How to Choose Stylish One Piece Swim Wear

When one thinks of going on a holiday then one of the most preferred choices is at the beaches. And when at the beach definitely one wants to look sexy along with being comfortable. Varieties of swimsuits are available in the market. The price ranges for swimwear varies from extremely high to low. These are available at retail outlets as well as stores and if wants to get a too different one then try at the fashion boutiques.

Since the beginning, one piece swimwear items are very popular and the demand for them is still the same. When choosing one piece swim wear one must pick any item after considering the shape of the body. Let’s say if you have a body shape that is small at the top and wider at bottom then try to get a one piece swim wear that concentrates on the upper part. For this halter neck lines are considered best.

On the other if it is vice versa, that you have broad shoulders and waist that is too thin in comparison then go for the one piece swim wear with a high neck line. This helps in drawing the attention at the waist line and making the figure look well adjusted. And if you have an extremely lean figure, then in order to make it appear fuller pick a swim wear that enhance your curves.

Along with the shape and size of the swim wear one has to think about the color of the body too. This is important when settling on any color. if your color is dark then try you can try bright colored swim wears and in case you’re a quite fair, that is not tanned then go for the darker shades. The dark colors are good for those with a bit hefty figure as they make the body look balanced and the ones with slender one must try the swim wear that are prints.

For those who do not want to show their body much, the one piece swim wears are a very good option. When choosing one piece swim wears above all the things, comfort is the most important aspect. So always choose a swim wear chose as if you are choosing a layer for your skin. It must help in reducing the friction. The fabric must be such that it allows cutting through the water effectively.

How to Fold and Store Your Laundry the Right Way

It may seem like a no-brainer but you do absolutely have to fold your laundry when it comes out of the dryer. This is not only to keep your clothes looking nice but it also makes everyday living easier. Who wants to have to wade through a pile of clothes every day just to find something to wear? No, there’s no way around it, folding is a necessity and there is a right way and a wrong way to fold your laundry.

One of the places where people think they really do not need to fold is their sock drawer. Some people just throw all of their socks into the drawer and take out two matching socks every day. This may sound simple but it’s not really. Again, you’re rooting around in clothes just so you can get dressed for the day. Just about everyone knows that you fold socks by placing them side to side and then folding the top down and over. Once they have completed this process, many people just throw them into the drawer. This is also incorrect. After socks have been folded, they should be placed neatly in the drawer, lining up side by side. Not only does this give a nicer appearance, it also allows for socks and undergarments (which are also often kept in the same drawer) separate.

Just like socks, many people believe that not only do they not need to fold their undergarments but that undergarments can’t be folded. This is just not true. Men and women’s underwear alike can be folded in half and placed neatly in the drawer. Bras can be folded so that one cup sits inside the other and the straps then placed against each other and folded against the cups. This allows for one solid piece of clothing, and will prevent the straps getting tangled up with socks, underwear, and other garments that may be in the same drawer.

Shirts are generally hung up in a closet but there are some shirts that simply don’t need to be placed on hangers. These shirts should be laid flat on their front and the sleeves should be brought to the back of the shirt. The sleeves should be laying flat against the rest of the shirt. The shirt can then be folded in half or to save storage space, can also be folded in thirds by folding first the bottom up over the back of the shirt and then the top folded down over the bottom.

Heavy clothing such as sweaters should always be folded in the same way as shirts and stored on a shelf. Many people think that sweaters should be hung up but the fabric is just too heavy and you will result in the hanger embedding its shape into the shoulders of the sweater. To maintain freshness while they sit on the shelf, slip a fabric softener sheet between each sweater.

Depending on the pant, the two sides of the waistband should be folded so that they meet. Fold the pants in half once, and then fold them in half again. If the pants have pleats, gather the ends of the pleats at the bottom of the pants together and fold them this way the first time. Then fold them in half once, and then again.

Water – The Real Fountain Of Youth

Water is the universal liquid. But how important is it really to life? Very important if you consider all the things it does inside your body like maintaining your internal temperature, you blood is mainly water, and helping to keep your bodies pH in check are just a few of the thousands of functions water performs in your body. We’ve all heard the spiel about drinking eight to ten glasses of water a day, but how many of us do? I know I don’t, I consciously kept track of my regular water consumption for the last three days I get maybe an average of three or four glasses of water. That’s half of what I should be getting, and I know that my sister is worse; she’s lucky to get two glasses of water in.

But seriously I know I’d rather have juice, or tea in place of water…and I know for some they replace water with coffee. I’m off the coffee; it was getting to become an addiction. But that’s beside the point, how many people drink enough water?

I guess now is the point where the benefits of drinking enough water should be revealed. So here it goes…

    1. Keeps your body functioning properly and in top form; ALL of you’re the functions your body performs requires water, and well it just can’t perform the way it should without the stuff. The more water, the better it’ll perform.
    2. Helps keep your skin clear of acne and nasty blemishes; again this goes into the functionality of the body.
    3. Increases your metabolism; if your body functions better that means the digestion of fats, carbs, and all other cellulite inducing foods will get better. With those being digested better, less fat and cellulite will end up in your thighs.
    4. Helps to curb hunger; when you’re hungry there’s really no avoiding it, but if you feel just a little hunger sometimes a little water is all you need to tide you over between meals.

So if water does all these things, why are we still not getting enough? Personally it’s because water has no taste. I like things with lots of flavor, which explains my love of curry chicken. Sometimes it’s because when we’re thirsty water just isn’t there for you, or it’s more expensive to buy at the coffee shop than a coffee.

Whatever the reason, I don’t know anyone who drinks enough water and I intend to make a conscious effort at doing so. My point to this entire thing…drink more water because it’s great for you, not just good but yes it’s great, and because the better your body performs the better you feel about yourself.

Emotional Difficulties of Weightloss

Weight Loss Cartoon I would have to say that I am my biggest critic. When I look into a mirror and see myself I find myself wishing that my skin didn’t have so may freckles, that I didn’t break out so often, I wish my breasts were a little larger, my butt a little smaller, and even my tummy a little flatter. I find that we sometimes become so consumed by our little imperfections that we forget the things we like about ourselves. We punish ourselves internally because we’re not what we think is perfect. Weight troubles and self-esteem issues come hand-in-hand. Sometimes all it can take is one comment to get someone who’s feeling down to feel high as a kite, or to send him or her over the edge. I know that when someone tells me I look pretty or beautiful, especially a man I fancy, that I may not fully believe I am but makes me feel very happy. I also find that women are less likely to tell each other that we look good, or that we like what the other is wearing. Competition is fierce between us, but if we already beat ourselves up inside, being beaten up by others isn’t very great. My personal mission for the week is to compliment at least one other woman.

Speaking of compliments, we should compliment ourselves more often. When I stand in front of the mirror now instead of focusing on what I want to change I try to focus on what I like about myself. Try and boost my self-esteem a little. The better you feel about yourself, the more confidence you have. And confidence is key to everything you do, especially if you’re trying to lose weight.

Support is very important to weight loss and dieting, it is for any important, life altering decision you make. But your support group should always start with you, if you’re not confident in your decision it’ll be hard to convince other people to support you. Instead of thinking “I’d like me better if I were just a little bit lighter,” I try and think “I’d be able to dance for longer,” or even “I’d be able to do more of the things I love if I lost a little weight.” They may not be perfect statements, but they don’t put me down.

Confidence and self-esteem are two things inexplicably tied to each other and tied to the troubles that come with weight gain, and with dieting. If we’re too hard on ourselves, and constantly berate ourselves for not being perfect no comment, not even a suave young George Clooney praising our beauty, will change our minds. Focus on the things you like about yourself, and the rest will follow. Personally I love my hair color, it’s a pretty red color…but I digress. What I’m trying to say is be nicer to yourself, losing weight will be easier, and your confidence will increase.

The implantable defibrillator can prevent deaths

The implantable defibrillator, an enhanced pacemaker that can stop cardiac arrest by shocking the heart into beating again, can prevent deaths in a much broader group of patients than it has been used in so far, concludes a new study.

The study divided participants into two groups, all of whom were implanted with a defibrillator. Two-thirds of the defibrillators were turned on, and the rest were left off.

Those with active defibrillators had a 31 percent lower death rate in a 20-month period than participants whose defibrillators were not turned on, said Arthur J. Moss, M.D., of the University of Rochester, N.Y., lead researcher in the study.

Dr. Moss presented results of the study, which enrolled about 1,200 participants at 76 medical centers, at the annual meeting here of the American College of Cardiology, the nation’s largest group of heart doctors. The research also is being published in the March 21, 2002, issue of the New England Journal of Medicine.

Implantable defibrillators first got widespread public attention in summer 2001, when Vice President Richard Cheney was implanted with a defibrillator made by Medtronic Inc.

The current study was funded by Guidant Corp., which manufactured the defibrillators used in the study. St. Jude Medical Inc. also makes implantable defibrillators.

Researchers have wondered whether implantable defibrillators could benefit patients who were not quite as sick as those for whom the devices originally were intended.

In the current study, all participants had had a previous heart attack, and their hearts’ pumping ability was measured as less than half that of a normal heart. About 3 million to 4 million people in the United States would meet these criteria, according to the study results.

But these patients, unlike those in previous studies that led to approval of implantable defibrillators by the U.S. Food and Drug Administration, were not tested to see if they had specific types of irregular heart rhythm that might put them at risk of sudden death.

Nevertheless, researchers had good reason to think patients who had survived a heart attack and had reduced heart-pumping ability (a measurement called ejection fraction) might be at risk for sudden death from a heart-rhythm abnormality, or arrhythmia. According to the American College of Cardiology, about one-tenth of heart attack patients who are left with poor heart function will die from a heart-rhythm abnormality within two years.

Cardiac arrest, a stoppage of the heart, typically occurs as the result of a sudden, severe malfunction in the heart’s rhythm. About 95 percent of people who collapse from cardiac arrest die before they reach the hospital. Cardiac arrest in older adults — the group most at risk — often is caused by blockages in the coronary arteries or scarring from an earlier heart attack, according to Dr. Moss.

Of the 1,232 participants in the study, 742 — about two-thirds — received the active defibrillator and 490 were given an inactive device, Dr. Moss reported at the conference. The patients’ average age was about 53, and 85 percent were men.

All patients received other treatments, the most common of which were the drugs known as ACE inhibitors and beta-blockers. “We worked hard to optimize treatment,” Dr. Moss said.

After an average follow-up of 20 months, 14.2 percent of the patients who received the active defibrillator had died, compared with 19.8 percent in the group with inactive devices, he said.

About half of the deaths among the inactive-defibrillator group were caused by an irregular heart rhythm, Dr. Moss said. Only about 27 percent of the deaths were from arrhythmia in the group that had the active defibrillators.

One concern raised by the study was that although patients with the active defibrillators had lower death rates, they had a higher rate of hospitalization for heart failure than the patients with the inactive devices.

Asked to explain this difference, Dr. Moss said, “We believe that it relates to the improved survival of the [active defibrillator] patients.” In other words, the patients with active defibrillators were more likely to be admitted to the hospital than the other group, in part because more of them lived longer.

Besides this concern about hospitalization, the cost of implanting defibrillators also could limit their usefulness, says J. Thomas Bigger, M.D., in an editorial that accompanies the study in the New England Journal of Medicine. Continued follow-up of the patients should give a better idea of how long the defibrillator extends their lives, Dr. Bigger writes.

Hormone Therapy Not Recommended For Heart Disease

Women with heart disease should not start taking hormones to prevent heart attacks because so far there is not enough evidence that this treatment works, the American Heart Association says in a new policy statement.

Women still may want to take hormones after menopause to ease the symptoms of menopause or to help prevent the “brittle bones” disease called osteoporosis, the association says.

The guidelines, published in the July 24, 2001, issue of the AHA journal Circulation, summarize the evidence from several recent studies on the effects of replacing the hormones estrogen and progestin (a form of progesterone) in women after menopause.

Earlier research had indicated that women who used hormone-replacement therapy developed less heart disease than those who did not. In these studies, however, researchers simply looked at the health of women who had chosen to take or not to take hormones. Many factors, including the women’s education, habits and overall health, could have affected the results.

Newer studies, designed in a different way, so far have found no benefit from hormone therapy in preventing heart disease or avoiding heart attacks. These studies randomly assigned women with similar health histories to receive either hormones or a placebo. This type of study is considered the most accurate and least biased way to do medical research.

JoAnn Manson, M.D., a professor of medicine at Harvard Medical School who is one of the principal investigators n several major women’s health studies, including the Women’s Health Initiative, says she hopes the heart association’s statement gets wide circulation among physicians and patients.

“I think it’s important that physicians not expect and women not expect that these hormones will prevent heart disease, and that they understand that these hormones are not currently indicated for the express purpose of preventing heart disease,” says Dr. Manson, chief of preventive medicine at Brigham and Women’s Hospital in Boston.

On the other hand, she says, “there are still suitable candidates for hormone therapy,” which is known to help relieve menopause symptoms and prevent bone loss.

In an article in the July 5, 2001, issue of the New England Journal of Medicine, Dr. Manson and Kathryn A. Martin, M.D., a Harvard colleague, outline criteria for deciding who can benefit from taking hormones to treat menopause symptoms or prevent osteoporosis.

One reason to be cautious in using hormone therapy is that it carries risks as well as benefits. It may increase the risk of blood clots, gallbladder disease and, with long-term use, breast cancer. Use of estrogen alone, without progestin, may increase the risk of endometrial cancer.

One study among women with heart disease also found that they had 52 percent more heart attacks in their first year of using hormone therapy than women who received a placebo. At the end of four years, the average rate for the two groups was the same.

Therefore, the heart association says:

  • Doctors should not offer hormone therapy to prevent heart attacks in patients with heart disease.
  • Decisions on whether to continue hormone therapy for women who already receive it should be based on its benefits for helping menopause symptoms or preventing osteoporosis.
  • If a woman receiving hormones has a heart attack or is otherwise forced to be immobile for a while, doctors should consider stopping the hormones to compensate for the increased risk of a blood clot during this period of inactivity.
  • To minimize their risk of heart disease, women should quit smoking, eat a healthy diet and get regular exercise. Medicines that reduce cholesterol and blood pressure also can be effective and should be prescribed more often for women.
  • Several studies are continuing to test the effects of hormone-replacement therapy for women who have heart disease or atherosclerosis (hardening of the arteries). Other long-term studies, including the Women’s Health Initiative, are examining whether hormones can help to prevent heart disease in healthy women.

Until the results of those studies are available, Dr. Manson offers these suggestions for deciding who should use hormone therapy:

  • Avoid starting hormones unless the patient is bothered by menopause symptoms or is at increased risk for osteoporosis.
  • Women who are taking hormones and doing well do not necessarily need to quit taking them.
  • Hormone therapy can be used safely for up to five years to ease menopause symptoms. Because of their higher risk of heart attacks, women with heart disease should first consider other therapies first. These include several medications and soy products.
  • Longer-term use of hormones may increase the risk of breast cancer. Such use may be considered for women with osteoporosis or a strong risk of osteoporosis who are at low risk for breast cancer. One option is to resume therapy (after menopause symptoms ease) only when tests show actual bone loss.
  • Other strategies to prevent osteoporosis include exercise, adequate consumption of calcium and vitamin D, and certain drugs. Menopause symptoms may be eased by quitting smoking, increasing physical activity and eating a healthy diet.

Strategies To Prevent Heart Disease In Women

Your actions today can help to prevent, delay or minimize the effect of heart disease. The key strategy is controlling risk factors.

True, you cannot control every risk factor. For example, family history is considered a risk factor for heart disease. In other words, heart disease tends to run in families. However, this may have as much to do with behavior as genetics; family members tend to eat the same foods, and whether or not family members are physically active or smoke depends a great deal on the home environment.

Age and gender also influence your risk of heart disease. The good news for women is that they develop heart disease later in life than do men. Estrogen levels prior to menopause are thought to protect against heart disease.

Major Risk Factors

Here is a review of key risk factors for heart disease.

Cholesterol Levels

Cholesterol is a type of a lipid, a soft, fatlike substance that serves as a source of fuel. Excessive cholesterol can cause buildup of atherosclerotic plaque. Accumulation of plaque in arteries can block blood flow and lead to a heart attack.

To circulate through your blood, cholesterol and triglycerides (another lipid in the blood) combine with proteins to form lipoproteins.

There are four types of lipoproteins, differing in the ratio of protein to triglyceride and cholesterol. The main types are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

LDL cholesterol, the so-called “bad” cholesterol, is transported to sites throughout the body, where it’s used to repair cell membranes or to make hormones. LDL cholesterol can accumulate in the walls of your arteries.

HDL cholesterol, the so-called “good” cholesterol, transports cholesterol to the liver, where it’s altered and removed from the body.

Every woman should know her total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels. All four values help create your lipid profile, and this profile helps define your heart disease risk.

Women tend to have higher HDL levels than men do, but after menopause, the HDL level often drifts down and the LDL level tends to go up. Diet, exercise and one drink of alcohol per day (for women who already drink) all help to restore an appropriate balance of HDL and LDL cholesterol. Cholesterol-lowering medications, especially drugs called statins, continue to provide great results for women with heart disease and women with an increased risk of heart disease.

Blood Pressure

Normal blood pressure level is defined less than 130 millimeters of mercury (mm Hg) for systolic blood pressure (the top number in the blood pressure ratio) and less than 85 mm Hg for diastolic blood pressure (the bottom number in the blood pressure ratio). The higher the blood pressure, the more likely it is to take a toll on the heart and on the brain. High blood pressure is strongly associated with stroke, as well as with heart failure and kidney failure.

How frequently should you get your blood pressure checked? The answer depends on whether or not your levels are high. If your blood pressure is normal, get it checked at least once every two years. If it is high-normal, get it checked once a year. If it’s extremely high, you should get immediate care. Because blood pressure varies, it’s important to get multiple measurements to know if a high level is sustained over time.

Diabetes

Another risk factor for heart disease is diabetes, a chronic disease of insulin deficiency or resistance. Diabetes is a contributing factor in a significant percentage of heart attacks and strokes. Type 2 diabetes, the most prevalent type, is commonly associated with obesity and may be prevented by maintaining ideal body weight through exercise and balanced nutrition. If you have a first-degree relative with type 2 diabetes, your risk of developing the disorder is especially high.

Tips For Controlling Risk

Lifestyle modification is helpful for controlling high blood pressure, moderating lipid levels and managing or preventing diabetes.

Here are guidelines for lowering your risk of heart disease.

Stop Smoking

Don’t start smoking. If you smoke, do everything you can to stop. It is the single most important thing you can do for yourself. And not just because of its effect on your heart and your blood vessels. The effect of smoking on your lungs aggravates almost every other medical condition.

Get Active

Routine physical activity is highly recommended and helpful in controlling obesity. Try to perform 30 minutes of moderate physical activity every day. Fast walking is one of the best things you can do. You may enjoy it more if you walk with a companion or listen to music on a portable stereo.

Keep in mind that if you can lose even a small amount of weight, five pounds for example, it may have a positive effect on lipid levels and blood pressure.

Limit Alcohol Consumption

Limit daily alcohol intake to three ounces or fewer . People who drink large amounts of alcohol (defined as six to eight ounces a day) tend to have higher blood pressure. Alcohol may also aggravate triglyceride levels, as well as make it harder to control diabetes.

Watch What You Eat

Here are common guidelines for eating healthy.

  • Eat five helpings of fruits and vegetables daily.
  • Maintain adequate dietary potassium, calcium and magnesium intake.
  • Reduce saturated fats and cholesterol.

You should also be aware of your salt sensitivity. Women who are salt sensitive retain salt and water as part of the cycle of estrogen. Before your menstrual period, you may notice that your shoes don’t fit quite so well, your rings get tight and you feel bloated. Salt and water retention may be associated with high blood pressure.

Salt-sensitive women with high blood pressure should reduce salt intake to less than six grams a day.

Reconsider Hormone Replacement Therapy

Hormone replacement therapy is no longer recommended to prevent heart disease. Although the incidence of heart disease in women changes significantly after menopause, when estrogen levels decline, taking hormone replacement therapy does not provide a simple solution. Earlier studies showed an association between estrogen use and a reduced risk of heart disease. However, more recent clinical trials have overturned this theory.

The National Institutes of Health Women’s Health Initiative enrolled the largest group of women to take HRT and found that women taking Prempro had an increased risk of heart attack and stroke that persisted after five years. Further studies are needed to see if alternative forms of HRT, such as the patch or lower doses of HRT, have any heart benefits.

Questions From Women About Heart Disease

Here are questions from women about heart disease. Click on the question to find the answer.

I come from a family with a history of heart disease, but all my risk factors are normal. How significant is my family history?

A: Your family history is still a factor. We are learning more about the genetics of all conditions, heart disease in particular. We might inherit a predisposition to certain metabolic abnormalities in how our blood clots, in our cholesterol levels or in the tendency to develop high blood pressure. So I would say stay vigilant. It’s wonderful that everything is normal right now, but the likelihood that some risk factors may develop is considerable. Keep monitoring what your values are, and be proactive about your health.

Also pay attention to your brothers’ and sisters’ health. If they are having heart attacks, that’s a sign that you are at increased risk.

I am an elderly woman and have already undergone bypass surgery. Do I need to be concerned about my cholesterol level?

A: It’s very important for you to try to keep your cholesterol level down. The fact that you’ve already had bypass surgery indicates that you’re at higher risk of future heart problems. No matter what your age, if you’ve had had symptomatic coronary disease, risk-factor modification is appropriate as long as you’re otherwise healthy.

When should I undergo a treadmill stress test?

A: Exercise stress tests to diagnose coronary artery disease are less helpful in predicting the risk of heart disease in women than in men. In general, women with no symptoms should concentrate on risk-factor modification.

For women with symptoms that may indicate coronary artery disease, routine resting electrocardiography (ECG) will be performed first. Your doctor will look at the ECG result and review your risk factor profile based on your age, family history, smoking, blood pressure and cholesterol levels and based on whether you have diabetes. A treadmill stress test will usually be ordered. The test result will be interpreted in relation to the type of symptoms you have and your risk factor profile.

Women older than 40 who wish to begin vigorous exercise should check with their doctor before starting. Those with a high risk profile may benefit from stress testing before starting a high-intensity program.

My doctor tells me I have high levels of HDL. Will that protect me against heart disease?

A: A high HDL level indicates a lower risk of heart disease. Whether the HDL cholesterol itself is providing the protection is not clear. But evidence suggests that the higher the number, the less the risk. Greater than 60 millimeters of mercury is a good level of HDL. But if someone smokes, has high blood pressure, diabetes and a family history of coronary artery disease, then even a high HDL level won’t balance out the negatives.

A woman’s HDL level tends to drop with menopause, but physical activity is very helpful in keeping it from dropping as much as it might.

I have high cholesterol but no other symptoms of heart disease. Should I seek treatment?

A: It depends on your risk-factor profile. Any woman who has had a heart attack or known coronary artery disease, even if she has no symptoms now, should be treated. Usually, treatment requires medication, usually a statin drug. Women without heart disease who have very high LDL cholesterol levels and low HDL cholesterol levels may benefit from drug therapy. The more risk factors they have, the more protective benefit they receive from cholesterol-lowering medication. This is especially true in diabetic women.

At what age should I begin hormone replacement therapy?

A: The time to start HRT is when you first develop symptoms of menopause such as hot flashes and vaginal dryness. Your doctor can order a blood test to confirm that you are in the perimenopausal or menopausal period. A small dose such as 0.3 milligrams of conjugated estrogen can be started at any time and increased as necessary. Conjugated estrogen (estradiol) is the form that is found naturally in the body. Synthetic versions come in different forms and often use different doses. You should ask your health-care provider whether you are taking low or high doses if you are not using conjugated estrogens.
For prevention of osteoporosis, beginning therapy at the start of menopause protects bones the best, but it can also be started anytime after menopause begins when bone loss is noted. Starting HRT should always involve a careful weighing of risks and benefits. HRT is no longer recommended for the prevention or treatment of heart disease.

I took estrogen for many years and recently stopped. Is there anything I need to know?

Women who took estrogen for a good period of time most likely have less plaque in their arteries. But restarting estrogen just to prevent heart disease is not recommended.

If you need to stop taking estrogen, you can still do a great deal to prevent osteoporosis by being physically active. Walk, walk more and then walk some more. Also, evidence indicates that weight training may have important benefits. If you perform a lot of muscular activities, actually pulling and working the bones, that’s beneficial, even for women well in their 80s. Even a sport such as swimming, in which you’re not bearing weight, the movement of the muscles moves all of those bones.

What is the ideal dose of estrogen to take?

Unfortunately, the ideal dose isn’t yet known. To treat symptoms of menopause, a small dose (for example, 0.3 milligrams of conjugated estrogen) may be sufficient. To prevent osteoporosis, a higher dose of 0.625 milligrams is usually recommended.

Are patch estrogens effective?

Like the pills, estrogen patches cannot be recommended for heart-disease prevention. They are effective for menopausal symptoms and osteoporosis prevention.

Women And Heart Disease

For years, heart disease was considered a man’s disease. But postmenopausal women are just as likely to develop heart disease as men. When heart attack or stroke do occur, they are more likely to be fatal in women. Unfortunately, many women remain unaware of the extent of their risk.

In a survey by the American Heart Association, 63 percent of women named breast cancer as their greatest health threat — nine times as many as those citing heart disease. (Seven percent of women cited heart disease.) In fact, half of all American women will die of heart disease or stroke, which claim 500,000 female lives each year in the United States. By comparison, breast cancer kills about 44,000 American women each year.

Misinformation And Myths

Less than one-third of the women surveyed said their doctor ever discussed heart disease with them during a general health discussion. This probably reflects the fact that, for many years, physicians and the media tended to provide less information on heart disease to women than men.

Even if the information is offered, the common misperception that heart disease is a “man’s problem” may lead many women to ignore what they hear. Another myth is that heart disease is a “good” way to die — suddenly and without the long suffering of cancer. Many women also mistakenly think that strokes only affect the elderly.

The good news is that women now are hearing a lot more about heart disease. One reason is that “baby boom” women are heading towards menopause, when hormonal changes and lifestyle factors come together to increase the risk of heart disease dramatically.

The Hormone Connection

Before menopause, circulating hormones such as estrogen are at their highest, a possible reason why women have a much lower risk of heart disease and stroke than men. As estrogen levels begin to drop off, the risk of heart disease and stroke in women increases until eventually it equals that of men. This has led scientists to believe that estrogen somehow protects women’s arteries, but more research is needed to know exactly how estrogen exerts its beneficial effects.

Unfortunately, simply replacing estrogen by taking hormone replacement therapy may not be the answer. While some studies suggest that there may be benefits, other studies do not support this claim. Most recently, the National Institutes of Health Women’s Health Initiative, the largest study of women taking HRT, determined that the increased risks of breast cancer outweighed the benefits of preventing osteoporosis and lowering the risk for colorectal cancer. In addition, during the entire five years of using Prempro, women on HRT had a higher risk for heart disease and stroke rather than a lower risk.

What You Can Do

Even if you can’t change certain heart disease risk factors — your age, race, and family history — you can increase you odds of good cardiac health. As you approach menopause, it becomes even more important to adopt heart-healthy practices. It’s never too late to make a change, even if you’ve already had bypass surgery or heart attack.

In fact, most women can decrease risk in just a few months by not smoking, eating a diet that includes five or more servings of fruits and vegetables daily and foods low in cholesterol and saturated fats, and exercising for at least 30 minutes every day. Women who take medication to lower blood pressure and cholesterol levels should be careful not to miss a dose.

Menopause doesn’t have to be a time of fear of this so-called man’s disease. Women can prevent heart disease. Your greatest weapon is knowledge and engaging in heart-healthy behaviors.

Cholesterol Guideline Changes Call For Treatment Changes

If you have one or more risk factors for heart disease, and your doctor was not sure at your last visit whether you needed drugs to lower cholesterol, chances are you should call back for a new assessment.  And if you have diabetes and even moderate cholesterol levels, your doctor now might want to prescribe drugs to reduce those numbers, and your risk of heart disease.

These are two of the changes that may occur in the way doctors and their patients treat potential risks for heart disease as the result of new guidelines from the National Cholesterol Education Program, experts at Harvard Medical School say.

The program, which last released guidelines in 1993, is a partnership of the National Institutes of Health, the American Medical Association and numerous other government agencies and professional organizations.

Overall, the new guidelines urge more aggressive treatment — diet, exercise and often medicine — for patients with certain levels of cholesterol levels and other risk factors for heart disease.

The recommendations are based on a large volume of research in the last eight years that has shown the value of drugs, particularly those in a class called statins, to reduce cholesterol and lower the risk of heart attacks, even among people who are not known to have coronary heart disease, says Christopher Cannon, M.D., a cardiologist at Brigham and Women’s Hospital and assistant professor of medicine at Harvard Medical School.

If the recommendations are followed, the National Heart, Lung and Blood Institute estimates that the number of people taking cholesterol-lowering drugs will almost triple — from 13 million now to 36 million. And most of those people will have no known heart disease but will have factors known to increase their risk.

“The difference between the old guidelines and the new is that there’s more emphasis on primary prevention” before heart attacks or strokes occur, Dr. Cannon says. “It should lead to major reductions in heart disease, if the guidelines are followed.”

The biggest possible changes in treatment are likely to come for three groups, says Murray Mittleman, M.D., director of cardiovascular epidemiology at Beth Israel Deaconess Medical Center in Boston:

  • Diabetics
  • People with many risk factors but no previous heart attack, stroke or other diagnosed coronary heart disease.
  • People with less than 40 milligrams per deciliter (mg/dL) of high-density lipoproteins (HDL), also called “good cholesterol.”

One major difference is that the new guidelines recommend that all diabetics be treated the same as someone who has already had a heart attack in aggressively using diet, exercise and drugs, if necessary, to lower cholesterol. An estimated 15 million Americans have diabetes.

Dr. Mittleman, an assistant professor of medicine at Harvard who has done research about the risk factors for heart attack, says the American Diabetic Association has recommended such treatment for several years, but it may not be common practice among physicians who do not specialize in treating diabetes.

The new guidelines also recommend that people with many risk factors for a heart attack be treated as aggressively as those with known heart disease. They also raise the minimum level of HDL considered too low for heart health from 35 to 40 mg/dL.

“While that sounds like a small change, it actually represents a large group of the population,” Dr. Mittleman says. “That will actually put more people into the category of being considered to have an extra risk factor.” He says perhaps 5 percent of the population has levels under 35, but many more people have HDL of less than 40.

The guidelines also recommend more intensive treatment for patients with even moderate risk. “I would think if you have even one risk factor — high blood pressure or if you’re a smoker — or certainly if you have two risk factors, you should go in and talk to your doctor about what the best treatment for you is,” Dr. Cannon says.

Because the guidelines are based on research, many physicians already treat their patients based on similar criteria, but the guidelines draw together the findings of research into a format that makes it easier for physicians and patients to use, the Harvard doctors says.

Dr. Cannon, for instance, says he was especially pleased that the National Heart, Lung and Blood Institute Web site provides a risk calculator that physicians can download onto a Palm, or a similar handheld device, and use in their evaluations of patients.

The new guidelines divide patients into three categories and recommend various combinations of diet, exercise and drug therapy for each category to reduce so-called “bad cholesterol,” or low-density lipoprotein (LDL).

The categories are based on risk factors, each of which is assigned a certain number of points using an evaluation tool called the Framingham scale, based on a long-term Massachusetts study of heart disease. Various point ranges are equated to a percentage risk of having a heart attack in the next 10 years. The higher the risk, the lower the goal for LDL.

The highest risk level is for patients with established coronary heart disease, diabetes, carotid artery disease with symptoms, peripheral arterial disease, abdominal aortic aneurysm or multiple risk factors that add up to a 10-year heart attack risk of more than 20 percent on the Framingham scale.

Risk factors listed are cigarette smoking, high blood pressure, low HDL level, family history of premature heart disease (before age 55 in a father or brother, before 65 in a sister or mother) and age (45 or older for men, 55 or older for women).

Here are the recommendations for three levels of risk:

  • Highest risk: This includes patients with diabetes, coronary heart disease or the equivalent, or a 10-year heart attack risk of more than 20 percent. The goal is to reduce low-density lipoprotein (LDL, or “bad cholesterol”) to less than 100 mg/dL. For levels above 100, patients should use diet, exercise and other lifestyle changes to reduce LDL. At 130 mg/dL or more, cholesterol-lowering drugs should be considered.
  • Two or more risk factors: This includes patients with a 10-year heart attack risk of 20 percent or less. Lifestyle changes should be used to reduce LDL levels of 130 or more. Medicine should be considered if the 10-year risk is 10 to 20 percent, or if the risk is less than 10 percent but LDL is 160 or more.
  • Zero or one risk factor: Lifestyle changes should be used to reduce LDL levels of 160 or more, and medicine may be suggested at 190 mg/dL or more.

This set of guidelines also refers for the first time to the importance of a group of risks, known collectively as metabolic syndrome, that research has shown increases the risk for heart disease. Metabolic syndrome is defined as any three of the following characteristics:

  • Abdominal obesity: A waist measurement of at least 40 inches in men or 35 inches in women
  • Elevated triglycerides: Defined for the first time in this study as 150 mg/dL or more (200 or more in previous guidelines)
  • Low HDL: Defined as less than 40 in men and less than 50 in women
  • High blood pressure: At least 130 systolic or at least 85 diastolic (130/85)
  • High fasting blood sugar: At least 110 mg/dL

Like most of the other risk factors, metabolic syndrome is best treated with dietary changes and exercise, the Harvard doctors say. Although the guidelines are considered likely to increase use of cholesterol-lowering medicines, they always list such lifestyle changes as the first treatment to use for any heart-disease risk factors.

“I think it’s a reaffirmation from this panel that lifestyle changes are the single best thing a patient can do for themselves,” Dr. Cannon says, “so please go out and exercise and reduce your fat intake.”

What Are The Nation’s Leading Health Risks?

The start of a new year is often a time for looking ahead and reflecting on the past. If one of your goals is to improve your health this year, a look at the nation’s leading health threats can be a first step toward identifying behaviors — such as exercising regularly or changing your eating habits — that may help you ward off these conditions.

Longer Life Expectancy

The good news is that life expectancy is increasing. According to the most recent mortality statistics from the Centers for Disease Control and Prevention (CDC), in 1998, life expectancy reached a record high of 76.7 years, a slight gain over life expectancy figures from the previous year.

Although life expectancy has increased in the past 30 years for all men and women, gender plays a role in determining average life spans. Women continue to outlive men by about 5.7 years. However, since the 1970s, the gender gap has slowly been narrowing. From 1900 to the late 1970s, the gulf in life expectancy for men and women widened, growing from 2 years to 7.8 years, but in the past two decades, the divide has dwindled by 2.1 years.

Race is also a factor, with whites outliving blacks by an average of 6 years. Although that figure remained steady between 1997 and 1998, the difference in life expectancy for whites and blacks has alternately widened and narrowed over the past 18 years. The gap reached its narrowest point at 5.7 years in 1982, then grew to 7.1 years in 1989, before declining to its present 6-year differential. Of interest, when adjusted for educational level, there is no difference in life expectancy for black and white men — a marker for the value of education.

Current life expectancy rates, broken down by gender and race, are:

  • White women — 80 years
  • Black women — 74.8 years
  • White men — 74.5 years
  • Black men — 67.6 years

Among these groups, black men had the greatest gain in life expectancy, an increase of 4 years between 1997 and 1998.

Leading Causes Of Death

Although people are living longer, certain diseases take a greater toll. According to the CDC, 14 of the 15 leading causes of death for Americans of all genders, races and ages remained the same from 1997 to 1998. The only change was that hypertension (high blood pressure) became the 15th leading cause of death, whereas AIDS fell from the top 15.

Although most of the leading causes of death remained the same, there were some changes in the rankings. Septicemia (blood poisoning) and Alzheimer’s disease flip-flopped, with septicemia moving from 12th to 11th and Alzheimer’s dropping a spot. Also, atherosclerosis (buildup of fatty deposits in the arteries) became a greater threat, climbing from 15th to 14th. Heart disease, cancer and stroke remain the nation’s top three killers.

The 15 leading causes of death for Americans of all genders, races and ages are:

By Race And Age

Although this list provides some insight into the health risks that you face, your race and age also shape which diseases pose the greatest threat. For example, although AIDS is not among the top 15 causes of death for the general population, it is the leading cause of death for black Americans aged 25 to 44. And suicide is a leading threat for 15- to 24-year-olds of all races, although it is not one of the top three causes of death for any other age group. Thus, a closer look at health threats by age and race can help you understand more precisely which conditions pose the greatest risk for you and your loved ones.

The chart below lists the three leading causes of death by race and age.

Age All Races White Black Hispanic
1 to 4
  1. Accidents
  2. Congenital anomalies
  3. Homicide
  1. Accidents
  2. Congenital anomalies
  3. Cancer
  1. Accidents
  2. Homicide
  3. Congenital anomalies
  1. Accidents
  2. Congenital anomalies
  3. Cancer
5 to 14
  1. Accidents
  2. Cancer
  3. Homicide
  1. Accidents
  2. Cancer
  3. Congenital anomalies
  1. Accidents
  2. Cancer
  3. Homicide
  1. Accidents
  2. Cancer
  3. Homicide
15 to 24
  1. Accidents
  2. Homicide
  3. Suicide
  1. Homicide
  2. Accidents
  3. Suicide
  1. Accidents
  2. Homicide
  3. Suicide
25 to 44
  1. Accidents
  2. Cancer
  3. Heart disease
  1. Accidents
  2. Cancer
  3. Heart disease
  1. AIDS
  2. Heart disease
  3. Accidents
  1. Accidents
  2. Cancer
  3. Homicide
45 to 64
  1. Cancer
  2. Heart disease
  3. Accidents
  1. Cancer
  2. Heart disease
  3. Accidents
  1. Cancer
  2. Heart disease
  3. Stroke
  1. Cancer
  2. Heart disease
  3. Chronic liver disease and cirrhosis
65 and older
  1. Heart disease
  2. Cancer
  3. Stroke
  1. Heart disease
  2. Cancer
  3. Stroke
  1. Heart disease
  2. Cancer
  3. Stroke
  1. Heart disease
  2. Cancer
  3. Stroke

Great strides have been make in the past 100 years to allow life expectancy to increase by almost 30 years for Americans. The top three illnesses are amenable, in many cases, to preventive strategies. It is hoped that these preventive strategies will be operating fully in this century, further increasing healthy life expectancy.