When I hear of a woman dying suddenly at the age of 58 the first thing I think of is heart attack. Another likely event is brain aneurysm. Both relate to cardiovascular disease which is a preventable disease, even in the face of strong genetics. According to Dr. Jeffrey Bland in his book Genetic Nutritioneering diseases that we have blamed on genetics can now be modified using nutrition, so no more cop outs!

Jane, a 50 year old woman, consulted with me to help lower her LDL cholesterol and her overall risk for heart disease. She had a very strong family history of heart disease in both her mother and father and so she, being a smoker, wanted to take precautions now. She read an extensive article in Time Magazine in April 2003 on women and heart disease and so she knew the following statistics. She wanted to broaden her knowledge base and learn what a naturopathic doctor would do for her.

Most women fear breast cancer more than they fear heart disease. 1 in 8 women will develop breast cancer at some point in her life while 1 in 3 will suffer from heart disease. More than 40,000 women die each year in Canada (2003 stats) from cardiovascular disease. The condition is more often fatal in women than men and is more likely to leave women severely disabled by a stroke or congestive heart failure. Women usually start showing signs in their 60s compared to men who develop symptoms 10 years earlier. When the HRT study showed that the combination pill of estradiol and provera did NOT protect women against heart disease the myth that estrogen protects women against heart disease began to unravel. At the top of the list of risk factors for men and women is smoking, then diabetes, high blood pressure, high cholesterol levels, excess weight and physical inactivity. Women are more likely to be overweight, less likely to exercise and appear to be affected more adversely by stress than men.

It is true that women often exhibit different symptoms of a heart attack than men do. However it is also true that 40% of men don’t have the classic heart attack symptoms either. The truth may be that women are in denial about their heart disease risk and when they do experience the prelude to a heart attack such as shortness of breath, extreme fatigue or a bad case of indigestion they often can’t believe their symptoms are cardiac in origin. Equally important their physicians don’t believe it either and often it takes several visits to the doctor before they will order a cardiac work up. This delay in early treatment then makes female patients too sick to treat with lifesaving treatments such as clot buster drugs and because women are older when they develop heart trouble they are more likely to suffer from complications.

Women tend to have stress related chest pain at rest, compared to men. In a WISE study in 2003, (Women’s Ischemic Syndrome Evaluation) data showed that if a woman is diagnosed with an abnormal ECG during a classic treadmill test even when the heart is functioning normally, this should not be classified as a false positive but as an early warning sign of ischemic heart disease.

Cholesterol testing in men with an increase risk of heart disease show elevated LDL cholesterol whereas in women an elevation of triglycerides is seen. Women who have low HDL’s (the good cholesterol) are more likely than men to develop heart disease later on. Some cardiologists recommend levels of greater than 1.3. I suggest closer to 2 is even better!

The tests and information I gathered from Jane included homocysteine, highly sensitive C reactive protein (CRP), fasting blood sugar, serum ferritin, waist circumference, blood pressure, GFR (glomerular filtration rate, a kidney function test) and I measured the ratio of triglycerides to HDL cholesterol. Homocysteine is a protein in the blood, a test that cardiologists may order, however GP’s tend not to. Elevations above the optimal level of 5 reveal a deficiency of B12 and folic acid which increases the risk of heart disease, Alzheimer’s Disease, osteoporosis and diabetes. CRP is a marker for inflammation and is not terribly specific, however it can be used as a marker for inflammation anywhere in the body including the brain and the heart. A level under 1 is ideal. Fasting blood sugar is actually the first parameter to raise in most patients and often MDs’ won’t even mention anything until the blood sugar is upwards of 6.0. Anything over 5.2 and I am educating the woman about insulin resistance and its major cause of heart disease. Once the ratio of triglycerides to HDL cholesterol is above 3.3 and the waist circumference is above 35 inches and there is an elevated homocysteine then insulin resistance is a problem that can easily be treated but it needs to be acknowledged first. Often blood pressures start to creep up over 135/85 as well.

The good news is that all of these parameters are treated fairly easily with natural remedies such as good quality fish oils, low carbohydrate diets, exercise, supplementing with B12, folic acid, B complex, and liver herbs such as milk thistle. LDL cholesterol is not that hard to decrease and is not a statin deficiency disease! The statin drugs may cause cancer and worsen heart disease, because they lower CoQ10, as well as interfere with cognitive function.

The overall treatment strategy for Jane was to: stop smoking (there are wonderful homeopathic programs for this too!), lose inches around the belly first by following the premises of The South Beach Diet by Dr. Agatston MD, walk 30 minutes daily, lower the LDL cholesterol to below 3.0 by reducing sugar and carbohydrates, not just the bad fats (and yes free range eggs are good for you and don’t raise cholesterol), ingest one tablespoon of Carlson’s Cod liver oil or Herring Oil per day, lower the blood pressure by taking a good Calmag Plus by Jarrow, garlic and CoQ10 and I told her of wonderful antioxidants for the heart such as resveratrol, lycopene, and hawthorne and amino acids such as taurine, carnitine and arginine. Reducing stress is easier said than done but I gave her my "52 Stress Reducers Handout" and suggested a few heart loving things to start with: a massage once per month, doing the Hydropath at Kingfisher Spa every four months and keeping a gratitude journal.

There are many things women can do to take charge of their health and their heart. The reality is women have an extra 10 years over men to adopt healthy lifestyles to prevent heart disease. Many men would love to have these extra 10 years. Women who fail to take advantage of this gift do so at their own peril.