Heart Health: Q&A with Dr. Shalizeh Shokooh

February 17, 2021

Shalizeh Shokooh, MD is a Cardiologist at Providence St. Joseph Hospital with more than 27 years of experience in healthcare. She discusses heart disease and what we can do to protect our heart.

What is heart disease?

Heart disease, also known as cardiovascular disease (CVD), is the leading cause of death in women. The incidence of a heart attack increases after menopause partly because of age. One in nine women will develop symptoms of CVD between ages of 45-64. This ratio dramatically increases to one in three women after the age of 65. 

What are symptoms of heart disease in women?

Chest pain is the most common symptom in both men and women as the initial symptom. It is described as a crushing pressure, tightness, and/or squeezing in the chest. However, in women this chest pain may present at rest, during sleep or mental/emotional stress more often than during physical stress. Women are more likely than men to have symptoms unrelated to chest pain. These symptoms include jaw pain, shoulder or arm pain, abdominal discomfort, indigestion, unusual fatigue, cold sweats, nausea, lightheadedness, and/or shortness of breath.  Many women may not identify their initial symptoms as related to heart disease and therefore, may not seek medical evaluation. 

What are risk factors for heart disease in women?

There are major risk factors that cannot be changed. Those include increasing age and family history. 

Family history is a significant independent risk factor for heart disease. In general, the presence of coronary heart disease in a first-degree relative (parent or sibling) prior to age 55 if male and prior to age 65 if female is considered a significant family history. 

Then, there are also major risk factors which can be controlled and treated. Those include smoking, lack of physical activity, high blood pressure, diabetes, high blood cholesterol, obesity, and physical inactivity. 

Other factors include stress, poor diet, and excessive intake of alcohol. 

The American Heart Association recommends a few lifestyle changes to achieve heart health:

  1. Manage blood pressure
  2. Control cholesterol
  3. Reduce blood sugar
  4. Get active
  5. Eat better
  6. Lose weight
  7. Stop smoking

When should you see a doctor?

It’s important to remember that heart disease can be prevented. To identify risk factors and appropriately manage and offer guidance, patients aged 20 years and older without known cardiovascular disease should undergo periodic risk factor assessment every 4-6 years. 

Above age 40 or in presence of cardiac risk factors, you should closely work with your doctor to address those risk factors to reduce future risk of heart disease. Heart disease starts early in life but manifests itself as we get older. Know your risk factors, know your numbers and discuss with your physician if cardiac screening is recommended for you.

Some recommended screenings can be found here.

What’s the best diet for heart disease?

A healthy diet promotes longevity and fights against heart disease. What we eat affects our blood pressure, blood sugar, cholesterol, weight and overall sense of well-being. 

A heart healthy diet is one that includes fruits, vegetables, fish, poultry, legumes, nuts, non-tropical vegetable oils, low-fat dairy products, and whole grains. It should be low in red meats, sweets, salt and sugar-sweetened beverages.

To maintain a healthy weight and promote a healthy diet, adding regular physical activity to our daily routine is vital. Perform 30 minutes of exercise on most or all days of the week or per the recommendation of your doctor.   

What is the link between stress and heart disease?

A stressful situation starts a chain of reactions in the body to prepare us for the “fight or flight” response. This body’s response is meant to protect us. However, constant stress can be damaging to your health. Over the years, scientists have observed and noted a relationship between coronary heart disease risk and stress. People with chronic stress are more prone to have poor diet, start smoking or smoke more, sleep poorly, and consume excessive alcohol. As a result of these poor lifestyle behaviors, known cardiac risk factors are adversely affected which lead to increased risk of heart disease.

We all live in a fast-paced stressful environment. Despite the constant threat of chronic stress, we have a choice to counteract it with exercise, eating well and rest. Remember to take a little time off every day and practice mindfulness daily.   

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