No Heart Left Behind

Assess Your Risk for Heart Disease

What you need to do this week:

Help the person you are coaching to complete the Assess Your Risk form.
Discuss the difference between modifiable risk factors and those that can’t be changed.
If the person you are coaching uncovers three or more risk factors, suggest that she contact her doctor.

Understanding risk factors

Several factors increase a woman’s risk of heart disease. Some of these can be modified, treated or controlled, and some can't. The more risk factors you have, the greater your chance of developing coronary heart disease.

Ask the person you are coaching the following questions, as she refers to her Know Your Numbers worksheet. Have her mark “yes” or “no” for each risk on her form. This form is for her own personal use and to share with her physician.

The following risk factors are modifiable; she can control them to reduce her risk for heart disease:

Do you have high blood pressure? Ideal blood pressure is < 120/80 mm Hg.
What are your cholesterol numbers? Total cholesterol is ideally < 200 mg/dl. In women, HDL numbers above 50 are recommended.
What is your BMI? BMI numbers above 25 generally indicate overweight; numbers above 30 are in the obese category.
Does your waist circumference put you at risk? Waist circumference for women should be less than 35 inches.
Do you smoke? Smoking dramatically increases her risk for heart disease. It’s even a greater risk for women who also take birth control pills.
Do you get enough physical activity? Adults are encouraged to get at least 30 minutes of moderate-intensity physical activity 5 or more days/week.
Do you experience a lot of stress? If you have a high demand/low control job, or experience sustained high levels of stress, this can put you at risk.

The following risk factors are out of her control and can’t be changed. If she has these risks, that makes it even more important to control the modifiable ones above:

Are you an African-American woman? African-Americans are at a greater risk for heart disease.
Do you have a family history of heart disease? Your father or brother under age 55 or your mother or sister under age 65 has had a heart attack, stroke, angioplasty or bypass surgery.
Do you have diabetes? Individuals with diabetes are at a significantly higher risk for heart disease.
Have you experienced early menopause? Either natural or through surgery, before age 40.
Are you age 55 or older? Our risk for heart disease increases with advancing age.

Next, discuss her results. Which of her individual risk factors can she control?
Her goals for this week are to:

Decide which modifiable risk factors she is able to change to reduce her risk for heart disease.
Continue to increase her activity level. The goal is to work up to 30 minutes as many days per week as possible. Keep track of her progress on her Activity Log.
Review the No Heart Left Behind brochure, which spells out the risk factors using the letters from “No Heart Left Behind.”
Attend the COPP Stress Management Program (see schedule).

Coaching tip

It’s unrealistic to expect the person you are coaching to change her habits overnight. She needs to understand the benefits of the new habit, and also overcome obstacles for making the change. It’s complex. Continue to offer your support, encouragement and ideas for action.

Jamie's story

Lea McElrath

Jamie McElrath Schwartz, M.D., and Max

Jamie McElrath Schwartz, M.D., works as a pediatric anesthesiologist at Johns Hopkins Hospital in Baltimore, Md. She was extremely close with her mother, Lea McElrath, who died suddenly of a heart attack in 1992 at the age of 41. At the time, Jamie was 23 years old and was enrolled in her second year of medical school at Thomas Jefferson University.

Lea McElrath was a beautiful woman and a wonderful mother, daughter, wife and friend. She was slender and athletic, and had recently participated in the M.S. Society’s “Bike to the Bay” fund-raising event. Outwardly, she appeared healthy.

She did, however, have risk factors for heart disease: Her father had died from a heart attack. She was a smoker. And she had endured the stress of losing her only son, Donnie, who was killed by a drunk driver at age 16.

Today, Jamie can look back and remember her mother complaining of indigestion, waking up at night with chest discomfort, jaw pain and fatigue. In retrospect, her symptoms were obvious. However, at the time, when information about women and heart disease wasn't commonly available, Jamie remembers telling her mother, “You’re too young to have heart disease.”

On the weekend she died, Jamie remembers her mother saying, “If I still feel this way on Monday, I'm going to call the doctor.”

Today, we know that heart disease isn’t just a man’s disease. It’s the leading cause of death among women. The symptoms for women are often different than men. Women need to learn about the symptoms and seek medical care at the very first sign of a problem. They should also assess their risk, and adopt heart-healthy lifestyle habits.

Today, Jamie is happily married and has a beautiful 5-year-old daughter, Taryn Lea, and 2-year old son, Max. Tragically, Jamie’s mother missed her graduation from medical school, her wedding to Jeff, and the birth of her children.

When Jamie heard about “No Heart Left Behind,” she was pleased. “A program like this could educate and save lives," Jamie said. "I often regret not pushing my mother to seek medical attention. I hope that others can learn from my experience and influence women to be more alert for signs of heart disease.”

Weekly review question

Q: Which type of risk factors for heart disease are high blood pressure, high cholesterol, obesity, smoking, physical inactivity and stress?

A: These are modifiable risks—ones that we can control.