December 2009

Dr. Ali Zentner: Your Heart Health is In Your HandsA few weeks ago, I found myself at a cocktail party (yes doctors are people too) and the “what do you do” question came up.“I’m a physician”, I responded to the woman, innocently enough -- between sips of Riesling.

“Family doc?” she asked, eagerly. Given the shortage of female family doctors, I anticipated that her next question would likely have been "do you have any openings?"“No," I said. "I’m a specialist in Cardiac Risk Management. You know, Diabetes, High Blood Pressure, Cholesterol....” “Oh," she said, disappointed. “I’ll never need you then. No family history and I am a Yoga freak."

We shared a laugh, and the conversation about yoga continued. In the end, it was not the place, nor the time for me to give my infomercial speech about the importance of risk factor screening in women. But, here I sit in a local Vancouver café, where the wine has been replaced with a non-fat latte, and I’m feeling a burning need to educate.

Don’t get me wrong, I hope that lovely woman at the party NEVER needs my help, but there is a very good chance that she will.

When it comes to risk factors for heart attacks and strokes, as women, we have a ways to go. One in three Canadian women will die of a heart attack or stroke, compared to one in twelve women who will die of breast cancer. It sounds bleak, but the best thing we can do for ourselves is what women have always done when faced with a challenge: inform and reform. So, I thought I would spend my first five inaugural entries on the five greatest risk factors for heart attacks and strokes in women, and what we can do about them:
First up this week is High Blood Pressure (also called Hypertension):
Sixty percent of Canadian women over the age of 60 have high blood pressure and only about half of them are aware of it. The average person will need at least 3 medications to control their blood pressure to target. The numbers for target blood pressure are listed below:

Class of Blood Pressure                                   Systolic                 Diastolic
Optimal                                                             Less than 120      Less than 80
Normal                                                             120-130                80-84
Pre-hypertension (high Normal)                       130-139                85-89
High Blood Pressure                                        140 or higher        90 or higher
High Blood Pressure (w/Diabetes)                   130 or higher        80 or higher

The top number is called the systolic (systole is Latin for “pump”) and the bottom number is called the diastolic (diastole is Latin for “relax”). Both numbers are equally important and home blood pressure readings are far more accurate than the readings at a doctor’s office. (Hell, the book is always better than the movie!) Your optimal numbers at home should be 5 mmHg lower than in the office. (So high blood pressure at home would be numbers greater than 135/85).

So Ladies... You know your shoe size, you hair colour and your dress size in Europian and North American variation. It's time to know your blood pressure, too. Next time you are at the drug store, spending $40 on lip plumping serum that you probably don't need, make your way over to the pharmacy and sit down at the blood pressure machine. There, just follow these steps:

1.    Put down the basket, purse and cell phone you are holding.
2.    Turn off your iPod- 3 minutes with your own thoughts will not kill you.
3.    Think good thoughts
4.    Sit down at the machine, comfortably, feet on the floor
5.    Wait 3-5 minutes quietly.
6.    Longest 5 minutes ever -- isn’t it?
7.    Put arm in the machine, elbow resting, make sure the machine’s “sleeve” is covering your bare bicep.
8.    Push the button on the machine marked “start” (I’m really not a jerk)
9.    The cuff does the rest for you!
10.  Take 2 readings; about 2-3 minutes apart and keep track over a period of a few weeks.

It's not rocket science. Anyone who can put lipstick on in a moving vehicle should find this frighteningly simple.  It is probably one of the best screening tests a woman can do in terms of cardiovascular health. So, now you know your numbers… What to do about them? Well, if you have high blood pressure, see your family doctor. It is likely (almost certain) you will need blood work monitored and medications to control your blood pressure. The biggest thing to remember is that there are a variety of classes of medications to choose from so don’t be discouraged. Your doctor will find the right one for you to take. Most agents have very little side effects for the majority of patients. Lifestyle modification is also key and I will get to that in a minute.
What do you if your blood pressure is “kissing” high? Studies show that women with mild elevations in blood pressure (pre-hypertension) can dramatically reduce their blood pressure and their risk of developing high blood pressure through diet and exercise. I know, a doctor who preaches lifestyle modification? Where the heck did I go to school? Well, here are 3 things you can do today to lower your blood pressure and reduce your risk of developing high blood pressure:
1.    Exercise: I’m not asking you to go “boot camp”. A simple 30-minute walk per day is a perfect place to start. If you are on a treadmill aim for a speed of 3.6mph or faster. Studies show that women who exercise for 30 minutes daily have half the cardiac risk as women who don’t. You hate walking? Cycle. You hate Cycling? Swim. You hate swimming…. um, bowling? Pick an activity, anything and do it DAILY. And no, shopping is not a sport. Think of it this way; your life is worth a half hour a day.  As for my Yoga guru at the party….Power Yoga is probably the best cardiovascular activity of all the Yoga as opposed to gentle stretching.
2.    Read labels: You know what you take in your coffee, you should know what your putting into your body. If you spend as much time perusing your grocery items in terms of fat grams, salt and calories as you do the latest US weekly and you will be quite nutritionally savvy. As for what to watch for? Keep the fat grams low (below 5g) and the salt to a minimum (250mg or so per serving) Need more info? Canada’s Food guide is pretty decent, check their website for more info and stay tuned for my future articles on label reading and portion control.
3.    Healthy Choices Really ARE Healthy: Brown bread is the new black. Nutrition should be like the spring lines…FULL OF COLOUR! Five servings of vegetables never hurt anyone and your colon will thank you as much as your blood vessels.
Remember, these are just guidelines to better living. This is not the gospel according to Dr. Z. It’s something to think about the next time you find yourself alone at a restaurant waiting for your girlfriends to arrive, and your Blackberry has run out of batteries. My bottom line? Check your blood pressure, know your numbers and get moving a little more each day. Know a bit about what you are eating and don’t just “live green” – eat it. Finally, don’t rush towards the next big change. All in all, change is good but it is best when it is done in steps. We tend to stick to things if they come on gradually rather than if they are severe. Think of it like running in heels. You really need to walk first. Dr. Ali Zentner (Tanya Zentner’s first cousin)Source: http://woman.ca/

---