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The #1 Killer in Women? Heart Disease

Dr. Eileen A. Kelly February 06, 2009 12:00 PM This chat has ended. Thank you for participating.
Teddy (Moderator) - 11:29 AM:
Eileen Kelly, M.D., Director, Women’s Heart Program
Dr. Kelly helped establish the Women’s Heart Program of NorthShore University HealthSystem, the only program devoted to women’s heart care on the North Shore. The program provides heart care to women in every stage of life, by offering comprehensive care for women with existing heart disease and primary prevention strategies for patients at risk for heart disease. Dr. Kelly is a clinical cardiologist with a decade of experience in treating heart disease in women. She is dedicated to encouraging women to better understand and manage their heart risk factors with the guidance of their primary care physicians.

Teddy (Moderator) - 11:38 AM:
Dr. Kelly will join us at noon. Please feel free to begin submitting questions, and she will answer them when she arrives.

Kristin (Moderator) - 12:00 PM:
Welcome to NorthShore University HealthSystem's latest chat, "The #1 Killer in Women? Heart Disease" hosted by Dr. Eileen A. Kelly Hensing. The chat has now started, so please welcome Dr. Kelly.

Dr. Eileen A. Kelly Hensing (NorthShore) - 12:04 PM:
Hello everyone. Thank you for joining today's chat. I'm looking forward to answering as many questions as possible.

Kathy Ashlevitz (Vernon Hills, IL) - 12:05 PM:
I have a pain that occurs vertically on the center left and seems to move below my ribcage on the left and sometimes accompanied by a feeling of pressure - no other symptoms. Noticeable when I am sitting or lying down. Deep breaths sometimes improve. Heart problem symptoms?

Dr. Eileen A. Kelly Hensing (NorthShore):
It is difficult to completely assess your symptoms over the internet. I recommend that you have this further evaluated with your primary care doctor.

Tracy (Chicago, IL) - 12:06 PM:
Hi Doctor. At what age can someone develop heart disease?

Dr. Eileen A. Kelly Hensing (NorthShore):
Heart disease can develop at any age. We know from many studies that young men who die prematurely from accidents have evidence of atherosclerosis in their aortas as young as teenagers. This is why it's so important to have your global risk of developing heart disease evaluated regularly with your primary care doctor.

James (Tinley Park, IL) - 12:08 PM:
If I have high blood pressure, how should I go about planning an exercise regime? I feel as though it would be easier to overexert myself.

Dr. Eileen A. Kelly Hensing (NorthShore):
The first order of business would be to get your blood pressure under good control. While diet and exercise is an important part of this, you should check with your doctor to make sure exercise is safe for you. Your doctor might recommend a stress test before you start an exercise regimen. Current recommendations for exercise are 30-45 minutes "most days of the week" (4-5 days a week).

Lilly (Hoffman Estates, IL) - 12:10 PM:
My father has high blood pressure and high cholesterol. What can I do to prevent developing the same problems?

Dr. Eileen A. Kelly Hensing (NorthShore):
Eating a heart healthy diet low in saturated fat and salt as well as regular exercise, would be a great start! Go to it Lilly!

Tiffany (Evanston, IL) - 12:11 PM:
What are simple checks that someone on a fixed income can do to check for any heart problems that do not have marked symptoms?

Dr. Eileen A. Kelly Hensing (NorthShore):
There are several places where you can have your overall risk assessed for a nominal fee. At NorthShore University HealthSystem's Women's Heart Program, we offer these services regularly for $25. This would be a good place to start. Go to northshore.org to classes and events and then look for CV risk assessment or call 847-570-5020.

Tracy (Chicago) - 12:15 PM:
What's the youngest case of heart disease, such as high blood pressure, that you have come across?

Dr. Eileen A. Kelly Hensing (NorthShore):
I'm an adult cardiologist so usually don't see patients under the age of 18. However, with the rising obesity and diabetes epidemics in children, high blood pressure is being seen frequently in our youth.

James (Tinley Park, IL) - 12:16 PM:
Are there any exercises that you can think of that I should completely avoid?

Dr. Eileen A. Kelly Hensing (NorthShore):
It's important you check with your doctor first however, regular aerobic activity is best for the heart. Walking at a moderate pace is a great way to get started. There's little proven cardiovascular benefit from heavy weight lifting.

Cindy (Evanston, Il) - 12:18 PM:
I have been on BP medication for several years. My doctor has changed the type and dosage of medication several times trying to find the best "fit". Do long term users tend to develop a tolerance to the medications over time that causes them to be less effective?

Dr. Eileen A. Kelly Hensing (NorthShore):
While I have seen this in some patients, I do not think that "tolerance" is a common clinical problem.

Lilly (hoffman estates, il) - 12:19 PM:
Thanks, Dr. Kelly. Is there any form of genetic testing that is available for heart disease?

Dr. Eileen A. Kelly Hensing (NorthShore):
Yes. We are learning more about the roll of genetics in cardiovascular disease every day. Most of the cardiovascular genetic testing available currently is for certain cardiomyopathies and specific electrical abnormalities of the heart.

Tracy (Chicago) - 12:22 PM:
Okay. What can I do to help my children who have a history of heart disease on their family to try and avoid this becoming a problem in their teen and adult lives?

Dr. Eileen A. Kelly Hensing (NorthShore):
Prevention works. It's very important for children to develop healthy eating and regular exercise habits. Diets that are low in saturated fat and sodium are best. It's obviously important that they get the protein they need as well as the rest of their "building blocks" including dairy, fruits and vegetables... Try to keep your kids active every day for at least 60 minutes.

James (Tinley Park) - 12:25 PM:
Other than salty or fatty foods, are there other foods should I avoid if I have high blood pressure?

Dr. Eileen A. Kelly Hensing (NorthShore):
Optimal BMI or Body Mass Index is important in maintaining a good blood pressure. You should eat a diet with the proper amount of calores to maintain a BMI between 18 and 25.

James (Tinley Park) - 12:28 PM:
Also,I’ve heard mixed opinions about the effectiveness of a stress test. Do you think it is worth it to have one done?

Dr. Eileen A. Kelly Hensing (NorthShore):
I believe in the appropriate use of stress tests. Stress tests are good at looking for big blockages (greater than 70% or so). They're not good at predicting heart attacks or detecting blockages that are smaller than that.

Lilly (hoffman estates) - 12:31 PM:
What is the difference between having high cholesterol and high triglycerides?

Dr. Eileen A. Kelly Hensing (NorthShore):
Triglycerides are one of the levels measured in a total cholesterol panel, along with the LDL and HDL. You can have high triglycerides while the rest of your panel is normal. High triglycerides might be a sign of or associated with diabetes or metabolic syndrome.

Tracy (Chicago, IL) - 12:34 PM:
Not that many people know the severity of women and heart disease. How can I further educate myself, my friends and my family about the issue?

Dr. Eileen A. Kelly Hensing (NorthShore):
That's true, Tracy. I can give you a couple of good web sites that have a lot of information for you. www.americanheart.org, www.womenheart.org and of course www.northshore.org.

Lilly (Hoffman Estates) - 12:36 PM:
Can you recommend some books on heart disease?

Dr. Eileen A. Kelly Hensing (NorthShore):
A recent book that's in publication by Harlan M. Krumholz, M.D. is The Expert Guide to Beating Heart Disease. What You Absolutely Must Know. There are also other resources on the Web sites I just mentioned.

Talia (Evanston, IL) - 12:37 PM:
Are any ethnicities more at risk for heart disease?

Dr. Eileen A. Kelly Hensing (NorthShore):
Yes. African Americans, Hispanics, and Native American Indians are all high risk groups.

James (Tinley Park) - 12:38 PM:
At what age or at what point would a doctor issue a stress test without knowing the amount of blockage? How is an amount of blockage determined?

Dr. Eileen A. Kelly Hensing (NorthShore):
Stress tests are usually driven by symptoms. Although in patients with diabetes, a stress test may be requested without symptoms.

Lilly (hoffman estates) - 12:39 PM:
Would you say that one is worse than the other for High triglycerides vs. high cholesterol?

Dr. Eileen A. Kelly Hensing (NorthShore):
Yes, while it's important to strive for optimal levels of HDL (good cholesterol), LDL (bad cholesterol), and triglycerides, it's most important to have your LDL at goal first.

Tracy (Chicago) - 12:41 PM:
What kinds of screenings are available for those at risk at developing heart disease?

Dr. Eileen A. Kelly Hensing (NorthShore):
We mentioned earlier that the cardiovascular risk screenings are available. These screenings consist of an assessment of the common risk factors pre-disposing to heart disease. At NorthShore, this would include a finger stick blood assessment for glucose and cholesterol and blood pressure and body mass index assessments. These assessments are done by a cardiovascular nurse who also provides counseling regarding risk factors.

Talia (Evanston, IL) - 12:43 PM:
As an African American, are there extra precautions I should or can take?

Dr. Eileen A. Kelly Hensing (NorthShore):
While the risk of African Americans may be higher, the precautions are the same. Regular evaluation of your risk with your doctor is important. Eating a healthy diet and exercising is also very important and finally, NO SMOKING.

James (Tinley Park) - 12:44 PM:
Does NorthShore have any classes that educate those unaware of the risks of heart disease?

Dr. Eileen A. Kelly Hensing (NorthShore):
We try to get out into the community as much as possible. Check the calendar on our Web site frequently for updates.

Lilly (hoffman estates) - 12:46 PM:
Thanks doctor, I've had higher readings for triglycerides. What do you recommend I do to get them back to normal? Is treatment the same as with high cholesterol?

Dr. Eileen A. Kelly Hensing (NorthShore):
We can't stress enough the importance of living a healthy lifestyle. The American Heart Association Web site given earlier has excellent information and recommendations about cholesterol including triglycerides. A good start to dietary changes would include taking all of the "white things" out of your diet and substituting with whole grains (pasta, bread, potatoes). Alcohol can also increase triglycerides so should be used in moderation. i.e. for women one alcoholic beverage a day is the recommendation.

Tracy (Chicago) - 12:50 PM:
Is there a specific age which these assessments should be completed?

Dr. Eileen A. Kelly Hensing (NorthShore):
The American Heart Association recommends that everyone should have their initial assessment at age 20. Follow up is dependent on the results.

Kristin (Moderator) - 12:50 PM:
Thank you everyone for your great participation, but unfortunately we only have ten minutes remaining, so please submit any final questions you may have. Thank you.

James (Tinley) - 12:51 PM:
Can someone with high blood pressure be able to manage it without medication?

Dr. Eileen A. Kelly Hensing (NorthShore):
We have learned that diets high in sodium and excessive weight can elevate the blood pressure. Current recommendations are to limit your total daily sodium intake to less than 2300 mg.

Lilly (Hoffman Estates) - 12:52 PM:
How does drinking alcohol affect heart disease?

Dr. Eileen A. Kelly Hensing (NorthShore):
Individuals who consume excessive amounts of alcohol can develop weak heart muscles and irregular heart beats. There is also some data though supporting moderate intake as beneficial. This may be due to antioxidants in the alcohol such as wine.

Lilly (Hoffman Estates) - 12:54 PM:
How does alcohol change triglyceride levels?

Dr. Eileen A. Kelly Hensing (NorthShore):
It can increase the level.

James (Tinley) - 12:55 PM:
What are some foods that many people do not know are high in sodium that can appear harmless?

Dr. Eileen A. Kelly Hensing (NorthShore):
Soups, marinades and many processed or pre-packaged foods. The sodium content is listed on the labels.

Dr. Eileen A. Kelly Hensing (NorthShore) - 12:56 PM:
We have time for one or two more questions. Thank you.

Maria - 12:57 PM:
Are their any concerns with having a bovine arch???

Dr. Eileen A. Kelly Hensing (NorthShore):
I'm not sure I understand your question. Could you please rephrase and/or elaborate?

James (Tinley Park) - 12:58 PM:
Would going vegetarian or vegan improve high blood pressure?

Dr. Eileen A. Kelly Hensing (NorthShore):
Not necessarily

Tracy (Chicago) - 1:00 PM:
I'm aware of gestational diabetes, but would pregnancy affect blood pressure or cholesterol?

Dr. Eileen A. Kelly Hensing (NorthShore):
In a normal pregnancy, the blood pressure usually stays the same or may go down. As for cholesterol if anything, it may go down but it's not a good time to check.

Kristin (Moderator) - 1:00 PM:
Thank you again to everyone for joining us today. If you have any more questions, please visit the Women's Heart Program website for additional information and resources.

Dr. Eileen A. Kelly Hensing (NorthShore) - 1:02 PM:
This concludes our chat today. Thank you for your good questions. I encourage you to participate in the rest of the chats taking place this month in honor of National Heart Month.
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