**National Wear Red Day**

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A National Awareness Campaign for Women about Heart Disease

*The Heart Truth is that heart disease is the #1 killer of women* and
that *o*ne in four American women dies of heart disease. Most women fail
to make the connection between risk factors---such as high blood
pressure and high cholesterol---and their personal risk of developing
heart disease. Additionally, women often experience symptoms which might
not be attributed to heart disease. An myocardial infarction (MI) in
women occurs 43% of the time without chest pain. The most common
nonspecific acute symptoms that women experience are shortness of breath
(58%), weakness (55%), and fatigue (43%) (*Circulation*
2003;108:2619-23). Others studies show that among MI patients without
chest pain, nausea and vomiting occurred in 41% of women but in only 14%
of men; diaphoresis (sweating) in 22% of women vs. 11% of men, dyspnea
in 48% of women vs. 35% of men; and arm/shoulder pain in 19% of women
vs. 8% of men. Younger women have higher rates of death from acute
myocardial infarction than comparably aged men. Furthermore, women take
longer to seek emergency care with heart attack symptoms than men. To
learn more about *The Heart Truth* go to
[www.nhlbi.nih.gov/health/hearttruth](http://www.nhlbi.nih.gov/health/hearttruth)
(The National Heart, Lung, and Blood Institute (NHLBI)*.*

Challenges remain to get women to take heart disease seriously and
personally. To bring attention to this important issue, consider
promoting [National Wear Red
Day](http://www.nhlbi.nih.gov/health/hearttruth/wrd/) on February 1,
2008.

Several excellent power point presentations on heart disease can be
found on MED's Travax web site in the following folder: Medical Library/
Additional Educational Resources/ Power Point Presentations.

#### Risk factors for Coronary Heart Disease

> \* Elevated Cholesterol \* Cigarette Smoking \* Obesity
>
> \* Hypertension \* Diabetes \* Family History of Heart Disease \*
> Sedentary Lifestyle

Furthermore the metabolic syndrome increases one's risk of death from
coronary artery disease by threefold. The metabolic syndrome is defined
has having three of these five risk factors:

-   Serum Triglycerides [\>]{.underline}150mg/dl

-   Serum HLD \<40mg/dl (men), \< 50mg/dl (women)

-   Blood Pressure[\>]{.underline}130/85

-   Plasma Fasting Glucose [\>]{.underline} 100

-   Waist girth \> 40 inches in men and \>35 inches in women.

The Cold Update -- Back to Basics

Over-the-counter (OTC) cold supplements for prevention of a cold
(Vitamin C, Zinc, and Echinacea) and cold medicines themselves offer
questionable benefit and may cause harm. This is discussed in the
December 2007 Harvard Health Letter which can be accessed at
[www.health.harvard.edu/health](http://www.health.harvard.edu/health).
(Recall the October 2007 FDA recommendation to ban cold medicines for
children under six.) Best practice for prevention of infection is
regular *handwashing* as cold viruses are spread by way of the hands -
only a small percentage of the viruses are contained in sneeze and cough
particles. Regular moderate exercise boosts the immune system and may
prevent colds though exercising very hard may temporarily lower the
immunological guard. Vitamin D may also help prevent colds by boosting
the immune system. (The safe upper limit dose for vitamin D is 2,000
International Units.) If presented with a cold, get extra sleep and
rest, hydrate well, steam to decongest, and nose blow gently as forceful
blowing can drive the nasal fluids into the sinus cavities and possibly
result in further infection of the sinuses. Back to Grandma's basics!

**Pearls for Practice**

**\-\--** From [www.medscape.com](http://www.medscape.com/) we are
reminded that The Modified MyPyramid for Older Adults specifically
emphasizes nutrient-rich and fiber-rich foods within each group and
recommends food sources of nutrients rather than supplements. These
include whole grains; variety within the grains group; variety and
nutrient density; vegetables and fruits that are easy to prepare (eg,
frozen foods); low-fat and nonfat dairy products including reduced
lactose alternatives in the milk group; low saturated fat and trans fat
choices in the oils group; and low saturated fat and vegetable options
in the meat and beans group. See
[www.mypyramid.gov](http://www.mypyramid.gov/) for more information.

\-\-- Practical Strategies for Motivating Physical Activity

-   Establish doable goals.

-   Make it easier -- not harder -- and, certainly, as enjoyable as
    possible.

-   Suggest multiple approaches.

**\-\--** The following illustrations of portions and other guidance are
from "Small Steps and Practical Approaches to the Treatment of Obesity"
<http://www.medscape.com/viewprogram/8204_pnt>

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