Heart Disease and Women

Women Heart Care By Mary L. Mervosh

Health Management Specialist, UPMC Health Plan

You can say this much about heart disease – it isn’t sexist. The No. 1 killer of men in the United States – heart disease – is also the No. 1 killer of women in the United States. That message has not really gotten through, however, since a majority of women do not realize it.

For a number of reasons, women consider a heart attack as something that primarily happens to men and is unlikely to happen to them, even though statistics definitely say otherwise.

More than a third of American women die of heart disease and more than 35 percent of women over age 20 die of the disease. Five times as many women die each year of heart attacks than they do of breast cancer, although the latter is probably much better known as a disease that women need to be concerned about.

What is good news is that for women, as well as men, heart disease is the single most preventable cause of death. There are lifestyle factors that play a role in heart disease, including smoking, exercise and diet that affect your risk of heart disease.

What are the signs of a heart attack?

  1. Women and men don’t experience heart attacks in the same way. The biggest example is that women can experience a heart attack without feeling chest pressure. Instead of chest pressure, women may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue.
  2. Women may break out in a cold sweat or experience nausea.
  3. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Risk factors for a heart attack

Men and women share some of the same risk factors for heart attacks, such as high cholesterol, high blood pressure and obesity. However, there are other factors unique to women. These include:   

  • Metabolic syndrome – the combination of fat around the abdomen, high blood pressure, high blood sugar and high triglycerides – has a greater impact on women than men.
  • Mental stress and depression has a greater impact on women’s hearts than on men.
  • Smoking is a greater risk factor for heart disease in women than in men.
  • Low levels of estrogen after menopause. This poses a significant risk for developing cardiovascular disease in smaller blood vessels.    

What to do if you think you are having a heart attack?

  • Immediately sit or lie down.
  • Call for emergency help, such as 911.
  • Describe symptoms briefly and clearly.
  • Chew and swallow aspirin if you are not allergic to it.
  • If your doctor has prescribed nitroglycerin tablets take them as directed.

`Silent’ heart attacks

Women may experience a heart attack and not realize it. Women who have so-called “silent” heart attacks experience no pain and no symptoms and the event can only be detected by a subsequent EKG or blood enzyme test. Even so, some damage to the heart may have been done by the attack. For instance, the heart’s ability to survive another heart attack has been greatly reduced.

“Silent” heart attacks are often caused by a long-term shortage of blood and oxygen to the heart due to the gradual accumulation of plaque in the arteries. If you have three of the risk factors for heart disease and you are a post-menopausal woman you are at greater risk for a silent heart attack.

Birthday reminders?

Many women like to use their birthdays as a way to remind themselves to get their annual mammogram and pap test. That date can also be a good time to remind you to have your blood pressure and cholesterol checked at the same time.   

It’s never too late

With heart disease it’s never too late to get started on the path to strong preventive measures. Of course, the most helpful thing would be: If you smoke, quit. Smoking increases your risk of heart disease while also presenting other health issues for women.

It’s never too late to begin to exercise more. While it’s true that most Americans do not get enough physical activity, it is worth noting the impact it can have. One hour of aerobic activity three-to-five times a week has been shown to significantly lower a woman’s risk for heart disease.  The hour of activity can be broken down into 15-minute or 10-minute segments spread throughout the day, if you prefer.

One of the major causes of heart disease is obesity and its related complications. Over 50 percent of Americans are considered overweight and one-quarter are obese. Obesity raises blood cholesterol and triglyceride levels. Obesity lowers HDL (or “good” cholesterol) which is linked with a reduction of the risk of heart disease. Also, obesity raises blood pressure levels and can induce diabetes which increases other risk factors and raises the danger of heart attack. 

Obesity is caused by eating too many calories. When people eat too many calories, or too much saturated fat, trans fat and cholesterol, their blood cholesterol levels rise which raises their risk of heart disease.