Women and Heart Disease

Heart disease causes more deaths among women than all cancers combined. Nearly 500,000 women will die of heart disease this year. And unfortunately most women think breast cancer is their biggest health threat. Cardiovascular research specific to women has generated important information to help in the fight against heart disease. And doctors are hoping that women are listening.

Cardiologist Lawrence Moschitto, MD, said, "Every year we learn more about what causes heart disease and the difference in the way men and women are affected. Women were excluded from the research for a long time because heart disease was considered a 'man's disease.' The more women know about their risk for heart disease, the better able they are to prevent and manage it."

Women fare worse than men-why?

Although more men than women have heart attacks each year, outcomes are significantly worse for women. Of the approximately 1 million people who will have a mild heart attack this year, 24 percent of men and 42 percent of women will die within one year.

"Women don't always have the same symptoms as men. Although some men present with atypical symptoms, generally it's women who don't know that indigestion, nausea and jaw discomfort can often be signs of a heart attack," Dr. Moschitto said. "Eighty-five percent of men will have classic symptoms of chest pain, shortness-of-breath, and sweating, while only a fraction of women will have these symptoms."

Most women have fewer chest symptoms, but other symptoms include stomach or abdominal pain, nausea or dizziness, unexplained anxiety and nervousness, weakness or overwhelming tiredness, cold, sweaty skin, and paleness, and swelling of the ankles and/or lower legs.

"As we learn more, we see that women may have a different response to pain and delay seeking treatment, resulting in more severe damage. They also have smaller arteries, which become blocked more quickly," Dr. Moschitto said.

Managing the risk

"We used to view heart disease as a condition that a person 'has' or 'does not have,'" stated Dr. Moschitto. "Now we know that everyone is at risk. A clear definition of where you are on the continuum of risk-low to high-allows you to develop a more specific plan to decrease your risk."

Significant information about the effects of long-term hormone replacement therapy (HRT) was generated from the Women's Health Initiative, a major 15-year research program to address the most common causes of death, disability and poor quality of life in postmenopausal women - cardiovascular disease, cancer, and osteoporosis.

"The study produced evidence that long-term HRT increases the risk of heart disease and stroke," Dr. Moschitto said. "Knowing this, every woman and her doctor should discuss the risks and benefits of HRT as well as the other options available to reduce osteoporosis risk and decrease the symptoms of menopause."

Early diagnosis-the key to saving lives

Other differences between women and men involve the effectiveness of standard diagnostic tools. With men, standard treadmill stress tests adequately test a man's heart but other imaging tests such as echocardiograms often are more conclusive when testing women.

"Some of the tests used to diagnose heart disease are less accurate for women," Dr. Moschitto said. "It is very important to be an active participant in your care, pay attention when you 'don't feel right,' and establish a relationship with a physician who really listens."

Heart-healthy habits reap long-term benefits

Many studies have validated that exercise successfully decreases heart disease risk for women. The American Heart Association (AHA) recommends 30 minutes of moderate physical activity most or all days of the week.

"The benefits of exercise are indisputable, yet many of us find it hard to fit it into an already hectic schedule," Dr. Moschitto said. "Small changes to your routine, such as taking the stairs instead of the elevator, parking further away and walking briskly to your destination, or putting more energy into regular household tasks is a good way to start."

"Women today are 'doing it all' and therefore should be even more careful about taking care of themselves whether single, married, a mother, a caregiver, a career woman or all of the above," Dr. Moschitto concluded. "By taking care of themselves with heart-healthy habits, they are setting a good example and will be better able to take care of themselves and their loved ones in the long run."


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