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The number one cause of death in women …
but many women still don’t know they’re at risk.
The statistics are alarming: more women die of cardiovascular disease than from the next four causes of death combined – including all forms of cancer. Although many women still may mistakenly believe that heart disease is a “man’s disease” or may think that they are too young to have heart problems, the fact is that one in four women in the United States will die of heart disease – and more women than men die of heart disease each year. Not only that, but an astonishing 80 percent of women between the ages of 40 and 60 have one or more risk factors for heart disease (including high blood pressure, high cholesterol, diabetes, tobacco use, and positive family history of early heart disease). Recent studies suggest that having even one of these risk factors can double the chance of developing heart disease, so it’s critical that women know what their risk factors are.
Although much has been done to raise awareness of women’s risk for heart disease, nearly 50 percent of women today don’t realize that heart disease is their number one killer – and are still unaware of their own risk factors. February is designated as American Heart Month – and the American Heart Association’s “Go Red for Women” and the National Heart, Lung and Blood Institute’s (NHLBI) “The Heart Truth” initiatives are in full swing, so this month is the perfect time for women of all ages to take steps to protect their heart health.
Understanding Heart Disease: How It’s Different in Women than in Men
Heart disease includes a number of problems affecting the heart and the blood vessels in the heart. In the United States, the most common form of heart disease is coronary artery disease (CAD), which can lead to heart attacks.
When you have CAD, your arteries become hardened and narrowed, and blood has a hard time getting to the heart muscle, so the heart does not get all the blood it needs, especially during exertion. This can lead to symptoms called “angina”, which are any sensations that a person feels when the heart is not getting enough blood. For most people, angina feels like a heaviness or pressure in the center of the chest. However, up to 30 percent of heart patients, particularly women and diabetics, may not feel chest discomfort at all. Instead, their angina may be shortness of breath or other symptoms, as detailed below. In addition, if the heart artery blockages are severe, there may be damage to the heart muscle, called a heart attack. A heart attack occurs when a blood clot forms in the heart artery, cutting off blood supply to the heart muscle. Other cardiovascular diseases include stroke (not enough blood flow to the brain), high blood pressure, and enlargement or tearing of the aorta.
There are a number of similarities and differences between women and men when it comes to heart disease. For both women and men, heart disease remains the leading cause of death; in addition, risk factors for heart disease are the same in both sexes – and prevention and treatment are also largely the same. However, women may experience different symptoms than men when they have angina or heart attacks, as mentioned.
Unfortunately, women also suffer a worse prognosis after a first heart attack (with statistics indicating that up to 38 percent of women, versus 25 percent of men, will die within one year after a first heart attack). In addition, although heart disease can affect people of all ages, women typically tend to experience heart disease about 10 years later than men, with a sharp rise occurring after menopause.
Know Your Unique Symptoms
When it comes to symptoms of heart disease for women, the most common heart attack symptom for both sexes is some type of pain, pressure or discomfort in the chest. However, women are also more likely than men to have other, more subtle heart attack symptoms, which may include:
• Unusual fatigue
• Shortness of breath
• Nausea
• Gas-like pain, “indigestion”
• Back pain, pain between shoulder blades
• Lightheadedness or dizziness
• Pain or discomfort in one or both arms, the neck, jaw or stomach
Pay Attention Before it’s too Late!
Unfortunately, because these symptoms are often subtle and are not typically associated with the crushing chest pain most people recognize as a heart attack, many women do not even realize that they are having a heart attack – until it is too late. Many women, in fact, tend to show up in emergency rooms after much heart damage has already occurred.
If you are experiencing any of these symptoms and believe you may be having a heart attack, it is critical that you call 911 right away. If you are having a heart attack, every minute counts, because once heart muscle cells die they cannot grow back – so don’t wait more than five minutes before calling for help. Also, if you are having a heart attack, you should call an ambulance rather than driving yourself to the hospital, because one out of four heart attack patients can experience abnormal heart rhythms in the first hours. If these occur in an ambulance, resuscitation is often possible, but in a private vehicle, these rhythms are often fatal.
Know Your Risk Factors
Up to 80 percent of cardiac events in women could be prevented if women were to know their risk factors and make the right choices for their hearts.
There are certain risk factors for heart disease that you can’t control – including age, family history of early heart disease, and ethnicity (with research suggesting that some racial and ethnic minorities are more likely to develop heart disease.) However, there are a number of lifestyle changes you can make to lower your heart disease risk.
Here are some risk factors for heart disease that you can control:
• High cholesterol and triglyceride levels
• High blood pressure
• Cigarette smoking
• Diabetes
• Being overweight or obese
• Lack of physical activity
Although these cardiac risk factors affect both men and women, there are some factors that are believed to play a bigger role in women. These include:
• Metabolic syndrome (increased fat around the abdomen, high blood pressure, high blood sugar and high triglycerides) seems to have a greater impact on women than on men
• Mental stress and depression may affect women’s hearts more than men’s
• Smoking is a greater risk factor for heart disease in women than in men
• Low levels of estrogen after menopause pose a significant risk factor for developing heart disease in smaller blood vessels
Reducing Your Risks: Make Lifestyle Changes
Although heart disease is a serious concern for women, there are active steps that you can take to reduce your risks. Talk with your doctor about your risk factors and determine if any medication may be needed to keep risk factors such as high cholesterol and/or high blood pressure under control.
In addition, there are some simple things that you can and should be doing when it comes to diet and lifestyle that can significantly reduce your risk of heart disease.
In fact, experts agree that by doing just four things – eating right, being physically active, not smoking and keeping a healthy weight, you can reduce your risk of heart disease by as much as 82 percent.
Heart disease can affect any woman at any age – and although your risk increases as you get older, it’s never too early to take steps to ensure heart health.
Heart disease develops over time and can start as young as your teen years. Take steps now to live a heart-healthy lifestyle through a good diet and plenty of exercise, and talk to your doctor about your family history of heart disease. Most importantly, make sure to know your personal risk factors for heart disease – and make heart health a priority at all stages of your life. •
Dara Lee, M.D. is a non-invasive cardiologist at Presbyterian Heart Group whose professional interests include preventive cardiology, echocardiography, cardiac issues in pregnant women and general cardiology issues. For more information visit www.phs.org/PHS/heartcenter/.
