Women and Heart Disease

Cardiovascular disease should concern every woman. More women die from heart disease than any other cause. The statistics are very sobering. Almost half of all women will die of heart disease or stroke, compared with 1 in 25 women who will die of breast cancer.

One in 10 women age 45 to 64 has some form of heart disease. The figure grows to one in five for women age 65 and above. Another 1.6 million women have suffered a stroke. Heart disease and stroke are known as cardiovascular diseases, which are serious disorders of the heart and blood vessel system.

Although most people know that crushing pain in the chest and sharp pain in the left arm are symptoms of heart attack - few realize that those symptoms are more likely to be suffered by men than women. Women often experience subtler symptoms such as abdominal pain, weakness, dizziness, nausea, cold sweats and fatigue.
 

Another finding has emerged:  warning signs for women having heart attacks can occur as much as six months before the actual heart attack.  Symptoms of female heart attack can sneak up slowly or be mistaken for something less serious.  Women are often slower to seek medical attention during heart attack, a delay that can be the difference between life and death.

The most common subtle warning signs of a heart attack for women are:

1. Unusual and unexplained fatigue
2. Dizziness or light-headedness
3. Nausea and cold sweat
4. Suddenly having trouble sleeping when you didn't before
5. Shortness of breath
6. Indigestion
7. Anxiety or a sense that something is wrong or an impending sense of doom

Be aware of the warning signs, and don't wait if you are experiencing symptoms of a heart attack.  Contact your physician or go to the Emergency Department.

The physicians, nurses and other medical staff affiliated with the OSF Saint Anthony Cardiovascular Services know that women and men sometimes experience symptoms of heart disease. They also know that prevention is the best medicine when it comes to cardiovascular disease.

If you are healthy and have no history or symptoms of cardiovascular disease, you can help catch it early by having your blood pressure checked at least every two years and have a blood cholesterol test every five years. Your doctor may recommend more frequent measurements if your levels are abnormal.

Any time you have a significant cardiovascular condition, you may require the attention of a cardiologist, a physician who is highly trained in diseases of the heart. Symptoms like shortness of breath, chest pain, or dizzy spells often require special testing. Most importantly, cardiologists are experts in diagnosing and treating heart attacks, heart failure and other heart-related conditions.

If you suspect you have a heart problem, visit your doctor. Your primary-care physician may recommend a cardiologist or you can suggest a cardiologist affiliated with Cardiovascular Services. You can feel confident that the physicians of Cardiovascular Services at OSF Saint Anthony know that women have special health needs. If you have a question, please call (815) 395-5493.

Major Risk Factors

Extensive research has identified the major heart disease risk factors for women. Although there is nothing you can do to change risk factors such as your age or heredity, there are many other that you can influence. The following is a list of some of the major cardiovascular disease risk factors for women.

Smoking. Either stop or don't start smoking. Cigarette smoking is the most common preventable cause of premature death. Women who smoke increase their heart disease up to 400 percent.

Physical inactivity. Physically active women reduce their heart disease risk between 60 and 75 percent. Get at least 30 minutes of moderate-intensity exercise (such as a brisk walk) each day.

Obesity and overweight. Those who are more than 30 percent over their ideal body weight increase the risk of developing heart disease.

Stress and depression. The body's physiological reaction to high levels of sustained stress include increased blood pressure. Depression, which is more likely to affect women, is also dangerous to the heart.  Loneliness can have an adverse effect on the heart.  People who have active social lives are less likely to have heart problems.

High blood pressure. High blood pressure puts more stress on the heart workload, weakening it over time. It also increases the risk of stroke, heart attack, kidney failure and congestive heart failure. Aim for a blood pressure of 120 systolic (top) and 80 diastolic (bottom).

High cholesterol and high triglycerides. Women with total cholesterol over 200 are more likely to have heart disease. The goal is to have an LDL ("bad" cholesterol) lower than 160, HDL ("good" cholesterol) over 45, and to keep triglycerides to 200 or even lower.

Diabetes. Diabetes is a more powerful risk factor in women than men. Women with diabetes have a 300 to 700 percent greater chance of developing heart disease. If you have diabetes, work with your doctor to control your risk factors. If you had elevated blood sugar during pregnancy, your risk of having heart disease is greater than for someone who did not experience gestational diabetes.

Waist circumference.  If your waist measruement is greater than 30 inches or your waist-to-hip ratio is greater than 0.8, you have a greater risk for developing heart disease. 

Premature menopause. Due to removal of the ovaries accompanying a hysterectomy or chemotherapy, cutting off estrogen at an early age can affect cardiovascular health.

Breast calcifications.  If a mammogram shows specks of calcium deposists in the arteries of your breast, you may want to consioder a cardiovascualr assessment.  You may have more than triple the risk of heart disease of a woman without these depostis.

Estrogen replacement therapy (ERT). The risks (and benefits) of ERT are a little less well-defined, although studies are in progress that should help clarify this area. Currently, this decision should be made between you and your doctor.

Low vitamin D levels.  In a large study, adults over the age of 30 who had the lowest blood levels of vitamin D were more likely to die from cardiovascular disease later in life than those with the highest levels.  Only 23 percent of Americans have adequate vitamin D levels.

For lifestyle changes, physicians at  OSF Cardiovascular Services offer these recommendations:        

Diet:  Major changes introduced too quickly sabotage our diets. We alter our shopping, preparing and cooking and then are overwhelmed and feel deprived.

Instead, eat regular meals but cut one thing in half.  If you eat a whole sandwich for lunch, cut it in half.  Or cut that baked potato in half, or the hamburger. Meals are still supposed to be enjoyable.

The "half-rule" helps you re-consider your food choices and introduces you to nutrition labels.  We need fewer calories as we age.  You think you're eating like a bird, but if you're gaining weight, it's too many calories for you!

Even more than men, women derive health benefits from plant-based foods, such as soy, nuts, flaxseed, peas and legumes, because of the plant estrogens.  Be patient and give your body time to adjust to fewer calories. 

Ensure that your vitamin D levels are adequate, whether through exposure to sunshine for aobut 15 minutes a day (without suncsreen) or supplement with vitamin D.

Quit smoking:  The "cold-turkey" approach may work for some; others may want to consider nicotine replacement products or a prescription that blocks the effects of nicotine on the brain.  You have to break the habit as well as the dependency. The first habit to break is buying cigarettes.  Get rid of all smoking paraphernalia, change routines and avoid situations that prompt you to smoke.

Exercise:  For heart health, aerobic exercise should be sustained for 30 minutes at least every other day.  For strength, the number of repetitions is more important than the pounds you can lift.  It's better to lift 10-pound weights 20 times than to lift 200 pounds once.

Medications:  If these measures don't lower blood pressure and cholesterol, medications may be needed.  Ask your physician if taking one baby aspirin a day is appropriate for you. 

If you suspect you have a heart problem, visit your doctor. Your primary-care physician may recommend a cardiologist or you can suggest a cardiologist affiliated with OSF Saint Anthony Cardiovascular Services. You can feel confident that the physicians of Cardiovascular Services at OSF Saint Anthony know that women have special health needs. If you have a question, please call (815) 395-5493.

Links

Cardiac Heart Disease Risk Assesment
http://www.nhlbisupport.com/chd1/tx2.asp

The Healthy Heart Handbook for Women--2003 Edition
http://www.nhlbi.nih.gov/health/public/heart/other/hhw/index.htm

American Heart Association
http://www.americanheart.org/presenter.jhtml?identifier=1200011

The Heart Truth
http://www.nhlbi.nih.gov/health/hearttruth/index.htm