The development of The Heart Truth for Women: A Speaker's Kit involved the dedication of many individuals and organizations committed to educating women about their risk for heart disease and what they can do about it. The National Heart, Lung, and Blood Institute gratefully acknowledges everyone who contributed to the development of this kit.
John McDonald and Francis Dixon, Housing Authority of Baltimore City, Baltimore, MD
Nancy Zionts, Jewish Healthcare Foundation and Working Hearts Coalition, Pittsburgh, PA
Jo Jean Elenes and Rosie Piper, Mariposa Community Health Center, Nogales, AZ
Jill Pyle and Justina Trott, M.D., Sante Fe National Community Center of Excellence, Santa Fe, NM
The Heart Truth is a national awareness campaign for women about heart disease sponsored by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, U.S. Department of Health and Human Services (DHHS) in partnership with: Office on Women's Health, DHHS; American Heart Association; WomenHeart: the National Coalition for Women with Heart Disease; and other organizations committed to the health and well-being of women. The Heart Truth created and introduced the Red Dress as the national symbol for women and heart disease awareness in 2002. Women throughout the country are enthusiastically embracing the Red Dress, which is propelling a national awareness movement about women and heart disease.
The goal of The Heart Truth is to "put a face on heart disease" and motivate women ages 40 to 60 and health professionals to take heart health seriously and engage in action to reduce women's risk of heart disease. The campaign is the result of recommendations from more than 70 experts in women's health who helped NHLBI develop a national plan for women's heart health.
The Heart Truth campaign seeks to:
Many women think heart disease is a man's disease. It isn't. Heart disease is the leading cause of death of American women in all racial and ethnic groups in the United States (with the exception of Asian and Pacific Islanders, in whom it is second to cancer). In fact, one in four women dies of heart disease. It can also lead to disability and significantly decrease one's quality of life.
Despite this fact, many women do not realize their risk:
In order to reach as many women as possible with this important information, The Heart Truth uses a multifaceted approach. Its components include:
You can get involved in the national campaign by bringing The Heart Truth to women in your community. It's a message every woman needs to hear, because the truth is that being a woman is no protection from heart disease. Most women don't know that heart disease is the #1 killer of women and millions do not take their risk of heart disease personally or seriously. By presenting this talk, you will "put a face on heart disease," helping women to understand their personal risk of heart disease and motivating them to take action to lower that risk. The Heart Truth starts with you. The answers you give women in this talk will mean that fewer women have to answer to heart disease.
The Speaker's Kit, which includes this Speaker's Guide, is designed to
be used by anyone with an interest in bringing women the truth about heart
disease. No special training is needed. The Kit contains everything needed to
quickly and easily plan and conduct a compelling 1-hour talk. It includes a
10-minute DVD, speaker's notes, a set of reproducible overheads, and handouts
for the audience. Additional materials, including the Red Dress Pin and a
videotape version of The Heart Truth DVD can be ordered from the
NHLBI Health
Information Center. The overheads are also available as PowerPoint slides
on The Heart Truth Web pages at:
http://www.nhlbi.nih.gov/health/hearttruth/material/kitslide1.htm.
The talk covers the following topics:
The Heart Truth campaign seeks to increase women's awareness of the danger of heart disease and to motivate them to take action to protect their heart health. But that's not all women should know. To complete the heart care picture, NHLBI has the Act In Time to Heart Attack Signs: Small Group Session Kit, which presents the latest information about heart attack—how to recognize the signs of a heart attack and why fast action is needed to improve the chances of survival and a return to a full life. So make The Heart Truth the first in a series of special heart health presentations. To order, contact the NHLBI Health Information Center.
The Heart Truth presentation is designed especially for women ages 40 to 60, the years when a woman's risk of heart disease begins to rise. However, younger women will be interested in its message since heart disease, which develops over time, can start at a young age—even in the teen years. And women older than 60 need to hear the presentation too, because it 's never too late to take action to prevent and control the risk factors for heart disease.
The talk is designed to be given to audiences of various sizes; it works well with a small group or a large audience. However, for large audiences, use your judgment about how to distribute the handout material. You may want to arrange with someone ahead of time to distribute each handout when you ask for it, or you may want to give out a packet with all of the handouts at the beginning of the presentation.
The talk takes about 1 hour to present, allowing some time for questions and answers. It can be done in a shorter period if necessary by cutting down on the time for questions and/or condensing some of the material. It's designed to be flexible to accommodate your needs and the needs of your audience.
The Heart Truth can be presented in a wide variety of settings—hospitals and other health care facilities, adult education classes, recreation centers, sorority meetings, work sites, community group meetings, and places of worship, for example.
Use these simple steps to help plan and organize a successful presentation.
You may want to keep up the momentum and promote The Heart Truth message after the event. A good way to do this is to contact health reporters from local newspapers and television stations in your area. Try to interest them in doing a feature story about women and heart disease. For instance, suggest the reporter profiles women's experiences with heart disease and what they're doing to lower their risk. You may also want to consider working with organizations in your community to sponsor a Heart Truth Single City Event.
For additional information about women's heart health, see the Resources for a Healthy Heart handout.
The Heart Truth campaign materials are available online at
www.nhlbi.gov/health/public/heart/index.htm
or from:
NHLBI Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
Phone: (301) 592-8573
TTY: (240) 629-3255
[Show "Welcome" overhead.]
[Welcome each participant and, if desired, provide a nametag or name tent card for identification and introduction purposes. Review any relevant facility information, such as restroom, telephone, and water fountain locations, no smoking rules, and emergency procedures.]
Good morning/afternoon/evening. I'm very glad to see you all here, because this talk is about The Heart Truth, a topic of vital importance to women. It's about your heart, up close and personal, and why you need to get to know it better.
Let me begin by telling you who I am, and who's hosting this important presentation.
My name is __________________. I'm a [nurse, member of _____, mother, etc.]
I became involved in this presentation because __________________. ["I learned the hard way that I'm not immune to heart disease." Or: "I've seen heart disease strike a woman I know." Or: "I believe in taking action. And I know that with heart disease, there 's no time to waste."]
The group hosting this session is ________________, and it's committed to helping women protect their heart health.
[Show overhead 2.]
In fact, this session is part of a nationwide campaign called The Heart Truth.
Its goal is to help women understand their risk of heart disease and take action to lower that risk.
It's aimed especially at women ages 40 to 60, because it's during those years that a woman's risk of heart disease begins to rise.
But its message applies to younger women too, because heart disease develops over time and can start early, even in the teen years. And older women also need to take action, because it's never too late to protect your heart health.
The national campaign is sponsored by the National Heart, Lung, and Blood Institute, which is part of the U.S. Department of Health and Human Services' National Institutes of Health. But the campaign also has many partners—including national and community organizations and health agencies—who are working to help spread the messages.
The centerpiece of the campaign is the Red Dress, introduced by the National Heart, Lung, and Blood Institute as the national symbol for women and heart disease awareness. The Red Dress serves as a "red alert," giving women the message, "Heart Disease Doesn't Care What You Wear—It's the #1 Killer of Women.
Your having come today is a first step toward your knowing The Heart Truth. You will learn about how to protect your heart and increase your chance of enjoying many quality years with your family and friends. As first steps go, it's an important one. Because heart disease is something that you really can take action against.
[Show overhead 3.]
Today, we've got a lot of ground to cover. The topics we'll discuss in this session are:
The Heart Truth. Why is the campaign using that slogan?
Because women need to know the facts: The Heart Truth
is that heart disease isn't a "man's problem."
It was once believed that menopausal hormone therapy gave women an edge against heart disease. But findings from clinical trails showed this was not so. If you've got a heart, heart disease could be your problem.
[Show overhead 4.]
Heart disease is the #1 killer of American women—no matter what their race or ethnicity. One in four women dies of heart disease. By contrast, 1 in 30 dies of breast cancer.
But heart disease doesn't just result in death. It also can damage your heart—and your life. It can interfere with your activities and even your ability to do everyday things, such as climb steps.
If it's not treated, heart disease can lead to serious complications. These complications include angina, which is chest pain; heart failure, in which your heart loses its ability to function well; and heart attack. About two-thirds of the women who have a heart attack don't make a full recovery.
Unfortunately, there's a wide gap between what really threatens women and what they fear. Many women do not recognize heart disease as their leading health threat.
[Show overhead 5.]
It's not wrong to be concerned about breast cancer—and, in fact, the steps that protect you against heart disease also will help protect you against many cancers.
But heart disease casts a bigger shadow over your life, and it's important to take this message to heart: Start taking action against heart disease now. As one woman doctor put it: "Heart disease is a ‘now' problem. Later may be too late."
I want to show you a short video—it's only 10 minutes long. You'll meet a group of women and hear their stories about heart disease, how it's affected their lives, and what they are doing about it.
[Show video.]
As you heard, learning The Heart Truth cannot only change and improve your life, but also save it.
What is heart disease anyway? Most people have only a vague idea. And to understand why my message today is an urgent one, you need to know how heart disease develops.
Your heart is about the size of a fist. Make a fist and see. [Have women make a fist.] It's a hard-working muscle. It contracts and releases 24 hours a day, every day, no time off.
[Show overhead 6.]
To work effectively, your heart needs a steady supply of blood, which feeds the heart with oxygen and nutrients. Without nourishment, heart cells die—and the loss is permanent.
There are many forms of heart disease, but the type we'll be talking about today is called "coronary heart disease." It's the main form of heart disease, and I'll use "heart disease" to refer to it.
Heart disease develops over many years. As I said, it can start when you 're in your teens.
The process is called atherosclerosis. You've probably heard of "hardening of the arteries." What happens is that plaques or fatty substances build up in the walls of blood vessels. This process can happen anywhere in the body, but in heart disease, it happens in the coronary arteries of the heart.
The plaque buildup narrows the arteries. The plaques can rupture and, as with a wound, cause a blood clot to form. This further narrows the artery and the process repeats itself. Over time, the artery gets narrower and narrower, reducing blood flow.
Eventually, blood flow may be closed off. If this happens, a heart attack occurs.
[Show overhead 7.]
Certain procedures are used to reopen a blocked artery. One that you've probably heard about is bypass surgery. A piece of blood vessel is grafted onto the artery so blood can flow around the blockage. Another is angioplasty, in which a thin tube containing a deflated balloon is inserted into the artery and inflated to widen the narrowing. Sometimes, angioplasty is used to insert a wire mesh stent to keep an artery open. But these procedures do not "fix " a damaged heart. And the arteries are still affected by atherosclerosis. The buildup of plaque inside the arteries will continue to worsen unless it 's treated.
It's crucial to realize that there's no quick fix for heart disease.
[Show overhead 8.]
The good news is that heart disease can be prevented or controlled by making lifestyle changes, which we will discuss in more detail later, and, in most cases, by taking medication.
[Show overhead 9.]
All women need to take steps to protect their heart health. But as I mentioned, taking action is particularly important if you're 40 and older, and you're especially vulnerable if you're 40 to 60, the age when your risk of heart disease starts to go up. There are various reasons for this.
Estrogen does seem to play a role in preventing heart disease in younger women, although it's not understood how. When women go through menopause, the amount of estrogen in their body drops.
But another reason is that, during these years, many women develop one or more of the risk factors for heart disease.
What's a "risk factor?" Risk factors are behaviors or conditions that increase your chance of developing a disease. The heart disease risk factors will probably sound familiar to you. They are:
I'll be giving you a handout about them later. One of the dangerous aspects about them is how they gang up on you.
[Show overhead 10.]
The risk factors don't add their potential danger like one plus one equals two—they multiply it. They act both alone and together, through their effects on each other. For instance, overweight increases your chance of developing heart disease—and it increases your chance of developing high blood pressure. And that too increases your risk of heart disease.
Your risk skyrockets with each added risk factor. For example, if you have high blood pressure, high blood cholesterol, and you smoke, you're many times more likely to develop heart disease than a woman with no risk factors.
Fortunately, you can prevent or control most of these risk factors. Only family history and age are beyond your control.
And you can do a little ganging up of your own, because the same steps will prevent or control many of the risk factors.
For example, if you follow a healthy eating plan and lose excess weight, you'll not only help prevent high blood pressure but also high blood cholesterol, overweight, and diabetes.
I'm going to ask you to take a look inside yourself now. How's your heart doing in there? You may look good from the outside, but what's going on inside your body?
[Give out "What's Your Risk?" handout. Or refer the audience to the handout if you've given them a packet at the beginning.]
Here's a short quiz that will help you find out your risk. You may not be able to answer each of the questions on this handout. That's one of the issues—we too often don't know our complete "risk profile," which is based on how many risk factors we have. You may know if you're overweight, but not if you have high blood cholesterol, for example.
Take a few minutes and check off what you can. You may be surprised how easy it is to be at an increased risk.
[Give the group about 2 minutes to fill out the questionnaire.]
Finished? You may be surprised at this, but all it takes is one "yes" to be at increased risk.
The quiz gives you a quick look at your overall risk. But it's important for you to get your risk properly assessed. To do that, you need to see your doctor.
Your doctor can assess your risk factors. For instance, high blood cholesterol and high blood pressure can be measured with simple tests.
But don't assume the doctor will bring up the topic of heart disease. Few women have a heart-to-heart talk with their doctor unless they start the conversation. You have to speak up and ask questions.
[Give out "Questions To Ask Your Doctor" handout. Or refer the audience to the handout if you've given them a packet at the beginning.]
This handout has questions to ask your doctor. You don't have to ask each and every one. It's meant to help you talk more effectively with your doctor or another health care provider.
[Show overhead 11.]
This list is a good starting point for questions you may want to ask, but of course there may be other questions you have for your doctor as well. It's a good idea to make a list of questions and take it with you to the doctor's. It's also good to write down or tape record what the doctor says, so you'll remember it. For instance, it's hard for most of us to remember our blood pressure and blood cholesterol numbers. Naturally, it's also good to write down any recommended treatment.
Conversations are dialogues, of course, and it's important for you to tell the doctor information that can help to assess your risk. This includes family history of heart disease, if you smoke and, if so, how much, whether or not you're physically active, and if you have any symptoms such as chest pain or breathlessness. Don't be afraid to be honest—a complete picture will help your doctor develop an effective treatment plan.
[Show overhead 12.]
Your doctor will no doubt measure your blood pressure. Be sure you learn the results. Normal blood pressure is less than 120 over less than 80. Be sure it's being controlled to less than 140 over 90 or lower, if you have certain conditions such as diabetes. If it's not, ask what you can do to get it under control. A healthy woman should have her blood pressure taken at least once every 2 years.
To check your cholesterol, be sure your doctor does a blood test called a fasting lipoprotein analysis. A healthy woman should have this done once every 5 years. At the same time, get a fasting plasma glucose test, a blood test that tells if you have or are likely to develop diabetes.
As part of your risk profile, you should assess your body mass index—or BMI—and your waist circumference. These measures help determine your risk of heart disease and diabetes, and if you need to lose weight. BMI is a ratio of your weight to your height. Use the Body Mass Index table—it's in the "What's Your Risk?" handout. A BMI score of 25 to 29.9 means you're overweight. A BMI of 30 or more means you're obese. Waist circumference is an indicator of abdominal fat. The risk of heart disease increases for women if it's greater than 35 inches.
Another test is the EKG, or ECG. These are acronyms for the electrocardiogram. This test shows a record of your heart's electrical activity as it contracts and relaxes. It can detect various problems, such as abnormal heartbeats, muscle damage, and poor blood flow.
The stress test also records the heart's electrical activity but while you're exercising, usually on a treadmill or exercise bike. The heart works harder when you exercise, and the stress test can check if it's getting enough blood. If you can't exercise due to arthritis or another problem, a medicine can be used to get the same effect.
If you have heart disease, you may need additional tests. All of this information will help paint a picture of how your heart's doing.
A lot of us are at risk. What do we do about it?
As you've heard, surveys show that women may already know many of the risk factors for heart disease, and they may know at least some of those they have. But they still don't take their risk personally or seriously.
[Show overhead 13.]
Women put off taking action to lower their risk for many reasons. For instance, one woman in the campaign's focus groups gave a reason familiar to many of us. She said, "I think we get so wrapped up in our families that we do not put our health #1."
Other women say:
Also, many women believe that doing one healthy thing takes care of all their risk. As one woman said, "I know smoking is a risk, but I eat well, I work out, I do everything else, but it's just...I can't get rid of the smoking." The fact is that it's important to deal with all of the risk factors.
And social pressures and barriers can make it hard to take action. We're bombarded with ads pushing foods that aren't heart healthy. We go to restaurants and get super-sized meals. We can't find a safe place to walk.
Well, sometimes there's no easy answer. You have to do what you can. Tune out those ads. Don't eat everything on your plate. Walk at the mall or join your local YWCA. Make a start today.
Keep in mind that you don't have to make all the changes at once—small steps in the right direction will put you on the road to a healthy heart.
And the good news is that, no matter what your age, no matter how many risk factors you have, it's never too late to improve your heart health. If you make just two healthy changes—eating right and getting active—you'll reduce five of the risk factors.
And this is something that you can do with your family. Do it with your husband, your kids, your grandchildren. In fact, as I said, heart disease starts early, and the earlier you help children learn healthy habits, the less they'll be at risk for heart disease.
[Show overhead 14.]
Here are the key steps to a heart healthy lifestyle. We'll talk about where to get help with taking these steps in a moment.
Be physically active. This means getting at least 30 minutes of a moderate-intensity activity on most and preferably all days of the week. A moderate-intensity activity would be a nice brisk walk, for example. But you don't even have to do the 30 minutes all at once. You can divide them up into periods of at least 10 minutes each.
Follow a healthy eating plan—which means one low in saturated fat, trans fat, and cholesterol and moderate in total fat. Include lots of fruits and vegetables. If you have high blood pressure, cut down on salt and sodium. And if you drink alcoholic beverages, have no more than one a day.
[Show overhead 15.]
The first two steps—healthy eating and being physically active—will help you with another, which is to lose weight, if necessary, and maintain a healthy weight. To maintain a healthy weight, balance the calories you take in with those you use up in physical activity.
If you smoke, work hard to quit. It's the biggest favor you can do for your health. Start by writing down all of the reasons you want to quit. Then set a target date to quit. And don't be shy about using aids for quitting—nicotine gum, the patch, nasal spray, or medications. Reward yourself (with something besides food) for your progress.
If you have heart disease or risk factors for it such as diabetes and are taking prescribed medication, be sure to take it as directed.
That's it. Basically, we're talking about a sensible way of living. As one woman in the focus groups said, "It's very real. Deal with it. Get on with it. You can do it."
If you have heart disease—and if you've had a heart attack—then taking action becomes even more important.
No procedure will "cure" your heart disease. But taking action will improve your condition. It can keep you from having a repeat heart attack. It can save your life.
Sometimes, despite our best efforts, it happens—a heart attack occurs. What does it mean for your health to have a heart attack? How do you know if you’re having one? What do you do if you’re having one?
Let me answer the last question first. The most important factor in surviving a heart attack is getting help fast. It’s impossible to underscore this enough: You must call 9–1–1 within minutes of the start of heart attack signs—within 5 minutes at the most—so that you can get to the hospital quickly.
That’s because the treatment advances that can save your life and minimize the damage to your heart work best if given within 1 hour of the start of warning signs.
[Show overheads 16 and 17.]
Women often don't know what these warning signs are. Most of us think a heart attack will happen like we've seen it in the movies—a dramatic event where a man, of course, suddenly clutches his chest in agony and falls over.
Often, that's not the way it happens in real life. Many heart attacks start slowly, as a mild pain or discomfort.
Here are the main signs of a heart attack in both women and men:
So, if you have a symptom, what do you do?
[Show overhead 18.]
When in doubt, check it out. Call 9-1-1 at once—within 5 minutes. Don't wait to take an aspirin. If you're having a heart attack, the emergency medical personnel will give you one.
Calling 9–1–1 speeds treatment. It's like bringing the hospital to you, and emergency medical personnel can get to work at once to restore your blood flow.
You may be tempted to drive yourself to the hospital. Don't—not unless you have absolutely no other option. You could pass out on the way. Also, those arriving by ambulance are treated sooner.
Women are particularly likely to delay seeking help. They're afraid of embarrassment over a false alarm or of upsetting their family. Believe me, your death will be more of an upset. And, even if it does turn out to be a false alarm, you still need to get your symptoms checked.
Another way to increase your chance of survival is by planning ahead. Learn the heart attack warning signs, make a survival plan, and talk to your family and friends to be sure they know the warning signs and what to do if a heart attack happens.
[Give out "Heart Attack Survival Plan" handout. Or refer the audience to the handout if you've given them a packet at the beginning.]
Here's a handy heart attack survival plan. It tells the signs, what to do, and lets you write in important information. Fill it out and keep it in a convenient place. Make sure your family knows where it is.
But if you prepare for the worst, you'll fare the best.
[Show overhead 19.]
Many resources exist to help you take action against heart disease. This handout lists some of them. There are too many to talk about today but let me mention a couple of them.
[Give out "Resources for a Healthy Heart" handout. Or refer the audience to the handout if you've given them a packet at the beginning.]
The National Heart, Lung, and Blood Institute has publications, such as fact sheets and special interactive Web pages, on many of the topics we've discussed here, such as high blood pressure and overweight.
They also have a popular handbook called "The Healthy Heart Handbook for Women," which explains heart disease and how to protect your heart.
Other organizations—partners in The Heart Truth campaign— also have information, resources, and education programs for women.
[Show overhead 20.]
This has been a lot to digest. But don't be overwhelmed. Whenever you start something new, the effort can seem too great, too complicated. But, The Heart Truth has to start with you. I can give you information, but only you can make the changes. Keep in mind that taking action now can mean more years of healthy life. Do it for yourself and for—and with—those you love.
So how do you get started? Here are some tips on how to begin—and I'll follow them with some others on how to stick with it, because that's often the hard part.
How can you start and start today?
[Give out the "Heart Disease Risk Factors You Can Do Something About" handout. Or refer the audience to the handout if you've given them a packet at the beginning.]
A good place to start is this handout that summarizes heart disease risk factors and the steps that can help lower your risk. The trick is to make the change one step at a time. Replace some unhealthy habits with healthier ones. Get comfortable with one step and then take on another. Pretty soon, you'll wonder why you didn't make these changes sooner.
Take a first step by eating for a healthy heart. Try cutting back on saturated fat. Saturated fat raises your blood cholesterol more than anything else in your diet. Try switching from whole milk to low-fat milk and then to fat-free milk. Another step? Take the skin off the chicken before you eat it.
Here's another: Fat is rich in calories. Eat less fat, and you cut your calories, which will help you lose weight. But don't eat less fat and more food. Calories still count, even if the item is called a low-fat brownie.
Here's another: Step your way toward a regular walking program. Try walking briskly for 10 minutes a day. Then each week, increase your walking time until you're up to those 30 minutes a day.
You may be surprised that one study showed people benefit from even small changes in their routines.
So take a longer walk on the way to the office, use the stairs more, or take a walk after dinner.
[Show overhead 21].
So, once you've started, how do you keep going?
First, as I said, don't try to overhaul your life in a day. If you try to do too much at once, you'll probably feel overwhelmed and give up. This is about making changes that will stay with you for the rest of your life.
Set realistic goals. Be sure that each change is do-able without a super-human effort. For instance, if you're increasing your physical activity by swimming laps, don't go for 50 laps your first day out.
Enlist the help of a buddy. Get a family member or friend to make changes with you. Go for walks together, share recipes.
Don't kick yourself if you get off track. If you go back to eating a high fat diet for a while, don't attack yourself and give up. Everybody slips. It's what you do next that counts. Get back into your new routine.
Reward yourself. Changing habits is tough, so let yourself enjoy each success. But be careful: Don't celebrate with cake. Go to a movie, instead. Accomplishments are worth celebrating.
And finally—and this is very important—when it comes to your health, you must be your own advocate.
You can't let others, even the doctor, make your health decisions for you. Speak up. Ask for tests. Ask questions. Be sure you understand every issue and instruction. And seek out information. There's plenty of information out there.
[Show overhead 22.]
So that's The Heart Truth. Women's risk of heart disease is serious. It's up to you to take action to protect your heart. And I congratulate you on making a start. Now keep it up.
We have time for a few questions. If I don't have the answers, I'll try to point you in the right direction to find more information.
Thank you again for coming.
Heart Disease is the #1 killer of women.
Get The Heart Truth about heart disease and women. Get the facts. Know your risk. And be motivated to take action. Every woman needs this information. Take a first step to protect your heart. Attend this session. The Heart Truth campaign is sponsored by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, U.S. Department of Health and Human Services, in partnership with: American Heart Association; Office on Women's Health, U.S. Department of Health and Human Services; WomenHeart: the National Coalition for Women with Heart Disease; and other organizations committed to the health and well-being of women.
[LOCAL INFO—Date, Time, Place, RSVP info.]
[SUBJECT LINE]
Get The Heart Truth: Women and Heart Disease
[E-MAIL MESSAGE]
The Heart Truth: Women and Heart Disease.
Please join us for a free 1-hour health information session about women and heart disease on [date] at [location].
Heart disease is the #1 killer of women. Yet many women do not recognize heart disease as their leading health threat.
This 1-hour session can save your life—by giving you the facts about heart disease, explaining the risks and what they mean to you, encouraging dialogue with your physician, and empowering you to take action to lower your risk.
Don't miss it. Every woman needs this information. Invite your family and friends to attend with you.
RSVP by returning this e-mail. Or call [PHONE NUMBER]. We look forward to seeing you.
The Heart Truth campaign is sponsored by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, U.S. Department of Health and Human Services, in partnership with: American Heart Association; Office on Women's Health, U.S. Department of Health and Human Services; WomenHeart: the National Coalition for Women with Heart Disease; and other organizations committed to the health and well-being of women.
The Heart Truth: Women and Heart Disease. Heart disease is the #1 killer of women. Learn more. Attend this free 1-hour health information session about heart disease, women's risk factors for it, and steps for heart healthy living. [LOCAL INFO—Date, Time, Place, RSVP info.]
ANNOUNCER: Did you know heart disease is the #1 killer of women? Heart disease is not just a man's disease. Too many women don't take their risk seriously or personally…until it's too late. One in four American women dies of heart disease. And heart disease can cause disabilities and slow you down. Every woman needs to attend The Heart Truth for Women…a free, 1-hour health session about women and heart disease.
At The Heart Truth for Women presentation you will learn about risk factors for heart disease…like high blood pressure, smoking, and physical inactivity…to name a few. And you will learn what to do to improve your heart health.
Get The Heart Truth for Women on [DATE AND TIME] at [LOCATION]. Call [PHONE NUMBER] for more information. Get the facts. It's free. And it could save your life.
The Heart Truth is presented by [NAME OF LOCAL ORGANIZATION].
The Heart Truth is a national awareness campaign sponsored by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, U.S. Department of Health and Human Services.
ANNOUNCER: Did you know heart disease is the #1 killer of women? Too many women don't take their risk seriously or personally…until it's too late. Every woman needs to hear The Heart Truth for Women…a free, 1-hour health session about women and heart disease.
Get The Heart Truth for Women on [DATE AND TIME] at [LOCATION]. Call [PHONE NUMBER] for more information. Get the facts. It's free. And it could save your life.
The Heart Truth for Women is presented by [NAME OF LOCAL ORGANIZATION].
The Heart Truth campaign is sponsored by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, U.S. Department of Health and Human Services.
It's up to you to protect your heart health—start today!
Here is a quick quiz to find out your risk of a heart attack.
If you answered "yes" to any of the questions, you are at an increased risk of having a heart attack.
Here is a chart for men and women that gives the body mass index (BMI) for various heights and weights.*
| Height | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30 | 31 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4'10" | 100 | 105 | 110 | 115 | 119 | 124 | 129 | 134 | 138 | 143 | 148 |
| 5'0" | 107 | 112 | 118 | 123 | 128 | 133 | 138 | 143 | 148 | 153 | 158 |
| 5'1" | 111 | 116 | 122 | 127 | 132 | 137 | 143 | 148 | 153 | 158 | 164 |
| 5'3" | 118 | 124 | 130 | 135 | 141 | 146 | 152 | 158 | 163 | 169 | 175 |
| 5'5" | 126 | 132 | 138 | 144 | 150 | 156 | 162 | 168 | 174 | 180 | 186 |
| 5'7" | 134 | 140 | 146 | 153 | 159 | 166 | 172 | 178 | 185 | 191 | 198 |
| 5'9" | 142 | 149 | 155 | 162 | 169 | 176 | 182 | 189 | 196 | 203 | 209 |
| 5'11" | 150 | 157 | 165 | 172 | 179 | 186 | 193 | 200 | 208 | 215 | 222 |
| 6'1" | 159 | 166 | 174 | 182 | 189 | 197 | 204 | 212 | 219 | 227 | 235 |
| 6'3" | 168 | 176 | 184 | 192 | 200 | 208 | 216 | 224 | 232 | 240 | 248 |
* Weight is measured with underwear but no shoes.
Normal weight: BMI = 18.5 – 24.9.
Good for you! Try not to gain weight.
Overweight: BMI = 25 – 29.9.
Do not gain any weight, especially if your waist measurement is high. You need to lose weight if you have two or more risk factors for heart disease and are overweight, or have a high waist measurement, for women more than 35 inches.
Obese: BMI = 30 or greater.
You need to lose weight. Lose weight slowly—about 1/2 to 2 pounds a week. See your doctor or a nutritionist if you need help.
Source: Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults; National Heart, Lung, and Blood Institute, in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health; NIH Publication No. 98-4083; September 1998.
Another way to find your BMI is to use this three-step method: Multiply your weight in pounds (in underwear but no shoes) by 703; divide the answer by your height in inches; then divide the answer by your height in inches.
Learn the warning signs and steps to take if a heart attack happens. You can save a life—maybe your own.
If you or someone you are with begins to have chest discomfort, especially with one or more of the other symptoms of a heart attack, call 9-1-1 right away. Don't wait more than a few minutes—5 minutes at most —to call 9-1-1.
If you are having symptoms and cannot call 9-1-1, have someone else drive you to the hospital right away. Never drive yourself, unless you have absolutely no other choice.
Medicines you are taking:
Medicines you are allergic to:
If symptoms stop completely in less than 5 minutes, you should still call your health care provider.
Phone number during office hours:
Phone number after office hours:
Person you would like contacted if you go to the hospital:
Name:
Home phone number:
Work phone number:
For additional information on heart disease risk factors and how to take action toward having a healthy heart, contact the organizations listed below:
National Heart, Lung, and Blood Institute
Health Information
Center
P.O. Box 30105
Bethesda, MD 20824-0105
Telephone:
(301) 592-8573
TTY: (240) 629-3255
Fax: (301) 592-8563
E-mail:
nhlbiinfo@rover.nhlbi.nih.gov
Web site: www.nhlbi.nih.gov
Materials available from the NHLBI Health Information Center provide information about the prevention and treatment of heart disease risk factors. NHLBI's "Your Guide" series of booklets and fact sheets provide heart health information in an engaging and interactive format that can motivate you to embrace a healthy lifestyle. The "Your Guide" titles include: Healthy Heart, Living Well With Heart Disease, Healthy Sleep, Lowering Your Cholesterol with TLC, Physical Activity and Your Heart, and Lowering Your Blood Pressure With DASH. NHLBI's "Aim for a Healthy Weight" booklet will give you easy-to-use information for losing and maintaining weight.
NHLBI maintains a Web site at www.nhlbi.nih.gov. The site includes downloadable information and publications for health professionals, patients, and the public. Special interactive Web pages offer self-assessment quizzes, online menu planning, Body Mass Index calculator, heart healthy lifestyle tips, and more.
The NHLBI Diseases and Conditions Index at www.nhlbi.nih.gov/health/dci features easy-to-understand articles on a wide variety of diseases of the heart, lungs, blood vessels, and sleep disorders and common diagnostic tests and procedures.
The Heart Truth campaign Web pages can be found at www.hearttruth.gov. The Web pages provide access to all campaign materials, including the Red Dress Pin; Online Toolkits; Activity Registry; and more detailed information about heart disease risk factors, including how to assess personal risk and take action against heart disease.
For information about The Heart Truth Single City Program, contact the NHLBI Health Information Center.
American Heart Association
National Center
7272 Greenville Avenue
Dallas, TX 75231
Phone: (888) MY-HEART
(694-3278)
AHA Web site: www.americanheart.org
The American Heart Association aims to reduce disability and death from cardiovascular diseases and stroke by providing information on related topics. Through its national women's campaign, Go Red for Women, women can access educational tools and free programs to help them reduce their risk. To learn more about the prevention and treatment of heart disease and stroke, and Go Red for Women, contact the American Heart Association.
WomenHeart: the National Coalition for Women with Heart
Disease
818 18th Street, NW, Suite 730
Washington, DC
20006
Phone: (202) 728-7199
Web site:
www.womenheart.org
Founded by women with heart disease, WomenHeart provides women with information about the risks of heart disease, prevention, and survival skills. The coalition has community-based networks in nearly 40 communities across the United States that provide a variety of services to women heart disease survivors.
Office on Women's Health
U.S. Department of Health and Human
Services
200 Independence Avenue, SW, Room 730B
Washington, DC
20201
Phone: (800) 994-WOMAN or (800) 994-9662
Web site:
www.womenshealth.gov
Help yourself to better health! It's easier than you think. Use the National Women's Health Information Center (NWHIC) to get free, trustworthy women's health information on more than 800 topics. Find reliable publications and resources on heart disease, diabetes, nutrition and physical activity, eating disorders, and much more. Visit www.womenshealth.gov/ForYourHeart to fill out a profile of your health and lifestyle, and you will receive a series of articles detailing the latest information on exercise, nutrition, smoking, diabetes, cholesterol, high blood pressure and other factors that affect you and your risk for heart disease—all tailored to your needs.
|
Risk Factors |
Facts You Need To Know |
Take These Steps To Prevent Heart Disease |
|---|---|---|
|
High blood pressure |
When your blood pressure is high, your heart works harder than it
should to move blood to all parts of the body. If not treated, high blood
pressure can lead to stroke, heart attack, eye and kidney problems, and death.
|
|
|
High blood cholesterol |
Total cholesterol: |
|
|
Smoking |
Cigarette smoking is addictive. It harms your heart and lungs and can greatly increase your risk of a heart attack. |
|
|
Overweight |
Excess weight increases your risk of a heart attack and of developing high blood pressure, high blood cholesterol, and diabetes. |
|
|
Diabetes |
Diabetes is serious; you may have it and not know you have it. It can lead to heart attacks, blindness, amputations, and kidney disease. |
|
|
Physical inactivity |
Physical inactivity increases your risk of high blood pressure,
high blood cholesterol, and diabetes. |
|
There appears to be a strong connection between stress and heart disease. For instance, many people say that an emotionally upsetting event preceded their heart attack. There also is evidence that those who easily become emotionally upset are more likely to develop hardening of the arteries. In addition, some common ways women cope with stress are bad for your heart—such as overeating, drinking too much, and smoking.
Adopting good lifestyle behaviors and a positive outlook appears to help prevent and manage heart disease. Such practices seem to make women less vulnerable to heart disease and heart attack. For instance, regular physical activity relieves stress and lowers the risk of heart disease. And supportive relationships—from a spouse or support group or religious organization—appear to improve women's ability to cope with heart disease.
It's suggested that you ease stress by spending time reflecting on your life, sorting out priorities, and establishing new meaning in life. Having a positive outlook can improve the quality of your life and make you less vulnerable to heart disease.
This is especially important if you've had a heart attack. Feelings of guilt and loss of independence seem to affect how well women do. Supportive relationships are particularly important at such a time.
Until recently, many postmenopaual women were prescribed menopausal hormone therapy to help prevent heart disease. Menopausal hormone therapy can involve the use of estrogen plus progestin or estrogen alone.
Research now shows that estrogen plus progestin therapy increases the chances of developing heart disease, stroke, blood clots, and breast cancer. It also doubles the risk of dementia and does not protect women against memory loss. Research on estrogen-alone therapy shows it increases the risk for stroke and blood clots, but has no effect on heart disease and colorectal cancer, and an uncertain effect on breast cancer. Estrogen alone gives no protection against memory loss. Both estrogen and estrogen combined with progestin increase the risk of developing urinary incontinence and worsen the symptoms of incontinent women.
If you are on this medication to prevent heart disease or another chronic condition, such as osteoporosis, talk with your doctor about other approaches. If you decide to go ahead with it, use the lowest dose for as brief a period of time as possible.
Most people don't need to see a doctor before they start a moderate-intensity physical activity, such as brisk walking. You should check first with a doctor if you have heart trouble or have had a heart attack, if you're over age 50 and are not used to doing a moderate-intensity activity, if you have a family history of heart disease at an early age, or if you have any other serious health problem.
DASH stands for Dietary Approaches to Stop Hypertension. It's an eating plan that emphasizes fruits, vegetables, whole-grain foods, and low-fat dairy products. It is rich in magnesium, potassium, and calcium, as well as protein and fiber. It's low in saturated and total fat and cholesterol, and limits red meat, sweets, and sugar-containing beverages.
It was tested in clinical studies and found to lower elevated blood pressure and help prevent high blood pressure. One of the clinical studies also found that people who followed the DASH eating plan and cut down on sodium got the biggest reductions in blood pressure.
The National Heart, Lung, and Blood Institute has a booklet and fact sheet about the DASH eating plan. You can get them from the Health Information Center, which is listed on your resources handout, or from the Web site at www.nhlbi.nih.gov. The publications tell you how many servings of different food groups to have and gives you a week's worth of menus, plus some recipes.
This is one of the tests used to diagnose diabetes or prediabetes, which are risk factors for heart disease. If you have prediabetes, you are at a high risk of developing diabetes, as well as heart disease and stroke.
The other diagnostic test for diabetes is the oral glucose tolerance test. Both are done on a blood sample after a fast to see how much glucose (or sugar) is in the blood. With the oral glucose tolerance test, blood samples are taken before and after you drink a high-glucose beverage.
Being tested for diabetes and prediabetes is recommended every 3 years for those over age 45. It also should be considered for those below age 45 who have one or more additional risk factor for diabetes besides age.
The risk factors for diabetes include:
If you have diabetes, you'll need to take action to control your condition and prevent complications. If you have prediabetes, you'll need to take action too to prevent developing diabetes. In both cases, the steps include making lifestyle changes, such as losing weight.
Insulin is a hormone produced in the pancreas. It helps the body use glucose for energy. In insulin resistance, the body is unable to properly use the insulin it produces. Insulin resistance is often the first step in a pathway that leads to prediabetes and then type 2 diabetes, in which either the body is even less able to use insulin correctly or the pancreas no longer makes enough of it.
Aspirin has only been shown to lower the risk of a heart attack for those who have already had one. It also can help to keep arteries open in those who have had a heart bypass or other artery-opening procedure.
But it is not approved by the Food and Drug Administration for preventing heart attacks in those who have never had one or had a stroke. In fact, it can be harmful for some people. However, a recent large study found that in women 65 and older, taking low-dose aspirin every day may help to prevent a stroke.
Aspirin is a powerful drug and can have side effects, such as increasing your chance of ulcers and kidney disease. It also can mix dangerously with other drugs, including some over-the-counter medicines and dietary supplements.
It should only be taken with your doctor's specific recommendation and guidance.
In general, yes, you would take nitroglycerin at once, even before calling 9-1-1. But to be sure that this is so in your case, check with your doctor.
Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity that increase your chance for heart disease and other health problems such as diabetes and stroke. The term "metabolic" refers to the biochemical processes involved in the body's normal functioning.
The five conditions listed below are metabolic risk factors for heart disease. A person can develop any one of these risk factors by itself, but they tend to occur together. Metabolic syndrome is diagnosed when a person has at least three of these heart disease risk factors:
The more of these risk factors you have, the greater your chance of developing heart disease, diabetes, or a stroke. In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome.
NIH Publication No. 08-5208
Printed 2008