The National Heart, Lung, and Blood Institute (NHLBI) provides global leadership for the prevention and treatment of heart, lung, and blood diseases. Dr. Patrice Desvigne-Nickens is a program director in the Heart Failure and Arrhythmias Branch in the Division of Cardiovascular Sciences at the NHLBI. In this role, she is responsible for the scientific development and fiscal management of research programs focused on prevention, recognition, and treatment in cardiovascular medicine.
When it comes to preventing heart disease across all demographics in the United States, how are we doing? Are we getting better or worse?
Patrice Desvigne-Nickens, M.D.: Heart disease is still the leading cause of death in women of all racial and ethnic groups in the United States (with the exception of Asian and Pacific Islanders, American Indian/Alaska Natives, and Hispanics/Latinos). That said, we're seeing a steady increase in the number of women who are aware that heart disease is their leading cause of death -- and that this awareness leads women to take action to be healthier. In 1997, only 30 percent of women knew that heart disease was their leading cause of death. By 2009, more than half (54 percent) knew it. Of the women who know that heart disease is their leading cause of death, 35 percent are more likely to be physically active and 47 percent are more likely to report weight loss than those who are less aware. Overall, heart disease deaths in American women are decreasing. Of the women who died in 1999, nearly 1 in 3 died from heart disease. Of the women who died in 2009, 1 in 4 died from heart disease.
Many seniors, particularly women, discover they have heart disease when they have a heart attack. What are the warning signs of heart disease that seniors and their caregivers should be aware of?
PDN: A common symptom of heart disease is angina. Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn't get enough oxygen-rich blood. Another common symptom of heart disease is shortness of breath. This symptom happens if heart disease causes heart failure. When you have heart failure, your heart can't pump enough blood to meet your body's needs. Fluid builds up in your lungs, making it hard to breathe. The severity of these symptoms varies. They may get more severe as the buildup of plaque continues to narrow the coronary arteries. Some people who have heart disease have no signs or symptoms, a condition called silent heart disease. The disease may not be diagnosed until a person has signs or symptoms of a heart attack, heart failure, or an arrhythmia (an irregular heartbeat).
It's so important for seniors and their caregivers to talk with their doctors to understand whether they are at risk for heart disease and make an action plan for preventing it. Risk factors for heart disease include:
- High blood pressure
- High blood cholesterol
- Being overweight
- Being physically inactive
- Having a family history of early heart disease
- Age (55 or older for women)
Remember, once you get heart disease, it's a lifelong disease -- so it's much better to prevent it.
What do you find are the biggest misconceptions that seniors have when it comes to dealing with their high blood pressure or high cholesterol?
PDN: One of the largest misconceptions is that treating high blood pressure and high cholesterol isn't important. High blood pressure and high cholesterol often have no symptoms but can significantly damage the heart. It's important for providers, with the help of caregivers, to take the time to educate seniors about why taking the steps to reduce cholesterol and blood pressure levels -- either through medication, lifestyle changes, or both -- is so important.
Our population is aging and there are now more than 40 million people in the United States aged 65 or over, and the average person is living to an all-time high of 78 years. With people living longer than ever before, in what ways do we need to rethink or reprioritize heart health?
PDN: Men and women need to take steps at every age to protect their heart health. Heart disease can begin early, even in the teen years. About 60 percent of young women (ages 20 to 39 years) have one or more modifiable risk factors for heart disease. We need to start thinking about heart health across the entire lifespan. It's never too early -- or too late -- to take action to prevent and control risk factors.
Our aging population also means more people than ever are living with heart disease and the challenges that accompany it. What advice do you have for those seniors living with heart disease?
PDN: Once you have heart disease, it becomes even more critical to adopt a healthy lifestyle to manage the disease and prevent heart attacks. Adopting a heart healthy lifestyle includes following a healthy diet, being physically active, maintaining a healthy weight, and stopping smoking, and continuing these habits throughout the rest of your life. If the thought of adopting a healthy lifestyle seems overwhelming, remember that you can start small. Make changes one at a time and set realistic goals.
In what ways does having a healthy heart reduce the risk of developing other health conditions as we age?
PDN: Keeping a healthy heart requires that you follow a healthy diet, be physically active, maintain a healthy weight, and stop smoking. Following these four habits can provide you protection against other conditions, like high blood pressure and diabetes.
When it comes to heart health in the future, what makes you feel most optimistic?
PDN: I feel optimistic knowing that women are starting to take action to protect their hearts, and this will enable them to live longer, healthier lives. In 2009, 84 percent of women reported checking blood pressure, 66 percent had their cholesterol checked, 63 percent said they increased physical activity, 51 percent reported losing weight, and 29 percent said they quit smoking. As a result of these healthy decisions and advances in treatment, deaths from heart disease in women have decreased in each of the 11 years from 1999 to 2009, a consecutive yearly decline that has not occurred before.
Despite these gains, it is still critical for women to be aware of their risks for heart disease, and talk to their doctors about prevention. To learn more about heart disease in women, visit hearttruth.gov and http://www.nhlbi.nih.gov/health/health-topics/topics/cad/.