Women's Hearts

Living Well in Myanmar

Protecting Women’s Hearts

Every six months or so, I write an article about the importance of lifestyle in preventing disease. This is because medical interventions are typically more effective in preventing the onset of illness than treating illness itself. When it comes to long term health, a patient’s decision to change one of their day-to-day habits is better than any drug.

Medical research continues to support this premise. What if I told you that you, your mother, or your sister could reduce the odds of heart disease by 90 percent by following six recommendations for healthy-living? As a doctor, if I diagnose heart disease I certainly do not have any pills that can reduce the chance of a bad outcome by 90pc.

A study published this month in the Journal of the American College of Cardiology followed the habits of 90,000 nurses between 1991 and 2011. Researchers looked at six lifestyle factors:

·      Not smoking

·      Exercising 2.5 hours per week

·      Maintaining a normal weight

·      Watching less than seven hours of television per week

·      Eating a healthy diet

·      Drinking no more than around one alcoholic drink per day

After 20 years, the researchers found that coronary vascular disease – the most common heart problem – was absent among almost all women adhering to all six factors. Furthermore even women with established cardiac risk factors such as hypertension, high cholesterol or diabetes were found to be less likely to develop heart disease if they adhered to these healthy-lifestyle guidelines.

This study joins a growing family of analyses (some of which I’ve covered previously in Living Well in Myanmar) that teach us how lifestyle influences all of the world’s major longevity threats. The fact that these studies on prevention are increasingly showing up in the major medical journals is illustrative of how health promotion is becoming one of the leading disciplines in medical thinking. Now that we’re becoming more certain of what people need to do to combat the biggest killers, the next frontier of research is learning how to get people exercising, not smoking and eating well. 

The medical establishment has historically shown sex-bias in its notion that heart disease more commonly threatens the health of men. The typical heart attack victim is imagined to be a 68-year-old male who is overweight and smokes, and rushes into the emergency room clutching his chest and having difficulty breathing. As a result, many doctors and their female patients are not as assertive in looking out for the risk factors and symptoms of heart disease. The fact is that heart disease is also the number one cause of death in women around the world and, therefore, studies such as this one that provide research and recommendations specifically for women are important.

In Myanmar we face the dreaded “double burden” of disease. This means that while we continue to struggle with the big infectious diseases such as malaria, TB, and HIV, we are simultaneously seeing an absolute rise in noncommunicable diseases that are driven by the lifestyle factors described above. Data published by the World Health Organization in 2014 estimated that 30pc of women in Myanmar are overweight. So, primary care doctors and public health officials face the double challenge of disease treatment and lifestyle promotion in a population that is largely experiencing both for the first time.

gelsdorfMD@gmail.com  © Christoph Gelsdorf 2013