Pink Prescriptions - February 2023

Take Heart: Heart Disease is the No. 1 Killer of Women

February 2023 Issue — Pink Prescriptions
Take Heart: Heart Disease is the No. 1 Killer of Women

Matters of the heart are serious, especially when it comes to heart disease—the most serious disease today for women of all ages to pay close attention. In all its elements, more than any other female medical condition, heart disease is No. 1, and in this case, that’s not a good thing. It’s the No. 1 cause of stroke, disability and death in both men and women. Once thought to be only a concern for men, women need to take heart when it comes to their heart health.

Is your waist size creeping up? Are you eating more healthy foods than processed foods on a daily basis? Is your sweet tooth out of control? Is your body communicating any signs or symptoms? Are you paying attention? These Pink Prescriptions’ heart healthy answers to our questions, provided by our local panel of neuro and cardiology experts, are the facts. Please read on, and then, tear these two pages out to post to your corkboards and refrigerators as life-saving, heart reminders.

PinkRx0223 Sharp
Jay M. Kalan, MD | Hilton Head Heart, an affiliate of

Hilton Head Regional Physician Network

Heart disease is the leading cause of death for women in the U.S. While that fact is sobering, women can be proactive about their heart health. What are the important “numbers” I should be hitting to have Heart-Healthy stats?
Heart Disease is the leading cause of death for women in the United States. Heart Disease is caused by atherosclerotic plaque buildup in the arteries to your heart, and most strokes by the buildup of plaque in the arteries to your brain. The following risk factors, along with tobacco use, are all modifiable. You can be proactive about your health and actively lower your future risk. Whether by natural methods including diet and exercise, or with medications, if modified, each will lower your risk of a future heart attack or stroke.

The important “numbers” or goals to aim for include:
• Blood Pressure: Systolic BP under 130, and Diastolic BP under 80. These are the newest recommendations by the AHA, the first change in over 40 years.

• Cholesterol: Total Cholesterol under 200, with LDL (Bad cholesterol or Lousy) under 100, HDL (Good cholesterol or Happy) over 40, and Triglycerides under 150.

• Blood Sugar (Glucose): Fasting blood sugar (FBS) under 100 is normal. FBS 100–125 suggests pre-diabetes. FBS over 125 suggests diabetes mellitus.

• Body Weight: Most often measured as BMI (Body Mass Index). Calculated at your weight divided by the square of your height, healthy BMI for women is 18.5 to 24.9. Overweight is a BMI over 30. Though not perfect for all body types, it is a good guide. BMI tables are very easy to find on the Internet.

• Waist Size: If most of your fat is around your waist (rather than hips or other sites), this Increases your risk for heart disease and Type 2 Diabetes Mellitus. For middle aged women, waist measurement below 32 inches is low risk, above 35 inches Increases your risk of early death by 30%.

Jay M. Kalan, MD has been an Interventional and General Cardiologist in the community since 2000, and he is currently practicing at Hilton Head Heart. Born and raised in New York, he began practicing in Northern Virginia, but has enjoyed being in the Lowcountry over the past 23 years.


PinkRx0223 SharpTara Kay, PA-C | Beaufort Memorial Heart Specialists

Sometimes I feel like my heart is fluttering or beating too fast. Should I be concerned?
Occasional, brief “fluttering” is most often harmless. However, more persistent symptoms certainly could be a sign of an abnormal or irregular heart rhythm. Taking note of the duration, frequency, along with any specific triggers related to these symptoms can be helpful in determining whether there is cause for concern. Your provider can offer further testing such as an electrocardiogram (EKG) and/or a heart monitor that can record your heart rate and rhythm for a more extended time period to identify any arrhythmias (abnormal heart rhythms).
A few common triggers include caffeine, alcohol intake, sleep disturbances, dehydration, and stress/anxiety. Addressing these underlying lifestyle factors is always a good place to start if you are experiencing these symptoms.

What is the best way to prevent heart disease?

By consistently making healthy lifestyle choices, the best way to prevent heart disease is as follows:
• Maintain a healthy weight
• Follow a balanced, Mediterranean style diet
• Abstain from smoking • Keep up with routine health screenings for early detection
• Stay active and exercise regularly (ideally 30-60 minutes of aerobic activity daily)

Tara Kay, PA-C, is a board-certified physician assistant with Beaufort Memorial heart specialists in Beaufort.

PinkRx0223 Sharp
Paul Mazzeo, MD | Beaufort Memorial Hospital

What is a stroke?
Stroke is a loss of blood flow to an area of the brain due to blood vessel damage that causes neurologic dysfunction (e.g. paralysis). About 85% of strokes are due to arterial occlusion and 15% are due to arterial rupture with hemorrhage. The portion of the brain that is deprived of blood and oxygen, causing brain cells to die, determines the deficits of the stroke.

Common causes/risk factors include: high blood pressure, diabetes, high cholesterol, smoking, abdominal obesity, and atrial fibrillation. It’s important to remember that time is of the essence when it comes to limiting brain injury from a stroke. A stroke usually occurs when there is a blockage of blood and oxygen to the brain, which can kill or damage brain cells, so receiving treatment quickly can mean the difference between life and death, or between life-long disability and recovery.

What are the symptoms of a stroke—do they differ in women?
Women have more strokes than men, but the symptoms of stroke are the same. If you think someone might be having a stroke, “FAST” is the mnemonic that is easiest for people to remember.

Look for these symptoms:
• Facial drooping on one side when smiling
• Arm drifts downward when held in front of you
• Speech is slurred or nonsensical
• Time to call 911 when these signs are present.

Other symptoms of stroke may include a sudden loss of vision in one eye, sudden onset of severe headache (like someone flipping on a light switch) and staggering gait due to sudden imbalance or paralysis of a leg.

Dr. Paul Mazzeo is a board-certified neurologist with Beaufort Memorial Hospital and medical director of its Memory Center. Also certified in headache medicine, behavioral neurology and neuropsychiatry, Dr. Mazzeo practices with Coastal Neurology in Okatie and Beaufort.

PinkRx0223 SharpDr. Stuart Smalheiser | Beaufort Memorial Heart Specialists

What is a heart attack?

A heart attack is an event where the heart muscle is deprived of oxygen, which is often due to a blockage or narrowing in an artery that delivers blood to the muscle of the heart. These events can develop over minutes to hours if the artery is completely blocked due to the rupture of plaque in the artery, or even months to years as plaque in the artery progressively narrows the artery.

What are the warning signs or symptoms
of heart attack in women?

Classically patients with blockages or narrowing of a heart artery will have symptoms of angina—discomfort in their chest that may or may not radiate to their left arm or jaw, worsening with exertion and improved with rest.

Women and minorities, in particular, are more likely to experience less typical symptoms of a heart attacks such as: cold sweats, anxiety, fatigue, dizziness, or lightheadedness. It is not uncommon for women and minorities to not experience that “elephant-on-the-chest” pain that many of us have come to associate with heart attacks.

In addition, as patients age, they more commonly experience shortness of breath with exertion, rather than discomfort in their chest. Not every patient presents like a medical textbook would anticipate. Some symptoms may be subtle, so it’s important if you think you may be experiencing a heart attack to seek immediate medical attention so your signs and symptoms can be interpreted by an experienced medical provider.

Board-certified in general, nuclear, and interventional cardiology, Dr. Stuart Smalheiser is a cardiologist with Beaufort Memorial Heart Specialists. He sees patients in Beaufort and Hampton/Varnville.

PinkRx0223 SharpJ. Calvin Sharp, Jr., MD | Hilton Head Heart,

an affiliate of Hilton Head Regional Physician Network

Does smoking increase your risk for heart disease?
If I quit smoking, does that help

my heart get better, or is the damage done?

Coronary Artery Disease remains the leading cause of death for both women and men in the United States, and tobacco use is one of the most preventable risk factors for heart disease. The use of any form of tobacco results in blood vessel irritation that can lead to a buildup of cholesterol plaques in the blood vessels. This buildup can ultimately result in an increased risk for a heart attack. Tobacco use can also lead to an increased risk for underlying lung disease which can inhibit oxygen intake. The decrease in oxygen can in turn increase the risk of heart disease, as well as limit the management of coronary artery disease and congestive heart failure. Tobacco cessation is always highly encouraged. While stopping tobacco use cannot repair any damage that has been done, it can limit further progression of heart disease.

What is congestive heart failure? Is there anything
I can do to prevent getting congestive heart failure?

Congestive Heart Failure (CHF) is a clinical situation in which the heart is unable to keep up with the demand of the body to supply oxygen as needed. CHF is most often caused by underlying conditions such as high blood pressure, obesity, sleep apnea, and tobacco use. Congestive Heart Failure is a manageable chronic condition, but it is not curable.

There are two types of Congestive Heart Failure: Systolic and Diastolic. Systolic CHF is a condition in which the heart’s pumping, or squeezing ability, is inhibited, limiting blood flow throughout the body. Common causes of Systolic CHF include coronary artery disease and heart attack resulting in heart damage. Diastolic CHF is a condition in which the heart muscle is unable to relax, resulting in the heart’s inability to fill up with blood as it should. Diastolic CHF can be caused by factors such as viral infections, valve function, uncontrolled hypertension, and uncontrolled diabetes among others. Both types of Congestive Heart Failure result in the heart’s inability to supply the body with the oxygen it demands, which can lead to a backup of fluid in the lungs causing symptoms such as swelling and shortness of breath (on exertion or at rest). Treatments for Congestive Heart Failure include reversing of the underlying conditions such as cardiac bypass surgery or stent placement to open up any blocked blood vessels to improve heart function. Additionally, management and control of the aforementioned conditions (high blood pressure, obesity, sleep apnea, tobacco use, etc.) can also lead to reduced symptoms associated with Congestive Heart Failure.

J. Calvin Sharp, Jr., MD is a General/Interventional Cardiologist with Hilton Head Heart (locations in Okatie and Hilton Head) and performs interventional procedures at Hilton Head Hospital. He has been practicing in the Lowcountry since 2000.

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