With regard to their hearts, men and women are similar in one important way: For both, heart disease is the No. 1 killer. In fact, heart disease claims approximately 500,000 women’s lives a year in the United States—nearly one death every minute.
Most heart attacks and heart-related deaths occur in women over age 65, but each year more than 9,000 women under age 45 suffer a heart attack. Women who survive the initial heart attack fare worse than men. During the year following the event, 38% of women die compared with 25% of men.
In addition, a woman’s risk of experiencing a second heart attack is greater than a man’s: 35% of women will have another heart attack within 6 years compared with 18% of men.
Despite these sobering statistics, fewer than half of American women are aware that heart disease, not breast cancer, is their greatest health threat. In fact, heart disease claims more women’s lives than the next seven causes of death combined.
Women’s Risk Factors for Heart Disease
Coronary heart disease is progressive, and virtually all women, like men, have the beginnings of it to some degree. No matter where you are on the continuum of risk, you can take steps right now to reduce your chances of developing the serious consequences of coronary heart disease.
Age and family history are two risk factors for coronary heart disease that can’t be changed, but they can tell you when to pay attention to factors that you can do something about. For instance, having a sibling with coronary heart disease puts you at greater risk for developing it yourself.
As it does in men, risk of heart attack and stroke increases with age. After menopause, women need to pay particular attention to their heart disease risk factors, as the decrease in estrogen levels increases their chances of developing coronary heart disease. A daily aspirin is often recommended for postmenopausal women with other risk factors, which include high blood pressure, high cholesterol levels, smoking, a lack of physical activity, being overweight, and having diabetes.
The good news is that following a healthy lifestyle can slash your risk of coronary heart disease, no matter when you start. Such a lifestyle includes not smoking, getting regularly physical activity, following a healthy diet, and controlling your weight. Your doctor may also recommend a daily aspirin as well as medications to lower your cholesterol and blood pressure levels.
Testing for Heart Disease
If your physician suspects that you have coronary heart disease, you will undergo one or more screening or diagnostic tests. Common tests include: electrocardiography (known as ECG or EKG), exercise stress testing, thallium stress testing, echocardiography, and coronary angiography (angiogram or arteriography).
Keep in mind that an exercise stress test is more likely to produce a false-positive result (indicating a problem when none exists) in women than in men. And a positive result, especially in premenopausal women, might need confirmation with additional testing.
Heart Disease Symptoms in Women
Men often experience angina—squeezing chest pain resulting from reduced blood flow to the heart. But many women with a similar reduction in blood flow do not have chest pain. Instead, they may experience only shortness of breath or fatigue upon exertion. Other atypical symptoms include unusual fatigue or exhaustion; dizziness; nausea; and pain in the neck, jaw, arms, or back.
If you experience any heart attack symptoms for several minutes at a time, always remember to:
1) Call 911.
2) Chew and swallow a whole aspirin.
3) Get to a hospital immediately.
Treatment and Recovery for Women With Heart Disease
Women have special challenges in their treatment for coronary heart disease and in their recovery from a heart attack. Smaller arteries make angioplasty and bypass surgery technically more challenging for the surgeon and more risky. Although the risk of dying during bypass surgery is low, a woman is nearly twice as likely as a man to die during the procedure. Women also have a greater risk of bleeding complications during bypass or angioplasty and when given clot-busting drugs during a heart attack.
Research suggests that in the aftermath of a heart attack, women experience more anxiety and depression than men. That’s important, because several studies have found that depressed people have a higher risk of death in the years after a heart attack.
Women also report a lower quality of life after a heart attack, and they are less likely to be referred to cardiac rehabilitation programs, which often address psychological issues as well as diet and exercise.
Any woman who has had a heart attack or who has undergone angioplasty or bypass surgery should ask her physician to recommend a good cardiac rehab program that will address important recovery issues such as: a healthy diet, exercise, smoking cessation, stress reduction, psychological counseling, and group support.
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Posted in Heart Health on February 7, 2006
Reviewed May 2007
