Empowering Women in The Fight Against Heart Disease by Dr. Aparna Jaswal

The topic for discussion today is myth versus reality heart disease, inflammation. And we’re extremely honored to have with us Dr. Aparna Jaswal leading senior consulatant interventional Best Cardiologist in Delhi at Fortis escorts hospital daily. Thank you so much, mam. Once again for accepting our invitation to address this cause. And now I would like to hand out the session to you to guide us further around heart disease in women.

Thank you very much. At the outset, I would like to thank you, Ben, for giving me this opportunity to be amongst your there could be no better opportune day and moments than today, considering today is the world heart day. And we are seeing a lot of activity and buzz around this day in media, today’s newspapers all around. And I think it’s vital. We discussed this because heart diseases continue to remain a very big burden of disease across the globe.

 Even more so in India, there could be no better day than today to be discussing heart disease in women. I think a lot of attention in 2021 is being given to heart disease in women in general. And today is a special day. So I think I would like to take you along with me trying to understand why we need to discuss this. The reason the most important reason is that people have this myth that heart disease is generally a man’s disease. It was always believed that women do not die of heart diseases. However, the glaring reality and unfortunate one is that heart disease continues to remain the leading cause of death in women. It is important to remember that women develop cardiovascular disease about a decade later than men. But the outcomes for women are often worse. Women do not remember themselves, that heart disease is the number one killer in them.

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Read Also:- Are Women Also At The Equal Risk Of Sudden Cardiac Death (SCD)?

This brings us to the point to discuss today that awareness is lacking. We can only achieve what we wish to if we are aware of the problem. So I will make an attempt to take you through to understand why we need to remember that heart disease in women is a big burden. Women carry the traditional as well as non-traditional risk factors. The traditional risk factors being what we see in men, diabetes, smoking, obesity, sedentary lifestyle, hypertension, and abnormal cholesterol. However, in women, they should be aware that women undergo hormonal, emotional, the drug problem that they undergo with hemodynamics when they are pregnant, all these together become even more troublesome for women. As you can see, there are issues around delivery time during the pregnancy, hypertensive disorders, diabetes during the pregnancy, there is something called autoimmune disorders, breast cancer, and of course depression. Hyper hypertension, high blood pressure is a leading cause of cardiovascular disease worldwide. This is to be remembered that women have higher mortality than men when they are hypertensive. under the age of 45, men are more likely, however, as women get older women to develop hypertension more than men. And it’s important to remember this only 1/3 of elderly women have adequate blood pressure control. Often patients come to us and ask us, doctor, will I have to take the pill every day? Well, we must understand and remember, if you have high blood pressure, it’s important to keep your blood pressure under control. Because blood pressure is a silent killer and it destroys our other organs. And the most dramatic and devastating complication of high blood pressure is stroke. Diabetes confers a greater cardiovascular risk for women than men.

Diabetic women have a higher incidence of heart disease as well as stroke. Thus, diabetes correlates most strongly with Cardiovascular Disease mortality in women than men. High cholesterol, dyslipidemia, as it is called, has the highest population-adjusted risk among women, compared with all other known risk factors for heart disease, obesity. Now, this is a problem that is more specific to low and middle-income nations, there is double the amount of obesity in women than in men, the reason being the low and middle-income nations. Because the diet, the diet is rich in carbohydrates. As a result, it makes people obese. Hence, it is important that we control obesity as a risk factor for women in the developing world. Physical inactivity, we have to remember that we must get out of our beds and hit the box and walk for at least 30 to 45 minutes every day, we must take a pledge upon ourselves as women that we must take out that much time for our own activity. pregnancy. This is something that is unique to women. And it is important that we must assess the pregnancy history for women of all ages.

The problem of pregnancy is that during the pregnancy, they can develop high blood pressure, they can develop diabetes, they can be preterm delivery, all of these put the woman at a higher risk of heart disease, depression. I think depression is something that is a universal phenomenon that can affect men and women. But surely, women have more psychosocial problems. As a result, they are more inclined to go into depression. Depression is associated with increased cardiovascular mortality, because people will not exercise, they will eat unhealthily, they will eat out of time hence there is a problem. And why do women tend to delay care? This is important. They misinterpret their symptoms. They believe that I cannot have heart disease, there is a state of denial, minimizing the perception of risk. Competing obligations don’t want to impose their problem on the family and sometimes can be embarrassed about their symptoms. Thus, it’s important that women know their symptoms. Women don’t experience heart disease the same way as men do. They have less angina, they can present very differently. What is Heart Attack: Symptoms, Warning, and Treatments. Have heart attacks among women usually are more sudden and come on with less warning. As a result, women are less likely to take that they’re having a heart attack and to seek medical care. So what are the unusual symptoms? So typical symptoms one must remember is chest pain in the center, which is constricting as somebody has kept awake and paying and go to the job or to the shoulders, at least in our arms. But women can come even differently. They can be unusual upper body discomfort, they can be shortness of breath, break out of a cold sweat, unexplained fatigue, lightheadedness, or nausea. If you have any of these symptoms, and you have risk factors you must not ignore and you must seek medical care. It is time to tell the women that we must be increasingly aware and we must remain ready to be screened so that they have knowledge of lowering the chances of getting heart disease. Rule number one look before you eat. Eat a variety of fruits and vegetables every day. Eat a variety of great products. Choose nonfat and low-fat products, less fat meats, more chicken fish, and lean guts. Switch to fat-free and skimmed milk. Dietary Guidelines as I told you, you must limit the number of carbohydrates you must limit the number of calories you must not try to drink too much of soft drinks, candies and junk food, saturated fats trans fats and this is what comes in your pizzas, burgers, pastries, cakes, chips, so this is some more sauce. This is what is saturated and trans fats. You must remember you must eat less than six grams of salt today means a small teaspoon is five grams. It should be less than that all your day. exercises. Rule number two, maintain a level of physical activity exercises daily for 30 minutes. This is extremely important. It reduces your risk of obesity increases your good cholesterol, lowers your bad cholesterol helps keep lifestyle diseases such as diabetes and hypertension at bay. Walking for a healthy heart. It has been known that those people who walk live the longest and amongst all the exercises daily walk is one exercise which has shown to last the longest. So it is a good thing if you can go to the go to gym and do it every day. However, walking is something all middle-aged women must adapt because it lasts the longest stress management manage your stress well. A very good way to do that is by doing yoga. Take a daily sleep of seven to nine hours, but must attempt to sleep on time and wake up on time. Know your numbers. This is important when we deal with cholesterol. Total cholesterol should be less than 200. LDL should be less than 100 and HDL should be more than 40 triglycerides less than 200. Get these levels tested routinely after especially once you achieve middle-aged and keep them under control. They are not difficult to get under control. If you exercise well. eat healthily seek the help of your doctor and take the right medications. Benefits of reducing cholesterol. But 10% reduction of blood cholesterol produces a 20 to 30% decline in deaths because of heart disease. So you must remember that if you are an adult, get your levels tested 20 years and above, get it tested five years later again get it tested, one must not worry about drugs, one must not worry about the result, one must test it and get it treated. Control your blood pressure. We must try to achieve a blood pressure in the majority of the time to be between 120 and 80.

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If your blood pressure is more than 130 by 90, you are labeled as hypertensive, so you must try to achieve optimal levels. How can you keep your blood pressure at bay if you don’t want to eat medicine is diet, exercise solid restriction controlling your weight? And if you need medication as per your doctor, you must take the blood pressure medications. Do not stop your medications without consulting your doctor. Do not think that I’ll have to eat for a lifetime. Because most important is to keep your blood pressure controlled. Control your blood sugar. You must remember a fasting blood sugar has to be less than 100. Post means less than 140. modify your lifestyle, diet, exercise, and weight. These are the most important things. Do not stop your medications for diabetes without consulting your doctor. Remember, if you’re a diabetic once, you will need medications for blood pressure control. You can reduce your doctor can reduce your blood pressure medications. If you exercise well eat healthily and control your weight.

I think I would like to conclude here and open the house for the discussion. And I will be happy to take some questions. Yeah, thank you so much, man, for such an informative session. We have a few questions in the chatbox man. Would you like to take those questions first?

How Can I Keep My Cholesterol Levels in Check? 

Well, the most important thing is if you’re an adult, you’re more than 30 it’s a good idea to at least get your blood cholesterol checked once. If your cholesterol is on the higher side. The simplest thing is to exercise to eat healthily. If these don’t work, you may need a pill to discuss with your Best Heart Specialist in India or your physician. And if they think it is important, you must take a pill, exercise, and die. Bring your levels down. The doctor may think that you can stop your pill. That’s how you do it. The next is our pregnant women are at risk of heart disease. It’s not that pregnant women are at risk of heart disease.

How can I keep my cholesterol levels in check

It is the hemodynamic the autonomic, the hormonal, the emotional imbalances which come with pregnancy, which can put you at risk. You can develop gestational diabetes, you can develop hypertension. So hence you can be at risk. So does my menopause have anything to do with heart disease? Yes, menopause in women has a lot to do with heart disease. When you achieve, you know, cause you are now at risk of heart disease just as your male counterparts. So if you are in a menopausal age group, you must work aggressively to take care that you don’t develop high blood pressure. You do not develop diabetes, you take care of your cholesterol levels, you work aggressively on them because now your risk of heart disease is as much as men because the protection offered by the hormones when you were pre-menopausal has gone away. 

So The Next Question is My Father Aad A Heart Attack A  Few Years Back, Am I At Equal Risk To Get it? 

This is a very good question. Strong family history puts you at risk of developing heart disease. So you should remember that if you have a family history, you need to work over zealously over aggressively to make sure that your risk factors are very well controlled. 

The Risk Factors Are High Blood Pressure 

Diabetes, smoking, cholesterol levels, and exercise. If you take care of these five things, you can push your genetics and make sure that even your genetics do not allow you to develop heart disease. The lifestyle measures that you need to adapt to avoid heart attack on exercise every day. I often tell my patients that exercise nine days a week, it implies on some days, do twice a day, eat healthily, do not have transplants, have less salt, make sure your diet is not cholesterol-rich, do not have trans fats. So if you look into these things, do not smoke. I think that’s important. Do good stress management, sleep well do not remain essentially, these are the measures that are very simple and should be incorporated in our daily lifestyle, which can keep you healthy. Are women more vulnerable in heart disease as they lack vigorous exercise? Yes. So after menopause, if women don’t look after themselves, they will be at Risk of Sudden Cardiac Arrest, because as I told you, postmenopausal women are at equal risk as men. So to think in our homes, we have our mothers, we have our grandmothers who think that they will not develop heart disease, because they’re protected by hormones, is a bit postmenopausal, they must look after themselves, too. Young hypertension, has young hypertension become more common and women when hypertension has stepped into our lifestyles, and we are seeing more and more of high blood pressure, even in school-going children. What is the reason is inactivity. So being on the computers, being on their mobile phones, not going out to exercise, eating unhealthy foods, eating junk foods, all of these, remember the food that you get from outside, a very high inside preservatives, saturated fats, and trans fats. All these things together, combined with lack of exercise, push us to develop heart diseases. So it’s a combination of all of these factors, which pushes us to develop heart disease.

Right, thank you so much, ma’am. I think we have Thank you so much, first of all, for pretty much covering all the questions which our audience has asked. And this session has been really wonderful for us. We got to know a lot of facts about heart disease in women which is really a pressing need to understand at this point in time. We would like to thank you once again for sparing your valuable time to address this noble cause of heart disease in women thank you so much from local India. And that’s it from our side.

Thank you very much. I think it is it is activities such as these that will actually bring around awareness and all of us will make a concerted effort for a healthy life in this world hearty Thank you very much.


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