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Women and Heart Disease: Little Reported and Diagnosed Late

by Betty Soldz

Heart Disease is the leading cause of hospitalization and death among mid-life and older women in the United States.  More than one in five women has some form of heart or blood vessel disease and the chance of a woman having heart disease increases with age. One in every three women will die of coronary heart disease or heart attack, and the death rate is about 35% higher for African-American women.   Many women believe cancer is the number one killer of females but,  according to the American Heart Association, nearly twice as many women in the U.S. die of cardiovascular disease as from all forms of cancer. However, take heart, because there are ways to decrease risks for heart disease.

Heart, or cardiovascular disease is a condition in which insufficient amounts of oxygen rich blood flow to your heart, causing the heart muscle to deteriorate and, if not treated, die.  The usual cause of this condition is a blockage in the coronary arteries, due to an accumulation of a fatty substance called cholesterol.

While many of the risk factors associated with heart disease are controllable, the disease is often diagnosed late and many women are unaware of its symptoms and warning signs. Delayed diagnosis and treatment increases mortality rates.  Understanding the risks, knowing the symptoms, and what can be done to help prevent this life threatening disease is vital. 

Women seem to be partly protected from the risk of heart attack before menopause. Estrogen increases the amount of good cholesterol (HDL) and decreases the amount of bad cholesterol (LDL) in the body.  During menopause, women's ovaries stop producing estrogen; consequently, the amount of bad cholesterol rises and increases a woman's risk of heart attack. After menopause, a woman's risk of experiencing a heart attack begins to rise steadily. If menopause is brought on by a surgery to remove the uterus and ovaries, the risk of heart attack rises sharply.  When menopause occurs naturally, the risk may develop more slowly.  However, research shows that hormone replacement therapy after menopause may lower a woman's risk of coronary disease.  (Some data, however, has questioned this propostion but that, too, has been criticized.) 

The following list of risk factors might be an alert to discuss with a physician your chance of heart disease:

  •   A family history of the disease

  •   Smoking

  •   High Blood Pressure

  •   High Cholesterol

  •   Overweight

  •   Diabetes

 Many of the important risk factors for coronary disease are correctable, such as smoking, high cholesterol, high blood pressure and lack of physical activity. If you stop smoking, the risk of a heart attack drops sharply.

It is important to speak with the doctor about having cholesterol levels checked periodically.  If a cholesterol level is high, you can reduce your risk with diet changes such as reducing the fat in diet, increasing  physical activity and avoiding smoking.  If this doesn't lower cholesterol, speak with a doctor about taking one of the cholesterol lowering drugs.

More than half of all women over the age of 55 have high blood pressure.  It often has no symptoms.  It is usually defined as a blood pressure reading of 140/90 or higher.  It is important to have your blood pressure checked often. (Ask your doctor how often for your health situation.)  For some women, decreasing the salt in their diet, losing weight. limiting alcohol intake, and increasing exercise  may help.  If they do not, it may be prudent to speak to your doctor about medication. 

If you are a couch potato, this is just one more reason to get out and exercise. Lack of exercise may lead to an overweight condition which then can lead to increased cholesterol levels and high blood pressure. The American Heat Association recommends vigorous activity in order to condition your heart.  However, be sure to check with your doctor before starting any vigorous exercise program.

There are some common warning signs of heart attacks that everyone should know:

(1) Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back.

(2) Pain that spreads to the shoulders, neck and arms.

(3) Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.

According to The American Heart Association, women may also have other less common warning signs such as:
  • Atypical chest pain, stomach or abdominal pain.

  • Nausea or dizziness.

  • Shortness of breath and difficulty breathing.

  • Unexplained anxiety, weakness or fatigue.

  • Palpitations, cold sweat or paleness.

 If you have any of the above symptoms get emergency medical help immediately.  Immediate treatment can reduce the damage to the heart only in the first few hours after the symptoms begin. 

Today much more is known about heart disease in women.  Access to new information and medical technology to help prevent this deadly illness is available.  To reduce your risk it is important to take responsibility for your health and partner with your doctor and by following medical instructions and changing one's lifestyle, if needed, this number one killer of women can be licked.

 Note: For more information on women and heart disease contact, American Medical Women's Association or The American Heart Association.

Editor's Note: We're linking to a CDC article helpful in terms of ethnic diversity and heart disease:  Women and Heart Disease: An Atlas of Racial and Ethnic Disparities .



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