Heart Disease: Know The Risks

Are you aware that one of three women die of heart disease?

Unfortunately, only about one-third of women know that heart disease is the number one killer of women in the United States. Cardiovascular disease is the largest single cause of death among women, accounting for 38 percent of all deaths among females - It is the most preventable cause of death too. One in three American women dies of heart disease while one in 25 women die from breast cancer, but there is more screening and more efforts to attempt increasing the awareness regarding breast cancer than heart disease related awareness.

Both men and women have heart attacks, but more women who have heart attacks die from them. Women coming into the hospital for a heart attack have a higher death rate and higher risk of complications. A pre-menopausal woman having a heart attack has twice the death rate of a similarly aged man.  African American and Hispanic American/Latina women are more likely to get heart disease because they tend to have more risk factors such as obesity, lack of exercise, high blood pressure, and diabetes than white women. All women, of all ages, should take heart disease seriously.

The misleading notion that heart disease is not a real problem for women can be blamed in part on medical research. Historically, heart disease has been considered primarily a man's disease. For a very long time, heart disease studies have focused primarily on men. Changes are under way, but some doctors still fail to recognize the warning signs displayed by female patients. Significant differences exist in the symptoms displayed by women and men. Men typically experience the "classic" heart attack signs: tightness in the chest, arm pain, and shortness of breath, sudden profuse sweating. Women's symptoms are nausea, an overwhelming fatigue, and dizziness, back pain, jaw pain, shortness of breath - are strikingly different and are often chalked up to stress. Unusual fatigue, trouble sleeping, shortness of breath, indigestion, and anxiety were the top 5 symptoms reported by both black and white women in some studies.

Risk factors for heart disease are cigarette smoking, high blood pressure, high total cholesterol and high LDL (bad) cholesterol, Low HDL (good) cholesterol, overweight, physical inactivity, diabetes. Every woman should be her own advocate and have their risk factors well under control to prevent the first event. More aggressive control to risk factors should be undertaken after the first heart attack as the chances of a second event within the next five years is higher in women than men.

“High risk women”– Women with prior heart attack, stroke, blockages in other arteries, diabetics, those with renal disease or dialysis patients.

“At risk women”- Smokers, central obesity (predominantly those women who have more fat in the abdominal region, larger waists, waist size greater than 35 inches), high blood pressure, diabetes, high cholesterol and physical inactivity, family history of premature heart disease defined as any family member diagnosed with heart attack or stroke at less than 55 years for a man and less than 65 yrs for a woman. Metabolic syndrome – a combination of abdominal obesity, increased blood pressure, elevated blood glucose and triglycerides is another important and common risk factor among women.

Women who smoke and take birth control pills are at much greater risk of having a heart attack or stroke than non-smokers or those who do not use birth control. More than half of the heart attacks in women under 50 are related to smoking. By stopping smoking, the risk of heart attack is lowered by one third within two years. Alcohol intake should be one alcoholic drink or less per day. Medications should be used aggressively for control of diabetes and blood pressure. Optimal blood pressure is less than 130/80. Hormones in the form of estrogen alone or in combination with progesterone should not be used for prevention or treatment of heart disease. There has been no proven benefit, and there is higher risk of developing heart attacks or strokes by using hormone replacement. Depression is twice as common in women as in men, and it increases the risk of heart disease by two to three times compared with those who aren't depressed. Depression in women needs to be addressed aggressively.

Talk to your physician about your risks. Exercise regularly, aim for a healthy lifestyle and a longer life.


Guest Essay written 1/25/08


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