Contact: Will Sansom
Phone: (210) 567-2579
E-mail: sansom@uthscsa.edu

FELDMAN
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San Antonio (Feb. 20, 2007) – Heart disease and stroke combine to be the number one killer of women in the U.S., taking the lives of 349,000 women each year. We asked Marc D. Feldman, M.D., director of the Cardiac Catheterization Laboratory at The University of Texas Health Science Center at San Antonio, eight questions about cardiovascular disease, including women’s risk. The questions and his answers follow.
1. What determines someone’s risk for cardiovascular disease? A person’s risk is based on factors that can be controlled and others that can’t. Your gender, age and family history can’t be changed. Risk factors that can be modified include smoking or using any tobacco; being overweight; uncontrolled diabetes, blood pressure and cholesterol; and not exercising.
2. Are women more “immune” to cardiovascular disease because of hormones? More women than ever are aware that cardiovascular disease can affect them. Unfortunately, many more don’t see it as a big risk for them personally. Women are protected by estrogens in their younger years, but five years after menopause they catch up with men. And, while blocked arteries occur in women later than they do in men, woman have different symptoms and they often are more difficult to diagnose.
3. Since blood pressure is so important, what should I do to make sure mine is where it should be? Normal blood pressure is 120 over 80; however, there is no absolute normal cut-off. The lower the blood pressure, the better. The first step to controlling blood pressure involves a low-salt diet and exercise. If that does not control blood pressure, medication may be added. Many people require several medications for good control of their blood pressure. The key is to go to a health care provider and have it checked. High blood pressure has been called a silent killer. Even if you feel fine, you can’t assume you have a normal blood pressure.
4. Can I keep tabs on my blood pressure when I go to the pharmacy at my drug store or supermarket? The New York Times did an in-depth report on this subject (“Risk Seen in Move to Replace Gauge of Blood Pressure,” by Gina Kolata, published June 16, 2002). The bottom line is blood pressure cuffs in supermarkets and drug stores are not always accurate. They are supposed to be recalibrated every six months. Few places do that.
5. I’ve heard of “bad” cholesterol, “good” cholesterol and triglycerides. What if, because of my family history, I suspect these are out of control It would be best to have a blood test after fasting to determine your lipid profile. If you are a parent, you should even have your teenagers tested to get a sense of what their future risk is and to intervene with diet and exercise at an early age to teach good life habits. Lipids can fall into the normal range just by getting involved in regular exercise.
6. In addition to body mass index, waist measurement, lipids and blood sugar, what other screening tests for cardiovascular disease do I need? Health care providers also can measure a marker of inflammation called high-sensitivity C-reactive protein. Researchers have found these are better predictors of cardiovascular disease than even cholesterol. Ultimately, atherosclerosis is an inflammation of the blood vessels.
7. How much physical activity do I need to help protect my heart? People should be exercising at least five days a week for at least 30 minutes a day. Walking up and down the stairs at work does not count. It must be continuous activity for at least 30 minutes.
8. How can I tell if I’m having a heart attack? Women and diabetics often have atypical symptoms such as nausea, sweating, ill feeling and shortness of breath, and do not have the classic symptoms of a fist-like sensation and chest pressure. Half of myocardial infarctions (MIs) are silent. Even if you feel you are having indigestion, come to the hospital.
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The University of Texas Health Science Center at San Antonio is the leading research institution in South Texas and one of the major health sciences universities in the world. With an operating budget of $536 million, the Health Science Center is the chief catalyst for the $14.3 billion biosciences and health care industry, the leading sector in San Antonio’s economy. The Health Science Center has had an estimated $35 billion impact on the region since inception and has expanded to six campuses in San Antonio, Laredo, Harlingen and Edinburg. More than 22,000 graduates (physicians, dentists, nurses, scientists and allied health professionals) serve in their fields, including many in Texas. Health Science Center faculty are international leaders in cancer, cardiovascular disease, diabetes, aging, stroke prevention, kidney disease, orthopaedics, research imaging, transplant surgery, psychiatry and clinical neurosciences, pain management, genetics, nursing, allied health, dentistry and many other fields. For more information, click on www.uthscsa.edu.