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Women and Longevity

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Women under age 45 had lower awareness that heart disease is women's No. 1 killer ... Heart Disease Rate ... Diabetes doubles risk for heart disease ... – PowerPoint PPT presentation

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Title: Women and Longevity


1
Women and Longevity
  • Medical Secrets to a Long Life

Phyllis August, MD, MPH
Ralph A. Baer, MD Professor of Medicine in
Research Weill Medical College
of Cornell New York
Presbyterian Hospital
The fountain of youth
2
The River of Immortality
3
Ponce de Leon and the Search for the Fountain of
Youth 16th
Century
4
Health and Beauty Spa 2008
5
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6
Women and Longevity
  • How long do women live?
  • How well do we age?
  • What are the determinants of living long and
    well?
  • What are the major causes of death
  • How do we prevent premature death and disability

7
How Long Do Women Live?
She was a handsome woman of forty-five and would
remain so for many years. Anita Brookner
8
Recorded female life expectancy from 1840 to the
present (1)
Westendorp, R. G
9
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10
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11
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12
How Well Do Women Age?
  • You can only perceive real beauty in a person as
    they grow older Anouk Aimee

13
To die young, as late in life as possible
  • Ancient Greek saying

14
Successful Aging of the Population
  • By 2040 40 million persons 85 yrs
  • Ages 74-84 - 75 report no disability
  • Age 85- 40 are fully functional

15
What happens with Age
  • Deterioration hearing, smell, eyesight
  • Change Gray hair, thick waist, decreased sexual
    activity
  • Development and maturation tolerance, patience,
    acceptance

16
Berlin Aging Study (500 urban Berliners)
  • 70 yrs most will have a serious illness and
    arthritis
  • Up to age 95 only 10 had dementia
  • IQ at 75 is the same as age 20
  • 85 of those age 75 were in good health

Baltes 1999
17
Greater Longevity is associated with less
disability
18
Coping Strategies and Aging
  • Depression is not increased in elderly
  • Elderly do not perceive themselves as sick
  • Spirituality and serenity increase with age
  • Education and extended family predict aging well

Baltes 1999, Berlin Aging Study
19
What Can Be Done to Age Better?
  • To know how to grow old is the master work of
    wisdom, and one of the most difficult chapters in
    the great art of living
  • Henri Frederic Amiel

20
Study of Adult Development (Vaillant and Mukamel)
  • Harvard students and inner city boys born between
    1918 and 1932
  • 60 years follow up
  • Subjects classified as happy-well intermediate,
    sad-sick, prematurely dead

21
Predictors of Healthy Aging
  • Not smoking
  • Absence of alcohol abuse
  • Normal weight
  • Regular exercise
  • Stable marriage
  • Mature coping mechanisms
  • Level of education
  • Absence of Depression

22
Centenarians Living to 100 (New England
Centenarian Study)
  • 1 in 10,000
  • 85 female, 15 male
  • Centenarians escape lethal diseases, and
    experience less disability from non lethal
    diseases
  • Females have more age related illnesses compared
    to men
  • Females survive these illnesses at a greater rate

Thomas Perls, MD, MPH
23
What are the determinants of longevity?
  • Genetics 25-35 - decreased susceptibility to
    age related diseases including heart disease,
    cancer, diabetes
  • Environment diet, exercise, smoking, moderation
    in alcohol intake, maintaining normal weight

24
What are the Leading Causes of Death?
  • Cardiovascular disease
  • Cancer
  • Stroke

25
What is Cardiovascular Disease?
Cardiovascular disease (or CVD) includes heart
and blood vessel diseases diseases that affect
the circulatory system.        
26
Examples
  • Coronary heart disease (heart attack)
  • Cerebrovascular disease (stroke and TIA)
  • Congestive heart failure
  • Congenital cardiovascular defects
  • Peripheral vascular disease

27
Cardiovascular Disease Leading Cause of Death in
Women
  • Cardiovascular disease kills over 460,000 women
    per year about one woman per minute
  • CVD kills more women than the next 5 causes of
    death combined
  • One woman in three has some form of CVD

28
American Heart Association Survey of Women and
Heart Disease
  • Cancer still perceived as womens leading health
    problem
  • Women under age 45 had lower awareness that heart
    disease is womens No. 1 killer
  • Women know of CVD risk factors in general but
    often not their own risks

29
Risk Factors for Cardiovascular Disease
  • Hypertension
  • Diabetes
  • Smoking
  • Cholesterol
  • Menopause

30
Hypertension Responsible for Half of all CV
Deaths
  • Hypertension, (high blood pressure)
  • pressure in the arterial circulation
  • Normal blood pressure
  • systolic 100-120 mm Hg
  • diastolic 70-80 mm Hg
  • High blood pressure
  • 140/90 mm Hg
  • higher levels greater risk

31
Global Burden of Hypertension 1 billion 2000,
1.5 billion 2025
32
Prevalence of Hypertension in the US 50 million
Population,

Age, y
Age (years)
NHANES III, National Health and Nutrition
Examination Survey. Data not available
prevalence estimates for women aged 20-34 years
are considered unreliable. Source Health, United
States, 2003, CDC/NCHS.
33
Hypertension Increases Cardiovascular Disease and
Death


Heart Disease Rate
34
Treatment of Hypertension Prevents Strokes, heart
attacks, kidney failure and death
Heart Disease and Death
35
Poorly Treated Hypertension Impairs Cognitive
Function
  • Hypertension is a cause of dementia
  • Hypertension worsens preexisting dementia
    (including Alzheimers Disease)
  • Hypertension causes subtle progression of
    cognitive decline
  • Treatment of hypertension prevents dementia

36
You Can Lower Your Blood Pressure Without Drugs
  • maintain ideal body weight
  • regular aerobic exercise
  • diet fruits, vegetables, low fat, high fiber,
    low salt
  • moderate alcohol
  • no smoking!

37
Blood Pressure Lowering Medications
  • Overwhelming evidence that they save lives
  • Blood pressure should be less than 140/90 mm Hg
  • Use whichever drug works and which has the fewest
    side effects

38
Hypertension is the most easily treatable risk
factor for cardiovascular disease and death
39
Cholesterol
  • Dietary cholesterol animal fats
  • Strong genetic component
  • Excess cholesterol leads to atherosclerosis
    (hardening of the arteries) and cardiovascular
    disease

40
Do You Know Your Total Cholesterol Numbers?
  • Less than 200 mg/dl (5.18 mmol/L) Desirable
    (lower risk)
  • 200239 mg/dL Borderline high (higher risk)
  • 240 mg/dL and above High blood cholesterol,
    more than twice the risk than the desirable level
  • HDL (good cholesterol) is also
  • important, especially for women.
  • Goal above 50 mg/dl

41
Smoking
  • Smoking is the single most
  • preventable cause of death in the US
  • 18.5 percent of American women age 18
  • and older smoke
  •         

42
Smoking
  • If you dont smoke, dont start
  • If you smoke, quit
  • Avoid others tobacco smoke

43
Physical Inactivity
  • Increases heart disease and stroke risk
  • 30 minutes or more of activity on most or all
    days of the week helps
    reduce risk! It
  • Controls blood cholesterol
  • Controls diabetes and obesity
  • Helps lower blood pressure

44
Obesity / Overweight
  • Overweight/obese women 20 and older
  • American Females 60

2007
45
Even the French are fighting obesity Herald
Tribune 2005
  • 11 in France, compare with 30 in US
  • Increasing at a rate of 5 per year
  • Particularly in the young
  • Fast food, lack of exercise, shorter family meals

46
Diabetes
  • Women age 20 and older with diabetes
  • White females 5.6
  • Diabetes doubles risk for heart disease
  • Strongly associated with overweight and lack of
    exercise

47
What Is Diabetes?
  • A progressive disease in which your body doesnt
    make enough insulin / doesnt respond properly to
    it
  • Insulin regulates the blood sugar (glucose)
  • Goal fasting glucose below 100 mg/dl

48
Why Is Diabetes Bad?
  • At least 65 of people with diabetes die of some
    form of CVD
  • Diabetes lowers good cholesterol, and raises
    bad cholesterol and triglyceride levels
  • Many people with diabetes also have high blood
    pressure and are overweight

49
Heart Attack Warning Signs
  • Most common heart attack symptom is chest pain or
    discomfort
  • Women are more likely than men to experience
  • Pain or discomfort in one or both arms, the back,
    neck, jaw or stomach
  • Shortness of breath with or without chest
    discomfort
  • Profound fatigue
  • Cold sweat, nausea, vomiting or lightheadedness

50
What About Cancer?
  • Breast cancer
  • Lung cancer
  • Colorectal cancer

51
Cancer Screening and Prevention
  • Breast routine mammography
  • Lung dont smoke ?screening with CT scans
  • Colorectal high fiber diet, routine colonoscopy
    age 50

52
Secrets to Longevity
  • He who does not know food, how can he understand
    the diseases of man?
  • Hippocrates, the father of medicine (460-357 BC)

53
What is a Healthy Diet?
  • Whole, unprocessed foods
  • Vegetable, fruits
  • Plant based fats and proteins
  • Fiber
  • Whole grains

54
Secrets to Longevity
  • Exercise regularly 30 minutes daily, include
    strength training
  • Drink water alcohol in moderation, dont smoke
  • Stay involved and connected to loved ones

55
What about Antiaging Therapy?
  • Growth hormone, DHEA, testosterone no proven
    benefits and may be dangerous
  • Hormone replacement therapy for women
    controversial
  • Vitamins and supplements Vitamin D,
    multivitamins, Omega 3 fatty acids

56
What About Fad Diets ?
  • Avoid diets that overemphasize one nutrient over
    another
  • Not all carbs are bad
  • Unprocessed, natural food is better than vitamins
    or supplements

57
Old age isn't so bad when you consider the
alternatives Maurice Chevalier
58
With mirth and laughter let old wrinkles come…
Shakespeare
  • Merchant Of Venice
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