Your questions, answered.

We have gathered a list of the most common questions women ask regarding topics that affect your overall health and well-being.

According to the Heart and Stroke Foundation more women die from heart disease and stroke in Canada each year than all forms of cancer combined.(1) There are different risk factors associated with heart disease, some which you can control and others which you cannot. The more risk factors a person has, the greater their chance for developing heart disease. However you can take healthy steps today to reduce your risk.

Uncontrollable Risk Factors:

Risk Factors You Can Control:

High blood pressure raises the risk of having a heart attack or stroke by as much as four to five times!(4)


High blood pressure is diagnosed when doing a blood pressure measurement and the reading is 140 (or higher) systolic, and 90 (or higher) diastolic based on the average of two or more readings on two separate occasions.


People with diabetes can be diagnosed with high blood pressure if the reading is 130/80 mm Hg or higher.(5)


When your blood pressure goes up, the heart has to work harder to pump the blood though the body. This creates stress on the heart muscle, and over time can lead to a heart attack. High blood pressure also puts stress on blood vessel walls; increasing the chance of them being damaged, clogged, or rupturing. (6)

Keep your blood pressure in check by:

High cholesterol can result in the build up of plaque inside the blood vessels making it harder for the blood to flow through. This can result in a heart attack, stroke, or higher blood pressure.

Having too much cholesterol does not produce any symptoms; the only way to know if you have high cholesterol is through a blood test.(10, 11)

Keep your cholesterol in check by:

Women who are 30% over the limit range for their healthy body weight are two to three times more likely to develop heart disease, according to the Heart and Stroke Foundation.(2)

Carrying extra weight on your body (especially around the waist area) can lead to having high cholesterol levels, high blood pressure, and an increased risk for diabetes and heart disease.(13)

Maintain healthy weight by:

According to the American Heart Association heart disease is twice as likely to develop in women who do not participate in physical activities compared to women who are active.(14)

Remember that your heart is a muscle which needs regular physical exercise to stay healthy.

Increase physical activity by:

Smoking is a major cause of heart disease in women; it puts added strain on the heart causing blood vessels to constrict and become narrow. This increases the risk of a heart attack. (2,3)

Cut back and quit smoking by:

Women often may experience stress from taking on multiple responsibilities. In some women it has been shown that increased stress raises blood pressure and cholesterol levels putting you at increased risk for heart disease.(18)

For simple tips to reduce stress please visit the Heart and Stroke website at: http://www.heartandstroke.sk.ca/ and in the upper right hand corner you will find a search box, simply type in “tips to reduce stress”.

Created by Mia Kubrak for The Women’s Midlife Health Centre of Saskatchewan Nursing Education Program of Saskatchewan February 2010

1 Heart and Stroke Foundation (2010). A perfect storm of heart disease looming on our horizon. Retrieved January 26, 2010 from http://www.heartandstroke.com/atf/ cf/%7B99452D8B-E7F1-4BD6-A57D-B136CE6C95BF%7D/Jan23_EN_ReportCard.pdf

2 Heart and Stroke Foundation (2009). HeartSmart women: A guide to living with and preventing heart disease and stroke. Retrieved January 29,2010 from http://www.heartandstroke.com/atf/cf/%7B99452D8B-E7F1-4BD6-A57D-B136CE6C95BF%7D/WOMEN- HEART-DISEASE-STROKE-EN.PDF

3 Heart and Stroke Foundation (2003).The growing burden of heart disease and stroke. Retrieved February 1, 2010 from http://www.cvdinfobase.ca/cvdbook/CVD_En03.pdf

4 Price, J.A.D. (2004) Management and prevention of cardiovascular disease in women. Nursing Clinics of North America, 39: p.873-884.

5 Canadian Hypertension Education Program (2009). Hypertension in diabetes. Retrieved January 25, 2010 from http://hypertension.ca/bpc/wp-content/up- loads/2009/03/final2009recommendations-march-12.pdf

6 Public Health Agency of Canada (2009) Are Women at Risk for Heart Disease? Retrieved January 27, 2010 from http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/women- femmes_01-eng.php

7 Canadian Hypertension Education Program (2009). Hypertension in diabetes. Retrieved January 25, 2010 from http://hypertension.ca/bpc/wp-content/up- loads/2009/03/final2009recommendations-march-12.pdf

8 Dietitians of Canada (2009). Shake the salt habit with tips from Dietitians of Canada. Retrieved February 1, 2010 from http://www.dietitians.ca/resources/resourcesearch.asp?fn=view&contentid=14081&resource_resourcetype=News Release&resource_language=English

9 Heart and Stroke (2008). Lifestyle changes to manage your high blood pressure. Retrieved January 25, 2010 from http://www.heartandstroke.sk.ca/site/c.inKMILNlEmG/ b.4119671/k.8FE1/Heart_Disease__Lifestyle_changes_to_manage_your_high_blood_pressure.htm

10 Heart and Stroke Foundation (2008). What is blood cholesterol? Retrieved January 20, 2010 from http://www.heartandstroke.sk.ca/site/c.inKMILNlEmG/b.3657477/ k.5CF4/High_blood_cholesterol.htm?src=home

11 American Heart Association (2008). What is Cholesterol? Retrieved January 22, 2010 from http://www.americanheart.org/presenter.jhtml?identifier=3046103

12 Dietitians of Canada (2008). What is ‘good’ and ‘bad’ cholesterol?. Retrieved January 21, 2010 from http://www.dietitians.ca/resources/resourcesresearch.asp?fn=view&c ontentid=1314&resource_resourcetype=FAQ(Frequentlyaskedquestions)&resource_language=English

13 Canadian Medical Association. (2005). Canadian guidelines for body weight classification in adults: Application in clinical practice to screen for overweight and obesity and to assess disease risk Canadian Medical Association Journal, 172 (8), p. 995-998.

14 American Heart Association (2010). Women, Heart Disease and Stroke. Retrieved January 29, 2010 from http://www.americanheart.org/presenter.jhtml?identifier=4786

15 Public Health Agency of Canada (2007). Canada’s Physical Activity Guide. Retrieved February 1, 2010 from http://www.phac-aspc.gc.ca/pau-uap/fitness/pdf/guideEng.pdf

16 Heart and Stroke Foundation (2009). Healthy Waists. Retrieved January 18, 2010 from http://www.heartandstroke.sk.ca/site/c.inKMILNlEmG/b.4043499/k.88BC/ Healthy_Waists.htm?src=home

17 Health Canada. (2003). Canadian Guidelines for Body Weight Classification in Adults. Retrieved January 20, 2010 from www.hc-sc.gc.ca/fn-an/nutrition/weights-poids/guide-ld-adult/index-eng.php

18 Public Health Agency of Canada (2009). Women with heart disease: Living a good life. Retrieved January 27, 2010 from http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/women-femmes_04-eng.php

Every time your heart beats it pushes blood carrying oxygen and nutrients throughout the body. As the blood travel it puts pressure on the arteries. This is known as blood pressure.

Blood pressure changes through out the day depending on physical activity, rest, emotions, and whether you are standing, sitting, or lying down.(1)

High blood pressure also known as hypertension is the result of having too much pressure on your arteries.(2,3) High blood pressure is a silent disease that often shows no symptoms; an estimated 43% of Canadians currently have high blood pressure and not even know it.(4)

The only way to know if you have high blood pressure is to have your healthcare provider check for it. It is recommended by the Heart and Stroke foundation that healthy individuals should have their blood pressure checked once every two years by health care professional.

Blood pressure is always recorded in two numbers such as 120/80 mmHg (millimeters of mercury).(5)

High blood pressure or hypertension is diagnosed when the blood pressure reading is 140 (or higher) systolic, and 90 (or higher) diastolic based on the average of two or more readings on two separate occasions.(7) However, a person with diabetes can be diagnosed with high blood pressure if the blood pressure reading is 130/80 mm Hg or higher.(2)

Keep your blood pressure within the normal range by following these recommendations from Heart and Stroke Foundation of Canada and the Canadian Hypertension Education Program. Making lifestyle changes is the best way to control blood pressure.

Created by Mia Kubrak for The Women’s Midlife Health Program
Nursing Education Program of Saskatchewan
February 2010

1 Heart and Stroke Foundation (2007). Get your blood pressure under control. Retrieved January 27, 2010 from http://www.heartandstroke.com/atf/ cf/%7B99452D8B-E7F1-4BD6-A57D-B136CE6C95BF%7D/BP_Brochure_ENG.pdf

2 Canadian Hypertension Education Program (2009). Hypertension in diabetes. Retrieved January 25, 2010 from http://hypertension.ca/bpc/wp- content/uploads/2009/03/final2009recommendations-march-12.pdf

3 American Heart Association (2009). Understanding Blood Pressure. Retrieved January 29, 2010 from http://www.americanheartassociation.com/ presenter.jhtml?identifier=2112

4 Heart and Stroke (2009). What’s killing us? Retrieved January 26, 2010 from http://www.heartandstroke.sk.ca/atf/cf/%7B6C89E785-1760-4813-9070 FF7CFFCE319D%7D/HSFS%20Annual%20Report%202008_2009.pdf

5 Public Health Agency of Canada (2009). Diagnosing Hypertension. Retrieved January 29,2010 from http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/ hypertension_diagnosing-hypertension_diagnostiquer-eng.php

6 American Heart Association (2010). Blood Pressure Levels. Retrieved January 25, 2010 from http://www.americanheart.org/presenter. jhtml?identifier=4450 (chart that’s white and teal).

7 Blood Pressure Canada (2007). Measurement. Retrieved January 27,2010 from http://hypertension.ca/bpc/blood-pressure-information/measure- ments/

8 Heart and Stroke (2008). Lifestyle changes to manage your high blood pressure. Retrieved January 25, 2010 from http://www.heartandstroke.sk.ca/ site/c.inKMILNlEmG/b.4119671/k.8FE1/Heart_Disease__Lifestyle_changes_to_manage_your_high_blood_pressure.htm
9 American Heart Association (2010).Factors that contribute to high blood pressure. Retrieved January 25, 2010 from http://www.americanheart.org/ presenter.jhtml?identifier=4650

10 Heart and Stroke (2008). Lifestyle changes to manage your high blood pressure. Retrieved January 25, 2010 from http://www.heartandstroke.sk.ca/ site/c.inKMILNlEmG/b.4119671/k.8FE1/Heart_Disease__Lifestyle_changes_to_manage_your_high_blood_pressure.htm
11 Public Health Agency of Canada (2009). Effective ways for reducing high blood pressure. Retrieved January 26,2010 from http://www.phac-aspc. gc.ca/cd-mc/cvd-mcv/hbp_reduce-ha_reduire-eng.php

12 Blood Pressure Canada (2007). Lifestyle chioces. Retrieved January 27,2010 from http://hypertension.ca/bpc/blood-pressure-information/lifestyle- choices/

13 Dietitians of Canada (2009). Shake the salt habit with tips from Dietitians of Canada. Retrieved February 1, 2010 from http://www.dietitians.ca/ resources/resourcesearch.asp?fn=view&contentid=14081

Cholesterol is essential to help the body to create and maintain healthy cells and some hormones. About 80% of cholesterol is made by the liver, and the other 20 % comes from the food you eat. However, too much cholesterol can lead to the build up of plaque inside of the blood vessels; making it harder for the blood to flow through. This puts you at an increased risk for high blood pressure and having a heart attack or stroke.

In most cases having too much cholesterol does not produce any symptoms; the only way to know if you have high cholesterol is through
a blood test. Getting your cholesterol checked provides information about your risk for developing heart disease, and helps you make changes to your physical activity levels and eating habits.

Remember: you are not allowed any food, beverages, or medications approximately 9 to 12 hours before the test. This is in order to obtain more accurate results.(3)

According to the Dietitians of Canada, several factors can influence the levels of cholesterol in the body.

Factors include:

The blood test gives information about total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. In Canada the results are given in millimoles per liter (mmol/L).(4)

Canada’s Food Guide recommends that only 20-30% of your daily calories should come from fat. This is approximately:

Sometimes you can add extra fat into your diet without knowing it.  Did you know:

Dietitians of Canada recommend these healthy steps to reduce your risk of developing heart disease:

For more information on healthy eating and tips to reduce risk of heart disease, please visit:

Dietitians of Canada website
www.dietitians.ca

Heart and Stroke Foundation
www.heartandstroke.ca

1 Whitney E., Rolfes S.R. (2005). Understanding Nutrition (10th ed.). Wadsworth, Thomson.

2 American Heart Association (2008). What is Cholesterol? Retrieved January 22, 2010 from http://www.americanheart.org/presenter.jhtml?identifier=3046103

3 Heart and Stroke Foundation (2008). What is blood cholesterol? Retrieved January 20, 2010 from www.heartandstroke.sk.ca/site/c.inKMILNlEmG/b.3657477/k.5CF4/High_blood_cholesterol.htm?src=home
4 American Heart Association (2009). What Your Cholesterol Levels Means. Retrieved January 22, 2010 from http://www.americanheart.org/presenter.jhtml?identifier=183#HDL
www.americanheart.org/presenter.jhtml?identifier=183#HDL

5 Heart and Stroke Foundation (2008). Living with Cholesterol. Retrieved January 21, 2010 from http://www.heartandstroke.sk.ca/site/c.inKMILNlEmG/b.4375123/k.FB88/Heart_Disease__Living_with_Cholesterol.ht

6 Dietitians of Canada (2008). What is ‘good’ and ‘bad’ cholesterol?. Retrieved January 21, 2010 from http://www.dietitians.ca/resourc- es/resourcesresearch.asp?fn=view&contentid=1314&resource_resourcetype=FAQ(Frequentlyasked questions)&resource_language=English

7 Heart and Stroke (2009). Insider: Prevention Edition. Retrieved January 21, 2010 from http://www.heartandstroke.sk.ca/atf/ cf/%7B6C89E785-1760-4813-9070-FF7CFFCE319D%7D/SK_prevention%20newsletter%20mar09.pdf

Metabolic syndrome is a group of risk factors that significantly raises a person’s chance for developing type 2 diabetes and heart disease. Abdominal obesity has been linked as the warning sign for metabolic syndrome.

Diagnosis is made when an individual has 3 or more of the following risk factors:

Visit the Heart and Stroke website at www.heartandstroke.ca and check out the Healthy Weight Action PlanTM. A step-by-step program devel- oped by the Heart and Stroke Foundation to offer support, information, and tips on achieving healthy eating habits and a healthy weight.

Also visit the In Motion website at www.in-motion.ca to find activities and exercise programs happening in your community. The complete In Motion guide is available online filled with samples of excersices, tips on healthy eating, and keeping active.

For more information on tips on healthy eating and ways to reduce your cholesterol be sure to visit the Dietitians of Canada website: www. dietitians.ca and the Heart and Stroke Foundation at www.heartandstroke.ca.

Created by Mia Kubrak for The Women’s Midlife Health Program
Nursing Education Program of Saskatchewan
February 2010

1 National Heart, Lung, and Blood Institute (2010). “What causes metabolic syndrome? Retrieved February 8, 2010 from http://www. nhlbi.nih.gov/health/dci/Diseases/ms/ms_whatis.html

2 American Heart Association (2009). What is metabolic syndrome? Retrieved February 9, 2010 from www.americanheart.org/presenter.jhtml?identifier=3063528.

3 American Heart Association (2010). Metabolic syndrome. Retrieved February 9, 2010 from www.americanheart.org/presenter.jhtml?identifier=4756

4 Health Canada. (2003). Canadian Guidelines for Body Weight Classification in Adults. Retrieved February 8, 2010 from www.hc-sc. gc.ca/fn-an/nutrition/weights-poids/guide-ld-adult/index-eng.php

5 Grundy, S.M. (2004). Obesity, metabolic syndrome, and cardiovascular disease. The Journal of Clinical Endocrinology & Metabolism 89(6), p.2595–2600.

6 Dietitians of Canada (2008). What is ‘good’ and ‘bad’ cholesterol?. Retrieved January 21, 2010 from http://www.dietitians.ca/resources/resourcesresearch.asp?fn=view&contentid=1314&resource_resourcetype=FAQ(Frequentlyaskedquestions)&resour ce_language=English

7 Janssen, I., Heymsfield,S.B., Allison, D.B., Kotler, D.P., Ross, R. (2002). Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat. American Journal of Clinical Nutrition, 75, p. 683-688.

8 Blood Pressure Canada (2007). Lifestyle chioces. Retrieved January 27,2010 from http://hypertension.ca/bpc/blood-pressure- information/lifestyle-choices/

9 Public Health Agency of Canada (2009). Effective ways for reducing high blood pressure. Retrieved January 26,2010 from http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/hbp_reduce-ha_reduire-eng.php

Measuring the waist circumference can tell a person how much fat is located around their abdomen. Several studies have linked extra fat around the waist to an increased risk for developing metabolic syndrome, hypertension (high blood pressure), dyslipidaemia (high blood cholesterol), and type 2 diabetes.(2,3,4,5) This increases the risk for heart disease and stroke.
Measuring your waist circumference and calculating body mass index are two ways to spot your risk for developing health problems.

Items needed: measuring tape, pen or felt marker, mirror

Step 1: Remove any clothing, belts or accessories that may interfere with the measurement

Step 2: Using your hands and the tips of your fingers find the top of your hipbones. Either by moving down the sides of your body along the same line as your underarms or by finding the hip bones at the front of the body and moving upwards and back towards the sides of your body.

Step 3: Mark these areas with a pen or felt marker.

Step 4: Line up the measuring tape with the previously marked points on your hipbones. (Make sure the tape is parallel and not twisted).

Step 5: Take 2 normal breaths, and on the second breath exhale out; tighten the tape around your waist Remember: The tape should fit comfortably around the waist without digging into the skin.

Step 6: Breathing normally, take the reading on the measuring tape.(3)

Be sure to visit: www.heartandstroke.ca/healthywaists to order one free measuring tape.

 

The Heart and Stroke Foundation has set guidelines as to what is appropriate for your gender and ethnicity. There are different cut off points for waist circumference between men and women. In women the cut off point is lower than in men; because women are at a higher risk for health problems than men at the same waist circumference.(3,7,8)

If you are close to or above the following cutoffs for your gender and ethnicity, you are at increased risk for developing health problems.

European/ Caucasion, Sub-Saharan Africans, Eastern Mediterranean, Middle Eastern
• male 102 cm (40 in.) / female 88cm (35 in.)

South Asian, Malaysian, Asian, Indian, Chinese, Japanese, Ethnic South and Central Americans
• male 90 cm (35 in.) / female 80 cm (32 in.)

The waist circumference measurements and BMI do not apply to pregnant or breastfeeding women or people under the age of 18 or over the age of 65.

Heart and Stroke Foundation (2010). Retrieved from: http://www.heartandstroke.sk.ca/site/c.inKMILNlEmG/b.4043499/k.88BC/ Healthy_Waists.htm

If you are a man with a waist circumference over 102cm (40 in) or a woman with a waist circumference over 88 cm (35 in) then you are at an increased risk of developing health problems such as high blood pressure, diabetes, and heart disease.

 

Metabolic syndrome is a combination of risk factors that increases a person’s risk of developing heart disease. Abdominal obesity is strongly linked with metabolic syndrome.(4)

Secondary Osteoporosis Risk Factors

Gastrointestinal disorders – conditions that prevent absorption of nutrients such as:

Body mass index or BMI is used to calculate the level of health risk associated with being underweight or over weight. It does not measure the amount of body fat.(1,7)

Calculating body mass index (BMI) involves taking your weight in kilograms (kg)/ and dividing it by your height in meters squared.(9)

An online BMI calculator is available through the Health Canada website at: www.hc-sc.gc.ca

BMI Value Category Level of Health Risk for Heart Disease
• Under 18.5: Underweight Increased Risk
• 18.5 – 24.9: Normal weight Least Risk
• 25.0 – 29.9: Overweight Increased risk
• 30 and over: Obese High risk

BMI is not appropriate to use with pregnant or lactating women, children under the age of 18, or adults over the age of 65. Also people with dense muscle mass may have a high BMI score, but little body fat (since muscle weighs more than fat).(7)

Created by Mia Kubrak for The Women’s Midlife Health Program
Nursing Education Program of Saskatchewan
January 2010

1 Canadian Medical Association. (2005). Canadian guidelines for body weight classification in adults: Application in clinical practice to screen for overweight and obesity and to assess disease risk Canadian Medical Association Journal, 172 (8), p. 995-998.

2 Janssen, I., Katzmarzyk, Ross, R.(2004). Waist circumference and not body mass index explains obesity related health risk. American Journal of Clinical Nutrition, 79, p. 378-384.

3 Heart and Stroke Foundation (2009). Healthy Waists. Retrieved January 18, 2010 from http://www.heartandstroke.sk.ca/site/c.inKMILNlEmG/b.4043499/k.88BC/ Healthy_Waists.htm?src=home

4 Grundy, S.M. (2004). Obesity, metabolic syndrome, and cardiovascular disease. The Journal of Clinical Endocrinology & Metabolism 89(6), p.2595–2600.

5 Koster, A,, Leitzmann, M.F., Schatzkin, A., Mouw, T., Adams, K.F., Hollenbeck, A.R., Harris, T.B. (2008). Waist circumference and mortality. American Journal of Epidemiology, 167, p.1465–75.

6 Heart and Stroke Foundation (2010). Waist not, weight not. Retrieved January 18, 2010 from http://www.heartandstroke.sk.ca/site/apps/nlnet/content2.aspx?c=inKM ILNlEmG&b=4286059&ct=7137769

7 Health Canada. (2003). Canadian Guidelines for Body Weight Classification in Adults. Retrieved January 20, 2010 from www.hc-sc.gc.ca/fn-an/nutrition/weights-poids/ guide-ld-adult/index-eng.php

8 Janssen, I., Heymsfield,S.B., Allison, D.B., Kotler, D.P., Ross, R. (2002). Body mass index and waist circumference independently contribute to the prediction of nonab- dominal, abdominal subcutaneous, and visceral fat. American Journal of Clinical Nutrition, 75, p. 683-688.

9 Whitney E., Rolfes S.R. (2005). Understanding Nutrition (10th ed.). Wadsworth, Thomson