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HEART DISEASE

HEART disease is the No. 1 killer of American women, with 1 out of 2 women losing their lives as a direct result of heart complications--complications that sometimes aren't identified and treated in women as quickly as they are in men. According to the American Heart Association, every year about half a million women die of heart disease. And it has claimed the lives of more women than men each year since 1984. African-American women are at special risk; they are 60 percent more likely than White women to die of coronary heart disease.

Some new, experimental treatments that are being explored include inserting healthy muscle cells into the failing heart and using stem cells to grow new heart cells. There may soon be drugs available with multiple functions to improve the pumping ability of the heart, open clogged arteries, or prevent tissue damage from free radicals. Free radicals are often oxygen molecules that have lost or gained an electron. These molecules tend to become involved in chain reactions with other, less reactive molecules and can cause cellular damage. Other avenues of research include transplants from animals, and the development of an improved left ventricular assist device, which can help the functioning of the damaged heart.

Different surgical techniques are also getting attention. Advances are being made in less-invasive bypass surgery, which does not require the use of a heart/lung bypass machine. One technique, which may, for certain people, be an alternative to standard coronary artery bypass surgery, involves making a small incision on the left-hand side of the chest, and can be used to bypass one or two vessel. The procedure may be combined with balloon angioplasty.

 There are also special techniques designed to immobilize the part of the heart that needs the surgery, making it easier to see and access the coronary artery to be bypassed. This type of surgery is performed through an incision that runs the length of the breastbone.

While these procedures are a long way from being commonplace, findings so far suggest that patients make a speedier recovery with fewer complications such as bleeding, pain and breathing problems. These techniques may offer an earlier return to work and other activities than conventional surgery.

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STRESS

ARE you suffering from late-night insomnia? Constant back pains or a stiff neck? Have you lost or gained weight and are you experiencing problems in your relationship?

These may seem like simple, everyday problems that the average American ignores, but doctors say there's a very good possibility that they are signs of stress.

Stress, which is defined as a state of bodily or mental tension resulting from factors that tend to alter an existent equilibrium, can attack the immune system, bloodstream, nervous and limbic system as well as the heart.

With an unstable economy and the necessity of dealing with new forms of racism, stress, sometimes debilitating, has become a major issue in the African-American community, where it is a leading contributor to irritability, nagging pain and some major medical problems.

According to experts, there are three types of stress--acute, episodic acute and chronic--which affect the body physically, emotionally and psychologically.

Acute stress can cause the entire body to have an immediate reaction and is often linked to a variety of life of situations--an argument, a minor traffic accident or an approaching deadline.

Episodic stress is an extreme form of acute stress related to time management and anxiety.

Chronic stress, aka "long term" stress, affects the entire health system and can lead to degenerative and inflammatory conditions like heart attacks, arteriosclerosis, strokes and cancer, the No. 1 killer in Black America.

Now that it's clear how stress can cause an enormous amount of harm to the human body, what avenues should be chosen to prevent a lengthy pattern of stress?

The American Academy of Family Physicians (AAFP) recommends meditation, daily exercises, well-balanced meals, plenty of rest, exercise, and a more relaxed and conflict-free life.

DIABETES

ABOUT 18 million Americans have diabetes, and another 41 million people between the age of 40 and 74 (40 percent of U.S. adult population) currently have pre-diabetes, a condition that increases a person's risk of developing diabetes. The new pre-diabetes estimate is more than double the old estimate, and is based on a revised, more accurate definition of a person's normal blood glucose levels.

While diabetes affects African-Americans at twice the rate of Whites, new research points to ways to slow down the progression of diabetes, and to prevent it from occurring altogether. According to medical experts, losing 5 percent of a person's body weight through healthy eating and increased physical activity (as little as 30 minutes a day) can help to prevent the disease, which is linked with heart disease.

Doctors say deaths from heart disease in women with diabetes have increased 23 percent over the past 30 years, compared to a 27 percent decrease in women without diabetes.

Understanding how the insulin gene is regulated and how insulin-producing cells are generated is a promising area of research that could lead to a cure for diabetes, a disease that has tripled among Blacks during the past 30 years. The replacement of beta cells--cells within the islet cells in the pancreas that produce insulin--in an effort to produce sufficient quantities of insulin has shown tremendous progress during the past few years.

"Diabetes is a growing epidemic in our communities, especially for these high risk groups," says Dr. James chair of the National Diabetes Education Program and president of Morehouse School of Medicine. "If we are going to make a difference, we need to reach people where they live, work, and play."

According to the National Diabetes Education Program, everyone over age 45 should consult with his or her health care provider about testing for pre-diabetes or diabetes.

STRETCH MARKS

STRETCH marks--aka "badges of honor" for new and expectant mothers--occur in both men and women and can appear on various areas of the body, including the abdominal area, breasts, thighs, lower back and hips.

Perhaps the greatest news about stretch marks is that African-American women are the least likely group to get them.

Stretch marks (proper term, striae) occur when the elastic middle layer of skin (the dermis) is constantly stretched until it breaks. Stretch marks are rarely painful, although they may cause increased dryness or itching in the affected area, which is why for so many years, mothers, aunts and grandmothers have instructed their kin to slather on olive oil, cocoa butter, petroleum jelly and even cooled cooking grease to prevent the condition.

Were they right?

Keeping your skin properly moisturized is always a good thing, according to experts, but the verdict is still out on whether or not these oily rituals will prevent the familiar pattern from appearing. At least one expert says attacking stretch marks should begin from within.

"The most important thing I have found for the prevention of stretch marks is a good diet," explains Dr. Cathy an instructor of obstetrics and pediatrics at the Boucher Institute in Vancouver. "The skin needs key nutrients for its health, including zinc, beta carotene and essential fatty acids, so that the skin is supple."

Foods that are main sources of beta-carotene include yellow and green (leafy) vegetables, red peppers, spinach and carrots. Foods that are a good source of zinc include shellfish, meat, cereal products and dairy products.

On the opposite end of the spectrum, caffeine can increase your likelihood of getting stretch marks, so it's a good idea to balance your coffee and tea intake with equal parts water. (See your doctor or nutritionist before making any changes to your diet, especially if you're pregnant.)

Dr. Carlson-Rink also urges expectant mothers to monitor their weight gain--to put on the pounds at a safe pace, and to moisturize the abdomen as much as you like.

"It's vital to have a normal weight gain if you want to [deter the onset of stretch marks] as rapid weight gain does not give your skin any chance to slowly expand," Dr. advises. "I have not found creams to make much difference, but the ritual of rubbing your belly is always a great one."

 Doctors at the Cleveland Clinic's Department of Plastic Surgery suggest dermabrasion or chemical peel to address unwanted stretch marks. A popular nonsurgical option is cool-beam laser therapy. In this procedure, the skin's surface is cooled and a laser beam is repeatedly directed to the affected area until the stretch mark is "vaporized." Such a procedure can cost anywhere between $400 and $1,000, and the end result varies, depending on your age, skin tone and diet.

HAIR LOSS

FOR many Sisters, the price of looking cute has become too high to pay. For there is increasing evidence that too-tight braids, ponytails or extensions, bonding glue, chemical relaxers and layering of multiple hair treatments are among the most common reasons for hair loss in African-American women.

The problem affects an estimated 22 million women in the United States, often creating self-esteem issues and causing severe depression.

Three types of hair loss are common in women: androgenetic alopecia (female pattern baldness), alopecia areata and central centrifugal scarring alopecia, sometimes called follicular degeneration syndrome, experts say.

Aside from the hair loss that can be associated with hair-care practices, other causes include genetic predisposition, aging, medications, stress, diet and hormones, according to the U.S. National Library of Medicine and the National Institutes of Health.

Unlike hair loss or baldness in men, expressed in a bald spot or a receding hairline, women often experience thinning hair all over the head or patches of bald spots. As soon as you or your hairstylist notices thinning hair, you should make an appointment with a dermatologist, who can examine the scalp or perform a skin biopsy to find out what type of hair loss you're experiencing. The dermatologist may also be able to inform you if your hair loss is temporary or permanent.

Treatment depends on the type and the volume of hair loss, doctors say. If your hair loss is based on your hair-care practices, doctors advise that you immediately change those practices, particularly if the hair has been thinning for a long period of time. That may mean adopting a natural hairstyle rather than using chemical relaxers or hot combs.

Doctors can inject topical corticosteroids to treat hair-follicle inflammation. Other treatments include medications such as Minoxidil, estrogen or hormone replacement therapy for hormonal fluctuations, iron, B vitamins and drugs that are classified as anti-androgens.

There are more expensive options, which include wigs, hairpieces ($1,000 to $3,500), even hair transplants, which can cost $3,500 to $75,000 and can sometimes cause scarring. Consult your doctor before choosing a hair-loss treatment.

MIGRAINES

MIGRAINE treatment for episodic and chronic migraines has advanced recently, shifting the focus from acute or abortive treatment (taking medicine when the migraine starts) to preventative therapy (taking medication daily to prevent migraine occurrences). Although acute treatment may relieve pain and prevent progression, preventative therapy may reduce the frequency, severity and duration of an at tack. Patients who undergo preventative therapy may also use acute medication in the course of a migraine attack.

For the nearly 30 million Americans who experience migraine headaches, the daily practice of treating a migraine may improve life while preventing medication overuse and reducing health care costs. In the U.S., health care and lost labor costs related to migraines cost Americans $7 billion annually.

"Migraine treatment has come a long way in the past five years," says Dr. Stephen director of the Jefferson Headache Center at Thomas  University Hospital and professor of neurology at  Medical College of Thomas University in Philadelphia. "Topiramate at 100 mg to 200 mg a day produced a significant decrease in the frequency of migraine attacks and the number of days people experienced migraines," he says. In a recent study, 50 percent of the patients treated with topiramate--a drug previously used for seizures in patients with epilepsy--had a 50 percent reduction in the frequency of migraines.

Some side effects of topiramate therapy for migraines include nausea, depression, fatigue, and nervousness and weight loss. "The problem with treating migraines," Silberstein said in an American Medical Association report, "is we don't know who will respond to what treatment, and a given treatment can take four to six weeks to take effect."

An additional option on the horizon for migraine sufferers is a series of injections with botulinum toxin type A, currently used for dystonia (involuntary movements) and spasticity. Many over-the-counter drugs are useful in alleviating migraine pain including acetaminophen, ibuprofen, naproxen, ketoprofen, or an acetaminophen-aspirin-caffeine combination. But for more severe migraine sufferers, prescription medicines such as ergotamine, dihydroergotamine, sumatriptan, zolmitriptan, naratriptan, rizatriptan, almotriptan and fravatriptan may prove more effective. Consult your doctor before trying new drugs.