By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

As Miss Driver in Kill Bill Daryl Hannah plays an amoral villain with no compassion for her victims. Now the Blade Runner alum is helping track down a similar foe -- America's #1 serial killer of women - heart disease.

"I didn't know before I got involved with the American Heart Association that heart disease is the number one killer of women in America," says Hannah, 43. "Cardiovascular disease is deadlier than the next five causes of death combined. More than 500,000 women will die because of this disease."

That's nearly 13 times deadlier than breast cancer which kills an estimated 40,000 women annually.

Cardiovascular disease includes cardiac problems such as angina, heart attack and congestive heart failure as well as vascular diseases such as stroke, high blood pressure, and abdominal aortic aneurysm (triple A) to name a few. A woman's lifetime risk of cardiovascular disease is one in two.

While Go Red for Women may sound like the sequel to Kill Bill, it is in fact a national heart disease awareness campaign co-sponsored by Macy's and Pfizer. The initiative encourages women to make their heart health a top priority.

"Far too often women are too busy taking care of everyone else in their family and they don't stop to take care of themselves," Hannah states. "That's why this Friday February 6 as part of the campaign we're asking everyone to wear red to remind women about heart disease."

As a national 'note- to-self,' Niagara Falls and the Empire State Building were illuminated red Thursday evening February 5 to remind people to similarly color coordinate their Friday wardrobe and educate themselves about keeping their hearts healthy.

Heart aches

Hannah is passionate about women's heart health because she has experienced heart disease first-hand.

"My mother got a virus which weakened her heart and literally made her unable to even walk up a flight of stairs," Hannah says. "Fortunately, we caught it early so she was able to recover. But because of that she got panicked and made sure everyone in our family got checked. It turns out that some of my sisters had heart issues."

Hannah's credits her excellent blood pressure and low cholesterol to three decades of vegetarian living and getting regular exercise, an important component for heart health as noted in the newly released heart disease prevention guideline for women.

"People think of heart disease risk as a 'have or have-not' condition," states Debra R. Judelson, cardiologist and medical director, Women's Heart Institute at Cardiovascular Medical Group of Southern California as well as one of the heart experts who wrote the new women's heart disease prevention guideline. "But it isn't all or nothing. In fact, there is a range of risk. We all have plaque. We all have potential heart problems and some risk. We define that risk as your likelihood of having a heart event in the next 10 years."

By definition, the highest risk people have a greater than 20% chance of having an event in the next 10 years. Intermediate risk is 10%-20% and low risk is defined as less than 10%.

"Low risk is a one in ten chance of having a heart event in the next 10 years," Judelson notes. "At the morning business meeting you probably have ten people around the table and one of them is going to have an event -- if you all are low risk. That should be eye-opening for women."

There are many risk factors but among the most important are increasing age, previous coronary disease, diabetes and chronic kidney disease.

According to Judelson, the risk-reduction strategies outlined in the guideline include:

• Don't smoke or quit smoking
• Exercise - at least 30 minutes every day
• Follow a healthy diet with lots of fruits and vegetables
• Limit saturated fat
• Have your blood sugar, cholesterol and blood pressure checked

"When you have your cholesterol checked make sure you know your numbers for your HDL (good cholesterol), LDL (bad cholesterol) and triglycerides," Judelson advises. "For high-risk individuals, our goal is to get people's LDL under 100 or as close as is reasonable. We will give you a cholesterol-lowering drug if it's advisable. We'll give you a blood pressure medication, called an ACE inhibitor, even if it isn't high because ACE inhibitors reduce your risk of having a heart attack by 28%."

Take heart

Judelson cautions that these medications do have side effects and are not given to every patient. Lifestyle changes should be fundamental to a comprehensive heart health plan.

"We tailor medications to the people most likely to benefit from them," Judelson states. "And these medications are fine for women as long as they are not pregnant."

To further assist high-risk women in improving their heart health, the new guidelines also recommend use of:

• ACE inhibitors and beta-blockers for a weak or damaged heart
• Niacin and fibrate therapies for women with specific cholesterol abnormalities.
• Aspirin therapy - except for low-risk women. Intermediate-risk women can take aspirin if their blood pressure is well controlled and the benefit outweighs the risk of side effects.
• Blood pressure-lowering drugs for women with blood pressure greater than or equal to 140/90. 

According to Judelson, after reviewing numerous studies the guideline's authors do not recommend taking antioxidant vitamin supplements or use of combination hormone therapy for prevention of heart disease in post menopausal women.

But of particular concern to women should be sudden cardiac death.

"Of women who die suddenly from a coronary event, two-thirds of them had no prior symptoms," Judelson says. "Their first symptom of heart disease was cardiac death. That's compared to 50% of men in the same category."

Because heart disease can be so silent and a heart event so unexpected, many heart experts recommend more advanced screening methods.

"As we get more data we are seeing that the coronary calcium screenings really do give us very valuable information," Judelson explains. "These screenings tell us whether or not you have significant calcium within the blood vessels and help us identify which patients need more aggressive therapy."

Hannah wants women to be proactive and talk to their doctors and devise a plan to stay heart healthy and to follow it.

"The American Heart Association website is a great resource for information or women can call 1-888-MY HEART," says Hannah, who will soon appear in the Kill Bill sequel as well as the new John Sayles film Silver City. "First and foremost is your heart health. Women are led by their hearts and we are so ruled by them that we must remember to always take of our own hearts."

For more information on heart disease, click here.

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 2/7/2004  -  Donnica Moore, M.D.