Women Need to Be Proactive in Preventing Cardiovascular Disease

Wednesday, February 23, 2005

Despite the fact that heart disease kills nearly twice as many women each year as cancer, most American women don’t know about their risk for heart disease, nor do they recognize the major warning signs. Women may be hearing about heart disease more often today, but they don’t seem to think that it can happen to them.

Cardiovascular disease includes high blood pressure, coronary heart disease (heart attack and angina), congestive heart failure, stroke, and congenital heart defects. Most women, and even some physicians, consider women to be immune from cardiovascular disease. While cardiovascular disease tends to occur a generation later for women—in their 50s vs. the 40s for men—the fact is that heart disease is the No. 1 killer of women in this country, and cardiovascular disease kills nearly 500,000 women each year.

Despite the incidence of heart disease, most women don’t perceive it as a serious personal health threat. They believe that heart disease is “a man’s disease” and not something that they should worry about.

Women Have Different Symptoms
Women also lack awareness of heart attack warning signals, which are different than a man’s symptoms. We don’t fully understand why women have different symptoms. Although some women report classic symptoms of heart disease, such as chest pain, others experience symptoms less commonly associated with the heart like dizziness, nausea, fatigue, and back pain.

While some heart attacks are sudden and intense, most heart attacks start slowly, with mild pain or discomfort. Often people aren’t sure what’s wrong and wait too long before getting help. Signs of a heart attack include:

  • Chest discomfort—most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain.
  • Discomfort in other areas of the upper body—symptoms can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
  • Shortness of breath—this feeling often comes along with chest discomfort. But it can occur before the chest discomfort.
  • Exercise induced symptoms
  • Other signs—these may include breaking out in a cold sweat, nausea, or lightheadedness

Risk Factors
Along with the most common risk factors for cardiovascular disease—diabetes, smoking, high blood pressure, high cholesterol, lack of physical activity, and obesity—women face additional risks such as increasing age, and a strong family history of heart disease. In addition, a previous heart attack or “mini stroke” can put a woman at a higher risk for a second event. Plus, cardiovascular disease is an important problem among minority women; the death rate is substantially higher in African-American women than in white women.

Prevention is Possible
Women need to be proactive and work with their physicians to help reduce the risk of cardiovascular disease. In addition to seeing a primary care physician regularly, women should learn about the symptoms of cardiovascular disease, and report any symptoms they may be experiencing, even if they don’t seem to be heart-related. Physicians need to aggressively screen women age 45 and older who have identified risk factors for cardiovascular disease.

The good news: we know that heart attacks and other cardiovascular events are clearly preventable, and that proper management of cholesterol and blood pressure helps to lower the risk of cardiovascular disease. Women can greatly reduce many of their risk factors with a few lifestyle changes. These include:

  1. Increase physical activity.
  2. Make heart-healthy food choices.
  3. Don’t smoke.
  4. Have regular medical check-ups that include blood pressure and cholesterol monitoring.
  5. Maintain a healthy weight.
  6. Take your medicine, if needed, to control high blood pressure, high cholesterol, or diabetes.

Dr. Robert Roth is a cardiologist on staff at Columbia St. Mary’s. For more information on heart disease in women, call 414-271-1633.

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