Heart Disease - Prevention is better than cure

Dateline: 04/12/98

WEIGHT MANAGEMENT

Obesity is another risk factor for heart disease. Being obese increases the chances of developing hypertension, some types of cancer, bone and joint problems, diabetes and respiratory disorders as well.

Goals of Weight Control

The goal of primary prevention is to achieve and maintain desirable weight.

But what does "desirable" body weight mean ?

For this we need to understand a value called the body mass index (BMI). The BMI is measured as the body weight in kilograms, divided by body surface area (BSA) in square meters. An ideal BMI value is 21 - 25 kg/sq.meter BSA.

Increasingly, physicians are measuring weight, height, BMI and waist-to-hip ratios at each patient visit as part of routine evaluation. The waist-to-hip ratio is another good index of fitness, and a normal value for men is below 0.9 and for women is below 0.8.

Activity and Weight Control

Weight management is closely linked to physical activity levels. Dietary modifications also help.

ESTROGEN REPLACEMENT

One special aspect of heart disease preventive intervention is specific to post-menopausal women and involves replacement of estrogens.

At menopause, due to atrophy of the glands called ovaries, the level of the female hormone estrogen decreases. This leads to several effects that collectively produce the post-menopausal syndrome. Estrogens are also partly responsible for the lower risk that women have for heart disease as compared to men.

Estrogen replacement therapy is considered in postmenopausal women, especially in those with multiple risk factors for coronary artery disease, such as elevated LDL. Recommendations are individualized in accordance with other health risks.