Keeping Heart Healthy

By Megan Russell

What women need to know about cardiovascular disease.

heartFebruary is American Heart Month, and while many people focus on taking care of their romantically charged heart, it is important to remember your physical one as well. World-renowned cardiovascular specialists Dr. Bradley Bale and Amy Doneen have written a guide that will inform and direct you in healing and preventing the clogged arteries that are the pathway to your ticker. Their new book, Beat the Heart Attack Gene: The Revolutionary Plan to Prevent Heart Disease, Stroke and Diabetes, is a must-read in 2014, particularly for women who are commonly misdiagnosed when it comes to matters of the heart.

“When I think about women’s health, we’re notoriously under recognized for our heart-attack risk,” Doneen says. “When compared to men, our bodies are unique and special. We may feel differently than any other time in our life and not know why.”

Discovering you may be at risk for a heart attack can be as simple as listening to slight differences in your body. Doneen uses the story of one patient, Juli, to emphasize this. Juli, a healthy 37-year-old woman, noticed her body was not feeling right. She checked herself in to the E.R. and was diagnosed with pneumonia, due to shortness of breath. This was strange because she had no other symptoms that were consistent with pneumonia, like cough or fever. What was really going on with Juli? This healthy young woman had two heart attacks and because of her health and youth, the doctors never even considered this an option.

“I wish I could say this was an original case,” Doneen says, but she and Bale give many more examples of cases just like this in their book, stories of women younger than 55 who were misdiagnosed with something other than the cardiovascular disease they had. And she points out that it affects 10 times more women than breast cancer. “It happens a lot and it happens prematurely.”

Cardiovascular, or heart, disease is a condition that happens when plaque develops in the walls of your arteries. Doneen explains it simply: Think of a garden hose as your artery. It’s not the interior tube of the hose that the water runs through where plaque develops, but in the actual walls of the hose itself. Similarly, plaque grows in the walls of your artery, so you don’t feel it happening. Heart attacks occur when the plaque in the wall ruptures and the body tries to heal this area by forming a blood clot. The blood clot is what can block the flow of blood, causing a heart attack.

Red Flags That May be Associated with Plaque in Arteries

  • Migraines
  • Polycystic ovarian syndrome
  • Gestational diabetes
  • Preeclampsia in pregnancy
  • Autoimmune disorders
  • Periodontal disease

Six Heart Attack Warning Signs Women Ignore

(These signs are often misdiagnosed as signs of menopause or even stress from a busy family.)

  • Shortness of breath
  • Shoulder or jaw pain
  • Unusual fatigue
  • Flu-like symptoms
  • Heavy sweating
  • Anxiety

The Latest on Hormone Replacement Therapy

After the Women’s Health Initiative Trials, it was thought that hormone replacement therapy put women at an increased risk for strokes and heart attacks. But what doctors have learned is that’s not the case. Each patient needs to be looked at individually and checked for vascular inflammation and clotting risk before beginning therapy and during hormonal therapy.

Life-Saving Screening Tests For Women

  • Carotid intima media thickness test (cIMT)
  • Coronary calcium test
  • Inflammatory conditions that can increase plaque (these can be addressed with simple blood tests)
  • Sleep apnea testing
  • Test for periodontal disease or periodontal pathogens
  • Oral glucose tolerance test

Genes Women Should Be Tested For

  • 9p21, known as the “heart attack gene”
  • KIF6, a gene that puts women at an increased risk for heart attacks
  • Lipoprotein (A)
  • ApoE. This is the gene that determines how the body metabolizes food. It’s interesting because it can determine exactly what type of diet you should be consuming. It also helps explain why some women may workout and eat right, yet still have bad cholesterol.

The Myth About What Really Causes Heart Disease

The most common myth about vascular disease is that high cholesterol is the only cause. In reality, it is only one of many causes, the most common of which being the most under diagnosed—insulin resistance— which causes 70 percent of vascular disease. It’s important to understand that because heart disease is caused by inflammation of the arteries and any condition that causes inflammation puts you at risk for heart disease. Most importantly, even if you’re healthy and active, genetics can cause a predisposition to cardiovascular disease. Listen to your body and ask your doctor about these tests. Women at any age can have deadly plaque in their arteries, so realizing that you have symptoms that can cause buildup may mean the difference between a heart attack and a healthy future. Doneen points out that vascular disease “is one of the most identifiable disease states; it’s not a mystery,” but women, more so than men, need to recognize their risk and be proactive about taking steps to minimize it.

To find out more about the Bale/Doneen Method of combining the science of disease-detection with lifestyle counsel, visit


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