Ladies, heart attacks are your primary killer, yet 82% of your heart disease is self-induced by bad habits, and thus avoidable. Four magic bullets - discipline, smoking, exercise, diet - are your keys to extra years or even decades of fun and productivity. Use the first key to avoid the second key and to improve the final two keys and you're much more likely to watch your great grandchildren grow up and achieve your life's dreams.
Even 20-something marathon runners, especially females, need baseline medical tests. A fasting lipid profile gleaned from a few ounces of blood will provide your physician the cholesterol and triglyceride data s/he needs to make a rough first estimate of your cardiovascular health. S/he'll also look at the sugar content of that blood sample (a glucose reading, plus maybe a hemoglobin A1c measurement) to assess your risk of insulin dependence (aka syndrome X, metabolic syndrome, or prediabetes, discussed in this column in August 2000) and full-fledged diabetes. People with these often self-induced (by obesity) disorders may actually benefit from low-carb diets; the rest of the low-carb lemmings are being duped by PR and by not reading the low-carb books closely enough to recognize their stated, specific target audience: insulin-dependent people.
Blood pressure checks are also important, because high BP combined with cardiovascular inflammation (as determined by a C-reactive protein (CRP) test on that same blood sample) can raise women's heart attack or stroke risks by up to 800%, far more than in men. CRP is gaining ground as a better cardiovascular health gauge than cholesterol, but it's not sufficiently well calibrated yet to raise a yellow or red flag by itself. So far it's better used as additional data when better-understood flags surface in a lipids check. Add high triglycerides to that BP/CRP pair and you're a walking bomb with a short, lighted fuse.
Does salt raise our blood pressure? Probably not; the high salt intake statistically associated with high BP was likely just an indicator of the real culprit - a poor diet low in minerals such as the calcium, potassium, and magnesium found in fruits and vegetables ... CARBOHYDRATES. Lowering your BP may help reduce inflammation, while aspirin will. Its reduction in cardiovascular inflammation is believed to outweigh its risk of pancreatic cancer, but it should be taken regularly only under medical supervision and only by women known to have a high risk of heart attack.
If the results of your blood chemistry and pressure tests are alarming, or if you have some of the cardiovascular symptoms described last month, you should ask a cardiovascular specialist about additional tests. Examples range from a treadmill stress test at the sweaty end of the spectrum to several lie-down-and-snooze exams involving innocuous external whiz-bang gadgets such as ultrasound wands, MRIs, or sensors taped to your torso.
If your HMO is too shortsighted to pay for advanced tests given alarming blood tests or heart disease symptoms, consider paying for carefully chosen tests yourself (some tests, such as standalone CRP tests or full-body scans, are still inconclusive and false-alarming). If you need more tests but are unwilling to pay for them with your own money, you may pay with something far more precious than money.
