Heart disease starts before heart attack, stroke

By Dr. Mona Alqulali Special to the Herald

CLINTON — DEAR DR. MONA: I was diagnosed with high cholesterol a few years ago, but with all the hype about cholesterol medication on the news, I stopped taking my medication about 11 months ago. Recently when I used one of the drugstore blood pressure machines my blood pressure was 142/90. How concerned should I be about this? — Marge

DEAR MARGE: You should be VERY concerned. You are showing several of the early signs of heart disease. Too often people think of heart disease as a heart attack or a stroke. But even with the heightened awareness of the public, thanks to the news media, there is still a failure to recognize that heart disease is a “process.”  

Heart disease is also a woman’s disease, contrary to popular opinion. In the past, the middle-aged woman was felt to be protected from heart disease, but now research shows that in the years both before and after menopause, the risk levels for women increase considerably. Women may not have heart attacks that exhibit the same symptoms as men, but rates of heart disease are increasing much faster than the rates for men. 

This year, in order to draw attention to women’s cardiac health, we have the Red Dress Collection with national sponsors, celebrities, and huge fundraising events.  Red dresses are fun and romantic, but this huge publicity effort attempts to draw attention to the seriousness of the issue — that heart disease is a women’s disease.  

So, Marge, your first symptom of high cholesterol is also one of the first signs of a process leading to more serious issues. The plaque build-up in the blood vessels caused by high cholesterol then leads to high blood pressure, another symptom in the progression of heart disease.

As the blood vessels narrow, the heart must work harder to pump the blood resulting in higher blood pressure. The force of the blood pumping through narrowed arteries creates small tears and then scar tissue. Damaged arteries then trap more plaque causing the blood pressure to increase.

Organs may be damaged as they fail to get the blood they need due to narrow and constricted arteries. There is then the possibility of clots developing in the blood vessels which can totally or partially block the supply of blood to the rest of the body. Thus the entire circulatory system and the heart as well may be affected by changes that begin their cycle with high cholesterol or high blood pressure, apparently simple problems that can start a deathly spiral progressing to heart attack or stroke.

Therefore it is extremely important, Marge, that you see your doctor to get your cholesterol under control and also monitor your blood pressure. If you get your symptoms under control, you delay rapid progression of the disease.

Having discussed the evolutionary process of heart disease, let’s talk about what women can do.  Known risk factors for heart disease in women in addition to high cholesterol and high blood pressure, are diabetes and obesity.  

Therefore besides taking medication prescribed by your doctor and following up with him or her on a regular basis, you can keep your weight under control through diet and exercise. If you have diabetes or high blood sugars this is especially important. Daily exercise that gets your heart pumping faster works wonders for your heart as well as helps with weight control.

If you are unable to lose weight on your own, enroll in a weight loss program, preferably under physician guidance. Additionally, you should decrease fats in your diet (like cakes, candy, sugar, fried food, fast food and desserts — sorry), increase complex carbohydrates (like beans and whole grains such as oatmeal). Stress reduction is important, and naturally, you should not smoke.

See your doctor, be healthy and Go Red for a healthy heart.



Dr. Mona Alqulali is a board certified OB-GYN.

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