Question:
Dear Dr. Dan,
Last month the FDA approved the “Plac Test”. It’s a blood test to help predict heart disease risk. How will this blood test be important? Specifically for women?
Once a woman finds out she’s at risk for cardiovascular disease, what steps do you recommend? What lifestyle changes can women make to reduce their risk? Can a woman’s hormones and estrogen level affect heart disease? Why do women and men experience heart disease differently, and why are these differences important to understand?
Answer:
One of the challenges in medicine is determining which person (patient) is at greater risk for developing a life threatening and preventable disease. The leading cause of death in both women and men is heart disease, caused by plaque in the arteries, which can lead to a heart attack or stroke (cardiovascular disease).
Traditionally, risk factors are identified and used as markers for future development of cardiovascular disease. Common risk factors include cholesterol level, age, high blood pressure, diabetes and smoking. The challenge is to find tests that may help identify patients at greater risk of heart attack and stroke, and those which have greater sensitivity than those we now commonly employ.
The PLAC TEST is a blood test that is available and approved for testing. It is another of many markers that reveals inflammation and risk of cardiovascular disease. The PLAC TEST marks inflammation in the body that is specific to arteries that have fat and cholesterol and inflammation. This test was recently identified as being sensitive to both women and men who are at greater risk for cardiac events (heart attack and stroke).
Women may benefit somewhat greater than men if identified by this test, because women have different symptoms than men, and these may be missed by the medical practitioners examining them. Earlier detection by a blood test may help in the treatment and prevention of heart and vascular disease. However, one cautionary note: At the present time the classic risk factors, if identified and treated, are still the major practice for treatment and prevention of cardiovascular disease.
Women after menopause or those with a strong family history of women having early heart disease, should start making lifestyle changes in their diet and in treatment of high blood pressure or diabetes. Doctors typically will advise these treatments and patients should take this advice seriously. Partial protection by one’s own hormones appears to be very helpful in women before menopause, but hormone replacement after menopause is no longer recommended for the prevention of heart disease.
A keen understanding by both women and men is crucial. Women may experience symptoms which traditionally have not been clear cut signs of cardiovascular disease when compared to men. Therefore prevention and detection is extremely important for females.
Diet is the cornerstone for prevention and treatment of heart disease. Less calories and fat in the diet is advised, as is stemming the habit of “over eating”. Reducing the consumption of animal products (red meat, chicken, pork, cheese and whole milk products) is also recommended. Some form of exercise, which may include walking or light exercise, is recommended for all who are physically able to move.
I recommend the American Heart and Stroke Association for more information.
Be well.
—Dr. Dan