Re: Heart Attack and Stroke Prevention in Women

[Guest guest]

Yesterday, I made an appointment to clean my teeth and learned that my

dentist was no longer working because he had had a heart attack and a

stroke. After the heart attack, he was treated with anticoagulants to

improve blood flow, but apparently they overdosed him and he had a

hemorrhagic stroke.

The same thing happened to one of my neighbors.

It makes me wonder why doctors are so aggressive in their use of

anticoagulants.

Tony

======

>

> Cardiology Patient Pages

> Heart Attack and Stroke Prevention in Women

> C. Becker

> Circulation 2005;112 e273-e275

>

> Introduction

>

> Each year, more than one million Americans experience a heart

attack, and nearly

> half of them are fatal. Stroke is the leading cause of disability

and the third

> leading cause of death for women and men.1–3

>

> Heart Attack and Stroke in Women

>

> Many people continue to believe that heart attacks represent a

problem targeting

> solely older men, yet heart disease is the number one killer of both

women and men

> in the United States. The difference is that among men, the risk for

heart attack

> increases steadily after 45 years of age. In women, the risk

increases after 50

> years of age. However, younger women and men can also have heart

attacks, and the

> current epidemic of obesity and inactivity among our nation's youth

will likely

> shift the risk toward occurrence at younger ages over the next one

to two decades.

>

> Each year, nearly 700 000 Americans experience either their first or

second stroke,

> and more than 20% of them are fatal. More women than men have

strokes, and they are

> more likely to die as a result. The problem is particularly serious

in black

> Americans.4–8

>

> Who Is at Risk?

>

> Being familiar with factors that increase the risk for either a

heart attack or

> stroke is the first step toward prevention. If you have one or more

of these

> factors, please contact your healthcare provider to discuss the

available means to

> reduce the risk.

>

> What Are the Signs and Symptoms?

>

> In most instances, a heart attack or stroke is caused by a small

blood clot lodged

> within a blood vessel leading to either the heart or brain (see the

Figure). The

> lack of blood (and oxygen) causes injury, which increases steadily

over time;

> therefore, prompt recognition and medical treatment are of utmost

importance.

>

> Fig: Blood clots forming in the blood vessels serving the heart

cause heart

> attacks; those that develop in or travel to the blood vessels in the

brain are

> responsible for strokes.

>

> The signs and symptoms of heart attack and stroke are listed in the

boxes. It is

> important to remember that they can differ from one person to

another and may " wax

> and wane " with time. If you are not sure, it is better to seek

medical advice than

> to wait.

>

> Warning Signs for Stroke

>

> Sudden weakness or numbness of face or limb on one side.

> Sudden, severe headache.

> Difficulty talking or understanding speech.

> Unexplained dizziness.

> Sudden dimness/loss of vision, often in one eye.

> Warning Signs for Heart Attack

> Chest discomfort: uncomfortable pressure, squeezing or fullness.

> Discomfort in other areas of the upper body: one or both arms or in

the back, neck,

> jaw, or stomach.

> Shortness of breath, either with chest discomfort or alone.

> Other signs, including nausea, lightheadedness, or breaking out in a

cold sweat.

>

> Risk Factors for Stroke

>

> High blood pressure.

> Diabetes.

> High cholesterol.

> Age (risk doubles for each decade over 55 years of age).

> Family history of stroke.

> Smoking.

> Birth control pills.

> Atrial fibrillation.

> Heart failure.

> Excess alcohol.

> Prior stroke or heart attack.

> Black race.

> Gender (women are at greater risk than men).

>

> Risk Factors for Heart Attack

>

> High blood pressure.

> Diabetes.

> Smoking.

> High cholesterol.

> Age.

> Hormone replacement therapy.

> Physical inactivity.

> Gender (men are at greater risk than women).

>

> Prevention of Heart Attack and Stroke

>

> Stop smoking.

>

> Engage in physical activity.

> Use diet therapy.

> Maintain/reduce weight.

> Control blood pressure.

> Undergo cholesterol control/statin therapy.

> Control blood sugar.

> Limit alcohol intake.

> Take aspirin as advised.*

> =========================

> *For women who have at least a 20% chance of a heart attack or

stroke over the next

> 10 years.

>

> How Aware Are You?

>

> A recent American Heart Association–sponsored telephone survey of

more than 1000

> women who were over 25 years of age found that only 1 of every 3

women correctly

> identified the warning signs of stroke. Awareness of heart attack

risk is low

> nationwide but was particularly low among Hispanic and black women.

>

> There has been an overall improvement in the level of awareness

among American women

> over the past decade. Both a clear need and a large margin for

improvement exist,

> however, for national and community prevention programs to develop

educational

> programs directed toward those at greatest risk.9

>

> How Can I Reduce My Chances of Having a Heart Attack or Stroke?

> Rather than consider heart and blood vessel disease as a

" have-or-have-not "

> condition, the medical community now looks at a " continuum of risk "

that requires

> intermittent appraisal by healthcare providers. Your physician can

assess the chance

> of your having a heart attack or stroke according to risk prediction

charts and can

> optimize strategies of preventive care.10,11 It is important for all

women to

> recognize the important role that they themselves play in preventing

heart attack

> and stroke by following a healthy lifestyle.12

>

> Is Aspirin for Everyone?

>

> In low doses, aspirin reduces " sticking " of blood platelets to one

another,

> preventing blood clots. A study of nearly 40 000 initially healthy

women 45 years of

> age or older13 found that aspirin (100 milligrams every other day)

reduced the risk

> of a first stroke by nearly 25%, and in women over 65 years of age,

it decreased the

> likelihood of both heart attack and stroke. On the flip side,

aspirin increased by

> 40% the risk of bleeding within the stomach and intestines, a known

side effect.

>

> What is the take-home message for women? Low-dose aspirin reduces

heart attack and

> stroke for women at high risk and for those over 65 years of age.

The balance of

> benefit with the risk of bleeding must be weighed carefully for each

individual and

> discussed with a healthcare professional.

>

> It must be emphasized that women with a prior heart attack or stroke

are known to

> benefit from daily aspirin.

>

> Are All the Answers About Aspirin in?

>

> The wide-scale availability, low cost, and proven benefits of

aspirin make it a

> topic of great interest and importance in public health. Women at

low risk for a

> heart attack or stroke do not benefit from regular aspirin use.

Similarly, it has

> been established that women at high risk benefit considerably. The

questions that

> remain unanswered are as follows:

>

> What is the role of aspirin among women at intermediate risk (10% to

20% risk over a

> 10-year period) for a stroke or heart attack?

>

> What is the safest and most effective dose of aspirin?

>

> Does the optimal dose of aspirin differ from one person to another?

>

> Do the protective effects of aspirin differ between women and men?

If so, how can

> the difference be explained and translated to health care?

>

> Can a simple blood test like C-reactive protein identify healthy

people who are

> likely to benefit from aspirin?

>

> Answers to these questions require additional research.

>

> What Should I Do if I Experience Signs or Symptoms of a Heart Attack

or Stroke?

>

> Time is of the essence. Treatments to restore the flow of blood (and

oxygen) to the

> brain and heart are available but are most beneficial when used in

the first several

> hours. Call 9-1-1. By calling 9-1-1 and taking an ambulance to the

hospital where

> heart attack and stroke care is available, you substantially

increase your chances

> of recovery. Remember, you should never drive yourself to the

hospital unless there

> is absolutely no other choice.

>

> Knowing how to prevent a heart attack or stroke, and being prepared

to act

> immediately if you experience the signs or symptoms of either one,

could save your

> life.

>

> Footnotes

>

> The information contained in this Circulation Cardiology Patient

Page is not a

> substitute for medical advice or treatment, and the American Heart

Association

> recommends consultation with your doctor or healthcare professional.

>

> Al Pater, PhD; email: old542000@y...

>

>

>

> __________________________________

> FareChase: Search multiple travel sites in one click.

> http://farechase.

>

[Guest guest]

Yesterday, I made an appointment to clean my teeth and learned that my

dentist was no longer working because he had had a heart attack and a

stroke. After the heart attack, he was treated with anticoagulants to

improve blood flow, but apparently they overdosed him and he had a

hemorrhagic stroke.

The same thing happened to one of my neighbors.

It makes me wonder why doctors are so aggressive in their use of

anticoagulants.

Tony

======

>

> Cardiology Patient Pages

> Heart Attack and Stroke Prevention in Women

> C. Becker

> Circulation 2005;112 e273-e275

>

> Introduction

>

> Each year, more than one million Americans experience a heart

attack, and nearly

> half of them are fatal. Stroke is the leading cause of disability

and the third

> leading cause of death for women and men.1–3

>

> Heart Attack and Stroke in Women

>

> Many people continue to believe that heart attacks represent a

problem targeting

> solely older men, yet heart disease is the number one killer of both

women and men

> in the United States. The difference is that among men, the risk for

heart attack

> increases steadily after 45 years of age. In women, the risk

increases after 50

> years of age. However, younger women and men can also have heart

attacks, and the

> current epidemic of obesity and inactivity among our nation's youth

will likely

> shift the risk toward occurrence at younger ages over the next one

to two decades.

>

> Each year, nearly 700 000 Americans experience either their first or

second stroke,

> and more than 20% of them are fatal. More women than men have

strokes, and they are

> more likely to die as a result. The problem is particularly serious

in black

> Americans.4–8

>

> Who Is at Risk?

>

> Being familiar with factors that increase the risk for either a

heart attack or

> stroke is the first step toward prevention. If you have one or more

of these

> factors, please contact your healthcare provider to discuss the

available means to

> reduce the risk.

>

> What Are the Signs and Symptoms?

>

> In most instances, a heart attack or stroke is caused by a small

blood clot lodged

> within a blood vessel leading to either the heart or brain (see the

Figure). The

> lack of blood (and oxygen) causes injury, which increases steadily

over time;

> therefore, prompt recognition and medical treatment are of utmost

importance.

>

> Fig: Blood clots forming in the blood vessels serving the heart

cause heart

> attacks; those that develop in or travel to the blood vessels in the

brain are

> responsible for strokes.

>

> The signs and symptoms of heart attack and stroke are listed in the

boxes. It is

> important to remember that they can differ from one person to

another and may " wax

> and wane " with time. If you are not sure, it is better to seek

medical advice than

> to wait.

>

> Warning Signs for Stroke

>

> Sudden weakness or numbness of face or limb on one side.

> Sudden, severe headache.

> Difficulty talking or understanding speech.

> Unexplained dizziness.

> Sudden dimness/loss of vision, often in one eye.

> Warning Signs for Heart Attack

> Chest discomfort: uncomfortable pressure, squeezing or fullness.

> Discomfort in other areas of the upper body: one or both arms or in

the back, neck,

> jaw, or stomach.

> Shortness of breath, either with chest discomfort or alone.

> Other signs, including nausea, lightheadedness, or breaking out in a

cold sweat.

>

> Risk Factors for Stroke

>

> High blood pressure.

> Diabetes.

> High cholesterol.

> Age (risk doubles for each decade over 55 years of age).

> Family history of stroke.

> Smoking.

> Birth control pills.

> Atrial fibrillation.

> Heart failure.

> Excess alcohol.

> Prior stroke or heart attack.

> Black race.

> Gender (women are at greater risk than men).

>

> Risk Factors for Heart Attack

>

> High blood pressure.

> Diabetes.

> Smoking.

> High cholesterol.

> Age.

> Hormone replacement therapy.

> Physical inactivity.

> Gender (men are at greater risk than women).

>

> Prevention of Heart Attack and Stroke

>

> Stop smoking.

>

> Engage in physical activity.

> Use diet therapy.

> Maintain/reduce weight.

> Control blood pressure.

> Undergo cholesterol control/statin therapy.

> Control blood sugar.

> Limit alcohol intake.

> Take aspirin as advised.*

> =========================

> *For women who have at least a 20% chance of a heart attack or

stroke over the next

> 10 years.

>

> How Aware Are You?

>

> A recent American Heart Association–sponsored telephone survey of

more than 1000

> women who were over 25 years of age found that only 1 of every 3

women correctly

> identified the warning signs of stroke. Awareness of heart attack

risk is low

> nationwide but was particularly low among Hispanic and black women.

>

> There has been an overall improvement in the level of awareness

among American women

> over the past decade. Both a clear need and a large margin for

improvement exist,

> however, for national and community prevention programs to develop

educational

> programs directed toward those at greatest risk.9

>

> How Can I Reduce My Chances of Having a Heart Attack or Stroke?

> Rather than consider heart and blood vessel disease as a

" have-or-have-not "

> condition, the medical community now looks at a " continuum of risk "

that requires

> intermittent appraisal by healthcare providers. Your physician can

assess the chance

> of your having a heart attack or stroke according to risk prediction

charts and can

> optimize strategies of preventive care.10,11 It is important for all

women to

> recognize the important role that they themselves play in preventing

heart attack

> and stroke by following a healthy lifestyle.12

>

> Is Aspirin for Everyone?

>

> In low doses, aspirin reduces " sticking " of blood platelets to one

another,

> preventing blood clots. A study of nearly 40 000 initially healthy

women 45 years of

> age or older13 found that aspirin (100 milligrams every other day)

reduced the risk

> of a first stroke by nearly 25%, and in women over 65 years of age,

it decreased the

> likelihood of both heart attack and stroke. On the flip side,

aspirin increased by

> 40% the risk of bleeding within the stomach and intestines, a known

side effect.

>

> What is the take-home message for women? Low-dose aspirin reduces

heart attack and

> stroke for women at high risk and for those over 65 years of age.

The balance of

> benefit with the risk of bleeding must be weighed carefully for each

individual and

> discussed with a healthcare professional.

>

> It must be emphasized that women with a prior heart attack or stroke

are known to

> benefit from daily aspirin.

>

> Are All the Answers About Aspirin in?

>

> The wide-scale availability, low cost, and proven benefits of

aspirin make it a

> topic of great interest and importance in public health. Women at

low risk for a

> heart attack or stroke do not benefit from regular aspirin use.

Similarly, it has

> been established that women at high risk benefit considerably. The

questions that

> remain unanswered are as follows:

>

> What is the role of aspirin among women at intermediate risk (10% to

20% risk over a

> 10-year period) for a stroke or heart attack?

>

> What is the safest and most effective dose of aspirin?

>

> Does the optimal dose of aspirin differ from one person to another?

>

> Do the protective effects of aspirin differ between women and men?

If so, how can

> the difference be explained and translated to health care?

>

> Can a simple blood test like C-reactive protein identify healthy

people who are

> likely to benefit from aspirin?

>

> Answers to these questions require additional research.

>

> What Should I Do if I Experience Signs or Symptoms of a Heart Attack

or Stroke?

>

> Time is of the essence. Treatments to restore the flow of blood (and

oxygen) to the

> brain and heart are available but are most beneficial when used in

the first several

> hours. Call 9-1-1. By calling 9-1-1 and taking an ambulance to the

hospital where

> heart attack and stroke care is available, you substantially

increase your chances

> of recovery. Remember, you should never drive yourself to the

hospital unless there

> is absolutely no other choice.

>

> Knowing how to prevent a heart attack or stroke, and being prepared

to act

> immediately if you experience the signs or symptoms of either one,

could save your

> life.

>

> Footnotes

>

> The information contained in this Circulation Cardiology Patient

Page is not a

> substitute for medical advice or treatment, and the American Heart

Association

> recommends consultation with your doctor or healthcare professional.

>

> Al Pater, PhD; email: old542000@y...

>

>

>

> __________________________________

> FareChase: Search multiple travel sites in one click.

> http://farechase.

>

[Guest guest]

Hi Tony:

Just approximately, what were his age and BMI?

Rodney.

>

> Yesterday, I made an appointment to clean my teeth and learned that

my

> dentist was no longer working because he had had a heart attack and

a

> stroke. After the heart attack, he was treated with anticoagulants

to

> improve blood flow, but apparently they overdosed him and he had a

> hemorrhagic stroke.

>

> The same thing happened to one of my neighbors.

>

> It makes me wonder why doctors are so aggressive in their use of

> anticoagulants.

>

> Tony

>

> ======

>

> --- In , Al Pater <old542000@y...>

wrote:

> >

> > Cardiology Patient Pages

> > Heart Attack and Stroke Prevention in Women

> > C. Becker

> > Circulation 2005;112 e273-e275

> >

> > Introduction

> >

> > Each year, more than one million Americans experience a heart

> attack, and nearly

> > half of them are fatal. Stroke is the leading cause of disability

> and the third

> > leading cause of death for women and men.1–3

> >

> > Heart Attack and Stroke in Women

> >

> > Many people continue to believe that heart attacks represent a

> problem targeting

> > solely older men, yet heart disease is the number one killer of

both

> women and men

> > in the United States. The difference is that among men, the risk

for

> heart attack

> > increases steadily after 45 years of age. In women, the risk

> increases after 50

> > years of age. However, younger women and men can also have heart

> attacks, and the

> > current epidemic of obesity and inactivity among our nation's

youth

> will likely

> > shift the risk toward occurrence at younger ages over the next one

> to two decades.

> >

> > Each year, nearly 700 000 Americans experience either their first

or

> second stroke,

> > and more than 20% of them are fatal. More women than men have

> strokes, and they are

> > more likely to die as a result. The problem is particularly

serious

> in black

> > Americans.4–8

> >

> > Who Is at Risk?

> >

> > Being familiar with factors that increase the risk for either a

> heart attack or

> > stroke is the first step toward prevention. If you have one or

more

> of these

> > factors, please contact your healthcare provider to discuss the

> available means to

> > reduce the risk.

> >

> > What Are the Signs and Symptoms?

> >

> > In most instances, a heart attack or stroke is caused by a small

> blood clot lodged

> > within a blood vessel leading to either the heart or brain (see

the

> Figure). The

> > lack of blood (and oxygen) causes injury, which increases steadily

> over time;

> > therefore, prompt recognition and medical treatment are of utmost

> importance.

> >

> > Fig: Blood clots forming in the blood vessels serving the heart

> cause heart

> > attacks; those that develop in or travel to the blood vessels in

the

> brain are

> > responsible for strokes.

> >

> > The signs and symptoms of heart attack and stroke are listed in

the

> boxes. It is

> > important to remember that they can differ from one person to

> another and may " wax

> > and wane " with time. If you are not sure, it is better to seek

> medical advice than

> > to wait.

> >

> > Warning Signs for Stroke

> >

> > Sudden weakness or numbness of face or limb on one side.

> > Sudden, severe headache.

> > Difficulty talking or understanding speech.

> > Unexplained dizziness.

> > Sudden dimness/loss of vision, often in one eye.

> > Warning Signs for Heart Attack

> > Chest discomfort: uncomfortable pressure, squeezing or fullness.

> > Discomfort in other areas of the upper body: one or both arms or

in

> the back, neck,

> > jaw, or stomach.

> > Shortness of breath, either with chest discomfort or alone.

> > Other signs, including nausea, lightheadedness, or breaking out

in a

> cold sweat.

> >

> > Risk Factors for Stroke

> >

> > High blood pressure.

> > Diabetes.

> > High cholesterol.

> > Age (risk doubles for each decade over 55 years of age).

> > Family history of stroke.

> > Smoking.

> > Birth control pills.

> > Atrial fibrillation.

> > Heart failure.

> > Excess alcohol.

> > Prior stroke or heart attack.

> > Black race.

> > Gender (women are at greater risk than men).

> >

> > Risk Factors for Heart Attack

> >

> > High blood pressure.

> > Diabetes.

> > Smoking.

> > High cholesterol.

> > Age.

> > Hormone replacement therapy.

> > Physical inactivity.

> > Gender (men are at greater risk than women).

> >

> > Prevention of Heart Attack and Stroke

> >

> > Stop smoking.

> >

> > Engage in physical activity.

> > Use diet therapy.

> > Maintain/reduce weight.

> > Control blood pressure.

> > Undergo cholesterol control/statin therapy.

> > Control blood sugar.

> > Limit alcohol intake.

> > Take aspirin as advised.*

> > =========================

> > *For women who have at least a 20% chance of a heart attack or

> stroke over the next

> > 10 years.

> >

> > How Aware Are You?

> >

> > A recent American Heart Association–sponsored telephone survey of

> more than 1000

> > women who were over 25 years of age found that only 1 of every 3

> women correctly

> > identified the warning signs of stroke. Awareness of heart attack

> risk is low

> > nationwide but was particularly low among Hispanic and black

women.

> >

> > There has been an overall improvement in the level of awareness

> among American women

> > over the past decade. Both a clear need and a large margin for

> improvement exist,

> > however, for national and community prevention programs to develop

> educational

> > programs directed toward those at greatest risk.9

> >

> > How Can I Reduce My Chances of Having a Heart Attack or Stroke?

> > Rather than consider heart and blood vessel disease as a

> " have-or-have-not "

> > condition, the medical community now looks at a " continuum of

risk "

> that requires

> > intermittent appraisal by healthcare providers. Your physician can

> assess the chance

> > of your having a heart attack or stroke according to risk

prediction

> charts and can

> > optimize strategies of preventive care.10,11 It is important for

all

> women to

> > recognize the important role that they themselves play in

preventing

> heart attack

> > and stroke by following a healthy lifestyle.12

> >

> > Is Aspirin for Everyone?

> >

> > In low doses, aspirin reduces " sticking " of blood platelets to one

> another,

> > preventing blood clots. A study of nearly 40 000 initially healthy

> women 45 years of

> > age or older13 found that aspirin (100 milligrams every other day)

> reduced the risk

> > of a first stroke by nearly 25%, and in women over 65 years of

age,

> it decreased the

> > likelihood of both heart attack and stroke. On the flip side,

> aspirin increased by

> > 40% the risk of bleeding within the stomach and intestines, a

known

> side effect.

> >

> > What is the take-home message for women? Low-dose aspirin reduces

> heart attack and

> > stroke for women at high risk and for those over 65 years of age.

> The balance of

> > benefit with the risk of bleeding must be weighed carefully for

each

> individual and

> > discussed with a healthcare professional.

> >

> > It must be emphasized that women with a prior heart attack or

stroke

> are known to

> > benefit from daily aspirin.

> >

> > Are All the Answers About Aspirin in?

> >

> > The wide-scale availability, low cost, and proven benefits of

> aspirin make it a

> > topic of great interest and importance in public health. Women at

> low risk for a

> > heart attack or stroke do not benefit from regular aspirin use.

> Similarly, it has

> > been established that women at high risk benefit considerably. The

> questions that

> > remain unanswered are as follows:

> >

> > What is the role of aspirin among women at intermediate risk (10%

to

> 20% risk over a

> > 10-year period) for a stroke or heart attack?

> >

> > What is the safest and most effective dose of aspirin?

> >

> > Does the optimal dose of aspirin differ from one person to

another?

> >

> > Do the protective effects of aspirin differ between women and men?

> If so, how can

> > the difference be explained and translated to health care?

> >

> > Can a simple blood test like C-reactive protein identify healthy

> people who are

> > likely to benefit from aspirin?

> >

> > Answers to these questions require additional research.

> >

> > What Should I Do if I Experience Signs or Symptoms of a Heart

Attack

> or Stroke?

> >

> > Time is of the essence. Treatments to restore the flow of blood

(and

> oxygen) to the

> > brain and heart are available but are most beneficial when used in

> the first several

> > hours. Call 9-1-1. By calling 9-1-1 and taking an ambulance to the

> hospital where

> > heart attack and stroke care is available, you substantially

> increase your chances

> > of recovery. Remember, you should never drive yourself to the

> hospital unless there

> > is absolutely no other choice.

> >

> > Knowing how to prevent a heart attack or stroke, and being

prepared

> to act

> > immediately if you experience the signs or symptoms of either one,

> could save your

> > life.

> >

> > Footnotes

> >

> > The information contained in this Circulation Cardiology Patient

> Page is not a

> > substitute for medical advice or treatment, and the American Heart

> Association

> > recommends consultation with your doctor or healthcare

professional.

> >

> > Al Pater, PhD; email: old542000@y...

> >

> >

> >

> > __________________________________

> > FareChase: Search multiple travel sites in one click.

> > http://farechase.

> >

>

[Guest guest]

Hi Tony:

Just approximately, what were his age and BMI?

Rodney.

>

> Yesterday, I made an appointment to clean my teeth and learned that

my

> dentist was no longer working because he had had a heart attack and

a

> stroke. After the heart attack, he was treated with anticoagulants

to

> improve blood flow, but apparently they overdosed him and he had a

> hemorrhagic stroke.

>

> The same thing happened to one of my neighbors.

>

> It makes me wonder why doctors are so aggressive in their use of

> anticoagulants.

>

> Tony

>

> ======

>

> --- In , Al Pater <old542000@y...>

wrote:

> >

> > Cardiology Patient Pages

> > Heart Attack and Stroke Prevention in Women

> > C. Becker

> > Circulation 2005;112 e273-e275

> >

> > Introduction

> >

> > Each year, more than one million Americans experience a heart

> attack, and nearly

> > half of them are fatal. Stroke is the leading cause of disability

> and the third

> > leading cause of death for women and men.1–3

> >

> > Heart Attack and Stroke in Women

> >

> > Many people continue to believe that heart attacks represent a

> problem targeting

> > solely older men, yet heart disease is the number one killer of

both

> women and men

> > in the United States. The difference is that among men, the risk

for

> heart attack

> > increases steadily after 45 years of age. In women, the risk

> increases after 50

> > years of age. However, younger women and men can also have heart

> attacks, and the

> > current epidemic of obesity and inactivity among our nation's

youth

> will likely

> > shift the risk toward occurrence at younger ages over the next one

> to two decades.

> >

> > Each year, nearly 700 000 Americans experience either their first

or

> second stroke,

> > and more than 20% of them are fatal. More women than men have

> strokes, and they are

> > more likely to die as a result. The problem is particularly

serious

> in black

> > Americans.4–8

> >

> > Who Is at Risk?

> >

> > Being familiar with factors that increase the risk for either a

> heart attack or

> > stroke is the first step toward prevention. If you have one or

more

> of these

> > factors, please contact your healthcare provider to discuss the

> available means to

> > reduce the risk.

> >

> > What Are the Signs and Symptoms?

> >

> > In most instances, a heart attack or stroke is caused by a small

> blood clot lodged

> > within a blood vessel leading to either the heart or brain (see

the

> Figure). The

> > lack of blood (and oxygen) causes injury, which increases steadily

> over time;

> > therefore, prompt recognition and medical treatment are of utmost

> importance.

> >

> > Fig: Blood clots forming in the blood vessels serving the heart

> cause heart

> > attacks; those that develop in or travel to the blood vessels in

the

> brain are

> > responsible for strokes.

> >

> > The signs and symptoms of heart attack and stroke are listed in

the

> boxes. It is

> > important to remember that they can differ from one person to

> another and may " wax

> > and wane " with time. If you are not sure, it is better to seek

> medical advice than

> > to wait.

> >

> > Warning Signs for Stroke

> >

> > Sudden weakness or numbness of face or limb on one side.

> > Sudden, severe headache.

> > Difficulty talking or understanding speech.

> > Unexplained dizziness.

> > Sudden dimness/loss of vision, often in one eye.

> > Warning Signs for Heart Attack

> > Chest discomfort: uncomfortable pressure, squeezing or fullness.

> > Discomfort in other areas of the upper body: one or both arms or

in

> the back, neck,

> > jaw, or stomach.

> > Shortness of breath, either with chest discomfort or alone.

> > Other signs, including nausea, lightheadedness, or breaking out

in a

> cold sweat.

> >

> > Risk Factors for Stroke

> >

> > High blood pressure.

> > Diabetes.

> > High cholesterol.

> > Age (risk doubles for each decade over 55 years of age).

> > Family history of stroke.

> > Smoking.

> > Birth control pills.

> > Atrial fibrillation.

> > Heart failure.

> > Excess alcohol.

> > Prior stroke or heart attack.

> > Black race.

> > Gender (women are at greater risk than men).

> >

> > Risk Factors for Heart Attack

> >

> > High blood pressure.

> > Diabetes.

> > Smoking.

> > High cholesterol.

> > Age.

> > Hormone replacement therapy.

> > Physical inactivity.

> > Gender (men are at greater risk than women).

> >

> > Prevention of Heart Attack and Stroke

> >

> > Stop smoking.

> >

> > Engage in physical activity.

> > Use diet therapy.

> > Maintain/reduce weight.

> > Control blood pressure.

> > Undergo cholesterol control/statin therapy.

> > Control blood sugar.

> > Limit alcohol intake.

> > Take aspirin as advised.*

> > =========================

> > *For women who have at least a 20% chance of a heart attack or

> stroke over the next

> > 10 years.

> >

> > How Aware Are You?

> >

> > A recent American Heart Association–sponsored telephone survey of

> more than 1000

> > women who were over 25 years of age found that only 1 of every 3

> women correctly

> > identified the warning signs of stroke. Awareness of heart attack

> risk is low

> > nationwide but was particularly low among Hispanic and black

women.

> >

> > There has been an overall improvement in the level of awareness

> among American women

> > over the past decade. Both a clear need and a large margin for

> improvement exist,

> > however, for national and community prevention programs to develop

> educational

> > programs directed toward those at greatest risk.9

> >

> > How Can I Reduce My Chances of Having a Heart Attack or Stroke?

> > Rather than consider heart and blood vessel disease as a

> " have-or-have-not "

> > condition, the medical community now looks at a " continuum of

risk "

> that requires

> > intermittent appraisal by healthcare providers. Your physician can

> assess the chance

> > of your having a heart attack or stroke according to risk

prediction

> charts and can

> > optimize strategies of preventive care.10,11 It is important for

all

> women to

> > recognize the important role that they themselves play in

preventing

> heart attack

> > and stroke by following a healthy lifestyle.12

> >

> > Is Aspirin for Everyone?

> >

> > In low doses, aspirin reduces " sticking " of blood platelets to one

> another,

> > preventing blood clots. A study of nearly 40 000 initially healthy

> women 45 years of

> > age or older13 found that aspirin (100 milligrams every other day)

> reduced the risk

> > of a first stroke by nearly 25%, and in women over 65 years of

age,

> it decreased the

> > likelihood of both heart attack and stroke. On the flip side,

> aspirin increased by

> > 40% the risk of bleeding within the stomach and intestines, a

known

> side effect.

> >

> > What is the take-home message for women? Low-dose aspirin reduces

> heart attack and

> > stroke for women at high risk and for those over 65 years of age.

> The balance of

> > benefit with the risk of bleeding must be weighed carefully for

each

> individual and

> > discussed with a healthcare professional.

> >

> > It must be emphasized that women with a prior heart attack or

stroke

> are known to

> > benefit from daily aspirin.

> >

> > Are All the Answers About Aspirin in?

> >

> > The wide-scale availability, low cost, and proven benefits of

> aspirin make it a

> > topic of great interest and importance in public health. Women at

> low risk for a

> > heart attack or stroke do not benefit from regular aspirin use.

> Similarly, it has

> > been established that women at high risk benefit considerably. The

> questions that

> > remain unanswered are as follows:

> >

> > What is the role of aspirin among women at intermediate risk (10%

to

> 20% risk over a

> > 10-year period) for a stroke or heart attack?

> >

> > What is the safest and most effective dose of aspirin?

> >

> > Does the optimal dose of aspirin differ from one person to

another?

> >

> > Do the protective effects of aspirin differ between women and men?

> If so, how can

> > the difference be explained and translated to health care?

> >

> > Can a simple blood test like C-reactive protein identify healthy

> people who are

> > likely to benefit from aspirin?

> >

> > Answers to these questions require additional research.

> >

> > What Should I Do if I Experience Signs or Symptoms of a Heart

Attack

> or Stroke?

> >

> > Time is of the essence. Treatments to restore the flow of blood

(and

> oxygen) to the

> > brain and heart are available but are most beneficial when used in

> the first several

> > hours. Call 9-1-1. By calling 9-1-1 and taking an ambulance to the

> hospital where

> > heart attack and stroke care is available, you substantially

> increase your chances

> > of recovery. Remember, you should never drive yourself to the

> hospital unless there

> > is absolutely no other choice.

> >

> > Knowing how to prevent a heart attack or stroke, and being

prepared

> to act

> > immediately if you experience the signs or symptoms of either one,

> could save your

> > life.

> >

> > Footnotes

> >

> > The information contained in this Circulation Cardiology Patient

> Page is not a

> > substitute for medical advice or treatment, and the American Heart

> Association

> > recommends consultation with your doctor or healthcare

professional.

> >

> > Al Pater, PhD; email: old542000@y...

> >

> >

> >

> > __________________________________

> > FareChase: Search multiple travel sites in one click.

> > http://farechase.

> >

>

[Guest guest]

Hi folks:

I know a physician who had a heart attack a few years ago. He now

says that if he was in a traffic accident today he would probably

bleed to death. Presumably because of his now-regular medications.

Rodney.

[Guest guest]

Hi folks:

I know a physician who had a heart attack a few years ago. He now

says that if he was in a traffic accident today he would probably

bleed to death. Presumably because of his now-regular medications.

Rodney.