Smart Tips for a Healthy Heart from Malissa Wood, MD

Although the month of February—also known as Heart Month—has come and gone, it doesn’t mean we need to stop thinking about our hearts. Heart disease remains the number one health threat to women and the good news it is largely preventable. Whether or not you have previously been diagnosed with heart disease, the course of your future is largely determined by the choices you make moving forward.

The first step to improving your heart health is to know where you stand right now. Be aware of the risk factors for heart disease and address them if they are present in your life. Well established risk factors for heart disease include: cigarette smoking, high blood pressure, high cholesterol, being overweight or obese, diabetes, living a sedentary life and consuming an unhealthy diet. Our genes also play a role in our risk for heart disease and understanding how our family tree affects our health is critical. Newer risk factors which clearly also now are playing a role include stress and depression. By taking a survey of your own health and knowing your numbers you are on the path to better health.

A great place to get more information is the American Heart Association’s website where you can find Know Your Numbers forms to complete as well a wealth of other helpful information. My experience and research has now shown that unless we address the underlying reasons for overeating, inactivity, smoking, obesity and high stress levels-all which lead to our risk of diabetes, high blood pressure and heart disease- we will not be able to start taking the steps in the right direction.

I have been lucky enough to have run the HAPPY Heart Study for the past four years and the lessons learned from this can be found in our book Smart at Heart. We offer an approach to improving your physical and emotional health overall with the end result being a healthier, happier heart.

In this study, I took a fresh approach to heart disease prevention in low income women at risk for heart disease. Instead of only trying to fix the end result of making bad choices, I sought to help the women make better choices up front as well as providing them with the medical support needed to address their multitude of health concerns. We provided a health/life coach, nutritionist, physical therapist and most importantly a twice-monthly group educational session where the women would meet, discuss the current stressors in their lives, have a healthy snack, learn about a topic tht would help ease some burden in their life and then finish the evening with a bit of Zumba, relaxation response or yoga. The friendships and network of support that emerged from these Tuesday evening sessions were crucial in helping the women continue to make the right health choices every other day of the week. Here’s a bit more about the study, and one Tuesday evening session in particular:

 It’s a Monday night, a few weeks before Christmas. Around 5:30, thirteen women file in a conference room at the Massachusetts General Hospital Revere Health Center in Revere, Massachusetts. Some grab a clementine from a table of healthy snacks, while others peel off the layers they’re wearing to protect themselves from the bitter wind coming off the Atlantic Ocean one hundred yards away. Of the thirteen, eight are participants in HAPPY Heart, a two-year-old program that integrates all the facets of a woman’s life, including (among other things) physical health, emotional well-being, stress levels, and relationships, in order to minimize her cardiac-related issues. Three of the women are nurses (or health coaches, in HAPPY-Heart speak) and one is a daughter of a participant. As the group begins to settle into seats around the table, Isabel, one HAPPY Hearter, announces that she’s going to gather clothes for the homeless in the next week and pass them out, and that she’s looking for donations of any size. Another participant, Jenny, mentions that her daughter is taking finals, and that those tests have the whole house stressed out. The ankle of Kim, a third subject, is hurting, and Donna Peltier-Saxe, one of the health coaches, promises to take a look at it later.

Self-care is a relatively new topic for the women here tonight. “I’ve never taken care of my health,” says Lucy, echoing the sentiments of many in the group, “I just hoped for the best.” Revere is a blue-collar town, and for most of these women’s lives, the natural order of basic human needs—food and water, a safe place to live and sleep, a steady income—dictated that their energy and effort be put toward simply surviving, as opposed to thriving. One woman is dealing with a foreclosure on her house; another, at age forty-nine, was forced to move back in with her mother because losing her job meant she couldn’t afford her own place. One was shot by a former boyfriend and still has three bullets in her body, while a different woman has a son who is a heroin addict. Understandably, self-care hasn’t been a priority for these women; they’ve been too busy figuring out how to pay the bills, put food on their tables, deal with abusive relationships, and just generally navigate the messy details of life. “My life has never been about me,” says Heather, mother of the addicted son, “I’ve spent it taking care of my mother, my siblings, my children, my husband. I never thought to put myself first.”

Those life circumstances, combined with their family health histories, put most of them at risk for cardiovascular disease. In order to be a participant in the HAPPY Heart study, participants have to have at least two major risk factors for cardiovascular disease: high blood pressure, abnormal cholesterol levels, diabetes, obesity, cigarette smoking, a sedentary lifestyle, and a genetic history of cardiac issues in the family. Over 80 percent of the sixty-five women in the program have at least three risk factors: the most common are obesity, low HDL (or the good kind) cholesterol levels, and a sedentary lifestyle.

One of the big takeaways from the study is to make realistic goals for improving your life in these risk areas and then, most importantly, look around you and seek to build a closer network of friends who will support you day to day in making these choices. Not only will your heart health benefit but so will theirs. Take care of yourself, and you’ll take care of your heart. Remember, your someday is today!


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