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Keeping Women Heart-Healthy

Keeping Women Heart-HealthyTufts School of Medicine professor Dr. Richard Karas recently spoke about waysto prevent the onset of heart disease and other ailments in women.

Boston [06.21.05] Thanks in part to thework of Tufts' Drs. Alice Lichtenstein and Miriam Nelson andtheir book Strong Women, Strong Hearts, the issue ofheart disease in women is gaining needed national attention. Theyare not alone among Tufts health experts in urging women and menalike to get healthier and avoid the risk of heart disease.

"Partof the problem in this whole area is that so much of what peoplecommonly think about heart disease was really derived from studyingmen," Tufts' Dr.Richard Karas explained to National Public Radio."So the idea of the kind of crushing chest pain maybe radiatingdown the left arm, etc. — that's really much more typicalin men."

Karas is directorof the PreventiveCardiology Center at Tufts-NewEngland Medical Center, directs the medical center’sWomen’sHeart Center and co-directs of the MolecularCardiology Research Institute.

Signs in women,as Friedman School of NutritionScience and Policy professors Nelsonand Lichtensteindetail in Strong Women,Strong Hearts, are more subtle – such as nauseaor breathing difficulties.

But not enoughwomen or doctors are focused on the correct warning signs. Theproblem, Karas noted, has fatal repercussions.

"Thoughthe rates of heart-disease death have been declining in men overthe last several years, that same success has not been found inwomen," he told NPR. "It is clearly impactedby the lower rates of aggressive treatment in women. Women don'tconsider themselves to be at risk for heart disease, so they don'ttend to be as interested in the preventive measures that theycould be and should be."

One treatmentpossibility mentioned by Karas was hormone therapy, which he explainedhas been studied with mixed results. Some scientists, the Tuftsprofessor explained, have speculated that an older woman's increasedrisk of heart disease stems from the halt in estrogen productioncaused by menopause – thus spawning the idea that perhapsa postmenopausal infusion of estrogen could continue to lowerthe risk of heart disease.

"Theclinical studies that have looked at that in the last severalyears have produced a lot of controversy and a lot of confusion,"Karas explained. "We had a whole series of studies initiallythat suggested that women who took hormone replacement therapypost-menopause had a reduction in heart disease. More recently,the randomized trials, which are really considered the gold standardin clinical medicine, in a population of older women did not showany benefit of estrogen on heart disease. And, in fact, in somegroups, there appeared to be an increase in heart disease withestrogen use."

Still, heexpressed optimism about sorting out the role of estrogen in womenfor heart disease. "With time and consideration, there aresome important ideas that are coming forward about what thosedifferences might be."

Another threatfor heart disease, the Tufts physician said, is the onset of diabetes.

"Theimpact of developing diabetes on heart disease risk is considerablyhigher in women than it is in men," Karas told NPR’s“Talk of the Nation – Science Friday” program."For a man and a woman of the same age, the woman typicallyhas a lower risk of heart disease than the man. If she developsdiabetes, that basically takes away that protection of being awoman, and her rate of heart disease becomes equivalent [to that]of a man of about the same age."

The key toprevention, Karas says, is starting healthy habits at a youngage.

"There'sa lot of information that suggests that youngsters who are overweightturn into adults who are overweight. And that is the leading causeof diabetes in this country," he told NPR.

Overall, Karasurged people – both men and women – to be mindfulof their health in order to stave off heart disease.

"Halfthe people who die from heart disease die right off the bat, nowarning," he explained to NPR. "And that'sa very, very important reason for all individuals to be awareof common preventive measures to reduce their risk of having heartdisease, because you don't always get a warning to let you knowthat that's a problem."





















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