February 19, 2025 • 36 mins
In this episode, Holly Thacker, MD explores the connection between hypertension and women's heart health, emphasizing the need for awareness and proactive management. She discusses risk factors unique to women and practical lifestyle modifications to reduce hypertension and prevent strokes.
• Discusses the historical context of heart health awareness
• Explains the importance of monitoring blood pressure regularly
• Highlights lifestyle changes to combat hypertension
• Addresses unique cardiovascular risks faced by women
• Provides practical tips for better heart health
• Stresses the urgency in recognizing stroke symptoms
• Encourages collaboration among healthcare providers for comprehensive care
If you've enjoyed this episode and you want to help support us at Speaking of Women's Health, please share it with others. You can donate on our nonprofit speakingofwomenshealth.com site and you can leave a five-star review.
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Speaker 1 (00:04):
Welcome to the Speaking of Women's Health
podcast and happy new year.
I'm your host, dr Holly Thacker, the Executive Director of
National Speaking of Women'sHealth, and I am back in the
Sunflower House for a brand newepisode of our Speaking of
Women's Health podcast, and thisis season three.
(00:27):
February 2025 is American HeartMonth, a time when the nation
spotlights heart disease Heartdisease, the number one killer
of Americans, men and women.
So President Lyndon B Johnsonwas among one of the millions of
(00:53):
people in the United States whosuffered from heart attacks In
1964, quite a long time ago,over 60 years ago issued the
first Surgeon General Report onSmoking and Health, and this was
published on January 11ththat's my son's birthday, but it
(01:16):
was 1964.
This landmark publication wasreleased by then Surgeon General
Luther Terry, md, and this wasthe first time the federal
government reported a link tosmoking and negative health
impacts, including lung cancerand heart disease, including the
(01:38):
dangers of even secondhandsmoke.
Now, sadly, take, I think,quite a while for physicians to
note this, and years ago therewere doctors smoking in the
operating room when they wereoperating on people's lung
cancer.
Just like during the time ofour first president, george
(02:03):
Washington, they were leechingand taking out blood as a
treatment, which of course isnot a good treatment and is
(02:27):
named after him, the cryobuilding.
He was drummed out of medicalsocieties because he suggested
just a lumpectomy instead ofradical mastectomy for breast
cancer.
And now that is standard ofcare.
And Semmelweis, an Austrian,made the notation that if people
washed their hands before goingbetween women to deliver babies
, that there wasn't as muchperipheral fever.
(02:47):
And they thought this was aheretic.
And he died in an insane asylum.
It was terrible.
So there is this history inmedicine where sometimes it
takes what I think is probably alittle bit too long for the
health community, public healthphysicians in general, to come
clean and note differentassociations.
(03:09):
So, with that said, it wasn'tthat long ago 1964, but that's
when we got some attention toall of this.
And I do have a SmokingCessation podcast with a guest
podcaster coming up soon.
And for any of you, if you'resmokers, if you have loved ones
(03:31):
who are smokers, if you justwant to find out really what's
the latest and greatest insmoking cessation, please tune
into that.
And if you don't alreadysubscribe to our podcast, hit
the subscribe or follow buttonand you'll be notified when
there's a new podcast, but inthis episode what I want to
(03:52):
focus on is high blood pressure,hypertension and stroke risk in
women.
Three of my four grandparentsdied from stroke and it's not
uncommon to have a stroke inwomen, especially over age 65.
And I've done other podcaststhat you can listen to, talking
(04:14):
about the heart and cholesteroland heart risk assessment, and I
talk about how I have a lot ofconversations with my patients
where I'll say, no, your bloodpressure is elevated, and
they'll say, no, it's alwaysgood.
And I said, well, the lastseveral times I pull up the
record and they say, but it'salways been good, and then my
(04:38):
answer is yes, everybody's bloodpressure is always great until
it's not.
And I pretty much tell all mypatients if they're over 45,
they should have a bloodpressure cuff.
And increasingly people aremonitoring their sleep, other
biometric aspects of theirhealth, and so you know you
might only see a doctor once ortwice a year and it might be
(05:01):
under circumstances where you'reuncomfortable and in pain or
nervous.
So I think to get a lot ofreadings in different situations
is really the right thing to do.
So hypertension, also calledhigh BP, high blood pressure is
when the pressure in your bloodvessels is just too hot and this
over time can damage yourarteries and it's like with
(05:24):
every heartbeat, your brain andyour heart and your kidneys are
kind of taking a beating.
If that pressure is reallyreally high and there can be
blockages or blood clots ordamage to the blood vessels that
give blood and oxygen to allyour vital organs.
And without oxygen andnutrients, the tissue can die.
(05:44):
And without oxygen andnutrients, the tissue can die
and that's why high bloodpressure can lead to strokes and
heart attacks.
Brain attack is another termfor stroke, kidney failure,
which is on the rise, and heartfailure.
(06:05):
So, in terms of hypertension,the DASH diet we talk about
helping to reduce heart risk andglobally, one in every three
adults ages 30 to 79 havehypertension.
A 2022 study looked atfollowing this DASH diet as a
lifestyle intervention to reducecardiovascular disease in
(06:27):
people with mild hypertension,and this study found that this
dietary change could preventnearly 3,000 deaths in the
United States alone.
It's been estimated worldwidethat over a billion adults have
high blood pressure andtwo-thirds of them can live in
low or middle-income countries,and hypertension can be a deadly
(06:49):
condition, causing 7.5 milliondeaths annually, and previous
research showed that there couldbe several lifestyle changes
that will improve a person'sblood pressure, including
regular exercise and reducingalcohol intake and ingesting
(07:10):
whole foods, healthy foods,heart, healthy fats, limiting
processed foods.
If you didn't listen to lastseason's podcast on food freedom
and so many foods that are inthe United States food supply
that are banned in othercountries, it's really worth
listening to.
(07:30):
I have so many friends who loveto travel the world and many go
to Italy and they say that theyhave their pasta and their
bread and their wine and theydon't gain weight.
They actually lose weight,whereas here in the United
States they eat less and havemuch more trouble with their
weight.
So I think there is a lot toadditives things that make food
(07:52):
taste addictive that can reallyinfluence your palate.
So the DASH diet was presentedat the American Heart
Association ScientificConference in 2022.
They estimated that they couldsave events in both men and
(08:12):
women in the United Statessignificantly.
Now, sometimes hypertensionsymptoms in women are mistaken
for menopausal symptoms, formenopausal symptoms, and some of
the unique issues in women isthat pregnancy complications
like preeclampsia, and alsoearly menopause before the age
(08:34):
of 45, and certainly prematuremenopause before the age of 40,
definitely increases a woman'srisk for future heart disease, a
woman's risk for future heartdisease.
Now cardiologists,gynecologists, women's health
specialists, endocrinologistshave recommended how midlife
women can help prevent laterheart problems.
(08:55):
And since 50% of women by age55 will have hypertension, just
like 50% of women by age 55 haveosteoporosis.
But sometimes when women havehot flashes and palpitations
it's just blown off or oh,you're going through the change,
you're in perimenopause, you'rein menopause and it could be
(09:16):
cardiac.
So that does have to be dealtwith.
And high blood pressure is alsocalled hypertension in men, but
in women sometimes it's blownoff as oh, it's stress, it's
menopause.
Many times blood pressure istreated less well in women
(09:37):
compared to men, putting them atincreased risk for atrial
fibrillation, heart failure andstroke.
Now if you or one of your lovedones had preeclampsia in
pregnancy, which is elevatedblood pressure, that is linked
to a four-fold increase in heartfailure and double the risk of
(09:59):
stroke.
So women who've had earlynatural menopause not surgical,
but they've just gone intopremature menopause before the
age of 45, and those before theage of 40 for sure have a
definite increased risk ofcardiovascular disease at least
a 3% raised risk for each earlyyear that they lose the sex
(10:21):
hormones and estrogen, which isvery cardioprotective.
Especially estrogen iscardioprotective for normal
arteries.
It's not a treatment fordiseased arteries.
Now, autoimmune inflammatoryconditions such as rheumatoid
arthritis and lupus are a lotmore common in women compared to
(10:42):
men and that also is a risk forcardiovascular disease.
So there's several phases oflife when we can identify
subgroups of high-risk women.
Certainly, any elevated bloodpressure in pregnancy is a
warning and we always takeobstetrical histories of women,
even when they're coming in fora midlife evaluation or a
(11:03):
menopause consult or anosteoporosis consult.
And if you have high bloodpressure that happens when you
enter early menopause and it'snot treated, there's also an
increased risk of dementia.
And if you don't address bloodpressure when you're in your 40s
and 50s and you're busy andyou're in that sandwich
generation, you're definitelygoing to have problems by the
(11:24):
time you're 70.
And it generally becomes harderto treat Optimal management of
menopausal health in women withPCOS polycystic ovarian
condition.
If you didn't hear my interviewwith Dr Ula Abed, our center
endocrinologist, on PCOS, that'sa great one to listen to.
So women with PCOS have a muchhigher rate of type 2 diabetes.
(11:48):
They have elevated risk of bothhypertension and diabetes in
pregnancy both hypertension anddiabetes in pregnancy and
gestational diabetes increasesthe risk of sleep apnea
significantly.
And if you didn't listen toseason one podcast in June of
2023 with dentist Dr MargaretFrankel, she talked about dental
(12:12):
treatments for obstructivesleep apnea syndrome.
I usually regularly will lookin the mouth of my patients to
look at the back of theiroropharynx, check their neck,
ask if they're snoring, gagging,choking, have any unusual sleep
behaviors, and we've got lotsof podcasts on sleep.
(12:32):
If you do not get sleep, yourbody cannot regenerate and
refresh.
So having a really goodcollaboration with cardiologists
, gynecologists, women's healthdoctors, endocrinologists is
really needed to give optimalpatient care to our women in our
practice and making earlierdiagnoses.
(12:54):
Knowing about complicatedpregnancies and early menopause
are important things to bring toyour doctor's attention.
So what are some of thelifestyle tips to lower your
blood pressure?
Well, number one limitsedentary time.
There is an inverse doseresponse relationship between
physical activity and theincidence of hypertension in
(13:15):
adults who start out with normalblood pressure.
In addition, physical activityreduces blood pressure amongst
adults with normal bloodpressure, pre-hypertension and
hypertension, and I certainlymonitor this.
I take my blood pressure andthere's times it's okay but not
great, and if that correlateswith me kind of slacking off
(13:35):
some of my intense exerciseregimen.
It makes sense if I haven'tbeen eating as well.
So it's important to try to aimfor at least 10,000 steps a day
.
For most people it's notpossible with all people with
orthopedic problems, but briskwalking is free and easy and
effective and is good for you.
(13:58):
You can plan for physicalactivity ahead of time in your
schedule.
Pick things that you enjoy doing.
I like to dance, I like to hike, I like to run around and chase
my grandchildren.
Um, I like to run around andchase my grandchildren and?
Um, I sometimes like to takethe long ways around.
(14:20):
I like to, if I have time, walkpatients out all the way to the
front desk.
They really like that touch andgets them oriented, as when
they see the scheduler and wherethe lab is.
Um, you really have to dothings you like to do.
Um.
Stationary bike in the winter.
I love getting up early in themorning and being like the first
one to have my recreationalexercise center almost to myself
(14:43):
.
I get so spoiled that whensomeone's on one of my machines
you know, like my elliptical,which is, you know, much less
pressure on the knees and hips Ikind of get irritated, thinking
it's my machine.
It reminds me of Beatrice's mymachine.
It reminds me of Beatrice, mygranddaughter, mine, mine.
That was like one of the firstwords she learned Chair yoga is
(15:03):
popular with seniors.
Swimming is an excellentexercise that really takes a lot
of pressure off the joints.
Number two stop smoking.
There's a significant dosepositive response between
smoking and the onset of highblood pressure and cardiac
disease, and it's not just withcigarette smoking, electronic
(15:25):
cigarettes, vaping, cigars,hookah, which is water pipe
smoking, not good.
Number three limit alcoholbecause there is a dose response
to alcohol consumption and theonset of hypertension.
So really a woman should notever have more than one drink a
day and a man not more than twodrinks a day.
(15:47):
And really women should notdrink more than a couple times a
week max because it doesincrease cancer risk.
A couple times a week maxbecause it does increase cancer
risk.
And one drink is 12 ounces ofbeer, 5 ounces of wine or 1.5
(16:09):
ounces of 80 proof liquor.
Choose herbal teas instead ofcaffeinated teas.
Studies show that hibiscus teadecreases blood pressure,
similar to blood pressuremedicines, so I love hibiscus
tea.
Decreases blood pressuresimilar to blood pressure
medicines, so I love hibiscustea.
And hibiscus tea also can helpreduce uric acid and if you
haven't looked at the list offoods high in purines which
raise uric acid, that'simportant.
If you're on a thiazidediuretic, you might want to get
(16:31):
your uric acid levels checked.
As a woman, the thiazidediuretics are great for bone.
They help reduce kidney stonesif you're leaking too much
calcium out the urine, but theycan reduce your uric acid
excretion.
So hibiscus and lemon and Greekyogurt and cherries are all
very good at helping to get ridof some of that extra uric acid.
(16:53):
Very good at helping to get ridof some of that extra uric acid
.
The other thing that's naturalthat can lower blood pressure
significantly.
My son's blood pressure wasstarting to creep up a little
bit and he started adding somered beet powder to his drinks
because when he did that incollege as a college athlete,
(17:15):
that was part of the pre-workoutand that improves nitric oxide,
which improves vasodilation andblood flow in the blood vessels
, and he noticed that when hestarted to add a little bit of
that back.
Some people like to eat redbeets.
I love red beets, but if youeat a lot it makes your stool
look like it's red and you'rebleeding and I've had more than
one patient come in concernedabout GI bleeding who's just
(17:36):
eaten a lot of red beets.
Now captopril, which is a bloodpressure medicine, may actually
also improve a little bit ofthe lipids.
Now, captopril is an ACEinhibitor and I'm not as much of
a fan of ACE inhibitors inwomen as in men, because women
have a higher rate of cough.
(17:56):
So if you're put on a bloodpressure medicine and you get a
dry cough, they could put you onan ARB.
That's similar to an ACEinhibitor.
So a meta-analysis of fiverandomized controlled studies
published in 2015 show thatregular drinking of hibiscus tea
can decrease your systolicblood pressure 7.5 and diastolic
(18:18):
3.5 millimeters, and so everylittle bit helps.
120 over 80, which a lot ofpeople think is normal.
Okay, that's nowpre-hypertension and you only
need a couple readings of 130over 85 to get you the diagnosis
of hypertension.
So you can make your ownhibiscus tea at home with a
teaspoon of loose, dry hibiscusflowers or tea bags and sip it
(18:42):
throughout the day.
Now my latest new favorite teais Yerba Mate Y-E-R-B-A the next
word is M-A-T-E, y-e-r-b-a thenext word is M-A-T-E and our
endocrinologist, the expert inthyroid weight and PCOS and
fertility in women, dr Ula Abed,who's been on our podcast a
(19:07):
couple of times and she's alsoan artist.
I think I showed you thebeautiful engraved with pearl
jewelry box that she made for meand sometimes we've posted
pictures of the two of ustogether in clinic.
She tipped me off to someresearch showing that Yerba Mate
actually acts like a GLP-1inhibitor, like the so-called
(19:30):
ozempic class of medications,and she said my in-laws drink
that tea all day long and theyare so stick thin.
Well, I'm not drinking it allday long, but I am drinking it
and it does seem to have a nicemild appetite suppressant effect
.
And I think that intermittentfasting and taking out the carbs
in your diet and just focusingon protein and heart-healthy
(19:54):
fats also curb your appetite.
As a midlife woman, that is thenumber one concern and I have
women come to me because theythink something's off with their
hormones, because they'regaining weight but they're
having regular periods.
So that's not menopause, that'snot hormone imbalance, that's a
lifestyle diet, diet and energyexpenditure problem.
(20:18):
So watching out for highlyprocessed foods that have a lot
of extra sodium added isimportant.
Home-cooked meals generally arehealthier, having more fiber
and vegetables and legumes andnuts and seeds not being as
processed, not using these seedoils, but all the commercially
prepared foods, like fast foodand TV dinners, and most
(20:42):
mayonnaise, most salad dressingsand chips and sweets tend to be
loaded in calories, low innutritional value and tasty
addictively tasty and they'realways usually found in the
middle part of the grocery store, and anything that has more
than five items in it kind ofmeets the criteria for
(21:03):
ultra-processed.
Now, besides salt, sugar, oilsand fats, you want to look for
other food substances thataren't usually used in regular
culinary preparations, such ashydrolyzed protein, modified
starches.
Stay away from hydrogenatedoils, any of the inflammatory
(21:25):
seed oils, especially cottonseedoil, which, when it's
crystallized, is Crisco, whichis terrible.
Don't use that.
Even canola oil maybe if it'scold pressed it's a little bit
better, but soybean oil, evenpeanut oil, safflower, corn oil
(21:47):
stay away from those.
Olive oil, extra virgin oliveoil and I have a lot on the
website about olive oil andspeakingofhimselfcom and avocado
oil are good, and you can usecoconut oil in moderation as
well.
That's another option.
And fully saturated fats arelike butter and beef tallow and
(22:10):
ghee.
So a study that was published afew years ago concluded that if
you have four or moreultra-processed foods a day,
it's independently associatedwith a 62% increased all-cause
mortality, and we in Americaaren't as healthy as other
countries and we need to changethat because we want to be the
(22:30):
leaders of the world.
We want to be the leaders inhealth and wellness.
We want to be the leaders ineducational achievement and
safety and scientific advances,and your health really impacts
all of these areas.
So you might ask why does highblood pressure increase stroke
(22:52):
risk?
Well, it makes your heart workharder, it damages your organs
and arteries and, compared topeople who have much better
blood pressures and better heartrates, they're less likely to
have stroke or some vascularcatastrophe.
And if you damage the arteries,they clog more easily.
(23:12):
About 87% of strokes occur whenthe blood vessel feeding the
brain gets blocked.
It could be from a clot, likean ischemic clot.
It can be from amyloid that hasweakened the blood vessel wall,
even in people who don't havehigh blood pressure, like my
pap-pap, who lived well into his80s and over time the vessels
(23:35):
just don't hold up to thepressure and they rupture and
that's a hemorrhagic stroke.
And 13% of strokes are of thistype.
And high doses of atorvastatinLibitor is the brand name in
older women is associated with atwofold increased risk of
hemorrhagic stroke in the SPARQLtrial and statins don't have
(23:55):
good evidence of any primaryprevention of heart disease in
women.
Now they do in men, but womenare not men and we know that
women who are given hormonetherapy within 10 years of
menopause do have a much lowerrisk of both diabetes and heart
disease.
And usually menopausal hormonetherapy, even given orally,
(24:17):
doesn't increase blood pressure.
It may actually reduce bloodpressure by improving the
symptoms.
Rarely it can.
Transdermal does not.
Transdermal natural estrogendoes not increase stroke risk
either, and you know I do somany consults every week with
women who've been on transdermalestrogen and you know they just
(24:38):
keep having birthdays, which isgreat.
It's wonderful to havebirthdays, right?
I mean, next year our countryis going to have its 250th
birthday.
Isn't that exciting?
So longevity is great andthat's something that we strive
for and we've had discussionsand podcasts on longevity strive
(25:01):
for, and we've had discussionsand podcasts on longevity.
And so, because you want toextend your life, really one of
the only things we do at Midlifefor Women to do that is hormone
therapy.
And when women don't takehormone therapy which is fine,
there's choices.
One size does not fit all.
We have non-hormonal options.
Not everyone flashes.
We have lots of greattreatments for bone and lots of
good treatments to keep thegenitourinary system in good
(25:23):
shape.
So for women who can't or won'ttake hormones, I say you know,
don't worry, we have a lot ofother things for you.
But a lot of times at that timeof life the weight goes up, the
cholesterol goes up, the bloodpressure goes up, the
cardiovascular risk goes up andit's kind of a fast, more
downward spiral.
So at midlife you've got tokeep track of all these numbers
and you need to have yourresults with you, hard copies
(25:47):
and kind of take ownership foryour health.
So some of the risk factorsthat do increase your chance of
developing hypertension, someyou can treat, you know, some
you can't.
You cannot change your geneticsokay, but you can work to
become smoke-free.
There are some great treatmentsfor diabetes, type 2 diabetes.
(26:09):
Many of my patients can getinto remission.
You can work on being having acloser to normal body weight and
we've had many podcasts onweight and nutrition.
Physical inactivity most of thetime can be dealt with.
A poor diet, eating processedfoods, too much sodium, not
(26:30):
enough potassium and magnesiumand drinking too much alcohol
sometimes become more common inpeople who are stressed Now,
things that you can't change.
We can't change our familyhistory and we can't change our
race and ethnicity or our age,our birth date.
We can't change our gender andmen do tend to get
(26:52):
cardiovascular disease at anearlier age than women.
Cardiovascular disease at anearlier age than women, chronic
kidney disease and autoimmunedisease also increase
cardiovascular disease risk.
Now, obstructive sleep apnea isa risk, definite risk for heart
disease and a shorter lifespan,and after alcohol and drug
abuse, is the second most commoncause of accidents on the
(27:15):
roadway.
But we can treat that and it'snot just nasal CPAP but weight
loss, oral dental treatments.
There's the Inspire devicechanging sleep positions.
So a lot of people don't wantto do a sleep study when I'm
concerned about their risk forsleep apnea and I really
(27:36):
encourage people to getevaluated if this is a concern.
So stroke is cardiovasculardisease and it's the number five
killer and it can lead to a lotof disability.
And a stroke occurs when ablood vessel that carries oxygen
and nutrients to the brain iseither blocked by clot or burst
or ruptures.
It's a brain attack.
(27:57):
The good news is strokes can beprevented many times from
treating the blood pressure,having a healthy diet, smoking
cessation and treating atrialfibrillation, which is a risk
for stroke.
You can take a stroke riskassessment on strokeorg to see
what your risk for stroke is.
You know I was fascinated thatneurologic conditions and damage
(28:23):
doesn't necessarily have to bepermanent, and I'm going to have
an upcoming podcast with anorthopedic surgeon,
acupuncturist, from China, andthey do acupuncture after stroke
to stimulate the peripheralnerves so that when the brain
recovers there's betterperipheral control, and he also
advocates acupuncture fortrigeminal neuralgia that
(28:47):
there's a faster recovery andthere are some complementary and
alternative therapies thatpeople may employ.
Time is certainly of the essenceand if you think that anyone is
off, they can't speak clearly,they can't communicate what
they're thinking, their facedrops, their arm or leg is weak,
(29:08):
it's time to call 911.
So that sudden numbness orweakness, confusion, trouble
speaking, trouble seeing in oneor both eyes, trouble walking,
loss of balance, incoordinationor, like the worst headache of
your life, could be asubarachnoid hemorrhage.
(29:29):
So you must act fast to helpstroke patients get the
treatment they need, and we wantto do it hopefully within an
hour, certainly no more thanthree hours, because time is of
the essence.
If you don't act fast F is forface.
Ask the person to smile.
If the face droops, it's aproblem Arm.
(29:50):
Ask the person to raise botharms S speech.
Ask the person to repeat asimple sentence T time.
If you see any of these changes, dial 911.
Note the time when thesesymptoms appear and give a clear
and coherent history to thehealthcare team.
(30:12):
Do not drive to the hospitalyourself.
If you think you're having astroke, or even you know a loved
one, call the ambulance.
What should you do to treat amini stroke, so-called transient
ischemic attack?
If you have stroke symptoms andthey go away, it might be a TIA
or a mini stroke.
(30:33):
It's a serious sign and you doneed medical evaluation and
treatment Now.
Sometimes, especially in youngerwomen, a TIA may be actually a
migranous effect, but you needto still seek treatment.
Unfortunately, because TIAscompletely clear up, many people
just ignore them, but payingattention to it can save your
(30:54):
life.
So what are the chances thatsomeone will have a second
stroke?
Well, one in four survivorswill have another stroke.
So you've got to get thatlifestyle together, and the risk
of a second stroke is as highas almost 13% in the first week
after a TIA, and the secondstroke within the next five
(31:16):
years can be as high as 30%.
Now, fortunately, 80% ofrecurrent strokes can be
prevented with diet modification, exercise, blood pressure
control, appropriate cholesterolreduction with statins or other
medicines if needed, as well asantiplatelet medicines.
So again, be healthy, be strongand be in charge.
(31:38):
Don't smoke or vape.
Don't eat junk food.
Plan for physical activity.
Learn about the foods that arenot good for you.
You can still enjoy wonderfullydelicious foods without all the
extra chemicals and substancesthat are not good for you.
Limit alcohol use and if youhave a problem with alcohol, if
(32:03):
you're drinking by yourself, ifyou're day drinking, if you're
drinking in the morning, ifyou've had a DUI driving under
the influence, if other peopleare concerned about your
drinking, you need to seek help,and there's a lot of help out
there.
Know your blood pressure.
Get one of those armsphingomamometers.
(32:23):
Bring it into your doctor'soffice so the nurse can check
your blood pressure with yourmachine and their machine Work
to reduce stress.
A little bit of stress insomeone's life can be motivating
.
Reduce stress.
A little bit of stress insomeone's life can be motivating
, but if it leads you to overeator not get exercise or do
unhealthy habits, you need toseek treatment for it.
(32:44):
Make sure you see your primarycare physician once a year at
least.
Check your height and weightand blood pressure, get an exam,
get some baseline medical worklabs done and get adequate sleep
.
We've got some great podcastson sleep.
You need at least seven to ninehours of sleep for adults and
more for children, teenagers and, of course, young children and
(33:08):
babies.
Now, heart disease symptoms canvary from one woman to another.
Some women have palpitations,others just have fatigue.
Some women might notice swollenlegs and ankles and shortness
of breath from early heartfailure.
So any of these conditions thatyou might have bring to the
(33:28):
attention to your physician.
If your blood pressure's up,you should have a baseline EKG
heart tracing.
You should know what yourfasting lipids are.
Lp little a is a marker and ifit's high that can increase the
risk of heart disease.
Inflammation levels can be veryimportant.
(33:50):
I'm not as much worried aboutcholesterol If the HDL, high
density cholesterol, is good andthe triglycerides are low and
there's no inflammation and noother risk, because some of it
is genetic.
But people with hightriglycerides, metabolic
syndrome, so-called syndrome X,which is central weight those
(34:13):
are much more concerning andknowing what your omega-3 to 6
fat ratio is important.
I've been doing that testlately.
We're going to have an upcomingpodcast going into that in more
detail and it's very importantto have those ratios at a good
level.
So thank you so much forlistening to the Speaking of
(34:37):
Women's Health podcast.
You can subscribe for free onApple Podcasts, spotify, tunein
wherever you listen to yourpodcast.
If you've enjoyed this episodeand you want to help support us
at Speaking of Women's Health,please share it with others.
You can donate on our nonprofitspeaking of women's healthcom
(34:58):
site and you can leave afive-star review, and we're
going to look forward to seeingyou next time in the sunflower
house.
Be strong, be healthy and be incharge.
Charge.
Welcome to the Speaking of Women's Health
podcast and happy new year.
I'm your host, dr Holly Thacker, the Executive Director of
National Speaking of Women'sHealth, and I am back in the
Sunflower House for a brand newepisode of our Speaking of
Women's Health podcast, and thisis season three.
(00:27):
February 2025 is American HeartMonth, a time when the nation
spotlights heart disease Heartdisease, the number one killer
of Americans, men and women.
So President Lyndon B Johnsonwas among one of the millions of
(00:53):
people in the United States whosuffered from heart attacks In
1964, quite a long time ago,over 60 years ago issued the
first Surgeon General Report onSmoking and Health, and this was
published on January 11ththat's my son's birthday, but it
(01:16):
was 1964.
This landmark publication wasreleased by then Surgeon General
Luther Terry, md, and this wasthe first time the federal
government reported a link tosmoking and negative health
impacts, including lung cancerand heart disease, including the
(01:38):
dangers of even secondhandsmoke.
Now, sadly, take, I think,quite a while for physicians to
note this, and years ago therewere doctors smoking in the
operating room when they wereoperating on people's lung
cancer.
Just like during the time ofour first president, george
(02:03):
Washington, they were leechingand taking out blood as a
treatment, which of course isnot a good treatment and is
(02:27):
named after him, the cryobuilding.
He was drummed out of medicalsocieties because he suggested
just a lumpectomy instead ofradical mastectomy for breast
cancer.
And now that is standard ofcare.
And Semmelweis, an Austrian,made the notation that if people
washed their hands before goingbetween women to deliver babies
, that there wasn't as muchperipheral fever.
(02:47):
And they thought this was aheretic.
And he died in an insane asylum.
It was terrible.
So there is this history inmedicine where sometimes it
takes what I think is probably alittle bit too long for the
health community, public healthphysicians in general, to come
clean and note differentassociations.
(03:09):
So, with that said, it wasn'tthat long ago 1964, but that's
when we got some attention toall of this.
And I do have a SmokingCessation podcast with a guest
podcaster coming up soon.
And for any of you, if you'resmokers, if you have loved ones
(03:31):
who are smokers, if you justwant to find out really what's
the latest and greatest insmoking cessation, please tune
into that.
And if you don't alreadysubscribe to our podcast, hit
the subscribe or follow buttonand you'll be notified when
there's a new podcast, but inthis episode what I want to
(03:52):
focus on is high blood pressure,hypertension and stroke risk in
women.
Three of my four grandparentsdied from stroke and it's not
uncommon to have a stroke inwomen, especially over age 65.
And I've done other podcaststhat you can listen to, talking
(04:14):
about the heart and cholesteroland heart risk assessment, and I
talk about how I have a lot ofconversations with my patients
where I'll say, no, your bloodpressure is elevated, and
they'll say, no, it's alwaysgood.
And I said, well, the lastseveral times I pull up the
record and they say, but it'salways been good, and then my
(04:38):
answer is yes, everybody's bloodpressure is always great until
it's not.
And I pretty much tell all mypatients if they're over 45,
they should have a bloodpressure cuff.
And increasingly people aremonitoring their sleep, other
biometric aspects of theirhealth, and so you know you
might only see a doctor once ortwice a year and it might be
(05:01):
under circumstances where you'reuncomfortable and in pain or
nervous.
So I think to get a lot ofreadings in different situations
is really the right thing to do.
So hypertension, also calledhigh BP, high blood pressure is
when the pressure in your bloodvessels is just too hot and this
over time can damage yourarteries and it's like with
(05:24):
every heartbeat, your brain andyour heart and your kidneys are
kind of taking a beating.
If that pressure is reallyreally high and there can be
blockages or blood clots ordamage to the blood vessels that
give blood and oxygen to allyour vital organs.
And without oxygen andnutrients, the tissue can die.
(05:44):
And without oxygen andnutrients, the tissue can die
and that's why high bloodpressure can lead to strokes and
heart attacks.
Brain attack is another termfor stroke, kidney failure,
which is on the rise, and heartfailure.
(06:05):
So, in terms of hypertension,the DASH diet we talk about
helping to reduce heart risk andglobally, one in every three
adults ages 30 to 79 havehypertension.
A 2022 study looked atfollowing this DASH diet as a
lifestyle intervention to reducecardiovascular disease in
(06:27):
people with mild hypertension,and this study found that this
dietary change could preventnearly 3,000 deaths in the
United States alone.
It's been estimated worldwidethat over a billion adults have
high blood pressure andtwo-thirds of them can live in
low or middle-income countries,and hypertension can be a deadly
(06:49):
condition, causing 7.5 milliondeaths annually, and previous
research showed that there couldbe several lifestyle changes
that will improve a person'sblood pressure, including
regular exercise and reducingalcohol intake and ingesting
(07:10):
whole foods, healthy foods,heart, healthy fats, limiting
processed foods.
If you didn't listen to lastseason's podcast on food freedom
and so many foods that are inthe United States food supply
that are banned in othercountries, it's really worth
listening to.
(07:30):
I have so many friends who loveto travel the world and many go
to Italy and they say that theyhave their pasta and their
bread and their wine and theydon't gain weight.
They actually lose weight,whereas here in the United
States they eat less and havemuch more trouble with their
weight.
So I think there is a lot toadditives things that make food
(07:52):
taste addictive that can reallyinfluence your palate.
So the DASH diet was presentedat the American Heart
Association ScientificConference in 2022.
They estimated that they couldsave events in both men and
(08:12):
women in the United Statessignificantly.
Now, sometimes hypertensionsymptoms in women are mistaken
for menopausal symptoms, formenopausal symptoms, and some of
the unique issues in women isthat pregnancy complications
like preeclampsia, and alsoearly menopause before the age
(08:34):
of 45, and certainly prematuremenopause before the age of 40,
definitely increases a woman'srisk for future heart disease, a
woman's risk for future heartdisease.
Now cardiologists,gynecologists, women's health
specialists, endocrinologistshave recommended how midlife
women can help prevent laterheart problems.
(08:55):
And since 50% of women by age55 will have hypertension, just
like 50% of women by age 55 haveosteoporosis.
But sometimes when women havehot flashes and palpitations
it's just blown off or oh,you're going through the change,
you're in perimenopause, you'rein menopause and it could be
(09:16):
cardiac.
So that does have to be dealtwith.
And high blood pressure is alsocalled hypertension in men, but
in women sometimes it's blownoff as oh, it's stress, it's
menopause.
Many times blood pressure istreated less well in women
(09:37):
compared to men, putting them atincreased risk for atrial
fibrillation, heart failure andstroke.
Now if you or one of your lovedones had preeclampsia in
pregnancy, which is elevatedblood pressure, that is linked
to a four-fold increase in heartfailure and double the risk of
(09:59):
stroke.
So women who've had earlynatural menopause not surgical,
but they've just gone intopremature menopause before the
age of 45, and those before theage of 40 for sure have a
definite increased risk ofcardiovascular disease at least
a 3% raised risk for each earlyyear that they lose the sex
(10:21):
hormones and estrogen, which isvery cardioprotective.
Especially estrogen iscardioprotective for normal
arteries.
It's not a treatment fordiseased arteries.
Now, autoimmune inflammatoryconditions such as rheumatoid
arthritis and lupus are a lotmore common in women compared to
(10:42):
men and that also is a risk forcardiovascular disease.
So there's several phases oflife when we can identify
subgroups of high-risk women.
Certainly, any elevated bloodpressure in pregnancy is a
warning and we always takeobstetrical histories of women,
even when they're coming in fora midlife evaluation or a
(11:03):
menopause consult or anosteoporosis consult.
And if you have high bloodpressure that happens when you
enter early menopause and it'snot treated, there's also an
increased risk of dementia.
And if you don't address bloodpressure when you're in your 40s
and 50s and you're busy andyou're in that sandwich
generation, you're definitelygoing to have problems by the
(11:24):
time you're 70.
And it generally becomes harderto treat Optimal management of
menopausal health in women withPCOS polycystic ovarian
condition.
If you didn't hear my interviewwith Dr Ula Abed, our center
endocrinologist, on PCOS, that'sa great one to listen to.
So women with PCOS have a muchhigher rate of type 2 diabetes.
(11:48):
They have elevated risk of bothhypertension and diabetes in
pregnancy both hypertension anddiabetes in pregnancy and
gestational diabetes increasesthe risk of sleep apnea
significantly.
And if you didn't listen toseason one podcast in June of
2023 with dentist Dr MargaretFrankel, she talked about dental
(12:12):
treatments for obstructivesleep apnea syndrome.
I usually regularly will lookin the mouth of my patients to
look at the back of theiroropharynx, check their neck,
ask if they're snoring, gagging,choking, have any unusual sleep
behaviors, and we've got lotsof podcasts on sleep.
(12:32):
If you do not get sleep, yourbody cannot regenerate and
refresh.
So having a really goodcollaboration with cardiologists
, gynecologists, women's healthdoctors, endocrinologists is
really needed to give optimalpatient care to our women in our
practice and making earlierdiagnoses.
(12:54):
Knowing about complicatedpregnancies and early menopause
are important things to bring toyour doctor's attention.
So what are some of thelifestyle tips to lower your
blood pressure?
Well, number one limitsedentary time.
There is an inverse doseresponse relationship between
physical activity and theincidence of hypertension in
(13:15):
adults who start out with normalblood pressure.
In addition, physical activityreduces blood pressure amongst
adults with normal bloodpressure, pre-hypertension and
hypertension, and I certainlymonitor this.
I take my blood pressure andthere's times it's okay but not
great, and if that correlateswith me kind of slacking off
(13:35):
some of my intense exerciseregimen.
It makes sense if I haven'tbeen eating as well.
So it's important to try to aimfor at least 10,000 steps a day
.
For most people it's notpossible with all people with
orthopedic problems, but briskwalking is free and easy and
effective and is good for you.
(13:58):
You can plan for physicalactivity ahead of time in your
schedule.
Pick things that you enjoy doing.
I like to dance, I like to hike, I like to run around and chase
my grandchildren.
Um, I like to run around andchase my grandchildren and?
Um, I sometimes like to takethe long ways around.
(14:20):
I like to, if I have time, walkpatients out all the way to the
front desk.
They really like that touch andgets them oriented, as when
they see the scheduler and wherethe lab is.
Um, you really have to dothings you like to do.
Um.
Stationary bike in the winter.
I love getting up early in themorning and being like the first
one to have my recreationalexercise center almost to myself
(14:43):
.
I get so spoiled that whensomeone's on one of my machines
you know, like my elliptical,which is, you know, much less
pressure on the knees and hips Ikind of get irritated, thinking
it's my machine.
It reminds me of Beatrice's mymachine.
It reminds me of Beatrice, mygranddaughter, mine, mine.
That was like one of the firstwords she learned Chair yoga is
(15:03):
popular with seniors.
Swimming is an excellentexercise that really takes a lot
of pressure off the joints.
Number two stop smoking.
There's a significant dosepositive response between
smoking and the onset of highblood pressure and cardiac
disease, and it's not just withcigarette smoking, electronic
(15:25):
cigarettes, vaping, cigars,hookah, which is water pipe
smoking, not good.
Number three limit alcoholbecause there is a dose response
to alcohol consumption and theonset of hypertension.
So really a woman should notever have more than one drink a
day and a man not more than twodrinks a day.
(15:47):
And really women should notdrink more than a couple times a
week max because it doesincrease cancer risk.
A couple times a week maxbecause it does increase cancer
risk.
And one drink is 12 ounces ofbeer, 5 ounces of wine or 1.5
(16:09):
ounces of 80 proof liquor.
Choose herbal teas instead ofcaffeinated teas.
Studies show that hibiscus teadecreases blood pressure,
similar to blood pressuremedicines, so I love hibiscus
tea.
Decreases blood pressuresimilar to blood pressure
medicines, so I love hibiscustea.
And hibiscus tea also can helpreduce uric acid and if you
haven't looked at the list offoods high in purines which
raise uric acid, that'simportant.
If you're on a thiazidediuretic, you might want to get
(16:31):
your uric acid levels checked.
As a woman, the thiazidediuretics are great for bone.
They help reduce kidney stonesif you're leaking too much
calcium out the urine, but theycan reduce your uric acid
excretion.
So hibiscus and lemon and Greekyogurt and cherries are all
very good at helping to get ridof some of that extra uric acid.
(16:53):
Very good at helping to get ridof some of that extra uric acid
.
The other thing that's naturalthat can lower blood pressure
significantly.
My son's blood pressure wasstarting to creep up a little
bit and he started adding somered beet powder to his drinks
because when he did that incollege as a college athlete,
(17:15):
that was part of the pre-workoutand that improves nitric oxide,
which improves vasodilation andblood flow in the blood vessels
, and he noticed that when hestarted to add a little bit of
that back.
Some people like to eat redbeets.
I love red beets, but if youeat a lot it makes your stool
look like it's red and you'rebleeding and I've had more than
one patient come in concernedabout GI bleeding who's just
(17:36):
eaten a lot of red beets.
Now captopril, which is a bloodpressure medicine, may actually
also improve a little bit ofthe lipids.
Now, captopril is an ACEinhibitor and I'm not as much of
a fan of ACE inhibitors inwomen as in men, because women
have a higher rate of cough.
(17:56):
So if you're put on a bloodpressure medicine and you get a
dry cough, they could put you onan ARB.
That's similar to an ACEinhibitor.
So a meta-analysis of fiverandomized controlled studies
published in 2015 show thatregular drinking of hibiscus tea
can decrease your systolicblood pressure 7.5 and diastolic
(18:18):
3.5 millimeters, and so everylittle bit helps.
120 over 80, which a lot ofpeople think is normal.
Okay, that's nowpre-hypertension and you only
need a couple readings of 130over 85 to get you the diagnosis
of hypertension.
So you can make your ownhibiscus tea at home with a
teaspoon of loose, dry hibiscusflowers or tea bags and sip it
(18:42):
throughout the day.
Now my latest new favorite teais Yerba Mate Y-E-R-B-A the next
word is M-A-T-E, y-e-r-b-a thenext word is M-A-T-E and our
endocrinologist, the expert inthyroid weight and PCOS and
fertility in women, dr Ula Abed,who's been on our podcast a
(19:07):
couple of times and she's alsoan artist.
I think I showed you thebeautiful engraved with pearl
jewelry box that she made for meand sometimes we've posted
pictures of the two of ustogether in clinic.
She tipped me off to someresearch showing that Yerba Mate
actually acts like a GLP-1inhibitor, like the so-called
(19:30):
ozempic class of medications,and she said my in-laws drink
that tea all day long and theyare so stick thin.
Well, I'm not drinking it allday long, but I am drinking it
and it does seem to have a nicemild appetite suppressant effect
.
And I think that intermittentfasting and taking out the carbs
in your diet and just focusingon protein and heart-healthy
(19:54):
fats also curb your appetite.
As a midlife woman, that is thenumber one concern and I have
women come to me because theythink something's off with their
hormones, because they'regaining weight but they're
having regular periods.
So that's not menopause, that'snot hormone imbalance, that's a
lifestyle diet, diet and energyexpenditure problem.
(20:18):
So watching out for highlyprocessed foods that have a lot
of extra sodium added isimportant.
Home-cooked meals generally arehealthier, having more fiber
and vegetables and legumes andnuts and seeds not being as
processed, not using these seedoils, but all the commercially
prepared foods, like fast foodand TV dinners, and most
(20:42):
mayonnaise, most salad dressingsand chips and sweets tend to be
loaded in calories, low innutritional value and tasty
addictively tasty and they'realways usually found in the
middle part of the grocery store, and anything that has more
than five items in it kind ofmeets the criteria for
(21:03):
ultra-processed.
Now, besides salt, sugar, oilsand fats, you want to look for
other food substances thataren't usually used in regular
culinary preparations, such ashydrolyzed protein, modified
starches.
Stay away from hydrogenatedoils, any of the inflammatory
(21:25):
seed oils, especially cottonseedoil, which, when it's
crystallized, is Crisco, whichis terrible.
Don't use that.
Even canola oil maybe if it'scold pressed it's a little bit
better, but soybean oil, evenpeanut oil, safflower, corn oil
(21:47):
stay away from those.
Olive oil, extra virgin oliveoil and I have a lot on the
website about olive oil andspeakingofhimselfcom and avocado
oil are good, and you can usecoconut oil in moderation as
well.
That's another option.
And fully saturated fats arelike butter and beef tallow and
(22:10):
ghee.
So a study that was published afew years ago concluded that if
you have four or moreultra-processed foods a day,
it's independently associatedwith a 62% increased all-cause
mortality, and we in Americaaren't as healthy as other
countries and we need to changethat because we want to be the
(22:30):
leaders of the world.
We want to be the leaders inhealth and wellness.
We want to be the leaders ineducational achievement and
safety and scientific advances,and your health really impacts
all of these areas.
So you might ask why does highblood pressure increase stroke
(22:52):
risk?
Well, it makes your heart workharder, it damages your organs
and arteries and, compared topeople who have much better
blood pressures and better heartrates, they're less likely to
have stroke or some vascularcatastrophe.
And if you damage the arteries,they clog more easily.
(23:12):
About 87% of strokes occur whenthe blood vessel feeding the
brain gets blocked.
It could be from a clot, likean ischemic clot.
It can be from amyloid that hasweakened the blood vessel wall,
even in people who don't havehigh blood pressure, like my
pap-pap, who lived well into his80s and over time the vessels
(23:35):
just don't hold up to thepressure and they rupture and
that's a hemorrhagic stroke.
And 13% of strokes are of thistype.
And high doses of atorvastatinLibitor is the brand name in
older women is associated with atwofold increased risk of
hemorrhagic stroke in the SPARQLtrial and statins don't have
(23:55):
good evidence of any primaryprevention of heart disease in
women.
Now they do in men, but womenare not men and we know that
women who are given hormonetherapy within 10 years of
menopause do have a much lowerrisk of both diabetes and heart
disease.
And usually menopausal hormonetherapy, even given orally,
(24:17):
doesn't increase blood pressure.
It may actually reduce bloodpressure by improving the
symptoms.
Rarely it can.
Transdermal does not.
Transdermal natural estrogendoes not increase stroke risk
either, and you know I do somany consults every week with
women who've been on transdermalestrogen and you know they just
(24:38):
keep having birthdays, which isgreat.
It's wonderful to havebirthdays, right?
I mean, next year our countryis going to have its 250th
birthday.
Isn't that exciting?
So longevity is great andthat's something that we strive
for and we've had discussionsand podcasts on longevity strive
(25:01):
for, and we've had discussionsand podcasts on longevity.
And so, because you want toextend your life, really one of
the only things we do at Midlifefor Women to do that is hormone
therapy.
And when women don't takehormone therapy which is fine,
there's choices.
One size does not fit all.
We have non-hormonal options.
Not everyone flashes.
We have lots of greattreatments for bone and lots of
good treatments to keep thegenitourinary system in good
(25:23):
shape.
So for women who can't or won'ttake hormones, I say you know,
don't worry, we have a lot ofother things for you.
But a lot of times at that timeof life the weight goes up, the
cholesterol goes up, the bloodpressure goes up, the
cardiovascular risk goes up andit's kind of a fast, more
downward spiral.
So at midlife you've got tokeep track of all these numbers
and you need to have yourresults with you, hard copies
(25:47):
and kind of take ownership foryour health.
So some of the risk factorsthat do increase your chance of
developing hypertension, someyou can treat, you know, some
you can't.
You cannot change your geneticsokay, but you can work to
become smoke-free.
There are some great treatmentsfor diabetes, type 2 diabetes.
(26:09):
Many of my patients can getinto remission.
You can work on being having acloser to normal body weight and
we've had many podcasts onweight and nutrition.
Physical inactivity most of thetime can be dealt with.
A poor diet, eating processedfoods, too much sodium, not
(26:30):
enough potassium and magnesiumand drinking too much alcohol
sometimes become more common inpeople who are stressed Now,
things that you can't change.
We can't change our familyhistory and we can't change our
race and ethnicity or our age,our birth date.
We can't change our gender andmen do tend to get
(26:52):
cardiovascular disease at anearlier age than women.
Cardiovascular disease at anearlier age than women, chronic
kidney disease and autoimmunedisease also increase
cardiovascular disease risk.
Now, obstructive sleep apnea isa risk, definite risk for heart
disease and a shorter lifespan,and after alcohol and drug
abuse, is the second most commoncause of accidents on the
(27:15):
roadway.
But we can treat that and it'snot just nasal CPAP but weight
loss, oral dental treatments.
There's the Inspire devicechanging sleep positions.
So a lot of people don't wantto do a sleep study when I'm
concerned about their risk forsleep apnea and I really
(27:36):
encourage people to getevaluated if this is a concern.
So stroke is cardiovasculardisease and it's the number five
killer and it can lead to a lotof disability.
And a stroke occurs when ablood vessel that carries oxygen
and nutrients to the brain iseither blocked by clot or burst
or ruptures.
It's a brain attack.
(27:57):
The good news is strokes can beprevented many times from
treating the blood pressure,having a healthy diet, smoking
cessation and treating atrialfibrillation, which is a risk
for stroke.
You can take a stroke riskassessment on strokeorg to see
what your risk for stroke is.
You know I was fascinated thatneurologic conditions and damage
(28:23):
doesn't necessarily have to bepermanent, and I'm going to have
an upcoming podcast with anorthopedic surgeon,
acupuncturist, from China, andthey do acupuncture after stroke
to stimulate the peripheralnerves so that when the brain
recovers there's betterperipheral control, and he also
advocates acupuncture fortrigeminal neuralgia that
(28:47):
there's a faster recovery andthere are some complementary and
alternative therapies thatpeople may employ.
Time is certainly of the essenceand if you think that anyone is
off, they can't speak clearly,they can't communicate what
they're thinking, their facedrops, their arm or leg is weak,
(29:08):
it's time to call 911.
So that sudden numbness orweakness, confusion, trouble
speaking, trouble seeing in oneor both eyes, trouble walking,
loss of balance, incoordinationor, like the worst headache of
your life, could be asubarachnoid hemorrhage.
(29:29):
So you must act fast to helpstroke patients get the
treatment they need, and we wantto do it hopefully within an
hour, certainly no more thanthree hours, because time is of
the essence.
If you don't act fast F is forface.
Ask the person to smile.
If the face droops, it's aproblem Arm.
(29:50):
Ask the person to raise botharms S speech.
Ask the person to repeat asimple sentence T time.
If you see any of these changes, dial 911.
Note the time when thesesymptoms appear and give a clear
and coherent history to thehealthcare team.
(30:12):
Do not drive to the hospitalyourself.
If you think you're having astroke, or even you know a loved
one, call the ambulance.
What should you do to treat amini stroke, so-called transient
ischemic attack?
If you have stroke symptoms andthey go away, it might be a TIA
or a mini stroke.
(30:33):
It's a serious sign and you doneed medical evaluation and
treatment Now.
Sometimes, especially in youngerwomen, a TIA may be actually a
migranous effect, but you needto still seek treatment.
Unfortunately, because TIAscompletely clear up, many people
just ignore them, but payingattention to it can save your
(30:54):
life.
So what are the chances thatsomeone will have a second
stroke?
Well, one in four survivorswill have another stroke.
So you've got to get thatlifestyle together, and the risk
of a second stroke is as highas almost 13% in the first week
after a TIA, and the secondstroke within the next five
(31:16):
years can be as high as 30%.
Now, fortunately, 80% ofrecurrent strokes can be
prevented with diet modification, exercise, blood pressure
control, appropriate cholesterolreduction with statins or other
medicines if needed, as well asantiplatelet medicines.
So again, be healthy, be strongand be in charge.
(31:38):
Don't smoke or vape.
Don't eat junk food.
Plan for physical activity.
Learn about the foods that arenot good for you.
You can still enjoy wonderfullydelicious foods without all the
extra chemicals and substancesthat are not good for you.
Limit alcohol use and if youhave a problem with alcohol, if
(32:03):
you're drinking by yourself, ifyou're day drinking, if you're
drinking in the morning, ifyou've had a DUI driving under
the influence, if other peopleare concerned about your
drinking, you need to seek help,and there's a lot of help out
there.
Know your blood pressure.
Get one of those armsphingomamometers.
(32:23):
Bring it into your doctor'soffice so the nurse can check
your blood pressure with yourmachine and their machine Work
to reduce stress.
A little bit of stress insomeone's life can be motivating
.
Reduce stress.
A little bit of stress insomeone's life can be motivating
, but if it leads you to overeator not get exercise or do
unhealthy habits, you need toseek treatment for it.
(32:44):
Make sure you see your primarycare physician once a year at
least.
Check your height and weightand blood pressure, get an exam,
get some baseline medical worklabs done and get adequate sleep
.
We've got some great podcastson sleep.
You need at least seven to ninehours of sleep for adults and
more for children, teenagers and, of course, young children and
(33:08):
babies.
Now, heart disease symptoms canvary from one woman to another.
Some women have palpitations,others just have fatigue.
Some women might notice swollenlegs and ankles and shortness
of breath from early heartfailure.
So any of these conditions thatyou might have bring to the
(33:28):
attention to your physician.
If your blood pressure's up,you should have a baseline EKG
heart tracing.
You should know what yourfasting lipids are.
Lp little a is a marker and ifit's high that can increase the
risk of heart disease.
Inflammation levels can be veryimportant.
(33:50):
I'm not as much worried aboutcholesterol If the HDL, high
density cholesterol, is good andthe triglycerides are low and
there's no inflammation and noother risk, because some of it
is genetic.
But people with hightriglycerides, metabolic
syndrome, so-called syndrome X,which is central weight those
(34:13):
are much more concerning andknowing what your omega-3 to 6
fat ratio is important.
I've been doing that testlately.
We're going to have an upcomingpodcast going into that in more
detail and it's very importantto have those ratios at a good
level.
So thank you so much forlistening to the Speaking of
(34:37):
Women's Health podcast.
You can subscribe for free onApple Podcasts, spotify, tunein
wherever you listen to yourpodcast.
If you've enjoyed this episodeand you want to help support us
at Speaking of Women's Health,please share it with others.
You can donate on our nonprofitspeaking of women's healthcom
(34:58):
site and you can leave afive-star review, and we're
going to look forward to seeingyou next time in the sunflower
house.
Be strong, be healthy and be incharge.
Charge.
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