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Health News
Women at special risk for heart disease
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Photo courtesy of MORTON PLANT MEASE HEALTH CARE
Dr. Eric Crall, primary care physician for Morton Plant Mease Health Care, examines Sharon Phillips, who at age 53, recently discovered she has an arterial age of 71 – thanks to a CIMT screening.
Heart disease can be a silent killer.

“For one in five, the first symptom is death,” said Dr. Eric Crall, primary care physician for Morton Plant Mease Health Care.

Another frightening statistic is the fact that women are more likely to die of heart disease than breast cancer. Heart disease kills more women over the age of 65 than all cancers combined.

Heart disease also is the leading cause of death in women over the age of 40 and the threat increases greatly after menopause.

More than 400,000 women in the United States die of heart disease every year which equals about one death a minute.

In fact, according to the American Heart Association, heart disease is the No. 1 killer of women in the United States.

Too many women do not understand the risk of heart disease. According to a study done by the American Heart Association in 2003, only 13 percent of women in the United States believe that heart disease and stroke are their greatest health threat.

What is heart disease?

The four most common types of heart (cardiovascular) disease are:

• Coronary heart disease which includes heart attack and chest pain (angina pectoris)

• Stroke

• High blood pressure

• Heart failure

According to experts at the Mayo Clinic, one of the biggest challenges is the fact that heart disease symptoms for women are different from those of men.

For example, pain, pressure or discomfort in the chest is the most common heart attack symptom for men and women. But for women it’s not always severe or the most noticeable symptom.

Women may experience neck, shoulder, upper back or abdominal discomfort; shortness of breath; nausea or vomiting; sweating; light headedness, dizziness; or unusual fatigue.

Crall said heart disease is a major public health problem, especially for women.

“The risk is underappreciated, especially the unique risks to women,” Crall said.

He said a key issue is the formula used to assess risk is better suited for men. He said the formula includes factors such as age, family history, blood pressure, cholesterol levels and whether or not a patient smokes.

He said the formula only addresses high risk factors and tends to miss a lot of women.

“The traditional approach doesn’t look at a typical system, and too often by the time the symptoms occur the horse is already out of the barn.”

Heart attack and stroke are usually associated with atherosclerosis, which is a fancy word for the buildup of plaque in the inner walls of the arteries.

Crall is one of few physicians in the United States and the only physician in Pinellas County that offers a simple screening test called CIMT (Carotid Intima Media Thickness) that can detect atherosclerosis in the earliest stages.

The test measures the thickness of the inner two layers of the carotid artery – the intima and media – allowing early detection and the ability to judge the actual age of a patient’s arteries.

CIMT screening can detect plaque in the arteries earlier than the traditional stress test, which typically doesn’t signal a problem until arteries are already 40 to 50 percent blocked, Crall said. Other traditional tests are very expensive or involve large doses of radiation.

CIMT uses ultrasound and can be done in as little as five minutes, Crall said.

“It allows us a window into the lining of the artery and the ability to take a snapshot that shows any plaque buildup,” he said.

Once plaque has already blocked the arteries, the damage can’t be reversed but treatment can stop it from worsening, Crall said. However, plaque buildup that is not yet causing a blockage can be reversed, which is another reason early detection is so important.

The only problem is currently most insurance companies will not pay for a CIMT. He said the state of Texas was the first to pass legislation requiring insurance companies to pay for the screening. Crall is working on getting similar legislation passed in the state of Florida.

Crall charges $175 for the screening done by a Utah company that travels to his office once a month. He recommends that anyone with a family history of heart disease, HDL cholesterol below 50 or high blood pressure be screened. Men under the age of 55 and post-menopausal women also should be screened, as well as people who smoke.

Treatment

Crall said the earlier that problems can be detected the sooner treatment can begin. In the earliest stages, treatment can be as simple as lifestyle changes.

Crall said treatment for heart disease is “not just getting on pills.”

He said treatment includes lifestyle changes: exercising more, eating healthier foods, maintaining a healthy weight and quitting smoking.

Anyone interested in more information about a CIMT screening can call Crall’s office at 375-0601. The next screening is scheduled on Monday, Sept. 21, 1 to 5 p.m. Trinity Family Medicine is at 2044 Trinity Oaks Blvd., Suite 130, within the Trinity Medical Arts Building. For more information, visit www.myspace.com/knowyourrisk.

For more information about heart disease, visit www.americanheart.org.
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