One in five American women are at serious risk for a heart attack, but the majority of them don't know it. Learn to recognize the risk factors and warning signs of heart disease in women before it's too late.
When Rita Potts walked into the emergency room in 1998, she felt foolish for even being there. She was sure the nagging ache between her shoulder blades and strange feelings of apprehension didn’t merit a trip to the hospital, but at the insistence of her husband had asked a neighbor to drive her there. Within hours, doctors performed an emergency angioplasty procedure to hold open a blocked artery in her heart. After several months undergoing treatment to strengthen her heart at a Heart Failure clinic Rita still lacks the strength and vitality she previously enjoyed, but she has a new appreciation for life.
Unfortunately, stories like Rita’s are all too common. Heart disease is the leading cause of death in women over 65, killing 4 to 6 times more American women than breast cancer every year, and one in five women have some form of cardiovascular disease. Women are also less likely to survive a heart attack than men. Many women don’t recognize a heart attack when it happens and don’t seek help in time because their symptoms can seem atypical. Although women over 65 should be most concerned, women of all ages can be at risk for this silent killer. Know your risk factor and what you can do to prevent or minimize the problems associated with heart disease, and learn to recognize the symptoms of a heart attack.
What is cardiovascular disease?
Cardiovascular disease (commonly known as heart disease) occurs when plaques (cholesterol, fatty substances, and other waste material from cells) collect in the arteries. This causes blood pressure to rise, and as a result the heart has a difficult time getting enough oxygen into the bloodstream. When enough plaque accumulates, a total or near total blockage of the arteries can cause a heart attack. A heart attack may feel different for a woman than it does for a man, so it’s important to know the warning signs.
Different Women, Different Symptoms
In the world of heart attacks, time is muscle. The sooner a heart attack is diagnosed and treated, the less damage the heart muscle endures, and the better the chances for survival and recovery. When a woman suffers a heart attack she may feel a variety of symptoms that have nothing to do with chest pain. In fact, a 2003 nationwide study reported in the American Heart Association journal found that out of 515 women who had suffered heart attacks, only 30% experienced any chest discomfort in the month prior to the attack. Instead, watch out for any of the following symptoms: fatigue, insomnia, dizziness, indigestion, nausea, shortness of breath, cold sweats, and chest pain while at rest or during exercise. If you experience any of these symptoms for no apparent reason (or know someone who does) see your doctor immediately.
Am I at Risk?
Knowledge and prevention are two keys to fighting heart disease in women. First of all, know your risk. Below are five important areas to help you asses your level of risk:
Family history – Look at your first-degree relatives (mom, dad, sister, brother.) If any of them have suffered from heart disease your risk is higher.
Age – Women develop heart disease at an increasing rate as they age. While women over 65 are most at risk, women of any age can still develop heart disease.
Weight – Being overweight contributes to a variety of health problems, including heart disease. Excess fat raises blood pressure and bad cholesterol, and lowers good cholesterol. Excess fat around the waistline is particularly concerning because it raises insulin levels, which can cause calcium deposits in the blood vessels. A tape measure around your waist should read less than 35 inches.
Smoking – Smoking constricts the blood vessels and makes blood more likely to clot. A year after quitting, your risk of heart attack is cut in half.
Stress – Intense emotions can raise your blood pressure and produce chemicals in your body, like adrenaline, that damage blood vessels. While we all experience some stress, a consistent lifestyle of stress of depression can put you at higher risk.
Diabetes – women with diabetes have a higher risk for developing heart disease than women without.
Menopause – women who have gone through menopause also have a higher risk for developing heart disease. Women who experience early menopause (before 40) can be at particularly high risk.
What Every Woman should Know
Unless you’re at high risk, you shouldn’t need to see a cardiologist. It is important, however, that your regular doctor give you some basic tests to determine your heart’s health. Next time you’re in his or her office, ask your doctor about:
Cholesterol – Ideally, your total cholesterol level should be below 200, with your bad cholesterol (LDL) level under 100 and your good cholesterol (HDL) above 50. If you have no family history of heart disease, be tested every five years. Those women with a history should be tested every year.
Blood Pressure – High blood pressure can mean that plaque is developing in your arteries. An ideal blood pressure should be no more than 120/80.
Stress – This test is often done while you walk or run on a treadmill. Your doctor will look at your electrocardiogram (EKG) to see how your heart reacts during and after exercise. This test is generally used on patients who report symptoms of blocked arteries, like dizziness, shortness of breath, etc.
C-Reactive Protein – Next time you have your cholesterol checked, ask your doctor about a blood test for CRP, which can help determine if you have plaque in your arteries.
Menopause – ask your doctor about the effects of menopause on your heart health and whether or not estrogen supplements may be useful in avoiding cardiovascular disease.
What Can I Do?
Protect your heart by watching your blood sugar, blood pressure and cholesterol levels. Doctors recommend the following steps to keep your heart in shape:
Don’t smoke - If you currently smoke, quit! Smoking is considered the single worst thing you can do for heart-health. Talk to your doctor about how to get help in your efforts to quit and see if your state offers a hotline or website for people trying to quit.
Maintain a healthy weight - A third of American women are considered medically obese, while another third are considered overweight. Losing weight may seem like a daunting task, but even losing a little can do a lot of good. Talk to your doctor about his or her recommendations for losing weight and try to avoid a sedentary lifestyle.
Eat heart healthy – That means more fruits and vegetables and less fast food. Try to include fish, which contains heart-healthy omega-3 fatty acids, in your diet. Think more high-fiber and less processed foods.
Exercise – The American Academy of Family Physicians recommends 30-60 minutes of exercise 4 to 6 times a week for general health and as part of a routine for maintaining heart health. If you’re not in the habit of exercising, talk to your doctor first and start slowly, but do start.
Talk to your doctor. While most physicians like to exhaust their other resources first, cholesterol and blood-pressure lowering drugs may be appropriate for some patients.
Learning about your risk for heart disease doesn’t have to be a frightening experience. Remember, knowledge plus action equals power. A few steps taken now to prevent or diagnose heart disease can equal a longer, happier life. If you think you (or a woman you love) may be at risk for heart disease, don’t wait to get help. Talk to your doctor as soon as possible to explore diagnosis and treatment options. If you feel you may be having a heart attack, don’t hesitate! Call 9-1-1 or go to an emergency room immediately for help.
For more information on heart disease in women, contact the National Women's Health Information Center or the following websites: