September is Irish Heart Month, and this year the focus is on ‘Her Heart Matters’ – A campaign highlighting the importance of women’s heart health, particularly in midlife.
Community pharmacy is at the ‘heart’ of women’s health and there is a plethora of support and advice pharmacy teams can give. Already helping millions of women every day, pharmacies have a unique role to play during this important campaign.
In recent years, there has been a welcome focus in the national conversation around women’s health issues, be it reproductive health, menopause, or cancer screening. However, there has been a glaring gap. One in four women dies from heart disease and stroke each year – the same as men and, incredibly, six times more than die from breast cancer. That’s over 4,000 mothers, daughters and sisters each year in Ireland. There is a false belief that cardiovascular disease (CVD) is a man’s disease but there are many female-specific factors that affect a woman’s risk, including menopause and hypertensive disorders of pregnancy. However, the good news is that 80% of premature heart disease and stroke is preventable through healthy lifestyles.
But too many women aren’t aware of these facts and many health professionals are also missing these important messages.
According to the Lancet Women and Cardiovascular Disease Commission, heart disease and stroke in women has been under-researched, underdiagnosed and under-treated.
• under-researched (women have been left out of clinical trials)
• under-diagnosed (women often present with more unusual signs of CVD and can receive an incorrect diagnosis. Rather than the classic version of a heart attack where someone is seen clutching their chest, the symptoms of a heart attack in women can be quite vague making it hard to diagnose. They can include nausea, tiredness, shortness of breath, back pain or tightness in the jaw rather than the more familiar scenario of a crushing pain in the chest that shoots down one arm).
• under-treated (women can be under-treated or treatment can be delayed if they are under-diagnosed. Many treatments are made for men and not adequately researched in women).
There are a number of advice points pharmacy teams can employ to help women take better care of their heart health.
Mindset
Getting into the right frame of mind is essential for change. Women need to feel ready and have clear, powerful reasons for making a change. As part of the Her Heart Matters campaign, the Irish Heart Foundation has created a free Self-Care and Wellbeing Journal to support women to reflect on their lifestyle habits and prepare for meaningful change.
Stress
While stress is a normal part of life, it can be negative when it starts to impact day to day tasks. Many women are juggling multiple demands, and this can be particularly challenging during menopause. Advise them to try to keep a regular sleep routine, be physically active and stay connected to friends and family. If they are struggling, they should contact their GP.
Physical Activity
Regular physical activity is one of the greatest tools for preventing heart disease and stroke as well as helping to reduce some menopause symptoms. Getting at least 150 minutes a week of moderate-intensity activity is recommended for good health. This can be broken down into three 10 minute sessions. They should try to add muscle-strengthening exercises too.
Nourishing your Heart
Research shows that a Mediterranean-style diet can help to reduce heart disease and stroke and help manage menopause symptoms. Like the Irish Food Pyramid, a Mediterranean-style diet is based around fruit and vegetables, whole grains, beans and other pulses, nuts, and seeds. It includes some olive oil, fish, seafood, and poultry, and is low in sugar, salt, processed foods, and red meat.
Start the Conversation
Be part of the movement of women and men who want to see change and protect all women from one of Ireland’s biggest killers. Talk with your sisters, mothers, daughters, and friends, share the campaign with them, and empower them to make changes.
What can women do?
Diet can play a major role in modifying the risk for CVD, women should focus on what they can add to their diets to make it more heart healthy.
One of the most important things is to focus on following a consistent healthy dietary pattern, one in line with the Mediterranean style of eating. This contains protein sources mainly from plants, nuts, fish, or alternative sources of omega-3 fatty acids; fat mostly from unsaturated plant sources; carbohydrates primarily from whole grains; at least five to seven servings of fruits and vegetables per day; and moderate dairy consumption.
Omega-3 fatty acids are polyunsaturated fats that are beneficial for heart health. Eicosapentaenoic acid (EPA), docosahexaenoic acids (DHA) and alpha-linolenic acid (ALA) are the three main omega-3 fats. As a group, omega-3’s lower blood triglyceride levels, slow the growth of plaque in arteries and have a slight effect on lowering blood pressure. EPA and DHA are found mainly in oily fish and should be consumed once or twice per week. ALA needs to be converted from ALA to EPA and DHA, but this happens at very slow rates, which means ALA food sources like flaxseed, olive oil, walnuts and avocado need to be consumed daily. Women who completely avoid these food sources or have raised triglyceride levels may benefit from omega-3 supplements with EPA and DHA, 200 to 500mg a day of combined EPA and DHA.
Saturated fats coming from fatty meats, butter, lard, palm oil and coconut oil, as well as cakes, biscuits, pies and pastries need to be reduced to prevent the elevation of LDL levels, which promote plaque build-up in the arteries. Ideally less than 10% of total daily calories should come from saturated fat.
The Role of CoQ10
CoQ10, also known as coenzyme Q10, is a naturally occurring nutrient found in every cell of our bodies. It’s a vital component of our cellular machinery, playing a key role in the production of energy. This compound is synthesised within our cells’ powerhouses, the mitochondria, where it aids in the creation of adenosine triphosphate (ATP), the primary energy source for our cells. CoQ10, a vitamin-like compound, has been linked to potential benefits for heart health. It’s been studied for its potential to improve conditions such as heart failure, atherosclerosis, and coronary artery disease. The high energy requirements of cardiac cells make them particularly susceptible to low levels of CoQ10, which is where supplementation may come into play.
Research suggests that CoQ10 may support heart health by reducing oxidative stress, a factor that can contribute to heart disease. It’s also been found to potentially aid recovery after heart attacks, easing symptoms of heart failure, and helping to regulate blood pressure.
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