(Charlotte Libov's second visit to Power Surge)

OnlineHost:     Charlotte Libov has entered the room.

Dearest:       It is with great pleasure that I welcome back to 
Power Surge journalist, author, women's health advocate, speaker 
and founder of Women's Heart Health Day (today, Feb. 1st)

              C H A R L O T T E      L I B O V

Charlotte Libov is the co-author of "The Women's Heart Book:
The Complete Guide To Keeping Your Heart Healthy and 
What To Do If Things Go Wrong". 

Charlotte has also written, "50 Essential Things To Do 
When The Doctor Says It's Heart Disease." (Plume) and her book 
to be released later this year, "The Migraine Book"

Charlotte helped create and was featured in the PBS one hour 
documentary, "Women's Hearts At Risk." Charlotte's newest 
book focuses on risk factors for many diseases including several 
types of cancer.

Charlotte, it's always a pleasure to welcome you back to Power Surge :)  
What new research or studies can you share with us regarding women 
and heart disease?  Thanks :) ....and welcome :)


Charlotte Libov:   It's wonderful to be back. I can't believe how much Power 
Surge has grown.


Dearest:  Yes, it has... thanks :)


Charlotte Libov: I'd love to be able to tell you about lots 
of exciting new research, but I'm afraid that I cannot.
There is the good news that the Women's Health 
Initiative, a huge research project that's been getting 
underway nationally has reached its enrollment goal,
but the results from that massive study are still years 
away. 

In the meantime, there has been 
research enabling the medical profession to gain a 
better understanding of how hormones affect heart 
disease, but I don't think there have been any large
breakthroughs since the last time I visited --wow!--
about two years ago. 


Dearest:       Thanks for that wonderful answer, Char....
                      Let me ask you the first question.... 
what are your thoughts on the new drug, one of the
SERMS --  Raloxifine  (aka Evista)... and its effects 
on heart disease? 


Charlotte Libov: I think that the new selective estrogen 
receptor modulators are very exciting. As I know you 
all know, one of the benefits -and potential problems 
with estrogen is that the hormone binds with receptors 
that we have throughout our body, including our breasts 
and uterus, potentially raising the risk of breast and 
uterine cancer. The exciting thing about these selective 
estrogens is that they bind to some sites and not others. 

A lot of research findings are just being 
released which will determine how effective they are.  
For example, a new study showed that there was a 
potential decrease in risk for osteoporosis, but this study 
did not assess heart disease. So we don't have all the 
answers yet. But for women who are at risk for heart 
disease and/or osteoporosis, but, for various reasons, 
cannot take HRT this may prove to be at least a partial 
answer. This is a very exciting area right now. 


Dearest:       Char, don't you have to be on HRT for 
quite a few years before it's effective against heart 
disease? 


Charlotte Libov: Yes, and that's one of the controversies. 
The benefits of HRT on both heart disease and
osteoporosis tends to show up when it's used on a 
long-term basis. 


Dearest:       So, women who think the minute they 
start taking hormones are protected against heart should 
be advised this isn't so, yes?


Charlotte Libov: That's true, although they probably are 
stemming the loss of bone fairly immediately if their 
concern is osteoporosis. But you raise a very good 
point. Personally, I think HRT should be looked upon 
as only one component, albeit a potentially very
important one, in a whole package of steps women can 
take to safeguard their hearts. 



Dearest:       Thanks so much, Char. 
                MBS, go ahead with your question.



MBS1058:        Will ERT help mood swings?  I had 
radical hysterectomy  3 weeks ago.  


Charlotte Libov: Mood swings and other menopausal 
symptoms really aren't my area of expertise.  In the 
realm of HRT, I deal really with heart disease and 
osteoporosis.  

But I did want to add something to the 
answer I gave Dearest about the effect of HRT on heart 
disease and whether or not it was immediate. Some of 
the recent research shows that estrogen does have an 
immediate effect on the widening of the coronary arteries, 
so, in that way, there may be an immediate impact 
from HRT. 


Dearest:       MKDJC, go ahead.


MKDJC:  Want to know about the role of 
hormones in causing adrenalin rushes and palpitations. 
Heart checked out O.K. 2 years ago but they're still 
bothersome. 


Dearest:       (MKD, email me)


Charlotte Libov: I don't exactly know what you mean by 
adrenalin rushes but I can speak to palpitations.  
Everyone experiences missed heartbeats and many of 
us aren't even aware of it. Some of us are more sensitive 
to it than others. Many types of palpitations, while 
worrisome, are harmless. 

However, if you do have "harmless" 
palpitations but they are really causing you disruption 
in your quality of life, your doctor may be able to put
you on a cardiovascular medication.  Only you can 
define how disruptive they are; if they wake you up 
at night, for example, or cause you to be faint or dizzy, 
you may want to have them treated even if they've
been diagnosed as being of the harmless variety. 


MKDJC:  Thanks!! 


Dearest:       Char, how about the many options, 
such as phytoestrogens, magnesium (excellent for
palps), and other natural remedies like antioxidants, 
CO Q10, Vitamin E, etc?  And selenium :)


Charlotte Libov: I really am not up to speed on 
Telomerase. As for natural remedies, if you are using 
them for palpitations that have been found to be of the 
harmless variety, and they work for you, I think 
that's terrific! 



Dearest:       Pazzeri, go ahead.


Pazzeria:       I had an hyst.   Dont want to take hrt.
Using soy products, and flaxseed.  What are your 
thoughts about how they protect the heart.


Charlotte Libov: I've got some info right here - give me 
a few minutes to get to it.


Dearest:       Phytoestrogens = soy products


Charlotte Libov: Ok, here goes, and I'm quoting from 
an article in the Harvard Women's Health Watch which 
notes that soy is now being studied at several US 
research centers.  In the meantime, there are several 
small studies that indicate that soy has many benefits,
including relieving some menopausal symptoms, possibly 
(and the word possibly should be underlined) reducing 
breast cancer risk and possibly even increasing bone 
density to reduce the risk of osteoporosis. However,
these research results are still preliminary. 

Regarding flaxseed, this has been 
known to improve the blood cholesterol levels but the 
research here is even sketchier than for soy. Personally, 
though, I think there are benefits to adding soy to your 
diet, but whether this can replace HRT if you are 
REALLY at increased risk of heart disease and/or 
osteoporosis isn't yet known. 

But I think this concept of risk is really
important, so I'd like to elaborate a little. Ascertaining 
what your medical risks are -and are not - is one of the 
most important things you can do. Too often, the media 
makes it appear that we are at risk for all manner of
dire diseases, but everyone has their own risk profile 
that they can ascertain if they study their family's medical 
history as well as their own medical history and lifestyle. 

My book, "Conquer The Odds"
which will be published next year, goes into more detail 
and I'll look forward to coming back and sharing it with 
you, but in the meantime, learning what you are 
personally at risk for can go a long way in helping you 
make decisions. 


Pazzeria:       Thanks.


Dearest:       Char,  the December issue of The 
Harvard Women's Health Watch listed Power Surge ....
as their only "favorite" Internet resource for women in 
menopause :)

Dearest:     <~~~ proud as punch


Charlotte Libov: I know. I was VERY proud too. 
You're in VERY rarefied company


Dearest:       Yes, Char.. very :) Thanks.
                CAudra, go ahead, please.


CAudra: Having had breast cancer and radiation 
on left breast,  how will that effect my heart for the  
future and also taking tamox.?  


Charlotte Libov: That's an interesting question. I'm 
unaware of any studies that have even looked at the 
issue of radiation to the left breast as affecting the heart. 
As for taking tamoxifan, that's an issue you need to 
answer with your doctor. But I would think that your 
utmost priority would be preventing a recurrence of
breast cancer. 


Dearest:       Thank you, Char.  Kaaitjie, go ahead :)


Kaaitjie:       Would you please tell us what your 
*personal* choice is re hrt, and why have you made this 
choice?  Thanks .


Charlotte Libov: I'm probably just approaching 
perimenopause (I'm 47 but my mother had me at the 
age of 40, if that's any indication), but I have given a lot 
of thought to this subject. Based on my own medical
history, I probably will not opt for HRT UNLESS I am 
faced with debilitating menopausal symptoms that I 
cannot relieve any other way, because I am not at any 
particular increased risk for heart disease or osteoporosis. 

However, I am at increased risk for 
diabetes, which my father had, and I work at
reducing that risk through diet and exercise. Like other 
women, I am also at some eventual risk for osteoporosis 
by virtue of being a woman, so I do strength training 
exercise to keep my bone mass from deteriorating. 


However, if I was at increased risk for heart disease and/or 
osteoporosis, I would seriously consider either HRT or one of 
the newer hormonal approaches. 


Kaaitjie:       Maybe you will reach meno in time for 
all the new research


Dearest:       Char, if you had to decide today  to 
take HRT,  what would  you take?  


Charlotte Libov: If I had to decide today, it would probably be standard 
HRT because I have a uterus that would need protecting against 
cancer (so that's why just taking estrogen would be out). But I'd 
probably spend some time researching the newer hormonal 
treatments. No matter what I decided, I would remember that it's 
my right to take -or not take - HRT and I'd also be keeping an eye on 
research so I could re-evaluate my decision when more findings are 
known. 


Dearest:       Thanks, Char.   VB, go ahead.


VBrando101:     I have reg. period...when I walk up stairs my heart 
pounds and am out of breath.  I am 30Lbs overweight.  What do 
you think?  I just had my heart tested this yr and it was fine.


Dearest:       (We need to go on a diet together, VB)


VBrando101:     LOL Thanks Dearest...I really do think that is it!!  
Stupid Question!!!


Charlotte Libov: That's a very broad question to answer because I don't 
know what kind of heart test you had. But one possibility is that 
you're not in condition. Even if you are 30 pounds overweight, 
you can be fit.   If your doctor has ruled out a medical problem, 
you might consider becoming gradually involved in an exercise 
program so you can get into condition and be able to do 
things like climb stairs without becoming winded (this is 
all easier said than done, btw  (g)! 


Dearest:       LOL


VBrando101:     Thanks Charlotte Libov....


Dearest:       Thanks so much, Char :) Dpd, go ahead


Dpd102: What do u know about the drug telomerase?


Charlotte Libov: If you wait a second I'll check my bookshelf...  I'm 
afraid that drug isn't listed in what I checked which is, btw, 
called "Everywoman's Guide to Prescription and Non prescription 
Drugs" so I'm afraid I have to say it sounds familiar, but I know 
nothing about it. 


Dpd102: It is supposed produce bone mass


Dearest:       Dpd, email me for more information. Thanks :)
Rmurr, go ahead.


Rmurr25:        Sometimes when I have had an active day and have 
not eaten a lot I experience an obvious arrythmias.  Could I be 
mildly hypoglycemic?


Charlotte Libov: I've spoken with researchers who believe that the diagnosis 
of hypoglycemia is very overdone. They are of the belief that it's 
fairly normal to experience symptoms of so-called "hypoglycemia when 
you don't eat right. The body needs fuel. An orange or a piece of 
cheese can do wonders, and you don't need a diagnosis to snack on 
something like that (g). 


Rmurr25:        Thanks!


Dearest:       Char, don't you believe it also becomes 
truer during menopause.. that we have .to make extra 
efforts to correct our habits to produce the best results?


Charlotte Libov: Absolutely. And, although you know 
more about it than I, it seems that chest pain from 
non-cardiac causes and palpitations occur more during
menopause and perimenopause as well. 


Dearest:       Thanks, Char :)  Stilts, go ahead.


STILTS58:       I'm 39, have MVP (mitral valve prolapse) 
& POF (Premature Ovarian Failure)& family history of 
Breast cancer, my NTX (bone mineral loss) is 118. I 
am considering Reloxifen, your opinion?  


Charlotte Libov: I'm not an expert in determining bone loss, 
but I do want to say that mitral valve prolapse does not 
increase the risk for heart disease, so you wouldn't 
have to include a concern about that in the equation. 


Dearest:       Sibyl, go ahead.


Sibylmorr:      What can you tell us about heart disease 
and diabetes?


Charlotte Libov: Aha! My favorite question!!! My father 
died at the age of 59 of a heart attack, a heart attack he 
would not have had if he had not been diabetic. Being 
diabetic greatly increases the risk of heart disease,
and research has shown this is true of women even more 
so than men. 

In addition, having diabetes also 
increases the risk of not experiencing important warning 
signs of heart disease such as chest pain because the 

nerve damage caused by diabetes can mask it. So if 
you're at risk for diabetes, like I am, reducing your 
risk factors through weight loss and exercise (especially 
exercise) is extremely important. If you are diabetic, 
having a doctor who will watch you carefully for signs 
of heart disease you may not even be aware of is very 
important as well. 


BTW, does anyone want to know about  symptoms of heart 
disease and heart attacks in women, as that's very important too. 


Dearest:       Yes, please.


Charlotte Libov: I knew I could count on you, Dearest (g)! 
                We all know the symptoms of heart 
attacks in men because we've been told about them simply 
forever. Women can have these symptoms as well, such 
as crushing chest pain. But it's been found that symptoms 
such as shortness of breath, fatigue, and even nausea
can be warning signs in women. 

Dearest:       Thanks, Char..  Tidbits, go ahead with your 
question for our guest, Charlotte Libov, medical journalist.


TidBits96:      Will there ever be a routine test to 
determine heart disease rather than waiting for 
symptoms to show?


Charlotte Libov: That's an excellent question.  Heart 
disease appears to be a more complicated problem in
women than in men, possibly because our hormones 
can play havoc with some of the indicators. For example, 
although a negative stress test rules out the possibility 
of heart disease, women are more likely to have "false 
positives" when it comes to what are considered simple 
stress tests. So they have to go on to the next level of 
testing, which is either a stress test taken in
conjunction with a test called an exercise echocardiogram, 
or a stress test which is done with radioactive imaging. 

These aren't cheap--say several hundred 
bucks--so they are impractical to use as screening tests 
for the population as a whole. A simple screening test 
would be a tremendous boon, but don't look for it 
anytime soon, alas. 


Dearest:       What wonderful answers, Char. Thank you :)
MsLizzie, go ahead :)


MsLizzieB:      Is high blood pressure (being treated 
with metaprolol) alone a risk factor for heart disease?


Charlotte Libov: Yes, I'm afraid that high blood pressure, 
even if its controlled, is considered a risk factor for both 
heart disease or stroke. However, if it's your only risk 
factor (you're not overweight, you don't smoke, you have 
otherwise so-called 'healthy habits' and your blood pressure 
is controlled, the odds are certainly in your favor. 


MsLizzieB:      I have no other risk factors


Dearest:       Lizzie, my mother is 86 and has been on 
hypertensives for years and years. Dan, go ahead.


DAN96OR1:       Is hrt needed if only risk factor is very 
high cholesterol? 


Dearest:       Dan, email me for info.


Charlotte Libov: If you have very high cholesterol which 
cannot be treated through diet and/or exercise, you might 
want to discuss cholesterol lowering drugs with your 
doctor. I'm not sure if HRT can do it for those who
truly have stubbornly high cholesterol. 


Dearest:       Stubbornly being the operative word.
                RDMOFFETT.. now you can go :)


RDMOFFETT:      Thanks.  Had  a hysterectomy 
3 weeks ago.  Feel fine except for the hot flashes.  Doctor 
wants to put me on hormones in another month.  


Dearest:       Again, Charlotte Libov is here primarily 
to discuss heart issues.
Dearest:       RDMOFFETT?


RDMOFFETT:      yes


Dearest:       Can you send me email?  RDM, I still 
have lots of info for you. 


RDMOFFETT:      okay


Charlotte Libov: I can make a comment on that, if you want 


Dearest:       Sure, Char.. go ahead :)


Charlotte Libov: When you have a hysterectomy, your 
body is immediately deprived of estrogen. On the other
hand, if you go through menopause naturally, this is not 
the case. So this would increase your risk of heart disease
and, even more especially, osteoporosis. However, how 
much of an increased risk depends on other risk factors 
in your individual case. I'm sure Dearest's information 
may help you answer that question. 


Dearest:       Thanks.... Kaait, go ahead.


Kaaitjie:       Would one's doc. be able to test for 
homostyceine levels as a precursor for heart disease?  
Is that the correct word?


Charlotte Libov: Homosyceine is a really interesting topic 
but I believe that it's too early for it to be considered as 
a precursor for heart disease. I believe that a lot of 
research on it is only currently being done. You could have
your level tested and discuss it with your doctor, but 
where it will end up ranking in the whole constellation of 
risk factors is not yet definitely known, I don't believe. 


Dearest:       Thanks.... VB, go ahead.


VBrando101:     Eye Dr. said she could see cholesterol in 
my hubby's eyes...what does that mean to you? 


Charlotte Libov: I'm not sure exactly what your husband's 
doctor meant, but I do know that the eyes, in addition to 
being the windows to the soul, also offer a tremendous 
wealth of information on the state of the human body. 
For example, a doctor can tell by the blood vessels if a
person has damage from high blood pressure and also if 
a person has diabetes, so there probably is an indication 
for cholesterol as well. 


VBrando101:     thank you 


Dearest:       THRV Coll, go ahead.


THRV Coll:      Doesn't watching your weight help 
lower your risk of heart probs though if you're diabetic?


Charlotte Libov: Regarding weight and diabetes, lowering 
your weight definitely helps control diabetes  which, 
in turn, helps control the complications, including heart
disease. But there's also very exciting research regarding
exercise. A diabetes expert told me that, when you exercise,
say, even briskly walk, your body creates little temporary
insulin receptors that helps your body metabolize properly.
Alas, they are temporary, but they are an indication of the
tremendous help that exercise can be. 

There's a diabetes specialist named 
Richard Bernstein who has done work in this area. I 
don't recall the name of his latest book, but you could
get it from Amazon.com or another source. He is an 
amazing man who became diabetic as a child and decided 
to go to medical school to become a doctor when he 
was in his 40's and he is now in his late 50's or early 
60's and is in tip-top shape where most others who 
have been juvenile diabetics are beset with terrible
complications years earlier. 


Dearest:       Char, what's the best type of diet for 
our heart health? 


Charlotte Libov: I think that's a more complicated topic 
than you suspect  :)
        Although there has been a lot written about
low-fat, high carbohydrate, not everyone agrees with this. 
There is also a tremendous amount of disagreement over 
how low in fat, etc. I'm a believer in moderation, which 
probably means the 30 grams of fat that the American 
Heart Association recommends. By certain standards,
this isn't low enough, but there are others, like Walt Willett, 
at Harvard, who believes it's not the amount of fat, but 
the type of fat.

So this is a quagmire! Personally, I advocate eating more 
of the foods one should eat, rather 
than focusing on what one shouldn't eat. And that means 
LOTS of leafy vegetables and fruits, high fiber foods
(these are good for your heart and reduce the risk of some 
cancers) and eating meat and chicken in moderation. But 
fish is supposed to be terrific. And let's not forget our 
daily RDA of calcium (and a bit of chocolate (g) ). 


Dearest:       And women in menopause should 
definitely NOT cut out fat entirely, what with the loss of 
estrogen and DRY skin, vaginal dryness, etc... Do you 
recommend Canola and Olive oils for cooking?  
(oil is important to keep the body lubricated, too)


Charlotte Libov: Yes, I do recommend those oils because 
they are not saturated fats. Staying away from saturated 
fats appears to be the key. But I have to tell you that 
there  is a small body of research that contends that 
low-fat is not the answer, so go figure! That's why I 
continue to wave the flag for moderation. And, while 
we're at it, although I don't advocate that anyone begin 
drinking wine for their health, studies consistently show
that an occasional glass is fine. 


Dearest:       Thanks so much, Char.. fabulous 
                answers (as always)  Giggles, go ahead.


GigglesUSA:     I had open heart surgery a year ago and 
just want to comment on how I agree that  women's 
heart disease is looked at differently.  I had the exercise 
echo and was told that I could wait four years for new 
valves.  I insisted to have the surgery and they found out
when I was opened up I also had other problems and 
would probably have died in a couple of months
now menopause is slapping me in the face and another
up hill battle to find my own answers with great support
groups  keep up the great work , ladies.


Dearest:       Thank you for sharing.


Charlotte Libov: I love your name, Giggles.  It's great 
that you've come through the surgery and I wish you 
continued good health. I had heart surgery myself, 
which is how I got into this whole field or writing, so I
can empathize. 


GigglesUSA:     yes I know ...glad to sit in tonight...
learned a lot.


Dearest:       Char, thanks for spending this time in Power Surge so
excellently fielding our many   questions about women and
heart disease. I strongly recommend Char Libov's
books, especially to women in menopause. 

Charlotte Libov is the co-author of 

"The Women's Heart Book: The Complete Guide To Keeping Your 
Heart Healthy and What To Do If Things Go Wrong. 

Charlotte has also written, "50 Essential Things To Do 
When The Doctor Says It's Heart Disease." (Plume) and her book 
to be released later this year, "The Migraine Book"


Please join me in thanking Char for such an enlightening evening in 
Power Surge. Thanks, Char. Come back very soon!  :)


Charlotte Libov: It was my pleasure. Everyone is also 
invited to visit my web page, Women's Health Hot Line, 
at  www.libov.com. Dearest, it was a pleasure and I 
won't be a stranger anymore :) ! 


Dearest:       That's wonderful, Char. It's important getting
together to commemorate this wonderful holiday you founded --
National Women's Heart Health Day every February 1st.  You should be 
very proud of your accomplishments :) Thank you for all you do in 
educating women about heart disease :)


Charlotte Libov: Thank you for "celebrating" this special day with me. 
This is what it's all about--women helping other women. 

Dearest:       Char, give us the names of your books again, please :) 

Charlotte Libov: Well, I'm sorry to say that "The Woman's 
Heart Book" is temporarily unavailable. We hope to be 
updating it and as soon as it's back in print, you all will 
be the first to know. But your library may have it.
The other book, "50 Essential Things To Do When The 
Doctor Says It's Heart Disease" is in print. Thanks for asking. 


Dearest:    Knowing you, I'm sure there are many books to come. 
Goodnight, and thanks for coming tonight, Char :)


Charlotte Libov: I will. G'night! 

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