for not only their first cardiac event, but [afterward], they're more likely to die sooner and to suffer further cardiovascular complications."

Reducing the Risk

An active lifestyle can protect you from this modern-day plague. "Exercise is very, very important," says Morris. "The great news is that people don't need a whole hour in the gym; they just need basically 30 minutes a day of exercise. The even greater news is that it can be broken up into five- or 10-minute increments; it doesn't have to be done all together. The important thing is to make sure that it gets done.

"In my practice, education is always the most important thing. Being knowledgeable about the importance of these risk factors, I think, will help you to establish better risk-reduction strategies. Preventive maintenance should be closely monitored through your doctor's office. And hopefully, with the exercise, with keeping your blood pressure and your cholesterol under control, with watching your diet, you'll achieve the weight loss that is so essential."