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Cardiovascular Diseases in Women

Women and Heart Disease

A heart attack occurs when an artery that carries oxygen-rich blood to the muscle of the heart (myocardium) becomes blocked. The resulting lack of oxygen causes tissue to die in the part of the heart supplied by the blocked artery. A heart attack is also called a myocardial infarction (MI).

Causes
Most heart attacks are indirectly caused by coronary artery disease (CAD) or Atherosclerosis, a condition in which fatty deposits (plaque) build up on the walls of an artery. This narrows the arteries and restricts blood flow to the muscle of the heart. A heart attack is usually triggered by a tear or rupture of the plaque, which leads to the formation of a blood clot that blocks the blood flow in the artery. Spasm of the artery can also contribute to the blockage.

Risk Factors
The risk factors for having a heart attack are similar to those for developing CAD.

Uncontrollable risk factors include:

Early menopause
Postmenopausal status
Increasing age
African American, Mexican American, American Indian, native Hawaiian, or Asian ethnicity
Family history of cardiovascular disease (These are diseases that affect the heart and blood vessels.)

Risk factors that you can control through lifestyle or treatment include:

Smoking or exposure to secondhand smoke
High blood pressure
High levels of low-density lipoprotein (LDL) cholesterol
Low levels of high-density lipoprotein (HDL) cholesterol
Sedentary lifestyle
Diabetes
Obesity and overweight (especially when focused around the waist)
Psychological stress

Symptoms
The symptoms of a heart attack may be far more subtle in women than in men. Chest pain or discomfort is typically the most common symptom in men and women. However, women may be more likely to experience some of the other common symptoms, particularly shortness of breath, nausea or vomiting, and back or jaw pain.

Common symptoms include:

Nausea and vomiting
Severe fatigue
Dizziness, fainting
Feelings of heartburn or indigestion in the upper abdomen
Pain that radiates into the arms (on the left side more than the right)
Pain high in the back, jaw, or neck
Heart palpitations
Profuse sweating
Shortness of breath
A fear of impending death

Diagnosis
The following tests may be done to confirm the diagnosis of a heart attack:

Electrocardiogram (ECG)—This test records the electrical activity of the heart. It is used to see if the heart muscle was damaged and where the damage is located.

Blood tests—These may include checking levels of enzymes, troponin levels, and other tests.

Echocardiogram —This test uses high-frequency sound waves to visualize the heart’s structure and function.

Myocardial perfusion scan —This scan uses small doses of a radioactive substance injected into the bloodstream to visualize how well blood is nourishing the heart muscle.

Coronary angiogram —This is an invasive test where a catheter is placed into the large artery in the groin and then advanced up the aorta and to the heart. Intravenous (IV) contrast is injected into the arteries to visualize blockages.

Treatment
As with men, heart disease is the number one killer for women, too. Women account for nearly half the deaths from heart attack. This makes it especially important for women to recognize the symptoms and receive immediate care.

Medical attention within the first hour after the symptoms start can significantly reduce the amount of heart damage. An electric shock using a defibrillator along with intravenous medicine may be administered if the heartbeat is dangerously irregular. Supplemental oxygen is usually given to increase oxygen in the blood and minimize tissue damage.

Other treatments may include:

Medications
A number of drugs can reduce clotting and improve blood flow, thereby minimizing damage to the heart. These include:

Drugs that alleviate pain and dilate blood vessels around the heart, increasing blood flow (eg, nitroglycerin, morphine)

Anticlotting drugs (eg, aspirin, heparin, clopidogrel, platelet GP IIb/IIIa inhibitors)

Drugs that dissolve blood clots (eg, streptokinase, alteplase, reteplase, anistreplase, urokinase)

Drugs that slow heart rate and/or lower blood pressure (eg, beta-blockers, ACE inhibitors, calcium-channel blockers)

Cholesterol-lowering drugs (eg, statins)

Revascularization Procedures
In some cases, opening the blocked arteries may be required or recommended. The two most common of these procedures are:

Coronary angioplasty —A small balloon attached to a catheter is inserted into an artery in the groin and threaded to the site of blockage. The balloon is inflated and deflated to open the artery, and then it is removed. This makes more room in the artery for blood to flow through. A stent may also be placed to help keep the artery open.

Coronary artery bypass graft (CABG)—This is a surgical procedure used when multiple vessels are blocked, a PCI cannot be done, or there is a critical blockage of the left main coronary artery. This is done by using blood vessels from other parts of the body to make a new route for blood to flow around blocked arteries.

Prevention
To decrease your chance of developing CAD and thus having a heart attack, try to make these lifestyle changes:

If you smoke, quit. Talk to your doctor about smoking cessation programs. There are also nicotine replacement products to help you kick the habit.

Exercise regularly. Aim for 150 minutes of exercise each week (about 30 minutes on most days). The activity should be moderate intensity, like walking or swimming. Or, you could do 75 minutes per week of vigorous exercise (eg, running, participating in an exercise class). It is also recommended that you do strength training twice a week. Remember to talk to your doctor before staring a new exercise routine!

If you have recently experienced a cardiovascular event (eg, heart attack or stroke) or had heart surgery, be actively involved in the rehab program that was designed for you. The program will help you recover and may lower your risk of having another event.

Eat healthier! There are many steps that you can take to improve your diet, like eating more fruits and vegetables, as well as whole grains and high- fiber foods. Also, try to eat fish twice per week. What should you avoid? Try to stay away from foods that are high in trans fat, saturated fat, sodium, cholesterol, and sugar.

Maintain a healthy weight. If you are overweight, talk to your doctor about ways you can lose weight and keep it off. Two main strategies for reaching your goal include reducing the number of calories that you consume and exercising.

If you have high blood pressure, take steps to keep your blood pressure within normal levels. This may include losing weight, being more active, eating a low-sodium diet, drinking only in moderation (one drink per day for women), and taking blood pressure medicine.

If you have other conditions like high cholesterol or diabetes, get proper treatment. By making lifestyle changes and taking medicine you can take control of your health.

Take steps to reduce stress. Yoga and meditation are just two ways that you can learn how to relax.

Also, ask you doctor if you should take an aspirin every day.

RESOURCES:
American Heart Association
http://www.americanheart.org

National Coalition for Women with Heart Disease

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Heart Problems in Women

Influential Women in Business

As Executive Vice President for Professional Development of Best Docs Network Houston Television Show, author of two books, singer/songwriter, fashion designer, running a bustling Cardiology Practice, Dr. Annie Varughese is a woman imbued with the spirit of entrepreneurship. Influential women have been seen throughout history to make their mark upon their generation and have created their moment in time to move nations as well as continents.

As queen of ancient Egypt, Cleopatra is one of the most famous female rulers in all of history. Helen of Troy had a face that launched a thousand ships and Florence Nightingale was a celebrated English social reformer and the founder of modern nursing. Modern times have seen outstanding women leaders including Golda Meir who was an Israeli teacher and politician who became the fourth prime minister of Israel, and Indira Gandhi who showed the world the ascension of a woman into the highest position in the world’s most populous democracy of India.

Keeping to the tradition of influential women in history, Dr. Annie Varughese, MD, FACC, a highly renowned interventional cardiologist and international speaker regarding the issues of Preventive Cardiology and of Women and Heart Disease, practices the art of Cardiovascular Medicine here in Houston and The Woodlands and Conroe areas.

Dr. Varughese is a highly qualified cardiovascular doctor. She raised herself from humble beginnings and attended the Medical College of Georgia, Augusta, Georgia, subsequently completing her residency in Internal Medicine and Fellowship in Cardiovascular Diseases at the University of Texas Medical School at Houston. She then attended The Texas Heart Institute/Baylor College of Medicine for further training in Interventional Cardiology. She was rewarded for her hard work recently when she was voted one of America’s Top Cardiologists/ Consumer Research Council of America for 2011. She has earned many awards and accolades which include being a member of Trademark’s Who’s Who Among Professionals in America. She is board-certified in Cardiovascular Disease, certified in Interventional Cardiology and Nuclear Cardiology and she holds the title of Clinical Assistant Professor of Medicine at the University of Texas Medical School at Houston.

Her own private practice, Advanced Cardiovascular Care Center, has been an establishment of the area of Northwest Houston, The Woodlands, and Conroe for over twenty years. She now promotes her message of wellness at medical conventions and seminars all over the world, imploring the public to do the little things that will keep their heart ticking. Having accomplished so much in her own life, she wants to ensure that her patients are, likewise, healthy enough to achieve their dreams.

One may think that a new career in television and running an already bustling practice is quite enough, but Dr. Varughese is a true entrepreneur who is always seeking new and improved ways of bringing life and education to those around her. She has authored two books: The High Octane Teen and How to Be A Healthier Slimmer You. She is a spokesperson for Unicity Balance Glucose Support Supplement and Weight Loss Line. She also has in the office an Antiaging Skin Care Line clinically proven to improve lines, wrinkles and overall skin tone. And now she can add Spa Entrepreneur to her long list of achievements.

The Heart Spa by Dolce Vita Cardio is a concept that was birthed in the mind of Dr. Annie Varughese to bring to the public what researchers have known for quite some time—that vascular flow equals life and that improving blood flow and diminishing Oxidative Stress throughout the body helps significantly to delay the aging process.

The Heart Spa will have advanced technologies and treatments to bring youth and vitality to patients here in The Houston Area. External Counterpulsation Therapy (EECP) will be one of the mainstays of Treatment at The Heart Spa.

External Counterpulsation in randomized controlled trials has been shown to improve Shortness of Breath, Chest Pain and Exercise Tolerance, Erectile Dysfunction, Help in the Prevention of Alzheimers Disease and Improve the Quality of Life as well as Improve New York Heart Association Functional Classification.

Using Unicity International’s highly acclaimed products Balance and Balance Glucose Control we can help in the fight against Oxidative Stress (damage of vessels). These Unicity products come in the form of a fiber drink which has policosanol and phytosterols, two powerful components that target oxidative stress and thereby assist in protecting the vasculature from inflammation and plaque formation.

These simple additions to your daily regimen favor successful vascular Anti-Aging and decreases the risk for cardiovascular disease.

Dr. Varughese is passionate about the care of her patients and always strives to bring the foremost in treatment advances to her community and the world. Ask about The Heart Spa by Dolce Vita Cardio today by emailing Dr. Varughese at DrAnnie@AdvancedCardioDr.com —take a moment to save a lifetime.

We asked Dr. Varughese where she finds her energy. She credits God, who opens doors, and her parents-her father a pastor and her mother a nurse, as well as her supportive husband and children. She was taught at an early age to minister to the soul and then to the body. She says with passion “Life is short and full of beauty and grace. It is our job to find the things that we love and pursue them.”

Dr. Annie Varughese is also Chair of The American Heart Association Go Red For Women for 2014-2015.

She would be honored to have your presence at our culmination luncheon May, 8 2015 at The Marriott Waterway and wanted to let you know that her mission and vision for the organization is that of bringing awareness regarding two Devastating Entities that affect Women Worldwide:

1. Oxidative Stress/Atherosclerosis

2. Sudden Arrhythmic Death Syndrome (SADS)

Dr. Varughese says with great passion: “The AHA touches the world regarding research and development in the realms of prevention and treatment of cardiovascular disease. We now know so much about heart attack and stroke due to intense teaching regarding risk factors and modification of risk.

We also know that some disease states show no warning and cause sudden death. My goal is to bring awareness of heart attack, stroke and sudden arrhythmic death that takes the lives of thousands of men and women worldwide every year. Please join me in this campaign with the American Heart Association and let’s change and mend broken hearts!”

Green Tea for Heart

Green Tea

One of the most exciting health developments of the nineties has been the discovery of the extraordinary anti-aging properties of green tea. Epidemiological observations have shown that people in green-tea consuming countries – mainly Japan and China – have very low rates of cancer. In Japan, the women who teach the tea ceremony, and thus drink more than the average amount of extra-strong green tea, are noted for their very low mortality rate and longevity; deaths from cancer are especially rare in this group.
The rates of breast, colon, skin, pancreatic, esophageal and stomach cancer have been found to be lower among drinkers of green tea. If those who consumed more than ten cups of green tea a day got cancer, it was at the considerably older age, especially in women. Likewise, it has been noted that those Japanese smokers who consume a lot of green tea seem to enjoy protection against lung cancer. In fact, the Japanese have both the highest smoking rate and the lowest lung cancer rate in the industrialized world.
Western epidemiological studies have also tended to confirm that higher consumption of tea and coffee is associated with a lower risk of breast cancer. On the basis of a number of such epidemiological studies, it could be tentatively asserted that the higher the consumption of tea in general, and perhaps of green tea in particular, the lower the incidence of breast, prostate and lung cancer. The same probably holds true for colon, stomach, pancreatic and skin cancer. In vitro or animal research indicates that green tea may be effective against an even wider variety of types of cancer, including leukemia and glioma.
Research aimed at finding the active compounds in green tea revealed that its protective effects are due chiefly to catechins. Powerful polyphenolic antioxidants, catechins are astringent, water-soluble compounds that can be easily oxidized. They are a subgroup of flavonoids, weak phytoestrogenic compounds widely available in vegetables, fruit, tea, coffee, chocolate, and wine. The antioxidant potential of both green and black teas, as measured by the Phenol Antioxidant Index, was found to be significantly higher than that of grape juice and red wines.
Green tea is manufactured from fresh, unfermented tea leaves; the oxidation of catechins is minimal, and hence they are able to serve as antioxidants. While the fermentation of tea leaves needed for the production of black tea produces some unique antioxidants such as theaflavins, bisflavonols, and thearubigens (polymers of simple polyphenols), such fermentation reduces the catechin content, especially the strongly bioactive catechin called epigallocatechin gallate. Epigallocatechin gallate has been singled out by many researchers as particularly important for cancer prevention.
So far, most research has been done on green tea and the activity of its various catechin components; the research on complex polymeric polyphenols found in black tea is still in an early stage.
Numerous recent studies continue to confirm that green tea polyphenols have powerful anticarcinogenic, cardioprotective, neuroprotective and antimicrobial actions. In the first of the two articles on green tea, let us take a closer look at the anticarcinogenic properties of green tea.
The latest good news about green tea comes from a study done at the Karolinska Institute in Stockholm. A team of researchers headed by Dr. Yihai Cao found that green tea can block angiogenesis – the development of new blood vessels that tumors need in order to grow and metastasize. The authors gave mice the equivalent of two-to-three cups of green tea a day. When lung cancer was induced, the mice supplemented with green tea showed significantly less tumor growth. The scientists found that green tea suppressed the development of new blood vessels and prevented metastasis. They hypothesize the epigallocatechin gallate is the compound responsible for the suppression of angiogenesis.
In an interview, Dr. Cao explained that all solid tumors depend on angiogenesis for their growth. If green tea polyphenols can prevent angiogenesis, then this would go a long way toward explaining why green tea is effective in preventing so many kinds of cancer. Dr. Cao stressed that it takes long-term consumption of green tea in order to obtain these chemopreventive benefits.
Green tea has also been shown to help prevent metastasis. Cancer cells secrete special enzymes called collagenases in order to penetrate and colonize various tissues. It is the metastatic process that is lethal, not the primary tumor. Hence finding substances that can prevent metastasis is of prime importance in fighting cancer. A study done at the University of Shizuoka in Japan found that epigallocatechin gallate does, in fact, inhibit the secretion of collagenases by tumor cells (in this study, highly metastatic lung cancer cells), thus arresting their ability to invade normal tissue. Black tea theaflavins were also effective. There is also additional evidence that green tea polyphenols help inhibit angiogenesis or the growth of new blood vessels that nourish the tumor.
Two of the green tea polyphenols, epigallocatechin-3-gallate and epicatechin-3-gallate, have been found to be effective inhibitors of 5 alpha-reductase type I, reducing the synthesis of DHT, a potent form of testosterone implicated in causing prostate enlargement and prostate cancer. Epigallocatechin gallate has also been found to be the most potent catechin in inducing apoptosis in human prostate cancer cells when tested on various cell lines. Together with lycopene and selenium, green tea should be considered as a special prostate-protective agent.
One interesting recent study compared the effects of epigallocatechin gallate, curcumin (a powerful anticarcinogenic compound from the curry spice turmeric), and the combination of both on an in-vitro model of oral cancer. It was found that epigallocatechin gallate helped arrest tumor cell growth in a different cell-cycle stage than curcumin. When the two compounds were combined, growth inhibition was enhanced, suggesting a synergistic effect.
Green tea catechins are among the phenolic compounds known to suppress the formation of heterocyclic amines and nitrosamines, known to be potent carcinogens. Nitrosamines have been tentatively linked to brain cancer and leukemia. Drinking green tea with or after a meal containing meat cooked at a high temperature or treated with nitrites (a meat ‘preserver’) seems to offer a degree of protection.
Many other carcinogens are likewise rendered less harmful thanks to the action of green tea polyphenols on inducing enzymes that detoxify various undesirable compounds and inhibiting those enzymes that would make certain carcinogens bioactive. Glucuronidation (conjugation with glucuronic acid) is another detoxifying mechanism that is enhanced by catechins.
It has been also postulated that green tea catechins inhibit the activation of protein kinase C, and interfere with the binding of growth factors to their receptors. (In the case of breast cancer, catechins were in fact shown to interfere with the binding of estrogen to estrogen receptors.) Catechins were also found to inhibit the release of tumor necrosis factor-alpha (TNF-alpha), a highly inflammatory cytokine, and of nitric oxide synthase, an enzyme necessary for the production of nitric oxide (nitric oxide plays an important role in inflammation and carcinogenesis).
A particularly exciting study, done at the Cancer Chemotherapy Center in Tokyo, Japan, and using leukemia and colon cancer cell cultures, demonstrated that “epigallocatechin gallate strongly and directly inhibits telomerase.” Telomerase is the enzyme that “immortalizes” cancer cells by maintaining the end portions of the tumor cell chromosomes. Even in the presence of non-toxic concentrations of epigallocatechin gallate, cancer cells exhibited telomere shortening and senescence. Thus, inhibition of telomerase could be one of the main anticarcinogenic mechanisms of catechins.
Obviously, the anti-cancer mechanisms of green tea polyphenols are complex, and not yet completely understood. Research at the level of molecular genetics is particularly promising. We already do know enough to state with certainty that green tea is an effective chemopreventive agent. And we also know that it is best to use several anti-cancer agents (including all the major antioxidants) for synergistic prevention along all the possible pathways. Green tea works along so many pathways that it is simply an indispensable part of any serious cancer-prevention program.

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