A heart-to-heart talk with women

A woman’s heart is said to be, figuratively speaking, very resilient. It can take in a lot of heartaches, disappointments, hurts, betrayals and all sorts of emotional torture imaginable — and survive. Ask any wife who has seen her soldier husband killed in battle, or a mother who has witnessed her conjoined twin babies take their last breath. On the physical level, however, that same heart is not anywhere near invincible and is posing a serious threat to countless women’s lives.

In an alarming turn of events, cardiovascular disease is now considered by doctors as the leading cause of death among women. It is said that about 50,000 Filipino women die of cardiovascular diseases every year. In fact, CVD is the leading cause of death among men and women. An estimated 55,000 men are said to die of CVD every year. The World Health Organization was quoted recently as stating that "CVD-related deaths could reach a high of 25 million by 2025."

Cardiovascular disease is a collective name for any ailment related to the heart and blood vessels. The most common types of CVD include high blood pressure, coronary heart disease (including heart attack and chest pains), stroke and rheumatic heart disease. Other forms include diseases of the arteries and capillaries, cardiomyopathy, congestive heart failure, circulatory defects, among others. A most surprising addition to CVD is diabetes, which could lead to serious complications if left untreated.

At the Philippine Heart Association’s 36th Annual Convention’ Puso sa Puso media forum, eminent cardiologist Dr. Esperanza Cabral discussed the CVD menace in the female population. The event also launched the PHA Council on Women’s Health, a brainchild of Dr. Cabral, which will aim to make women aware of heart disease and "to educate, empower and motivate them in preventing CVD."

According to Dr. Cabral, one of the country’s top cardiologists, for every woman who dies of breast cancer, eight die of CVD, and for 11 women who die of childbirth-related complications, 33 die of CVD. "The focus of women lately has been on pregnancy/childbirth diseases and different types of cancer that they have taken for granted the threat of CVD in their lives," says the former director of the Philippine Heart Center.

Latest studies show that the prevalence rate of high blood pressure in the adult population 20 years old and above is 17.2 percent, which is equivalent to 7.8 million Filipinos. Of this number, 3.9 million are women.

The high incidence of CVD among Filipino women, opines Dr. Cabral, could be attributed to an unhealthy – not to mention, highly stressful – lifestyle as well as genetics. Also, doctors have noted that Filipino women tend to neglect their own health in favor of their family’s health. Thus, they aren’t really keen on having their blood pressure checked regularly, usually dismissing a headache or breathing troubles as "mere fatigue or stress."

Women, too, will tend to deny their illnesses or keep it to themselves more than men. "In the US," says Dr. Cabral, "some people have observed that women are at a disadvantage as far as health care is concerned. Doctors tend to dismiss a woman’s complaints as mere nerves or hysteria."

The general observation, she adds, is that women are underdiagnosed and undertreated. Less attention is paid to them and they are less likely to be given intense treatment. Could this be due to the universal impression that females are the stronger gender and are thus more likely to overcome physical ailments merely by willpower? Your guess is as good as ours.

Dr. Cabral emphasizes the importance of prevention of the disease and maintaining a healthy lifestyle. She notes that women, especially mothers, tend to become "basureras" at the homefront, indiscriminately eating their kids’ leftovers including junk food. In the long run, this haphazard eating habit would get them into trouble diet-wise. Either that, or they go to the other extreme, which is to skip meals because they have to finish all those housework. If they are not eating all that junk food and preservative-laden food, they’re getting too stressed out because of household responsibilities and, if they’re unlucky, worry about a philandering husband or the high cost of living. Either way, they’ll most likely end up hypertensive and heart attack grand finalists.

In fact, offers Dr. Cabral, studies in the US indicate that married women in stable relationships live longer than single women and married women in bad relationships. As to whether heartbroken females eventually develop heart disease is still open to debate and speculations in the medical field. But if we are to consider what alternative healers have been saying for years, physical ailments are direct manifestations of emotional upheaval and other forms of mental, emotional and spiritual suffering.

When it comes to diet, women are advised to avoid food with high-sodium content, canned goods saturated with preservatives, and greasy food. Basically, the best way to avoid cardiovascular problems is to eat healthy. There are no magic bullets involved – just eat lots of fruits and vegetables, fish, just enough lean meat and rice or bread. And please, fair children of Eve, get on your feet and stretch those sleeping muscles. Exercise, exercise, exercise! Heart failure occurs when the blood flow to the heart is blocked by a blood clot, for instance. So, before you reach this stage, try to pump in more oxygen and get the blood circulating well by moving that body. It may sound simplistic, but this is one of the easiest ways to prevent future cardiovascular problems.

Women smokers, though looking glamorous and oh-so sophisticated, are really better off putting out those death sticks. Several studies done by health organizations in Australia indicate that smoking "increases the artery-clogging process called atherosclerosis," which results in the narrowing of arteries. This leads to limited blood flow and less oxygen being supplied to the body and will, in turn, lead to a heart attack.

Studies also show that smoking "increases the risk of heart attack by two to six times and stroke by three times."

A report on smoking and CVD at www.holyname.org says that "about 30 percent of all coronary heart disease deaths in the US each year" can be attributed to cigarette smoking. It also reveals that smokers are "eight times more likely to suffer an aortic aneurysm than non-smokers" and among persons below 65, "44 percent of strokes in men and 39 percent in women are caused by cigarette smoking."

In the Philippines, it is said that the incidence of heart disease in men climbs up at ages 45 to 55, while in women, it’s 55 to 65. This is because at a younger age, women still in the child-bearing age are protected with their bodies’ production of estrogen, which is believed to protect the system from diseases. But the risk starts to rise once women reach the menopausal stage and, if they don’t follow a healthy lifestyle at this age, are most likely to suffer from CVD.

"One of the most common misconception is that CVD is a man’s illness. But recent studies clearly show that it’s not. Women are at risk as well," says Dr. Cabral, who is the chief cardiologist of Asian Hospital.

The PHA Council on Women’s Health intends to embark on a nationwide public awareness campaign focusing on heart disease and ways to avoid it. But Dr. Cabral is realistic enough to say that they aren’t expecting any big improvement of the numbers in the next 10 years. "The process has been going on for the past 20 years and what we can do is to be consistent in this endeavor," she says.

The Council is also set to reach out to civic organizations to raise the level of awareness of a wider sector of society and will soon link up with schools and parents-teachers associations nationwide.

One very novel approach that the Council is considering is to have a dialogue with owners of noodle companies and ask them to reduce the sodium content of instant noodles. A highly popular – and very affordable – food item especially among the lower brackets of society, instant noodles are admittedly quite tasty. These instant hot meals can be found at breakfast and dinner tables, a favorite midnight snack, and are even popular choices of mountaineers. Truly, instant noodles have become part of every Filipino’s fast-paced life. But what most Filipinos don’t know is that too much of the high-sodium stuff would practically make them living "salt mines". Tsk, tsk, bad for the heart.

For those who still can’t see the wisdom of prevention, maybe an "economic" approach would finally convince them to stop a while and listen good. We asked Dr. Cabral to give us an idea of the cost of having CVD. Take hypertension, for instance. A pill for hypertension would, on the average, cost P10 a day. If one is to visit the doctor three times a year, one would have to shell out P500 for each visit. And if you were to take a battery of tests per year, be prepared to part with P2,000. Or worse, if you’re also suffering from diabetes and have high cholesterol levels, expect the price to shoot up further. If you got careless and didn’t heed the warning signs, you could end up at the intensive care unit, which could easily fetch P50,000 a day in some hospitals. And the worst-case scenario? A bypass operation which could cost a whopping P500,000 to P1 million. Now, if that doesn’t give you a heart attack, then you have earned the right to be called Superwoman.