Questions to Ask Your Doctor
Sometimes you have to be the one to suggest further testing. Be aggressive in taking charge by asking for help in reducing your risks. Don't wait for your doctor to talk to you if you fall into one or more of the risk categories. Make sure that he or she understands your concerns by printing out these ten questions to ask your doctor. Take these questions to your next doctor's appointment.
Ten Questions a Woman Should Ask Her Healthcare Provider
1. What are my risk factors for heart disease?
While there's no way to be sure, certain factors can increase your risk of heart disease. You can't do anything about unchangeable risk factors like age, family history, race or gender. But you can lower your risk by changing some of your habits and taking medicine if needed.
The major risk factors for coronary heart disease that you can modify, treat or control are
High blood cholesterol
High blood pressure
Obesity or overweight
2. Am I at risk for stroke?
We don't know who will have a stroke, but we know several factors increase your risk. Some risk factors you can't change, others you can. The more risk factors you have, the greater your chance of having a stroke.
Risk factors you can't change:
Heredity (family history) and race
Prior stroke or heart attack
Risk factors you can treat and control:
High blood pressure
Carotid or other artery disease
Other heart disease
Transient ischemic attacks ("mini-strokes")
Certain blood disorders
High red blood cell count
Sickle cell disease (also called sickle cell anemia)
High blood cholesterol
Physical inactivity and obesity
Excessive alcohol intake
Some illegal drugs: Intravenous drug abuse and cocaine use
Other factors that may affect your risk of stroke:
Individual response to stress
Aging and menopause (see question 4 below)
Birth control pills: Women on the Pill who smoke or have high blood pressure or other risk factors are at higher risk of stroke.
Remember the three "R's" for life: Reduce, Recognize and Respond!
Decrease your blood pressure (if it's too high).
Reduce high levels of blood cholesterol.
Control or delay the onset of diabetes.
Reduce excess weight or maintain a healthy weight.
Moderate use of alcohol.
Recognize the warning signs of stroke. Offer information to your doctor, nurse or other healthcare provider about any new symptoms or changes in how you feel.
Respond to warning signs of a stroke. If you notice one or more of these signs, get emergency medical help immediately. New treatments that break up blood clots can reduce the damage to your brain if given within three hours of the onset of symptoms. Every minute counts!
3. What are the warning signs of heart disease and stroke?
Some heart attacks are sudden and intense, but most start slowly, with mild pain or discomfort. Here are some of the signs that can mean a heart attack is happening.
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath. This feeling often comes along with chest discomfort. But it can occur before the chest discomfort.
Other signs. These may include breaking out in a cold sweat, nausea or lightheadedness.
If you or someone youre with has chest discomfort, especially with one or more of the other signs, dont wait longer than five minutes before calling for help. Call 9-1-1. Get to a hospital right away. (Calling 9-1-1 is almost always the fastest way to get lifesaving treatment.)
If youre the one having symptoms, and you cant access emergency medical services (EMS), have someone drive you to the hospital right away. Dont drive yourself, unless you have absolutely no other option.
The warning signs of stroke are
Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
Sudden confusion, trouble speaking or understanding.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, loss of balance or coordination.
Sudden, severe headache with no known cause.
Not all the warning signs occur in every stroke. Dont ignore signs of stroke, even if they go away! If you or someone with you has one or more stroke symptoms that last more than a few minutes, dont delay! Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance (ideally with advanced life support) can quickly be sent for you.
4. What should I know about the effects of menopause on my health?
Compared to men, many women before the age of menopause seem to be partly protected from coronary heart disease, heart attack and stroke. As women age, their risk of heart disease and stroke begins to rise and keeps rising. The risk appears to rise more quickly if early menopause is induced by surgical removal of the uterus and ovaries than if it occurs naturally.
The reasons for the lower incidence of coronary heart disease and stroke in younger women aren't clear. The loss of natural estrogen as women age may contribute to the higher risk of heart disease after menopause. However, in light of recent results from clinical trials, the American Heart Association does not advise women to take postmenopausal hormone therapy (PHT, formerly called hormone replacement therapy or HRT) to reduce the risk of coronary heart disease or stroke.
If youve gone through menopause or had your ovaries removed, you may be taking or considering taking estrogen or estrogen plus progestin. Many people have been confused and alarmed by the news about the Women's Health Initiative (WHI), which investigated one form of estrogen plus progestin. To help you understand what the results of this study mean, see Estrogen and Cardiovascular Diseases in Women. Before you make any decisions about PHT, though, its very important to consult your physician.
5. Do I need to lose or gain weight for my health?
Obesity is a risk factor for heart disease and stroke. It also influences blood pressure, blood cholesterol and triglyceride levels and makes diabetes more likely to develop.
You can often help lower your heart disease and stroke risk by losing 10 to 20 pounds! But beware of fad diets, programs and products that promise rapid weight loss. Work with your doctor or a registered dietitian to set up a sensible program of eating and physical activity that will help you reach and maintain a healthier weight.
The AHA follows the body mass index (BMI) guidelines of the National Heart, Lung, and Blood Institute. (See Body Composition Tests.) If underweight, you should eat a balanced diet low in saturated fat, cholesterol and sodium. You can add calories from the breads, cereals, pasta and starchy vegetables food group, and the fruits and vegetables food group, to maintain a healthy weight for your height and build.
6. What is a healthful eating plan for me?
Better food habits can help you reduce one of the major risk factors for heart attack -- high blood cholesterol. This eating plan from the American Heart Association describes the latest advice of medical and nutrition experts. The best way to help lower your blood cholesterol level is to eat less saturated fat and cholesterol and control your weight. The eating plan is based on these AHA dietary guidelines:
Eat a variety of fruits and vegetables. Choose 5 or more servings per day.
Eat a variety of grain products, including whole grains. Choose 6 or more servings per day.
Eat fish at least twice a week, particularly fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna and salmon.
Include fat-free and low-fat milk products, legumes (beans), skinless poultry and lean meats.
Choose fats and oils with 2 grams or less saturated fat per tablespoon, such as liquid and tub margarines, canola, olive, corn, safflower and soybean oils.
Balance the number of calories you eat with the number you use each day to maintain your best weight. Walk or do other physical activities for at least 30 minutes on most or all days. To lose weight, do enough activity to use up more calories than you eat every day.
Limit your intake of foods high in calories or low in nutrition. This includes foods with a lot of added sugar like soft drinks and candy.
Limit foods high in saturated fat, trans fat and/or cholesterol, such as full-fat milk products, fatty meats, tropical oils and partially hydrogenated vegetable oils. Egg yolks are high in cholesterol. Instead choose foods low in saturated fat, trans fat and cholesterol from the first five points above. (Trans fat comes from adding hydrogen to vegetable oil, which partially hydrogenates it. It also exists naturally in some foods such as meat and milk. This fat type tends to increase blood cholesterol.)
Eat less than 6 grams of salt (sodium chloride) per day. Thats equal to about 1 teaspoon of salt, or a daily sodium intake of less than 2,400 mg.
If you drink alcohol, have no more than one drink per day if youre a woman or two per day if youre a man. (One drink means it has no more than 1/2 ounce of pure alcohol.)
This is an easy-to-follow guide to delicious eating -- and you dont have to give up your favorite foods. Every meal doesnt have to meet all the guidelines. Its important to apply the guidelines to your overall eating pattern over a period of several days.
When selecting foods, it's important to remember the amount of total fat, saturated fat, trans fat, cholesterol and sodium these foods may add to your daily menu. Choose foods low in saturated fat, trans fat, cholesterol and sodium. Reading labels and ingredient statements to discover what is contained in a product.
Each of the basic food groups supplies a different combination of nutrients, vitamins and minerals. Let caloric needs and a healthy appetite be your guide. But remember, variety is the key to good nutrition. The basic food groups and recommended servings are these:
Lean meat, fish and skinless poultry
Up to 6 oz. (cooked) per day; at least 2 servings of baked or grilled fish (especially fatty fish) each week
One large, whole egg has about 213 mg of cholesterol, which is 71% of the daily limit of 300 mg. If you eat a whole egg, try to avoid or limit other sources of dietary cholesterol on that day, such as meats, poultry and full-fat milk products.
Egg whites have no fat and no cholesterol.
Vegetables and fruits
5 or more per day
Fat-free milk and low-fat dairy products
2-4 per day
Breads, cereals, pasta and starchy vegetables
6 or more per day
Fats, oils, nuts and sweets