Welcome to Penang Adventist Hospital... A Passion To Heal, A Heart To Care

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Mon-Thu: 8am-4:30pm
Fri & Sun: 8am-12:30pm

Pediatric Night Clinic Registration Hours

Mon-Thu: 7pm-8:30pm
Sun: 7pm-8:30pm

Visiting Hours

12pm-2pm
5pm-8:30pm

Address

465, Burma Road,
10350 Pulau Pinang,
Malaysia

Contact

Tel: (604) 222-7200
Fax: (604) 226-3366

Are Women Prone to Heart Diseases Too?

Do you think that only men get heart disease? Do you know heart disease is the number-one cause of death in women too? It strikes 1 out of 3 women over the age of 65. Eight times as many women die of heart disease each year compared to breast cancer. However, there is good news! You can reduce your chances of getting heart disease. Even if you have heart disease now, you can help slow it down.

Beware of the Myths

Many things you hear about women and heart disease may not be true.

Myth	Fact
Women don't get heart disease. Taking estrogen after menopause prevents heart disease. You can't get heart disease if you're not overweight, or if your blood pressure and cholesterol are normal.	They do. Estrogen may lessen your chances of getting heart disease, but alone it can't prevent it. These factors all help prevent heart disease, but none of them alone guarantees that you won't get heart disease.

The Earlier You Do Something, the Better

To reduce your chances of getting heart disease, first you need to know your risks then make plans to minimize them. you can start by eating low-fat diet, getting regular exercise, controlling stress, and, if you smoke, quit! These changes in your lifestyle will keep your cholesterol down and your blood pressure under control, and help you maintain a healthy weight. You don't have to change everything at once. Begin by making small changes today! Adventist Heart and Vascular Centre is here to help guide you.

What are the Risk Factors?

There are several factors that may increase your risk for heart disease.

Smoking

High Cholesterol

High Blood Pressure

Lack of Exercise

Stress

Excess Weight

Diabetes

Family History

Are You At Risk?

Most women do not worry about heart disease until it strikes them. However, you can lower your chance of having heart disease if you begin to identify and control each risk factor.

Smoking
	Do you smoke?	Yes	No
	Do you smoke and take oral contraceptives?	Yes	No

High Cholesterol
	Do you eat a lot of butter, oil, fried food, kuih, or animal fat?	Yes	No
	Do you often eat fast foods and hawker foods?	Yes	No
	Do you often eat lots of cheese, creamy sauce or santan?	Yes	No
High Blood Pressure
	Is your blood pressure higher than 140/90?	Yes	No
	Do you eat a lot of salty foods, such as salted pickled foods and salty fish?	Yes	No
	Do you always add extra salt or soy sauce to your foods?	Yes	No
Other Risk Factors
	Do you exercise fewer than 3 times a week?	Yes	No
	Are you more than 30% over the recommended weight for your height?	Yes	No
	Are you over the age of 55?	Yes	No

The more times you answered Yes, the higher the indication of your risk for heart disease. Read on to find out what you can do to lower your risks.

What Should a Woman Know?

There are special concerns for women and heart disease. A woman's risk of getting heart disease goes up rapidly after menopause. Women do not always feel the symptoms of heart disease the same way men do. On top of that, women's bodies may not respond the same way as men's to tests for heart disease.

There are two kinds of cholesterol:

Low-density lipoprotein (LDL) or "bad cholesterol builds up on the walls of the blood vessels. And the desirable level should be less than 3.3mmol/L (130mg/dL).
High-density lipoprotein (HDL) or "good" cholesterol removes LDL cholesterol from the blood vessels. High levels of HDL seems to protect against heart attack and reduce the risk of heart disease. The desirable level should be more than 0.9mmol/L (35mg/dL).

Depending on your risk factors, the definition of high cholesterol can vary. Your doctor would be the best person to determine what is considered high for you. Having your LDL and HDL cholesterol checked helps you know your risk.

Hormone Replacement

The female hormone estrogen appears to protect women against heart disease. Studies show that estrogen raises the levels of HDL (good) cholesterol in the blood. It may also lower the level of LDL (bad) cholesterol. After menopause, you no longer produce estrogen and that increases your risk of heart disease. About 10 years after menopause, a woman's risk is equal to a man's in getting heart disease. Studies show that taking estrogen after menopause can reduce this risk by 20-50%. However, not every woman is suitable to take estrogen. Be sure to talk to your doctor about the benefits and risks of hormone replacement for you.

Symptoms of Heart Disease

Women don't always feel the warning signs of heart disease the same way men do. For women, chest pain (angina) or a feeling of pressure may come and go. And it may occur in the upper abdomen rather than in the centre of the chest. A woman may also have trouble breathing or feel weak or tired when doing something that used to be easy. Or she may have heartburn or anything she has eaten. If you feel any of these signs for more than 10 minutes call your doctor or the hospital immediately.

Tests for Heart Disease

Some of the tests that are commonly used to detect heart disease may give false results more often in women than in men. That's because women's bodies are different. Breast tissue may get in the way of electrocardiogram (ECG) signals. Also, some women can't exercise long enough for an exercise ECG (stress test) to show a problem. A stress echo test, which uses sound waves to show how well the heart is pumping, may be a better early test for women. Talk to your doctor about the best tests for you.

Are You Eating Right?

What you eat affects your cholesterol level and weight. Remember, high cholesterol and excess weight are linked to heart disease. Making a few changes in your diet can help you keep your cholesterol and weight under control. It may also help prevent or control high blood pressure and diabetes.

Heart Healthy Diet

The Pyramid is an outline of what to eat each day. It's not a rigid prescription, but a general guide that lets you choose a healthful diet that's right for you. The Pyramid calls for eating a variety of foods to get the nutrients you need and at the same time the right amount of calories to maintain a healthy weight. If you would like to seek guidance in your diet from a qualified dietitian, you can do so by scheduling an appointment to meet with our dietitian at Penang Adventist Hospital, ext. 1270.

Cholesterol Lowering Diet

Blood cholesterol is made by the liver, and the amount it produces increases when we eat large amounts of saturated fat. One of the most effective things you can do to help reduce your cholesterol is by making some simple changes to you diet. For example:

Reduce the total amount of fat and/or change the type of fat you eat.
Limit the intake of cholesterol-rich foods.
Increase dietary fiber intake.

Remember

To have a variety of fiber rich foods.
Start slow. Too much fiber, too soon, can cause intestinal discomfort or diarrhea.
Drink at least 6-8 glasses of fluid per day.

Guidelines to a Heart Smart Diet

Reduce All Added Fats

Limit fat intake to total of 6 teaspoons per day.
When cooking foods use boil, bake, stew, grill, steam instead of deep frying.
Choose: canola oil, olive oil, flaxseed oil.
Avoid: butter, margarine, coconut milk (santan), lard.

Reduce High Fat Snacks and Desserts

Avoid: deep fried snacks, chips, local kuih, nuts, ice-cream, cream cakes, chocolates, pastries and cookie.
Choose: dried fruits, steamed kuih, agar-agar, wholemeal buns and wholemeal crackers.

Eat More Whole Grain Products

Choose: wholemeal bread, rolled oats, unpolished rice, chapitis, barley and muesli.
Avid: roti canai, fried noodle, santan rice, white bread and oily rice.

Eat More Vegetable and Fruit

Eat at least 5 servings of vegetables per day (1 serving = 1/2 cup cooked or 1 cup raw).
Eat at least 3 whole fruits a day.
Choose dark green and orange vegetables such as green leafy vegetables, spinach, flowering mustard, broccoli, carrot, tomato, pumpkin etc.
Nuts (except peanut): almond, walnut OR plant seeds: flaxseed, sunflower seed, sesame seeds twice a week and not more than 2 tablespoons each time.

Choose Low Fat Dairy Products

Choose: soya milk, skim milk, low fat yoghurt, low fat cheese.
Avoid: full cream milk, condensed milk, cream cheese, evaporated milk, milk shake.

Choose Meat Alternatives

Vegetarian diet is the best diet to a healthy heart.
If you choose to have meat, eat only chicken and fish and restrict to no more than 3 times a week. Remove skin and fatty part of meat before cooking.
Choose beans, legumes, dhal, soya bean and soya products. At least one serving daily.
Avoid: red meat, processed meat, egg yolks, organ meats, dried shrimps, and seafood as they are high in cholesterol.
Avoid deep fried cholesterol rich foods. Avoid thick creamy meat sauces or gravies.

Why Should a Woman Exercise?

Your heart is a muscle. Like any muscle, it works better and stays stronger with regular, brisk exercise. People who don't get enough physical activity are much more likely to develop heart disease and high blood pressure. Exercise can lower your risk of:

Heart disease and heart attack
High blood pressure
High cholesterol

What Else Can Exercise Do for Me?

Exercise offers lots of enjoyable and important benefits, including?
Lessening your chance of heart attack
Strengthening your heart, lungs, bones and muscles
Giving you more energy and strength
Helping control your weight and blood pressure
Helping you handle stress
Helping you sleep better
Helping you look good
Making you feel upbeat

What Kind of Exercise Should I Do?

To help your heart, exercise should be constant and last long enough to increase the blood flow to the muscles. Start slowly and build up as your heart gets stronger. you can try:

Walking or hiking
Jogging
Bicycling
Swimming
Rowing
Walking on a treadmill
Stair climbing
Aerobic dancing

How Often Should I Exercise?

Work up to 20-30 minutes of exercise.
Make sure it's regular--at least 3 times a week.
Try to spread it out over the week for best results.
An every-other-day schedule works best.

What Else Can I Do?

In addition to exercise, studies show that easy-to-do daily activities may benefit your heart. Also, making small changes in your lifestyle can make a big overall difference in your health. Here are some tips:

Take a stroll in the neighbourhood.
Get into gardening or yard work.
Use the stairs instead of escalators and elevators.
Park farther from the stores and walk through the parking lot.
Learn a new dance!

How Can I Make it Fun?

The more you enjoy exercise, the more you will want to do it. What are some fun ways to give your heart a workout? How about?

Walking with a friend or joining a working group.
Taking an aerobics or dance exercise class.
Biking through a park.
Swimming.
Going dancing.
Playing on a volley ball or softball team.
Joining a gym.

Make your own list. Try different activities to find ones that you enjoy and feel safe doing. Do them alone, go with a friend, or join a group.

Start Slowly and Stick to it!

You're never too old or too young to exercise. But if you haven't been active, the hardest part can be getting started. Take it slow.

Exercise for 5-10 minutes, 2 or 3 times a week at first. Then add a few minutes each week.
Start at a pace that's easy for you. Build up your speed slowly.
Work up to exercising at least 3 times a week for 20-30 minutes each time. Do more if you can.
Always warm up by stretching first. Then start out slowly.
Think of ways to build exercise into your daily routine, such as walking on your lunch hour or while you do errands.
If you find yourself getting bored, vary what you do. Or exercise with a friend, or a group to help you keep going.

Are You Stressed?

If you find yourself feeling tense or angry, you may be under too much stress. Excess tress can raise your blood pressure. It can also cause you to overeat. You can't get rid of all stress. But finding ways to relax and learning to set limits can help you control stress.

Learn to Relax
You can help control stress by taking a few minutes to relax whenever you feel yourself getting tense.
Picture stress going away. Sit comfortably. Close your eyes, and then imagine yourself in a peaceful setting.
Breathe stress away. Breath in slowly through your nose, feeling your stomach expand. Then breathe out slowly through your mouth.
Meditate, pray, do yoga or tai chi.
Try exercising. Exercise helps reduce stress, too.
Enjoy a good warm bath or shower.
Listen to some soothing music.

Do Not Try to Do Everything

Juggling too many things can cause stress. Learn to set limits.

Decide what is most important to do each day.
Set realistic goals for what you can do comfortably. Then learn to say "No" to what you cannot do.
Ask others to help when you have more than you can handle yourself.

7 Basic Health Practices

Get adequate sleep. 7 to 8 hours each night.
Maintain the recommended weight for your height, body build, and age.
Do not smoke.
Do not drink alcoholic beverages or drink only in moderation.
Engage in regular, moderate physical activity.
Eat a healthy breakfast each morning.
Eat regular nutritious meals and avoid frequent snacking on junkfood.

How to Control Your Blood Pressure?

The cause of high blood pressure in most people is unknown. Others may be due to kidney problem, thyroid disease or even illicit drugs. Regardless of the cause, it is imperative to get the high blood pressure under control before it leads to heart disease.

Here are a few ways to control your blood pressure:

Quit smoking.
Weight reduction.
Use salt sparingly.
Reduce alcohol consumption.
If permitted by your physician, exercise regularly and consistently.
Take your medication, if prescribed, as directed and don't run out of your medicine. Suddenly stopping certain medicines can cause chest pains or "rebound" your blood pressure extremely high. if you encounter any problems with your medicine, discuss this with your doctor. There may be other medicine that can be used to lower your blood pressure.

Do You Smoke?

Smoking just one pack a day triples your risk of dying from heart disease. Two or more packs a day takes a minute off your life for every minute you smoke. That's because smoking damages your blood vessels. When you stop, your risk falls to the risk of a non-smoker in about 10 years. Even if you gain weight when you stop smoking, the extra weight is less of a health risk than smoking is.

Tips for Taking the First Steps in Quitting!

You can quit - once you make the commitment.

Start by listing as many reasons as you can for quitting. Keep this list where you can look at it whenever you feel the urge to light up.
Then list the times when you want to smoke. Write down other things you can do, or ways you can deal with these times.
Set a date to stop. Tell your family and friends, and let them know how they can help you.
Stock up on sugarless gum or raw vegetables. You may also want to talk with your doctor about a nicotine patch.
Join a stop-smoking support group or class. You will have the best chance of success if you share tips with others.
If you start smoking again, don't be too hard on yourself. Set a new date and try again. You can do it!

If you need assistance with stop-smoking or find out more about the stop-smoking classes, you may contact Penang Adventist Hospital's Wellness Centre at Ext. 1287.

How to Make Changes?

Making even one lifestyle change for your heart reduces your risk for heart disease. Change is hard for everyone, so take it one step at a time. Here are some tips to help you get started. Begin by making small changes.

Make a Plan
Trying to do too much too fast can end in failure.

Start by writing down all the things you'd like to do to lower your risk.
Break each one into small steps. If you said, "Cut down on fat," a small step could be to use fruit spread (jam) instead of butter on your toast. Or to take wholemeal bread or unpolished rice instead of roti chanai and friend noodles.
Decide which step you'd like to take first. Then choose a second and a third step.
Check off each step as you achieve it. Add new steps as you go along.
If a step isn't working, try another. Come back to the first one later.

Keep Records

Keeping records helps you know your habits and see your successes.
Keeping an exercise record can help you see your progress and keep you going.
Keeping food records can help you see your eating patterns and plan ways to make small changes.
Note down when you feel stressed or want to smoke can help you think of ways to avoid these triggers.

Reward Yourself

Making changes isn't easy. You deserve to reward yourself when you succeed. Just making the change may be its own reward. But why not give yourself an extra pat on the back?
Give yourself something special you've been wanting, i.e., a new dress.
Do something that you've always promised yourself you'd do, such as going dancing or a night out with your loved one.

How Heart Disease Occurs

To help you understand why you need to make changes in your lifestyle, here are some facts about how the heart works. The heart is a muscle. To keep pumping, it needs oxygen-rich blood. Blood is supplied to the heart by the coronary arteries. When these blood vessels are healthy, blood flows through them easily. If they are damaged, blood flow to the heart is reduced or stopped.

If the wall of an artery is damaged by high blood pressure, smoking, or high cholesterol, fatty deposits (plaque) can build up on the wall of the artery. This narrows the artery and reduces blood flow to the heart.As plaque builds up more, blood flow is partly blocked. Then the heart muscles has a hard time getting the oxygen it needs. You may feel pain in your chest (angina). If a detached piece of plaque or blood clot gets stuck in a narrowed artery, blood flow stops (heart attack). Then part or all of the heart muscle dies.

Outsmarting Heart Disease

Heart disease is the number-one cause of death in women. But you can do a lot to reduce your risk for heart disease. Use the checklist below to help you remember the steps you can take to outsmart this killer.

Have your cholesterol checked regularly. Discuss your LDL and HDL levels with your doctor.
Discuss hormone replacement therapy with your doctor if you are close to or have passed menopause.
Know the signs of heart disease and how the signs can differ in women and men.
See your doctor right away if you have any symptoms of heart disease.
Eat less fat. Cook with less fat. And eat more whole grains, fruits, and vegetables.
Do aerobic exercise at least 3 times a week for 20-30 minutes each time.
Take time to relax and reduce your stress level.
If you smoke, make a plan to stop. Then act on it.