Among women, breast cancer may be the most feared disease, but in reality, heart disease is the leading cause of death. Among Latina women in the US, heart disease accounts for 29% of the 51,400 deaths that occur each year. Controlling Your Risk for Heart Disease While some risk factors for heart disease are not controllable, such as age and family history, the majority of risk factors are controllable. Controllable risk factors include: High Blood Pressure High blood pressure, also called hypertension, affects one in five Hispanic women. Hispanic women have a slightly lower prevalence of hypertension than non-Hispanic women, but only one third of Hispanics are treated and only 14 percent achieve blood pressure control (in contrast to 24 percent in the non-Hispanic white population).

Dr. Archelle Georgiou is executive vice president, strategic relations at Optum

Normal blood pressure is a systolic blood pressure less than 120 mmHg and a diastolic blood pressure less than 80 mmHg. High blood pressure is defined as systolic pressure of 140 mmHg or higher, or a diastolic pressure of 90 mmHg or higher.
High blood pressure can frequently be prevented or controlled by:
• Maintaining a healthy weight.
• Being physically active.
• Following a healthy eating plan, including eating a diet
with low sodium.
• Drinking alcohol in moderation.
• Taking medications as prescribed.

High Cholesterol
Forty-five percent of Mexican-American females have a high total cholesterol, defined as 200mg/dL or higher. When there is too much cholesterol in the blood, it builds up in the walls of the arteries, causing narrowing. This results in decreased blood flow to the heart. Chest pain occurs when heart muscle does not get adequate blood flow, and a heart attack occurs when the blockage is prolonged enough to cause damage to the heart muscle.
Numerous studies have shown that lowering high blood cholesterol can reduce the risk of developing heart disease. Sometimes, family history and genetics have a heavy influence on cholesterol level, but frequently cholesterol levels can be managed with diet. Recommendations from the National Heart, Lung, and Blood Institute suggest eating less than 7 percent of the day’s total calories from saturated fat, 25-35 percent of the day’s total calories from fat and less than 200 milligrams of dietary cholesterol per day.

Diabetes
Over 2 million Hispanics in the US have diabetes, but over 20 percent don’t know it. Adult onset diabetes is commonly seen in ethnic groups with diets high in fat and low in carbohydrate and fiber. In the United States, the ethnic groups with the highest risk of diabetes are African Americans, Mexican Americans, and Pima Indians.
A Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT) can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform. With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes; a fasting blood glucose level of 126 mg/dl or higher signals diabetes.
Talk to your doctor about having regular screening for diabetes. If you have pre-diabetes or diabetes, get your blood sugar checked regularly, and work with your doctor on your diabetes management plan.

Overweight and Obesity
Sixty-nine percent of Hispanic women are overweight and 37 percent are obese, as compared to 58 percent and 31 percent of non-Hispanic women, respectively. Being overweight or obese is not only a risk factor for heart disease, but it also contributes to the development of diabetes and hypertension. Losing weight is a big challenge for many people. The following behavior changes may help make losing weight a little easier:
Engage in regular physical activity. Exercise not only increases caloric expenditure, it increases feelings of well-being and perceived energy level.
Seek out social support. Long-term weight regulation is easier when you are supported by family, friends, colleagues and treatment support groups.
Focus on internal motivation. Focus on achieving a healthy weight as a gift to yourself—not to please someone else.
Gradual changes. Make gradual changes in diet and exercise, rather than making dramatic changes for brief periods of time.
Stop smoking. Almost 11 percent of Latino women smoke—lower than the rate in non-Hispanic woman. If you smoke, talk to your doctor about how to stop. In addition, call your insurer or health plan to find out if they have smoking cessation support programs. Keep in mind that 19 percent of Latino men smoke, which in turn may put you at risk for secondhand smoke exposure.

Physical Inactivity
For Hispanic/Latinos, only 24.9 percent of males and 21.8 percent of females get regular leisure-time physical activity. Stay active! Build up to 30 minutes of exercise each day.

If You Have Heart Disease
If you already have a diagnosis of heart disease, it is even more important to focus on controlling your risk factors. In fact, studies among people with heart disease have shown that lowering high cholesterol and high blood pressure can reduce the risk of dying of heart disease, having a nonfatal heart attack, and needing heart bypass surgery or angioplasty. In addition, you should:
Establish and maintain a regular relationship with a cardiologist. Besides selecting a physician with whom you feel comfortable, it is important to recognize that physicians aren’t all the same. A 2003 article published in the New England Journal of Medicine found that patients only receive recommended, evidence-based care from their doctors 54.9 percent of the time. There are several ways to identify physicians whose practice patterns are consistent with high quality care and evidence-based medical guidelines. Some health plans provide this information on their network doctors. In addition, there are web sites (such as www.healthgrades.com) that can help guide your selection of a physician. Choose carefully.
Follow your treatment plan and take medications as prescribed. Remember, over the counter medications recommended by your doctor, such as aspirin, are just as important to take regularly as prescription medications.
Know the warning signs of a heart attack. The most common heart attack symptom among women is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea and/or vomiting, and back or jaw pain.
If your doctor determines that you need to be hospitalized for a cardiac procedure or surgery, take the time to research the safety statistics of the hospital that you select for your procedure. Like physicians, there are differences in the quality of care provided by different hospitals. A well-known study that measured the death rate in hospitals after cardiac bypass surgery showed that both the annual number of surgeries done by the surgeon as well as the annual hospital volume are significantly related to mortality rate. Hospitals with low surgical volumes have a significantly higher death rate.
Breast cancer is scary, but heart disease is scarier. The good news is that by taking care of yourself, you can significantly influence whether you develop heart disease. And, if you have heart disease, you can make a difference in the quality of your care and your ability to live a healthy life.