"Goldilocks" Exercise and Sleep
Exercise and good rest are healthy habits, right? What is the right amount for optimal cardiovascular health? For exercise, brisk walking is good enough - 30 to 60 minutes on most days of the week does the trick! Women who exercise moderately and regularly experience fewer than half as many heart attacks as those who don’t. And, research in healthy women shows that the optimal sleep duration is seven hours. Less than seven hours is associated with increased heart risk. Now here’s the interesting part: you can get too much of a “good thing.” Exercise and sleep research also suggests that long-duration intense exercise actually reduces some of the benefits seen with moderate exercise. And, excessive sleep duration is also associated with higher heart risk. So, good sleep, and daily exercise - not too little, not too much - shoot for “just right!”
Are you Inflammatory?
Everyone should “know your numbers.” Blood pressure (below 140/90 mm Hg) and cholesterol (lower is better) are among the most important to know. But do you know your inflammatory number? Here’s the idea: All of us have a certain level of an “inflammatory” response in our bodies at all times - it is there to be ready to fight infections, but also can be slightly stimulated by chronic inflammation in our bodies: that chronic joint problem; a chronic illness (like rheumatoid arthritis); bad teeth and gums and so on. Doctors can measure your level of inflammation using a test known as C-reactive protein. It is a simple blood test that can be added to your cholesterol measurement test, and it indicates the level of inflammation in your body. Research in healthy women shows that optimal heart health is achieved when cholesterol and inflammation are BOTH at low levels. Interestingly, inflammation alone creates heart risk no matter how well your cholesterol is controlled. Thankfully, common cholesterol medications known as statins not only reduce cholesterol, but also reduce inflammation. So, the next time you have your cholesterol checked, ask your doctor if they can also check your CRP- you’ll learn more about your heart risk!
“Take an Aspirin and Call Me in the Morning?” - Not Quite
Do you take aspirin? If you do, but don’t have a history of heart disease or stroke, you should think about re-evaluating your treatment with your doctor. Recent advice on the use of aspirin in healthy women suggests that MOST women without prior heart disease should probably not be taking a “preventive” dose of aspirin. The reason is that the benefits, while real, are generally small and offset by the risks of aspirin - mainly bleeding. The decision can be a complicated one, based upon your individual heart risk. So, certainly ask your provider if preventive aspirin is for you. And, if you are on aspirin, it is worth a double check to make sure this treatment remains a good choice!
Should You Take a Cholesterol Pill?
To make this decision, it depends on your risk for heart disease and stroke. A detailed calculator is available to measure your heart risk. It depends on several factors such as your blood pressure, your cholesterol levels, inflammation, family history, age and smoking behavior. Recent guidelines say that if your risk is at least 7.5 percent, then there is a 7.5 percent chance of developing heart disease or stroke in the next 10 years, and a statin would be indicated. Statins are among our most effective and safest medications for heart disease prevention. And, here’s the good news: research across the last two decades show us that women who take a statin when indicated benefit at least as much, if not more, as men!
So, live well first, but when medications to treat your cholesterol are indicated, medications can be very helpful! You can check out your heart risk at www.reynoldsriskscore.org.
By Dr. Allen Taylor
Chief, Cardiology Division
Medstar Georgetown University Hospital
Medstar Washington Hospital Center
Medstar Heart and Vascular Institute