Dr. Kevin Most: Heart Disease and Osteoporosis

Steve Cochran

Dr. Kevin Most

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Women’s health is something we try to touch on few times a year. We all know that Mom’s , Wives, girlfriends all do a great job of organizing healthcare for the family. In fact, I bet there are many men who listened this morning were shaking their head yes, that the only reason they went to the doctor, had their flu shot, got their colonoscopy…… was because of some encouragement from their female partner. I am not saying that men are incapable of doing those things, it is just that we need a little encouragement.

One women’s health issue that is often overlooked is heart disease. Many think of heart disease of men when in fact, it impacts men and women equally. Heart disease is the number one killer of women causing more than 30% of deaths in women. Yet only 20% of women feel that heart disease is a major risk. It is known that heart disease is often under diagnosed in women and we as medical professionals need to make women more informed about the concerns of heart disease. Taking the opportunity to share with their female patients the impact of smoking, lack of exercise and diet on their heart needs to be promoted. Also women often may not have the classic signs and symptoms as they suffer from this disease. Women are more likely to have what is termed a silent heart attack. The symptoms of a silent heart attack are not the classic crushing chest pain and sweating that we tell individuals to look for. Silent heart attacks may have minimal symptoms like fatigue, indigestion, or back pain. For Women it is important that they know the risk factors for heart disease and eliminate them. Know what your blood pressure is and work on getting it to a normal level. Get your cholesterol checked, get it treated if elevated, eat a low fat diet. Most importantly is to stop smoking and get daily exercise which do more than lower your risk of heart disease.

The big message here is heart disease is an equal opportunity disease so we need to understand that and work together to keep the risk factors low. Encouraging or quitting smoking at the same time, taking a walk after dinner or finding time to exercise together, eating a healthy diet and making sure you know your cholesterol level. Doing those simple things will lower the chance of heart disease and stroke in both individuals

Another issue in health that needs more awareness is osteoporosis. We think of osteoporosis often as a medical condition that occurs in women in their senior years. Now It does impacts women more than men and is estimated to impact 53 million individuals in the US alone. But we need to realize that this is a health condition that again impacts both men and women, not just women as many think. The learning opportunity here is that osteoporosis is a preventable disease and the impact of lifestyle issues early in life will impact the chance of osteoporosis in the future. We know that we build bone mass in our youth and it continues to about age 30 at which time we stop forming new bone and at that time the body focuses on maintain that bone mass. Our bones are continual changing, damaged bone is replaced, healthy bone is being renewed constantly. We get to a point of osteoporosis when the body no longer corrects bone density as quickly as it is removed

We know that we not only need the dietary input to maintain bone mass but also the importance of weight bearing activities. The body is smart enough that if we are not using our bones enough the body won’t maintain them, and we lose bone strength. This has been shown in astronauts who spend a long time in space where there is no weight bearing, their bone density when they return is lower than when they left.

So, the importance of good dietary input and exercise in individuals under the age of thirty will impact their chance of advancing to osteoporosis in the future. We all need to understand that the activities and action that take in young years will impact our bone strength in the future.

So men, this is an opportunity to give back a little bit on all of the health tips that we have been given over the years, and this one also protects us. Women over the age of 65 should be screened for osteoporosis along with men over the age of 70. The screening is a simple non painful test called a Deja scan. It is in simple terms an x ray that checks bone density. This test does not have to be done yearly, in fact most physicians will not screen more often than once every two years. This test will give you a T score, the goal is to have a T score above a -1.0, so a T score of +0.5 is good and a T score of -2.5 is not good. Patients may also be given a Z score. The Z score is a score that compares you with others in your age and body size.

What can men do about this condition? Well 2 things, encourage your children to have good calcium intake and exercise often, this allows for good bone density to grow as we age. In adults, encourage the spouse to join you for a walk, eat a good balanced diet and get screened at appropriate times to see if you need formal treatment for osteoporosis. We all know that Vitamin D is important in bone health as well and as we approach the winter and shorter days it is probably time to start the Vitamin D supplement, taking a supplement of 1000 IU a day is a good idea for most patients. For women this is even more important as a study just came out that shows that having a normal Vitamin D level may be protective of breast cancer as well.

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